Café Recap: How to Write a Birth Plan

Panelists: Katie Page (Certified Nurse Midwife and Mama), Brenda Osterhus (Childbirth and Family Education Manager at Centra and Mama), Danielle Hunter (Mama and Birth Plan User), and our moderator Erica Wolfe.

We often field questions about birth plans in our small groups and online community.  Last year was the first time we had an entire Café devoted to the topic and when we surveyed our mamas, it was listed as one of their favorite Cafés.  So today we’re excited to again devote an entire panel to writing a birth plan! Our panelists include a care provider, a hospital representative and a mama who very recently wrote (and used!) a birth plan.  Here are their thoughts on what topics should be addressed, how to word things and how birth plans are received by your care providers.

First of all, what is a Birth Plan? Katie tells us that the history of birth plans is ambiguous, but they likely first appeared when alternatives to standard hospital procedures became more prevalent. The idea that each pregnancy and birth is not the same and therefore should not all be handled in the same way was a catalyst in the rise in popularity of birth plans. The process of creating a birth plan forces a family to consider various labor events and how they would like to handle them. A birth plan is the start of a conversation, deciding with your partner and your medical support team what the best choices are for you during labor.

Brenda tells us that the goal of a birth plan is to let your care providers know what your choices and decisions are. This is especially helpful when nurses and doctors rotate during your delivery. It is also an opportunity to make sure, well before labor, that you and your care provider are on the same page. It is a way to educate yourself about the choices and decisions you can make about your birth. Nurses and doctors are people too, and will each have their own ideas about how birth should go. It is important that your opinion is known to them, so that you will get the treatment you desire.

Danielle was lucky enough to have her care provider deliver both of her children, but this is not usually the case. A birth plan gives you the opportunity to do your research and decide what your priorities are. She says that not having expectations for how her birth will go keeps her flexible. She keeps an open mind so that she will be able to handle any unforeseen circumstances and take them in stride. A conversation with her midwife about her birth plan allowed her to remove some items that were unnecessary (like procedures that are not standard in our hospital). Sample birth plans and templates are available online (some here, here and here on our website).

Audience members shared both positive and negative experiences approaching their care providers about birth plans. One mama was nervous to approach her OB about a VBAC, but was met with his approval and willingness to work toward that goal with her. Another mama tried to broach the subject with her provider, but it was dismissed as something she didn't need to do. Her lack of education at the time robbed her of the confidence to push the subject although it was important to her.

Top Ten DOs for Writing Your Birth Plan: Tips from an L&D Nurse (from the blog Nursing Birth) #1 DO keep your Birth Plan short, simple, and easy to understand (1-2 pages max). Bullet points are fine! #2 DO keep the language of your Birth Plan assertive and clear. #3 DO use your Birth Plan as an impetus for doing your own personal research about your preferences for childbirth. #4 DO include your fears, concerns, and helpful things for the nurse to know. #5 DO review your Birth Plan with your birth attendant and ask him/her to sign off that he/she read and understands it. (Signing may be unnecessary and could even imply a lack of trust in  your care provider in some situations.) #6 DO make your Birth Plan personal (don’t just copy/paste) and DO make sure that you understand and can elaborate on everything in the Birth Plan if asked. #7 DO look at examples of great Birth Plans online to get some ideas. #8 DO run through scenarios in your mind about how labor could unfold and actually talk these scenarios out with your labor companions and doula (or perhaps even your childbirth educator or birth attendant too!) #9 DO try to treat researching and Birth Plan writing as a fun and exciting experience, not a chore! #10 DO remember to bring your Birth Plan to the hospital!!

Another positive result of a birth plan is having your choices in writing. If you decide during labor to veer away from your birth plan, your care providers and labor support can remind you of your initial intentions and help you either stay on track or choose a new path for your labor. It is also worth noting that birth plans are not just for natural births. Whatever your intentions, it is important for your labor team to know them.

After care is an aspect of labor that is often overlooked. These choices can also be included in your birth plan and will make your decisions much easier during your recovery time. Have your pediatrician lined up and ensure that they are on board with your choices for newborn procedures. Keeping your partner on board and informed about all of your choices will also help ensure that things go as planned.