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Making a Birth Plan

Birth plans - waste of time or vital tool? How do you make one?

What is a birth plan, and how - and why - should you make one? How do you negotiate the plan with your healthcare providers?

A birth plan is a list of preferences for your birth experience, to help guide your healthcare providers when you might be 'otherwise engaged'! But how do you know what your preferences are? The answer is, a great deal of reading, talking to other new parents or even online communities. There are lots of choices to make and things to think about. Start your plan by writing a list of everything you want at the birth. Rank your list, and take the top seven or eight to write into a birth plan. These are not the only things you care about - they are just the most important to you.

Your plan needs to be brief - no full-on, blow-by-blow 'report' - or it is quite likely that it will not be read. In an ideal world, there would be plenty of time for midwives to read and digest the minutiae of your every whim - but in reality they are busy people. Think of a birth plan as a tool for opening channels of communication with your doctor or midwife.

SO WHERE DO YOU START?

Find out about the typical experiences of parents who have had their babies in your chosen setting. This 'default setting' can then be adapted to fit your wishes by your birth plan. Finding out about routine care saves you cluttering up your plan with things that will happen anyway. Keep your plan clear and simple, on one page. Discuss your plan with your partner, your doula if you are having one, and your midwife. The birth plan should act only as a reminder of discussions had during your pregnancy. Nothing within it should then come as a surprise.

A birth plan is not some sort of contract or guarantee of the type of birth you will have - and neither you nor your healthcare provider is 'bound' by it in any way. I have talked to women who have felt a sense of failure because they have written an all-singing, all-dancing birth plan about a 'natural' birth with no pain relief, womb music and aromatherapy, but when push comes to shove (literally, in this case!) have opted for an epidural. Even if things do not go according to plan, unless there is an emergency and things have to move very fast indeed (and let's face it, if it's more than your belly going pear-shaped, then the obstetricians and midwives are the experts!) you should still expect to be consulted about your wishes. When I was having my baby at home, I had expressed a desire to let labour progress naturally and did not want my waters broken. My labour progressed for a long time with what my midwife charmingly referred to as 'bulging membranes'. Apart from having visions of giving birth to an alien swarm, I was fed up with the lack of progress and agreed to have my waters broken. It was the right decision, made with consultation, and Bethany was born soon after.


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