Tips On Writing A Birth Plan That Works For You And For Your Doctor

If you’re expecting a baby, chances are you’re thinking about writing a birth plan. Moms love birth plans, but some doctors and labor and delivery nurses? Maybe not so much. As a childbirth educator and doula, I know that a birth plan can be a terrific way to express your wishes for labor and birth, or it can set you up for disaster. Assuming you want to go the terrific route, I’d like to share the following tips to help you create a birth plan that works for you and hospital staff.
Ami Burns

What’s a birth plan and why should you have one?
A birth plan is a written document that lists your preferences for labor and birth. Not only is it a great way to clarify your wishes, many moms find it the ideal tool to start the conversation with their doctor or midwife about what they want during labor.

A wise doula trainer once told me to think of a birth plan as a “wish list.” Think about that slight change in language for a moment. A “plan” doesn’t really allow for flexibility, but a “wish” hopefully comes true, but sometimes may not. Since labor is unpredictable, and may not go according to plan, you may find it helpful to approach writing your preferences in this way. A birth plan may include pain relief preferences (natural coping techniques or medications), being able to move around freely during labor, minimal intervention, and breast or bottle-feeding. It’s a good idea to go over your birth plan with your provider before you are in labor so you can discuss options. Ask your provider to put a copy of your birth plan in your chart so that it’s easily accessible to nurses once you’re admitted to the hospital.

How do I write a birth plan?
First, do your homework. Ask your doctor or midwife for a list of the most recent statistics about interventions in her practice. Then find out these rates for your hospital. Take a tour of the labor and delivery unit and be sure to ask questions about issues that may be important to you.

Many moms write their birth plans as a brief letter to their provider and hospital staff. Others keep it short and sweet by bullet pointing their top preferences. Sample birth plans can also be found in books or online or check out our interactive birth plan creator here. If you decide to use one of the other templates, make sure you’re reading a recent article or book as some former standard procedures in labor -- like enemas and shaving public hair -- are typically no longer used.

What will the doctors and nurses think?
Many healthcare providers are okay with birth plans -- some may even encourage moms to write them. However, some may feel that moms with stringent birth plans may be setting themselves up for failure or don’t trust hospital staff to do their jobs. A great way to introduce your birth plan is to tell your nurse, “I’ve outlined a few things I feel you should know about me to best support me through labor and the birth of my baby.”

Birth plans do’s and don’ts
I always encourage moms to keep birth plans short and sweet. Do present your wishes in a positive way, for example “I prefer not to have continuous electronic fetal monitoring unless medically necessary.” Don’t make your birth plan a list of refusals, like “I refuse an episiotomy under any circumstances.” Many decisions can’t be made until labor has gone on for quite some time and staff has kept a close eye on you -- and your baby’s -- well-being. Try listing the top 10 things most important to you -- in addition to the best possible outcome for you and the baby, which is a given -- then whittle it down to 5.

However you decide to write your birth plan, it should never replace verbal communication, especially during labor when things may change due to a medical reason or you may simply change your mind.

If I’m having an out-of-hospital birth, do I still need a birth plan?
Giving birth at home means you don’t need to navigate hospital policies and procedures, but some moms find it helpful to create a plan just in case transfer to the hospital becomes necessary.

Whether you give birth at home, in a birth center or hospital, I encourage you to find out about the birth options available to you in your community. If you write a birth plan -- or if you don’t --communicate your wishes with your doctor or midwife early and often. Be sure to share your wishes with your partner, doula and whomever else may join you during labor, too.

All moms deserve a positive birth experience, and writing a birth plan is just one tool to help you have one.

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