Q. What is a birth plan and how do I make one?

A.   A good birth plan states clearly what you want or don't want for your birth experience. It can include all kinds of things, but is taken most seriously when it is quick to read, reasonable and polite.

• It is a good idea to have the doctor sign it, showing his staff that he supports your plan.
• It is a good idea to only include the essentials in your birth plan.
• Be polite.  No one wants to be treated like an idiot or mistrusted.  Your medical staff will be more compliant if they feel you are being reasonable with your requests and not making wild demands of them.
• Be realistic and flexible.  You may have a text-book labor, but you may not...if you get into labor and find that you really aren't doing well and want to change your birth plan, don't feel bad about letting people know that the plan has changed.  You may think you don't want a certain proceedure, but find that it is medically necessary for some reason, don't be crushed by this.
• If you feel you're not being taken seriously before the birth, find another doctor or hospital to deliver with...there are options, but be realistic in your goals.
• DO NOT ASSUME you will have trouble with your hospital, doctor, nurses or midwife.  Take the time to ask all your questions and to communicate with them.

A good birth plan might look something like this....

Dear___________staff,

We want you to know that we have confidence in you and we are looking forward to having our baby with your help. 

 Our goals for this birth are:

• a healthy baby and mother
• informed consent be given before any medical intervention is done
• epidural - if requested by mother (please do not offer pain medications)
• no episiotomy
• total mobility through-out the labor
• intermittent external monitoring
• breastfeeding immediately following birth

Thank you so much for helping us bring our beloved son into the world safely and gently.

Signed_______________________  Date_________

Doctor______________________ Date__________

Things to consider/research/talk with doctor about, when thinking about a birth plan:

• epidural ?
• episiotomy?
• narcotics ?
• food/drink during labor?
• how many people in the room with you?
• water therapy during labor - bath or shower use for pain management?
• labor positions?
• position used during pushing? (flat on your back, stirrups, squatting, standing, sitting up, kneeling, hands and knees, etc.).
• fetal heart monitors (internal or external or telemetry)?
• what to do if a c-section must be done (i.e. - who holds the baby after the birth while the closing is being done? does mom breastfeed while they are closing? Who goes into surgery with mom?)
• birth pool?
• parents to cut cord?
• dad to "catch" baby?
• natural pain reducing techniques?
• informed consent? (meaning that all your questions are fully answered before you agree to any intervention - and that you can refuse treatments)
• directed pushing?  -  do you want to be told "push" or allowed to wait for the urge to push? (this is a big one in some hospitals & can impact level of tearing)
• breastfeeding?
• nursery? or rooming in?
• bathing the baby - who does it and when?
• circumcision? -do or not do? - when? where?

Keep in mind that your hospital or doctor may have limitations on things you want.  And in some cases your doctor or nurse may be unhappy with you for making a birth plan at all.  When choosing your doctor and hospital you need to know as much as possible about their goals for your birth.  (see birth team page) 

Another suggestion I recently heard is this: send the hospital a copy of your birth plan and request that a nurse who is willing to work with your desires be assigned when you come.  This way they already have an idea of who will take care of your medical needs and you're more likely to have a supportive nurse!