Creating a Birth Plan

Planning Your Baby’s Birth.

These days it seems that women are reluctant to create a plan for their baby’s birth. They don’t want to get too attached to an idea that may not play out on the day and then have to deal with disappointment.  I’m here to say that birth planning can be a very useful tool in preparing for birth and the way around potential disappointment is to build in a great deal of flexibility so that you can continue to have your preferences met even if things turn out differently than you anticipated.

create a birth plan

I can remember when writing a birth plan was an innovative idea whose origin was born out of consumer awareness of women’s rights in childbirth in the United States. Initially it was met with resistance by the obstetric profession as something that challenged their authority, and they were not receptive. This had more to do with how women were approaching the process and the way that they were negatively expressing their ideas: mainly in refusing to do what had become the norms in obstetric procedures. I had some conversations with obstetricians in the area where I worked about the benefits of having a birth plan, and that began to soften their attitudes towards this idea. It wasn’t long before they were advocating for women to write a birth plan and asking to see them. Why? Because it put in black and white what it was that a woman wanted to experience and they therefore did not have to guess at what that was. The clarity of having it in writing meant that all partners within a practice would know what this woman wanted. I have also seen nursing staff in hospitals reading a woman’s birth plan at the nurse’s station.

Express your ideas in the positive

The best way of writing a birth plan is to express your ideas in the positive. When you express yourself negatively you are attacking the system, and the professional who subscribes to that system, and this will get their back up. Saying things like “I refuse to…”, or “I don’t want…”, or “I will not…” puts the professional on the defensive and that won’t be good for communication.  However, if you write your plan with a positive attitude, you can say things like “I feel strongly about…”, or “it is important to me that…”, or “I would like to…” and this is a clear expression of your preferences, and no one can argue with that. It will not feel as if you are attacking the practitioner when you are putting across your message in this way. You can have a long list of preferences that when framed in this positive way will communicate your desires and also create your intention for how you would like things to go.

And yes, things do not always go the way you might want them to, but that does not mean that you have to abandon everything you want. This is why it is crucial when writing a birth plan that you include a great deal of flexibility in it. The unpredictability of birth goes with the territory and therefore you want to consider the contingencies that allow you to stay in charge of your experience even when things get complicated. What would be important to you if you had to be induced? What if it becomes necessary to have a cesarean section? What if you learn that your unborn child is experiencing fetal distress? You want to have a built in set of preferences, in case things do deviate from the norm, which would accommodate this new set of circumstances. Flexibility allows you to cover all the bases and stay in control of what happens to you, rather than abdicate to the wishes of your birth professional. This is true whether you are receiving care from a midwife or a consultant.

A birth plan is a great communication tool

What I have come to understand after all these years of helping women to plan their births is that a birth plan is a great communication tool. Because you will probably not know the person whose care you are under (unless you have an independent midwife) it is good to have something in writing in your chart that a stranger can review when you are in labor, especially if you are going to the hospital. If you are dealing with a group of midwives or doctors who you do know, you want to discuss it with as many practitioners as you can. By doing this you can learn who is aligned with your preferences and who is not. It gives you a chance to negotiate about things you feel strongly about. It also alerts you to anyone who might give you a hard time. As I said above, it is useful to have it in writing because your care provider does not have to play guessing games when you are actually in labor, and you don’t have to start negotiating when you are in the vulnerable state of giving birth. Better to get the discussion going when you are in your place of power to communicate your needs. And it’s important to know that you are entitled to have your needs met even when you are giving birth.

I have seen some hospital versions of a birth plan that are no more than a tick sheet, with items on it that are about how the hospital maternity service functions. The kind of birth plan that I am talking about is one that covers your various options from the start of labor through the end of the third stage when the placenta is born, and includes what you are comfortable allowing the birth professionals to do to your new-born, whether you are at home or in the hospital. When I was teaching birth preparation classes I had a couple of sample birth plan templates that presented all the many choices that could come up when having a baby. Like a Chinese menu, you can pick and choose which ones resonate with what is important to you. Probably the best plans are written on one page, but I’ve seen many that are more detailed than that, and others that are a short list of preferences (always expressed in the positive!).  You can see how mainstream birth plans have become when even the NHS has a sample template to use. Have a look online for examples of birth plans and see which one resonates with what your wishes are for giving birth.

The best thing about creating a birth plan is it gets you to start thinking about what your options are. In writing it you start to crystallize ideas you may have picked up during your pregnancy and can now share with your partner, so that it’s a communication tool for your relationship as well. In sharing your ideas and preferences, you are deepening the connection between you, and also learning what the other feels about possible options. A flexible plan is the key to staying in control when having your baby. When a birth plan is done well, it opens doors to possibilities you may have never considered before, so it’s worth the effort to create something positive that will help you to have the experience that you want, with contingencies included.


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    1. You’re welcome, Dominga. I wrote that a while ago, but it’s always valid. For some reason I’m only seeing this comment today, though the date is from December. I’m sorry for the delay.

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