Sitting down to focus time and energy on writing your birth plan is for many women a cherished memory of their birth experience. This is often a fun & insightful exercise that is gaining popularity as our culture moves towards increasing birth rights awareness and placing the labouring woman and her family at the center of the birth experience. Over the years we’ve seen TV shows & documentaries focused on the topic of the birth experience and the impact it has on women, babies, families, and health.
I sat down with my colleague and Better Birth Plan Writing Webinar teammate Dr. Eevon Ling ND, birth doula to talk about the pros and cons of writing a birth plan in preparation for your birth experience.
#1. Why should I?
What are some reasons why people don’t follow thru with a birth plan?
It’s easy to formulate a negative attitude about birth plan writing. Concerns that they are not valuable, will be ignored, have little impact on the birth, or get families’ false hope to name a few. At times, families begin writing them and stop, due to mental fatigue, feeling overwhelmed with birth options, or not making them a high priority in their busy schedule.
#2. What’s the bottom line?
What information must I go over with my medical birth professional?
You don’t want to overwhelm or confuse medical birth professional (Midwife or Obstetrician), so how do you know what to include in the plan? It’s best to keep the information as concise as possible. Dr. Ling suggests organizing your birth plan in a way that is clear for your birth team. “Birth plan items can fall under two categories: Items you would discuss with your care provider [and] Items that are the personal preference of the mother.”
#3. What to worry about?
What are some cautions around having a birth plan?
Keep your fears in check. When fear influences your planning, It’s hard to set yourself up for success. Dr. Ling cautions, “Birth plans help mothers and parents to express and discuss their wishes, but I caution over being too rigid about how the birth has to be as this can set up some parents to be unnecessarily disappointed or feel guilty if the birth unfolds differently than what they had envisioned. “
#4. What’s so good about it?
What are some benefits to having a birth plan?
Dr. Ling explains that a Birth Plan is a good way to strengthen the relationship between caregiver and laboring woman. “The big benefits of having a birth plan are starting a discussion with your care provider about YOUR labor and birth, getting a sense of your care provider’s approach and philosophies around labor and birth, [and] having a document that is included in your patient file that you can refer to as needed throughout the process.”
Remember, each birth experience you have is a blessing that deserves its own attention & respect as it is shaping the future of your family.
#5. Does it really get any use?
Can you recount a time when the birth plan was integral to the birth experience?
Every time that the first person to mention pharmaceutical pain management (epidural or laughing gas) in the birth room is the laboring woman and no one else, that is a victory in my book. That is because it is not always the case & birth staff often have to be reminded of this, among other things. Dr. Ling adds, “With a birth plan in place, I can frame my approach from the mother’s point of view. I don’t like to make assumptions about what she would like or prefer during this important life event.”
She goes on to tell this story, “The mother had reached full cervical dilation within an hour of arriving at the hospital. Immediately the nurse starting instructing the mother on how to push her baby out, at which point I had to voice the mother’s birth plan wish of refraining from pushing, adding that she had been doing extremely well on her own, so why not let her do her own thing? Why rush it? The nurse did give me a “but this is how we do this” look, and then stepped back.”
It’s important to remember that doulas are advocates for the mother & family, not the birthing staff or hospital.
#6. Popular points of consideration?
What birth plan points arise most frequently during labour & delivery?
Particulars around pain management and cord clamping are two points I’ve seen come into play frequently during labour. Dr. Ling mentions that labour progression, allowing the mother the time she needs to birth her baby, positioning, and skin to skin as birth plan points that frequently get brought up during labour and delivery.
#7. What’s the worse that could happen?
What is the worst case scenario for not having a birth plan?
Dr. Ling cautions, “In the absence of a birth plan, written or oral, the attending care providers will go about their jobs in “default mode”, making decisions about how the labour and birth are managed that may be very different than what the mother would want.” Ling goes on to say, “…the absence of a birth plan might also mean the absence of any labour and birth preparation on the mother or parents’ part.”
Worst case scenario with respect to the plan at a birth, would be anything that can’t be corrected for and that has a impact on the core people involved; cord blood banking, cutting the cord, announcing the sex, washing the baby, number of support people who can attend, etc. Moments you can’t get back. These things can be hard to resolve feelings around, but not impossible. Each family has to determine their priorities and the birth plan helps you do just that. Without a birth plan, families may find that the birthing experience happens to them, not thru them.
#8. Fear Factor
What impacts have you seen fear play with respect to the birth plan?
Fear can make it difficult for the family to make lasting positive memories of their birth experience. Dr. Ling mentions, “A healthy dose of ‘anticipation’ can help parents be open to how a birthing may unfold. If a woman has strong pre-existing fear about labour and birth, she might create a rigid idealistic birth plan as a way to avoid her fears. When anticipation becomes worry and then fear, I’ve seen how it impacts the mother’s birth experience. The mother is so fearful that it prevents her body from doing what it needs to do during labor. This kind of fear can certainly influence the direction that the labour takes, leading to necessary interventions. And then afterwards that new mother feels a huge amount of guilt about not having the birth she planned for. That unnecessary guilt may be a disadvantage of a rigid birth plan.” Having someone at your birth dedicated to helping you manifest your birth vision as much as safe and possible may help to mitigate unnecessary fear.
#9. Who really matters?
Who to consider when making a birth plan?
The birth plan is in large part about the laboring woman. However, if her partner or co-parent is present they should be taken into consideration as they are making memories as well.
Dr. Ling says, “When making a birth plan, of course include the pregnant mother’s wishes but keep in mind that the role of making sure that everything is going according to the birth plan is really the role for someone else other than the laboring mother. This role could go to the partner or a doula or other labor support person. The partner should be honest about whether they feel comfortable and capable of upholding the birth plan when needed.”
#10. What else can you tell me?
What more will be covered at the webinar?
Dr. Ling asks, “Did you know that there are a number of routine practices during pregnancy, labour and birth that are not based on evidence?”
During the webinar, you will learn how to get around difficult situations, what not to include in the birth plan, how the birth plan can help avoid the ‘Unnecessarean’ aka unnecessary cesarean birth, how to prepare for the first couple hours after birth, and how to use evidence based medicine to support your decision-making, among other points.
There are also 30 minute individual birth plan consultations to help you craft the best plan for your family.
Pls join us on November 14, 2015 at 11am EST any where in the world when Dr. Ling and I will be joined by Texas-based doula Nathalie Saenz to host the Better Birth Plan Webinar. Register at BetterBirthPlan@gmail.com to empower your birth through education.