Have you heard nurses laughing at birth plans? Have you encountered OB’s tossing them to the side and saying, “No,” to them? Or gone over your ideal birth with a group of pregnant people and had your ideal plan picked apart? But you want to make certain that some things do or do not happen in your birth space! There are some non-starters that need to be heard! So how do you write a birth plan that will be read and respected?
Here’s a fact that we may not want to hear: not everyone believes in birth plans. But getting the response from your care team that reflects trust in your ability to birth, and respect for your wishes can happen! First, let’s go over some of the frustrations nurses and providers have.
Too Many Details
You’re really angling for a specific type of care. So, your birth plan has every detail mapped out. You include things like the time you’ll choose to show up at the birth space or call your midwife for your homebirth. You have the details of everyone allowed and not allowed in the space. You have a list of all the procedures you do and don’t want. In fact, you’re struggling to fit it all on a three-page document.
That birth plan isn’t likely to be read. Nurses and providers are handling numerous patients, some with specific, life-threatening needs, and juggling the wishes written in such a manner likely wouldn’t be something they can absorb.
Very Specific Outcomes
When our fear of not getting the outcome we wish for is strong, a lot of times we try to be very specific in our needs and wants. If we can control the people around us, perhaps we can control the birth. Feeling that if we state we don’t want something loud and clear, that it won’t happen at all.
Unfortunately for us, the metamorphosis of birthing a person can’t be controlled. But it can be planned for, and it can be beautiful. For people who see births all day long, every day, they know the unpredictable nature of it all, and they can become less sensitive to your desired birth story.
Unrealistic Options
Some things we wish for in our birth scenario may mean that we can’t have other things. For instance, if you want to labor in water the options for other augmentations, interventions and pain management tools become limited. If you say on your birth plan that you want continuous fetal monitoring, you likely can’t labor in the tub or shower, unless the facility has a water-proof monitor. If you’re being induced or are using pain medications, that requires a lot more, and in some cases, constant monitoring.
What does that leave? What does a birth plan need to have?
What to Write
It’s not up to me to tell you how your birth plan should be written, or what choices you should make. It’s not the point of this article to coerce you into a specific type of birth. So what should you write? Very important things! Who will be in the room with you? Your partner, your doula, your photographer? If you don’t want certain people in the room, it’s best not to let them know you’re in labor. If they already know, tell them that you’re at capacity with who can be in the room, and specify to the nurse and front desk that no one other than those on your birth plan can come back.
When you plan on calling your midwife or provider in labor doesn’t need to be included. What happens before the care team arrives doesn’t need to go on your plan. What you wish for them to do to you or your baby that isn’t part of their normal routine, or not do that is part of their usual care routine, however, does.
You don’t want an induction? Unless they discussed it with you prior to your arrival, you’re not there for one. No need to write that out. You don’t want Pitocin for the birth of the placenta? Put that on there! That is something they may routinely do. You don’t want a cesarean? Great! Most birthers don’t. But what if something necessitates it? What circumstances makes a cesarean birth okay? What does that birth look like? You don’t want an epidural? That’s totally fine! Include that. Also include what forms of pain management you are okay with that they can provide, such as hydrotherapy, specific medications or injections, nitrous oxide and air (gas and air, or laughing gas) or saline injections. If your doula squeezing your hips or using a TENS unit, or your partner whispering affirmations in your ear and breathing with you is your form of pain management, that doesn’t need to be included. If having the lights low and tea lights or a string of twinkle lights is part of your plan, that’s something to include so they know not to flick on the overhead as they walk in the room. Or maybe just have your doula put a sticky note on the light switch that says, “Do Not Use”.
If you’re struggling to figure out all your options, or it’s still looking like a pamphlet instead of a single sheet of paper, reach out to your doula or a birth consultant to help! We can go over what your wishes are, what your non-negotiables are, and what is acceptable and when. This is what we do, and we don’t have any reason to try to push our ideals or ideas onto you.
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