Birth Plan Basics

Everyone’s idea of the perfect birth is different, and chances are it won’t go according to plan. That doesn’t mean you can’t be prepared. We asked Birth Day Presence co-founder Jada Shapiro to give us the lowdown on how to put together the perfect birth. Here’s 8 tips that will help you lay the foundation for the perfect birth day.

1. Figure out where you want to give birth and choose your care providers accordingly. The most important decisions, in our opinion, are who is going to deliver your baby and where do you want to give birth. Some of what you are hoping for should influence who you hire as your birth team and where you plan to give birth. So consider whether you would like to use pain medication or not during your birth. Consider how much freedom of movement you would like to have. Do you want to have the option to give birth in a tub? Do you want to be able to bring lots of support people with you? Do you hope to avoid a cesarean unless absolutely medically necessary? All these factors will dictate your choices. The mom who hopes to give birth in the water is not going to choose Labor and Delivery in a hospital. The mom who definitely wants to use an epidural early in her labor is not going to give birth in a birthing center. The mom who truly hopes to avoid an unnecessary cesarean will not work with a doctor who has a 50% c-section rate.

2. Be clear with your provider…and your partner. Sit down, alone or with your partner, and really get clear on what is most important to you. The more clear you are, the more effective you will be at communicating your hopes to your care provider. Take this document into your care provider well before you give birth to make sure you and your midwife or doctor are on the same page about giving birth. As hard as it is to switch care providers mid-pregnancy, it is much harder to find out during labor that they don’t support you!

3. Keep it short, concise and positive! You should keep your birth plan to 1-2 pages max. Ideally one page. Resume-like. Clear and concise. And in a positive voice. The last thing anyone wants to receive is a long list of things they don’t want you to do to them. So for example, don’t write: Don’t give me an IV. Better: I would prefer to eat and drink to remain hydrated and nourished. Please offer me an IV only in the case that I am dehydrated or need specific medicines for my labor.

4. Make a copy for everyone who’s taking part. Give a copy to your midwife or doctor, bring one for your nurse, give one to your doula, and have three extra copies. Keep it in a folder with other important documents in your birth bag.

5. Hand it over with an explanation…and good manners. The best way to get a nurse to read your birth preferences is to take a moment to introduce yourself to her, and then kindly ask if she would mind reading through some of your preferences when she has a little time. Respect her time and her job and you will find you will have a lot easier time with some of the negotiable aspects of childbirth. Note: If you are refusing all care that is standard where you plan to give birth, you may want to switch care providers or birth places.

6. Keep it organized. We generally recommend that you begin with a short paragraph directed to your care provider, in which you thank them for assisting you with the pregnancy and birth and tell them that the following are your wishes under ideal conditions. It helps to note that you are happy to have their medical expertise and that you love to be informed and hope that they will inform you about anything which needs to be done during their care. Then organize your birth plan by the stages of labor. You can also add in a bit about in case induction becomes necessary and in case of cesarean birth.

7. Even a home birth can benefit from a plan, especially when thinking about contingencies. In a home birth setting, you can be a bit more luxurious with your vision, including how you envision laboring, what kind of pain relief you imagine might help and environmental factors that will help you. You should absolutely write an “In Case of Transfer Plan” though. This can be packed in your hospital bag which will only come out if your midwife determines you need to give birth at the hospital.

8. Remember that birth seldom goes according to your plan. You should plan that birth won’t go according to your plan! Going to a childbirth class that addresses issues like this and helps prepare women to meet whatever their labor asks of them can help. Talking with a therapist or close friends or your doctor or midwife can also help. If you find that in writing your birth plan, you are adamant about avoiding a procedure, try to talk with your care provider about how best to deal with the procedure if it becomes medically necessary. Your birth preferences are a general guideline. Ultimately, if medical necessity dictates changes in the labor, hopefully you have chosen a care provider you trust! The best we can do for ourselves as birthing mothers is choose the best team of support and then step back and let labor unfold.