Why Have a Birth Plan?

“Want a drink? Here’s some tea, with cream and two sugars. Don’t like your tea that way? Or don’t like tea at all? Well, sorry – that’s our standard beverage. If you wanted something different, you should have told us before. There’s not much we can do about it now.
Like that attitude? What if the item in question wasn’t a cup of tea, but your baby’s birth: the culmination of nine months of waiting and wonder – and the beginning of an incredible new life?”

This quote comes from an article on Pregnancy Today on why its important to have a birth plan. I think its a great way to look at the situation.
http://www.birthplan.com/why-would-you-want-a-birth-plan/

As a Doula, I always suggest my clients create a Birth Plan. I look at it like a learning tool, because in my early experiences as a Doula, as well as my experiences being the pregnant woman, I’ve found that there are so many subjects in a birth plan that many couples don’t even know they have a choice about! From the atmosphere in the room, to what a woman chooses to wear, from whether or not she wants pain medication offered to her, to how she wants her baby cared for after the birth, going over a Birth Plan can show a couple all of the various options they can have.

However…

Doing this at 36 weeks may not be the best timing. Its my belief that looking at the topics in a Birth Plan is something a couple should use when interviewing potential doctors or midwives. Why? Because if you choose to eat lightly during your labor, as is a option in a birth plan, or if you choose not to have a medical induction (barring the fact that it is MEDICALLY necessary (a topic that will come up in another post)) or if you want your newborn’s physical examination to be done on your chest and you suddenly find out that your OB or midwife will not permit this, its very late in the game to be switching care providers. Its not that it cannot be done, but why not start out with a care provider that’s on the same page as you and your partner, who has a philosophy about birth that is in line with yours? I’ve heard the stories of the doctor taking the birth plan and throwing it in the trash or the doctor who says to their client, “You should stop reading books and just listen to me.”

Some women may worry that they don’t have the knowledge to make decisions about their birth. I think there is nothing farther from the truth when it comes to the vast majority of women, because most women are perfectly healthy and able to birth their babies without intervention. Rest assured that just because you create a Birth Plan, does not mean it cannot be adjusted if necessary. It is not set in stone. If you state on your Birth Plan that you don’t want any pain medication, and yet during your labor you opt for it, no one will hold you to the Plan… unless you really want them too. The plan simply states your preferences, with the knowledge that they can be changed at any time.

All of this said, I heard from a long time L&D Nurse that a Birth Plan handedto the nursing staff may not be enough to forgo certain standing orders your OB might have. Let’s say you opt to not have a routine IV or for a HepLock (what’s basically the start of the IV needle into your arm.) or no routine Pitocin (a drug that is synthetic Oxytocin) to augment your labor. You may get to the hospital only to find out that your OB has standing orders that all of their patients receive this upon presenting in the hospital. A Nurse will not forgo this just because you are holding a Birth Plan stating you don’t want it, even if you tell her your OB ok’ed it.

Instead, get from your care provider a order slip that they have to fill out and give to you, which you bring with you to the hospital once you are in labor. Keep it with your Birth Plan and give it to the nurse as you are admitted.

There are many online resources that you can use to create a Birth Plan. Check out a few versions as some will have different questions, some are more thorough as well.