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Many couples are deciding to write a birth plan, deciding how they would like certain situations to be handled. By becoming informed on key issues surrounding childbirth, and after making mutual decisions on how to handle "surprises" Writing a birth plan is the best way to inform your birth team of your intentions and enables you to focus on the labor of labor instead of policing your caretakers.
Even before reading or researching any of these key issues many women have specific ideas about what they would and would not like to experience during labor and delivery. One woman might feel very strongly about having her husband and mother present during the labor and delivery. Another woman might be adamant that no one disturbs her while she labors.
After time spent reading all the pregnancy books, all the childbirth, talking with other mothers and her caretakers, many women develop VERY definite ideas about every stage and step of labor, and it becomes beneficial to begin writing them down.
Many caretakers advise women to "keep a list" of important areas at they think of them. It's important to review the evolution of this list with your caretaker every step of the way. Having a militant attitude that "This is MY birth" is not only intimidating to many caretakers, but it also threatens their professionalism and can make for uncomfortable moments in the event of an emergency. Maintaining open, honest communication is the key to a happy relationship.
Toward the end of your pregnancy, you will want to revise this "list of notes" into a readable "birth plan."
Begin with the admission procedures. On your list you might have noted "No shave or enema" and after discussing this with your caretaker, you would probably be removing this item altogether, since very few hospitals now routinely do these procedures. Including it would waste the time of the people expected to read it and diminish the credibility of your research and decisions. On the other hand, items like "no I.V." and "Light snacks" which aren't usually an issue at a Birthing Center, would have to be approved by your obstetrician if you're planning a hospital birth. Find out about your hospitals fetal monitoring practices, do you need permission to have electronic monitoring limited for your comfort?
After you've outlined your preferences for admission procedures, you will want to specify any preferences you have for the actual labor. If you would rather avoid pain medication, this is the time to mention it. Many hospitals make a point of periodically offering pain relief to women in labor- if you would rather it not be offered, but available upon request, now is the time to make that clear. Many women are disheartened at the idea of immobility during labor, so it would be wise to specify the desire to walk the corridors and reposition yourself as needed long before contractions begin, so as not to surprise nursing staff with a "difficult" patient upon arrival. Again, these usually aren't issues at a birthing center, but should be discussed beforehand regardless.
The next thing to consider is the actual delivery. Many birth teams employ a motivational chant of the word "push" during the actual delivery, and many women find this empowering and helpful. Others may find this distracting and insulting, and would wish to include a request of silence in their birth plan. Would you like the birth to be videotaped or photographed? Many hospitals have specific guidelines for this and you would need to discuss it before the birth for proper clearance.
The one thing many couples leave out of their birth plan is the dreaded "emergency" Often nothing more than little surprises or unpredictable turns of events; these can be very stressful if not considered beforehand. Decide what action you would like to take if fetal heart tones seem to weaken- would you like an instant C-section, or verification by ultrasound or stethoscope, or simply to reposition your body for better blood flow? What if your labor doesn't progress as fast as the hospital staff would like- are you the type to allow an induction to "speed things up" or do you feel strongly that it's important to allow your body to work alone? If a C-section becomes inevitable, would you prefer a general anesthesia or an epidural? Most Hospitals require the obstetrician's consent to allow a husband into the operating room in the event of a C-section.
The fun part- the end of your birth plan -your baby is here! It's wise to make hospital procedures known, so you're not surprised when your bundle of joy has finally arrived. Do you have specific preferences regarding newborn care? Most hospitals now allow the mother instant "bonding" time of an hour or so, where new mothers (and fathers) are left in the delivery room with their infants, to start breastfeeding or just cuddle. Don't assume your hospital has these procedures in place already, make sure beforehand. If New Daddy would like to cut the cord, don't assume you'll remember at the time, because it's often done before anyone notices- put it in your plan. Would you like the baby to be kept in the nursery, or in your room? Do you object to the use of a pacifier or artificial breastmilk? If you are rooming-in with your baby, who is allowed into your room? Many women are comfortable with everyone under the sun visiting them after birth; many other women would rather keep visitor at bay for a while, until after the excitement has passed.
Once you are finished writing out your birth plan, present it to your doctor (or midwife) for his review. It would be wise to ask for a few extra minutes before your appointment time comes, so he has time to review everything with you. After everything is agreed upon, you can all sign the bottom of the plan- then copies can be made and put into your file at the hospital and in his office.
Remember that your doctor will not be with you the minute you arrive at the hospital, so it would be wise to hand-carry a copy of the approved birthing plan into the hospital a week or so before delivery and introduce yourself to the nursing staff. Chances are, your file is already there and they can confirm that they have a copy. Striking up a friendly conversation with the women who will be spending more time with you than your doctor is a very wise investment. Remember that while a doctor during delivery can spend less than an hour with a patient, the nurses care for them the entire length of their 8-12 hour shift. Their professionalism is challenged and insulted more often than the doctor's, so it is important to maintain a friendly relationship with them. If you come across any you feel particularly drawn to, or particularly repelled by, write down their names, and when you are admitted, you are completely free to ask for a switch if necessary.
No two birth plans are alike, just as no two women or babies are alike. If you have specific requests or preferences regarding your labor and delivery, it is important to make your wishes known long before you are admitted!
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