It's beautiful to see the shift as a first time pregnant mother moves from her romanticized idea of pregnancy and birth, towards her "Birth Warrior" self as her pregnancy progresses. Ask any first time pregnant mother in her first trimester about her "birth plan" and you're bound to get a happy-confused response. "Birth Plan? What exactly do you mean? I'm just going to kind of let things happen! I'm super laid-back!" Or "Birth Plan? Oh, I trust my doctor! That's what I hired her for. She'll take care of my plans, completely." Now, ask any pregnant mother in her third trimester, with the reality of labor dancing in the not too distant future, and you're likely to get a much different response. Often times it's, "Birth Plan? Yep! I've printed off three; one has a checklist, one is in paragraph form and the other is pictures-only, to make it easy for the nurses to see what I'm talking about, at a glance."
What if we hit the rewind button for a moment, and took a look at the real purpose behind creating Birth Plans? By the time we're done here, I'm going to tell you the only thing your birth plan really needs to include. You may be surprised!
For many mothers, a Birth Plan gives a sense of control. It's saying, "Hey, I'm the one who's in charge here and this is how I'd like this whole labor thing to go down." And in that regard, I'm 100% on board. You, as the birthing mother, are in charge of your decisions and in communicating prenatally with your birth team, and in having those tough conversations early on so there are no (well, maybe less) surprises; it's your right to receive informed consent and to ask questions if you aren't receiving the information you need. The only teensy issue is that none of us have any real "control" over labor and many of us are not receiving true informed consent about tests and procedures during pregnancy, let alone during labor. We can influence how labor unfolds in numerous ways, we can learn about and demand informed consent, but control? Not so much. The Birth Fairy laughs in the face of control.
For example, some moms know they want the most natural birth possible, without any routine use of medical support. This might include no fetal monitoring, no IV, no inducing labor and no Pitocin for any reason, no epidural, no narcotics, no pain relief of any kind; being allowed freedom of movement, eating snacks, the use of essential oils; no vitamin K shot, no hepatitis B shot, no antibiotic eye ointment for their newborn; delayed cord clamping, exclusive breastfeeding, and a delayed bath for their baby.
Some moms know they want medical pain relief. They want an epidural right away, are fine with the idea of inducing labor or using Pitocin to speed things up, and are open to other methods of pain relief and medical support (some call them "interventions").
There are many preferences in between, and many mothers want these spelled out and handed to their nurse and doctor so that their preferences are honored. It makes perfect sense, logically. Mom wants to leave no stone unturned and not be caught unaware. And of course, we always include in our Birth Plan the line about if medically necessary you are willing to deviate from your plan in order to save or protect the health of yourself or your baby. Isn't this a given?
What if instead, we took one line, one sentence, and summed up our preferences? Check out this gem of a book called Natural Hospital Birth: The Best of Both Worlds by Cynthia Gabriel. The author gives a rich look into birth plans, how to write them, and what to include. She gives examples of an easy one-liner like the following, which I am paraphrasing from her book. It's really the only thing you need to include in your birth plan (modified to fit your preferences):
"I'd like to let labor begin on its own and have the most natural birth possible. Thanks for honoring this wish! Kindly, Chris"
How does that make you feel when you read that line? Think your nurses will understand what you mean by that? I guarantee they will. I think stating your preferences in this easy, straightforward manner shows respect for the nurses experience and also is appropriate because you've certainly talked with your OB about your birth preferences in detail over the past 9 months, yes? (nudge, nudge). Trust me, your nurses know that you don't want an epidural if you want a natural birth. They know that you're trying to avoid a cesarean. They know you want to move around during your birth. And also, they know that your labor might end up being 40 hours long, you may desperately need to get some sleep and an epidural might be the most compassionate tool for your labor in that instance. A simple sentence like the one above allows for major deviations from the "Plan" and also communicates your overall view and philosophy of birth.
Here's a template for writing *your* birth plan. The only thing you really need is the first one-line summary. But I'm going to over deliver here and include space for your top 3 birth preferences as well.
Dear nursing staff at ABC Hospital,
(State your one-line summary of your birth preferences, such as: We are so excited to birth our
baby boy! We'd like to have the most natural birth possible.) Our top three preferences are:
*[Birth Preference #1]
*[Birth Preference #2]
*[Birth Preference #3]
Thanks for supporting us!
This gets your point across and allows for you to spell out what's really important to you, is short enough that the nurses may actually read it, and is easy to remember for change of shifts in staff. Feel free to copy this template and use it. If you share it, please share the entire post, thank you!
One quick note about those longer birth plans, especially for those naysayers out there who are reading this and saying but! but! but!! Birth Plans do have their place are truly priceless in the planning stages. As you read through your copy of Thinking Woman's Guide to a Better Birth (truly a necessary read during early pregnancy), you'll find yourself asking questions and solidifying your personal plan and birth preferences. You'll comb through sites like evidencebasedbirth.com, and uncover your own opinions about delayed cord clamping, episiotomies, and labor augmentation. This early planning and discovery phase is when it's crucial to communicate-OFTEN, seriously, and on repeat- with your husband or birth partner about your preferences. Why? In labor, the decision making often falls to the father, so it's important that HE knows the plan. You're going to be busy laboring! So fill out those checklists and picture icon birth plans, comb through them with your partner, and help him shift his mindset to reflect your preferences. Sometimes it is a long road, but it's better to have the informed support of your partner than to rely on a piece of paper with your plans. If it becomes clear that your partner is on a different page of your metaphorical birth book, it's time to get serious about childbirth education classes that honor a father's unique emotional journey and hiring your doula.
So many birthing decisions are made in the moment, depending on how labor unfolds and what everyone involved has in mind. Remember, it's YOU driving this bus so you'll have to do the hard work of first, discovering your birth preferences; second, fully preparing your birth partner; third, communicating clearly with your provider; and lastly, creating your birth plan for your nurses, reflecting your preferences in a clear, concise manner. When writing your birth plan, think: How can I sum up my preferences in a sentence or two? (It's the only thing your birth plan really needs.) To take it one step further, think: What are my top 3 non-negotiables in any sort of birth situation, that I can bullet-point in case my partner isn't with me?
You can do this! If you found this article helpful, leave me a comment below and share around with your pregnant and birthy friends!