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Should I write a birth plan for labor and delivery?

Paula Greer
Midwifery Nursing

Birth plans are helpful to generate discussions with your health care provider about things you might like to have or wish to avoid in your labor. Just remember a birth plan should be a guide but you need to build in flexibility. In life we often have to make a detour so have other options available if things don’t work out the way you plan. A good example might be you wanted to deliver the baby lying on your side but for some reason the position of the baby might make you too uncomfortable in that position and you might need to choose another position for delivery. Sometimes women want to get in the tub but the baby has had a meconium bowel movement and needs to be monitored more carefully in labor. The goal for your birth is a healthy mom and baby and a happy birth experience. Being flexible and being able to adapt in labor makes for a happier experience and helps prevent disappointment if the road in labor makes an unexpected turn.

Many women have asked me about a birth plan. A birth plan is a list of the things they would like to see happen during their birth. The answer to that question is a little complex. Yes, you should write down the things you would like to do during your labor. That is, a list of those coping skills that you may have learned in your childbirth education class, things that you have practiced at home and that you are good at.

A woman, however, should not expect that because the word plan is in there, that the labor will go as planned. Babies tend to do their own thing, and the labor tends to take its own twists and turns. A woman should be able to be flexible with that.

To put all your hopes and dreams into a birth plan is probably the wrong idea. You should be flexible, and allow yourself to make adjustments along the way. The more skills you have, the more opportunities you have to use them. If you think of it as a wave in the ocean, that you are dealing with more than a brick wall, you know that you are going to be moving and trying different things and using coping skills. That way, there is less disappointment when things do not go quite the way you thought they might.
Kathy Snider
Neonatal Nursing

A birth plan is a written record of your personal requests for how you would like your labor, delivery and care afterwards to proceed. It can include anything you feel strongly about from pain management to infant care and breastfeeding. Making a birth plan can help you to consider what options are available and what is important to you with regard to how you want your labor and baby's birth to be handled. The best part about considering a birth plan is that it opens up a dialogue between you and your care provider to ask and answer important questions. Some women who feel strongly about having some sense of “control” during their labor and birth experience prefer to have a birth plan.

Obviously, you do have to be flexible, as there's no way of knowing if your labor will be exactly what you hope and plan for. Thinking about all these things in advance means that you can get as close as possible to having the birth you want, and knowing what to expect. It is also helpful to share your thoughts ahead of time with your primary care provider and the nurses who will care for you in the hospital setting, as well as your support team.

If you have a birth plan in your prenatal record when you go into labor, the midwives, doctors and nurses involved in your care will do their best to meet you and your baby’s needs. However, depending on how your labor progresses, this might not always be possible. Making a birth plan might be part of your prenatal care, so at your next prenatal appointment, asks your care provider about your desire for a birth plan. Working together with your health care team with help you feel that your desires and wishes are being heard, and help everyone to communicate any changes or concerns that may arise.

A birth plan is not necessary but can be a useful part of preparing for your delivery. First, you need to get information about the body's labor and delivery process as well as the possible interventions used during labor. You can get this information from your doctor/midwife, books, and childbirth preparation classes. Once you have the information, you can then talk with your doctor/midwife about the choices available and together you can come up with a plan of how you want your labor and delivery to be. Keep in mind that sometimes labor doesn't go the way we think it will and, in order to keep you and your baby safe, your plan might need to change a bit. If that happens, don't feel badly. At the end of the labor and delivery, a healthy mom and baby is all that matters.
Labor is unpredictable. Labor can be dangerous. Not so long ago, women used to die all the time in labor. We shouldn’t get too picky about the labor process. Thankfully, the vast majority of women, today, survive the process just fine. But the notion that we can control for all the possible complications that can happen is just plain wrong. And it’s human nature to react to an out-of-control situation with the fantasy that we really can control it. But it’s harmful to mothers out there who buy into the notion that they can and should control their delivery process…because many of us can’t, and then feel inadequate as a result.

I’ve heard heartbreaking stories from moms who felt guilty and disappointed because they couldn’t live up to their “birth plans”. Moms who felt scolded by their doctors, nurses, or midwives for going against the particular birthing approaches of the practice…mothers who changed their minds about pain control, or what kind of labor support to use, or even whether to scream and yell during labor. Mothers who had to have emergency C-sections, who delivered prematurely, or who had bleeding problems. These things happen, and birth planning can’t prevent them.

There is a mistaken notion that labor and delivery are somehow the culmination -- the end point -- of a process. After all, we go through a nine-month process to grow and deliver this child, which is truly a miraculous experience. But the truth is, labor and delivery are only the beginning. Choices we make during pregnancy and delivery are actually the first parenting decisions we make. And that’s the beginning of a life-long process; how to best parent this child we deliver, in whatever manner we choose to, on that miraculous day of delivery. And how best to roll with the punches of life, and still feel confident and satisfied with ourselves. After all, that’s an important life lesson to impart to our children -- the ability to be flexible and adaptable to life’s curve balls. The attitude that we can and will be “light on our feet” in the face of the unpredictable changes of life.

When seen that way, I think it’s easier to see the process in perspective: The ultimate outcome is what’s most important about labor and delivery. Forget techniques: You want a healthy baby and a healthy mom at the end of it all.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.