Written Birth Plan a Must for New Arrival

by Mary L. Bodnar

Preparing for the arrival of your new baby is an exciting time for all expectant parents, whether it’s your first pregnancy or fifth. One way to enhance your level of preparedness is to write a birth plan outlining your preferences.

Many expectant parents still do not understand the importance of having a birth plan, let alone know how to write one. According to Dr. Edwina Simmons of Westshore Women’s Health of Westlake, less than 10 percent of her patients come to her equipped with a birth plan. "I have no problem whatsoever with birth plans, says Simmons, a practicing OB/GYN for the past 19 years. "They provide us with an idea of what a patient wants. I seem to get them primarily from those who want to go natural."

Whether planning on having natural childbirth or an epidural, having a birth plan in place well before delivery is a good idea. This way, when the hard work of labor has begun, no energy is wasted on unnecessary and distracting conversations regarding your wishes.

A well-written birth plan states the parent’s personal preferences during labor and delivery of the baby, as well as immediately following birth. Because childbirth can take so many unexpected turns, each birthing experience is unique.

The key to a good birth plan is acknowledging, first and foremost, that it is a document outlining your wishes and serves as a guideline. Lakewood Hospital’s Joy Sedlock Naughton, a certified nurse midwife for nine years, says few of her patients have birth plans either due to a high percentage of Medicaid patients. "There is not a lot of empowerment there. Unfortunately, they don’t realize they have choices." She tries to make up for this by tailoring labor to fit their needs and to help them make important choices.

A birth plan provides an opportunity to convey to hospital staff what you do and don’t want. Remember, remaining flexible during labor and delivery is crucial, and the health and welfare of the baby and mother should always be first and foremost. In the event the labor takes an unexpected turn or there are other complications, allowances may need to be made. "If the baby gets into trouble," Simmons says, "sometimes the birth plan goes out the window."

Begin with an introduction about you and your partner. It should include what’s most important to you in the birth of your baby. The tone should be respectful and flexible. Be sure to use phrases like "I would prefer" and "we hope to" as opposed to negative terminology. To ensure hospital staff cooperation, you do not want to make it sound like a set of demands. Find out what the hospital’s normal procedures are, then leave those items out of the birth plan as those things should be done as part of the routine care.

Write the birth plan clearly and concisely, with the length no more than one full page and no need for lengthy narratives. Your priorities should be listed in order of importance to you.

Include the type of environment in which you expect to have your baby (women should no longer be confined to a cold, sterile maternity ward), who you would like to have present at your birth, what birthing positions you plan to use (like side-lying, squatting, using birthing ball, pelvic rock, etc.) If atmosphere, music and low lighting is important, request it.

Express your desire to have the freedom to walk around during labor and outline preferences regarding fetal monitoring and frequency of internal exams. Most importantly, outline your requests for pain management. If you plan on using alternate forms of pain relief, such as massage, relaxation, breathing, positioning, water (shower or tub), heat or cold therapy, itemize these things in your birth plan so you have the support of the hospital staff.

Upon completion, the birth plan should be discussed thoroughly with your OB/GYN or midwife. If your caregiver seems offended or is resistant to the idea of a birth plan, consider switching providers.

Finally, make several copies of your birth plan. Give one to your doctor, request one to be placed in your file with your medical chart, and make sure your birthing coach or partner has one ready to go to the hospital on delivery day. If you choose to use a doula (professional labor support person), make sure she has a copy.

Ensuring one is placed with your medical chart is especially important if your doctor or midwife is not available when your baby is born. If you end up delivering with a health care provider with whom you are not well-acquainted, a birth plan will help to ease the lack of established rapport.