Many women have never heard of birth plans. Those who have may wonder what the point of planning a birth is. Children show us from the very beginning who is in charge, and this is true even during labor and delivery. However, women still write birth plans and ask their doctors, midwives, and nurses to honor them as much as possible.
Birth plans are also called birth preferences, because they really are the things mom prefers if she can have them. Moms-to-be know that everything isn't always ideal, and some of the hopes they had for birth may not pan out in the delivery room if there's a problem.
The reason moms write birth plans in the first place is so they won't have to advocate for their desires while in the throes of labor. The major decisions are already made and down in writing, and they just try to stay the course as much as possible.
While it's rumored that many nurses and doctors practice the internal eye roll every time a mother presents a birth plan, that's not true. Many health practitioners are grateful when moms express their preferences so there's no confusion. The doctors and nurses who don't want to deal with birth plans are usually the ones that cause the need for them in the first place.
Mom knows her labor may throw some unexpected curve balls, but those helping her deliver her child shouldn't. They should be on her team helping her achieve the goal of experiencing the kind of birth she wants. That's why many moms cling to the birth plan, they don't want someone else making decisions about how their child is brought into the world. They also may have specific desires about the following issues.
15 They Don't Want To Lose Contact With Their Baby
A big fear many moms have is being separated from their child after birth. After nine long months of waiting to see that face, mom fears hospital staff will whisk her child away for measurements and cleaning when all she wants is to hold him.
Putting in the birth plan that mom does not want to be separated from her child gives nurses and doctors no excuse for taking the baby away unless it is a true, absolute emergency. Mom can say she does not care about the baby being weighed and measured immediately and that she wants to put off all non-essential procedures until a later time.
Again, unless there is an emergency, this should be an easy wish to honor.
Women who deliver at baby-friendly hospitals probably won't have to fight as hard for this since the goal of the hospital staff is to make sure the baby stays with mom and breastfeeding starts as soon as possible.
14 Mom Knows She Won't Be Able To Communicate During Labor
One great mental exercise for mom to perform during pregnancy is to imagine herself in the worst pain she's ever experienced and ask herself, how capable was I of functioning properly in that state? The reason for this exercise is to remind her that it's likely no matter what she wants for her birth, she may not be able to articulate it due to the contractions and exhaustion she's going through.
Planning in advance and writing it down so there is no doubt gives mom a voice when she may feel robbed of her own vocal chords. While some women have no problem staying in control and assertive during labor, many can only focus on the pain and want others to already know how to proceed.
Without a birth plan, women fear they won't be able to express their desires and may have a hard time even knowing for sure what it is they want.
13 They've Heard Horror Stories
Honestly, people with horror stories should not be allowed to corner expecting women and unload on them. Our imaginations are wild enough without other people telling us how their doctor demanded a C-section, the nurse gave the baby a pacifier even though they weren't supposed to, or the hospital personnel laughed at their wishes.
Unfortunately, many women do use the word "bullied" when asked about their birthing experience, and this leaves moms-to-be wanting to ensure as much protection as possible. Though a birth plan can't force a doctor to comply, patients can usually tell by a doctor's reaction to the birth plan if she needs to let this person deliver her child.
Birth plans give mom the opportunity to discuss her fears and make sure a doctor addresses them. It's a step in the direction away from a bullied birth.
12 They Don't Want An Induction
From the start, many women fear being induced. It's not that inductions themselves are bad. There are reasons a doctor may feel it's necessary to move things along, such as if mom is majorly overdue or the baby is showing signs of needing to make it to the outside world.
However, inductions are such a common practice now that many doctors want to perform them before a woman's due date even arrives. It's been speculated that the rise of C-sections in the United States could be because of the amount of inductions, and for women who want to avoid a C-section, avoiding an induction seems to be the first step.
Plus, women who do not want to be medicated during delivery hope to avoid inductions because using Pitocin to start contractions can increase the pain of them. That means a mom who wants to avoid an epidural or any other pain medication will have a much harder time if her labor is going to be more painful from the beginning.
11 They Want To Avoid A Surgical Birth
Having a child by C-section is not a bad thing, nor is it a lesser form of giving birth than a vaginal delivery. C-sections can save the lives of the baby and the mother, and they are a valuable tool to have when necessary.
The problem is the United State's C-section rate is over 30%, much higher than is considered safe or acceptable. Because of this, many women go into labor fearing they will end up with a C-section at the slightest sign of something being amiss, even if they don't need one.
Writing a birth plan allows mom to express her wishes for birth, including how she would like a C-section to be the very last option, not one of the very first. While this is a given for most doctors, patients are often afraid their doctor will choose a C-section if the length of the birth is affecting the doctor's plans. This is, hopefully, very rare, but mom needs to make it clear that a C-section only needs to occur if there is no other choice.
10 They Don't Want Drugs
Women choosing unmedicated childbirth is coming back in a big way, and they want to make sure everyone who will be around them is aware of their choice. Why? Because when the labor pains start, mom may not be able to say no to drugs!
While many moms want to avoid all pain medication during labor, most know they might not be able to explain that when going through back-to-back contractions or the intensity of transition. Before labor starts, they want it written in their birth plan that they are refusing drugs. This will help those aiding mom in labor, like the partner or the doula, reassure hospital staff when mom is clearly in pain.
Moms sometimes also want this written down so they can be reminded themselves. Moms put a lot of thought into refusing drugs during labor, and they don't want to change their minds based on fear or a few minutes of pain. Though some moms will decide to accept the pain medication, and that is fine, many will have their partner remind them of what was on the birth plan, and they will persevere.
9 They Want To Move
Fetal heart rate monitoring is common during labor, and many doctors require mom to be on the monitor throughout delivery. Doctors want to make sure the baby's heart rate doesn't change in a way that indicates problems, and if it does they want to make sure to catch it so they can intervene.
While fetal heart rate monitoring is not bad in and of itself, it doesn't have to be constant. Women who labor at home or in birthing centers often have their baby's heart rate checked periodically throughout labor, and the results haven't shown to be drastically different for the baby. In fact, evidence shows that intermittent monitoring is the better option if mom wants to avoid unnecessary interventions, such as a C-section.
Mom will not only need to clear this part of her birth plan with her doctor, but she will also need to make sure the hospital allows intermittent monitoring.
8 They Are Stuck With A Hospital Birth
Some women desperately want to deliver at their home or in the comfort of a birthing center. Midwives assist, and mom is in an environment that feels less sterile and foreign than a hospital.
However, not all women are good candidates for birthing outside of a hospital. Those with certain health conditions or whose babies are at a higher risk often end up at a hospital. It's wonderful to have the resources available, but it's difficult for mom to lose the birth she wanted.
Moms will often draft birth plans hoping to recapture some of what they hoped to experience with a home birth or birthing center experience. They will salvage what they can and negotiate the rest, and the birth plan will mean a ton to them going into a hospital experience. Many view it as their life preserver that keeps them from drowning in a fully medicinal birth.
7 They Want Their Crew To Know The Plan
Birth plans aren't just for moms and doctors. They are also for those assisting, such as partners or doulas. The people who will be most often communicating to doctors about what mom wants need to know for sure how she feels about every little issue, and the birth plan makes this possible.
It's a good idea to have whoever will be in the birthing room with mom help with the birth plan. Of course it's moms call as to how she wants to handle labor and delivery, but having her birthing team with her when she writes the plan will let them know in advance what she is choosing and if there is any time she wants to veer from the plan.
If confused or if mom has lost her way in a maze of labor pains and exhaustion, her birthing support team can always refer back to the birth plan and remind mom what her original intent was. This helps everyone involved stay on the same page.
6 Mom Wants To Breastfeed
Breastfeeding has been proven to be the best option for babies, with added benefits for moms as well. That's why most hospitals naturally offer mom the chance to nurse immediately and encourage her to visit with a lactation specialist during her stay.
Still, mom may want to add to the birth plan that she plans on exclusively breastfeeding. If the baby needs to be taken to the nursery for any reason, nurses need to know not to offer formula, and in many cases mom will request pacifiers not be offered so baby can perfect a nursing latch.
It's also okay to let the hospital know mom will be feeding on demand. Though nurses will request for mom to fill out a form showing how often a baby is nursing, women who nurse on demand may have a hard time filling it in since their children never stop eating.
5 All Scenarios Are Covered
Birth plans are not useless if mom doesn't mark off every request as completed. In fact, a birth plan that originally requested an unmedicated, vaginal delivery can still be used for mom if she undergoes an emergency C-section. The reason is because birth plans should cover every possible scenario.
Mom needs to sit down when making her birth plan and imagine every possible situation, within reason. What if labor stalls? Do I want to tear or have an episiotomy? What if I need a C-section?
By asking these questions, mom can write into the birth plan what happens in each situation and preserve some of her hopes for birth. Many women who have C-sections still have time with their baby right after birth if they request it. Breastfeeding can usually be prioritized no matter what. Losing one part of the plan doesn't mean losing it all, and birth plans let mom map out every scenario, just in case.
4 They Want To Delay Cord Clamping
Though it's common practice for doctors to cut the cord connecting the baby to the placenta right after birth, many moms are asking them to wait. The reason is that there are benefits to letting the cord finish pulsing, and there don't seem to be any risk to mom.
When the baby emerges, the cord will continue to pulse for many minutes. By allowing it to finish before the baby is disconnected from it, the baby will receive more blood, and that can lower the risk of anemia and iron deficiency. For premature babies, this option may also lessen the risk of bleeding in the brain.
However, if mom wants to delay clamping the cord, she needs to put it in her birth plan and talk to her doctor beforehand. It's important the OB knows before the birth takes place.
3 They Have Specific Postpartum Plans
Birth plans, despite the misleading name, are not just about birth. Mom may have very specific plans for postpartum care, and those go in a birth plan as well.
There are plenty of post-birth decisions to be made, such as does mom want her child to receive the vitamin K shot. What about the cream placed in the eyes after birth? Does mom want her friends and family to meet her in recovery, or does she want the first hour or so just for her, her partner, and her baby?
It's hard to think beyond birth when planning labor and delivery, but it's a good idea to think through to when the little one arrives. It will be an exciting time, but mom will want to focus on her child and not on making decisions on the fly.
2 They've Experienced a Traumatic Birth Before
Some women haven't just heard about traumatic birthing experiences. Many have actually lived through them. It's not uncommon to find moms who felt powerless during birth and like their wishes weren't respected. Even when mom goes home with a healthy baby to recover, the aftertaste from the birthing experience is bitter.
Though a birth plan doesn't ensure mom will have the birth she wants, it does give her a way to deal with the feelings leftover from her previous experience. By writing down what she wants and making it known to her doctor, she is taking a step to advocate for herself and avoid a situation where she feels out of control.
Traumatic births can happen, even with a birth plan, because birth is unpredictable. However, many women feel it's easier to recover from a birth that went off course due to uncontrollable circumstances than from one where doctors or nurses intentionally ignored mom's desires. The birth plan is a way to make those desires known.
1 They Have A Type A Personality
Honestly, every woman needs a birth plan, but women who are Type A may hold onto the paper the plan is written on like a life preserver. The uncertainty of birth is difficult for anyone, but for women who like to plan out all of the details, it can be almost impossible to let go.
A birth plan does not have to say that mom wants an unmedicated vaginal delivery. It may say she wants an epidural as soon as possible and to be given anything to move labor along as long as it's safe. Birth plans are unique to each woman, and they appeal to Type As because they offer the illusion of control. A mom who is Type A may be able to put her worries about labor to rest when she has the plan written down.
Remember, it is an illusion. Birth plans and preferences are great, but no mom knows what is going to happen until they day arrives and the birth unfolds. However, having a plan is like having a map on a journey; it offers guidance.
Sources: Fit Pregnancy, BabyCenter, Childrens MD, Evidence Based Birth