Why Write a Birth Plan?

by: Jess Turner

"You can't really plan birth, so there's no point in writing a birth plan." I've certainly heard this sentiment expressed before, and I'm guessing you have as well. There is an element of truth to it - we don't necessarily get to plan when our labor begins, how labor progresses, how our bodies or our babies' bodies respond to labor. I often tell my doula clients that there's a surprise in every birth. BUT! That doesn't mean there's no value in a birth plan! 


The primary reason to create a birth plan is that it requires you to educate yourself on all of your options. At its most basic level, the birth plan becomes a template which helps you organize information and your ideals. Research everything! Attend independent childbirth education classes as these are more in depth than the hospital based classes. As you research more and your knowledge grows, check in with yourself. Are you okay with some medical practices, and uneasy about others? Are you okay with routine interventions, such as IV fluids, continuous electronic fetal monitoring, cervical exams, etc? Be willing to create an ideal plan for yourself, based on the latest evidence. Consider writing a Plan B, where a more medicalized birth is indicated, and a Plan C(esarean). 


An ideal provider/patient relationship is built on mutual trust and respect. Your birth plan now becomes a tool you can use prenatally to ensure you've selected the right care provider and birth location. Take it with you to your next prenatal visit, and have an open and honest conversation with your care provider about your wishes for your birth. Your care provider should be willing to collaborate with you. Does your care provider respect your wishes and recognize your right to informed consent and refusal? Or do they make excuses as to why your birth plan is not practical? Trusting your care provider is essential. Consider that even if your provider is enthusiastic about your birth plan, others in the group may have a certain way they're comfortable practicing medicine, and your plan for your birth may make them uncomfortable. Ask about the other providers in the group, and consider meeting with them (if time allows). Be willing to find a new care provider if you are feeling disrespected, manipulated, or abused in any way. 

You can also use your birth plan to reference while you call the hospital or birth center to find out their policies, facilities, and statistics. If you would like to eat and drink freely during labor, but it's "against hospital policy", that may be an issue for you. Perhaps you deeply desire a water birth, but perhaps the hospital you'd planned to birth in doesn't have tubs. Is that a deal breaker? Only you can decide! If you deeply desire a vaginal birth, but you discover the hospital you were planning to birth in has a very high cesarean rate, that drastically increases your chances of having a cesarean birth. Be willing to find a new location for your birth if the location you've selected doesn't support your wishes. 


When you go to a hospital during labor you'll be meeting some members of your birth team for the first time. These are nurses you likely haven't met, there may be a shift change or several over the course of your hospital stay, and it's never a guarantee that your doctor or midwife will be on call. Having a birth plan makes communicating your wishes to the staff much more streamlined. They'll still ask you all the questions anyway (it's their job!), but now they'll know exactly what's important to you, and, ideally, will help realize your goals. Be willing to talk to the charge nurse if you feel your needs are not being met by the nurse assigned to you (yes, you can ask for a different nurse!). Effective communication in labor is not a nice extra - it's essential!  

Understand What's Controllable, and What's Not

The value of the birth plan is that it helps you set the stage and control what can be controlled: your own education, your choice of care provider/group, and your choice of birth location. Yes, there are surprises in every birth, but you can relax into the knowledge that you've made excellent, and informed choices for yourself and your baby. 

Jess Turner is a mama to two energetic boys, a prenatal yoga teacher, and a professional birth and postpartum doula.  She is a member of the Open Arms Birth Collective and the Richmond Doulas, a volunteer doula with Urban Baby Beginnings, and a prenatal teacher with Nurture., a local non-profit.