Understanding birth plans… should you write one? Is it worthwhile? What happens if things don’t go to plan on my birth plan? Michelle Penn, Midwife & Early Childhood Educator answers these questions and more…
As a midwife I am frequently asked if mums-to-be actually need a birth plan, what should be in a birth plan and if midwives and obstetricians actually follow your birth plan if you do have one. Of course I can’t speak for every doctor or ob-gyn around Australia but having delivered thousands of babies (and had four of my own) I can tell you what I have found to be true about birth, babies and birth plans:
1. Labour does not follow a plan.
2. Babies do not read the pregnancy books before they are born!
3. Your own body has a plan of its own that we often don’t know about.
4. AND your baby has a mind of its own already – and more often that not hasn’t read the instruction manual on how to give mum a ‘nice easy’ labour.
So, what is a birth plan?
A birth plan is usually written out by the mum-to-be and tells the people looking after her, for example midwives and doctors, what options for labour and delivery she would like to have. A birth plan may also outline preferences for pain relief and what the mum to be hopes to avoid during her labour and delivery process.
Regardless of whether you have a birth plan or not you should discuss with your support team what you would and would not like in labour. You should also discuss these ‘choices’ and ask any questions you may have regarding them with your care provider (midwife or obstetrician) prior to the main event. This is incredibly important as once you are in labour you may not be able to voice your opinions clearly due to concentration, pain, or drugs. Your support team will be your advocates – and as the name says, they are there to support, so it is very important that they know and will stand firm on what you want.
In this day and age as humans we have control over most things in our lives. However when it comes to what exact time our contractions will start, what day the baby will be born on, and how labour will progress, we really have very little control. Labour takes many varied paths and most people like to achieve the same two basic outcomes at the end of the day: a healthy baby and a healthy mother, even if the path isn’t exactly the one they hoped to take. As a mum-to-be what you need to remember is that your body has been designed for this process and you should have confidence and trust in yourself and in the people caring for you – both support people and medical staff.
So you may ask, why write a birth plan if it’s not going to go to plan anyway?
- Firstly, it may be better to actually call this plan ‘Birth Preferences’.
- Writing out your preferences for labour can help you to prepare and get to know the different processes in the hospital or home setting when delivering a baby. It can also give you an idea of what you would prefer not to have in labour.
- Birth preferences can give a woman a sense of empowerment and writing them down is part of gaining knowledge and learning about labour and delivery before it begins.
- Writing out your preferences can also be of great benefit for your support people in the room and also for different medical staff on each shift so they can quickly read and know your wishes.
Knowledge is power!
When considering your preferences for birth it is important to research and read about labour and delivery. It would also be good to look at other people’s birth preferences, or ask if your medical provider has a template. This is your body and you absolutely do have a right and a say in how your labour progresses.
A good acronym to remember for both you and your support people in labour is BRAN. When approached with different options in labour ask: What is the Benefit of this procedure/intervention, what are the Risks of this procedure/intervention, are there any Alternatives for this treatment or procedure and if so what are they, and does this procedure have to be carried out Now or can it wait a while?
What to include in your birth plan…
If you do choose to write out your preferences remember that they do need to be in keeping with the hospitals policy (if you choose to deliver in a hospital) and they should be short and to the point.
Your birth preferences should also cover different scenarios. For example: normal delivery; induction and intervention; caesarean section birth. Under these sub headings you can state your preferences regarding interventions, pain relief options, or drugs, and you can also mention finer points such as theatre set up if you happen to have a caesarean, episiotomy and tears, or skin to skin contact with your baby after birth.
There are many websites that will give you options about what to write as birth preferences however make sure these are relevant to your pregnancy and also the setting in which you are giving birth. You may like to write a paragraph on your birth preferences explaining that these are your preferences and you understand that the labour process can vary and if difficulties arise care may need to be re-negotiated.
Letting go & de-briefing
If at the end of the whole labour process you feel that your birth did not meet your plan, you may feel disappointed. It is important to debrief these feelings with your midwife or obstetrician to understand why things varied, and to help you to gain acceptance of your labour experience.
Above all, educate yourself and decide if you have preferences. Read and learn, attend antenatal classes, talk to others about their experiences, and be amazed by your body and the incredible way it is forming this new little human inside you. Good luck in your birth planning – the choice is truly yours!
*Please note that advice and suggestions contained in this article are of a generalized nature and do not replace advice given to you by your medical practitioner. If you do have any questions regards to your own birth preferences discuss them with your own care provider.
Michelle Penn has over 10 years experience as a midwife and child & family health nurse. As well as being mum to four little ones (including two-year old twin boys), she is passionate about empowering and educating new mums with relevant and interesting information to help them with the amazing journey which is motherhood. When Michelle is not delivering babies or raising her own tribe you’ll find her running, removing small pieces of lego from the bottom of her feet, reading chick lit or escaping the grind with Candy Crush and a red Lindt ball.
Medical disclaimer: Tips provided need to be considered in conjunction with medical advice. For immediate concerns, please contact HealthDirect (Australia wide) ph 1800 022 222 – to talk to a registered nurse 24hrs a day, and in emergencies call 000.
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