Birth Plans- A Doula’s Perspective

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If you’re pregnant, or have ever been pregnant, you’ll know firsthand that the advice you receive from those around you is often confusing and conflicting. It can be hard to tell, as you swim through the sea of unsolicited comments who is right and who is wrong.

As a birth doula, I’m used to supporting a variety of parents, all with unique philosophies regarding pregnancy, childbirth, and parenting. I also am in a unique position of getting to witness how different doctors and nurses react to patient requests.

Chances are, if you’ve read any books about childbirth, or taken any childbirth education classes, you’ve been prompted to write a birth plan. Its also pretty likely that you’ve heard from friends and family that their birth plans went out the window (thanks, Murphy’s Law!), and the birth plan became useless. So that begs the question- are birth plans worth the effort?

A birth plan is a document that lets your care providers know how you would like your labor and delivery experience to go. It can be short and straight to the point (I’ve had clients whose birth plan was only two sentences), or detailed and lengthy. There are thousands of templates that can be found online, with illustrations, pictures, and pretty fonts, or they can be scribbled onto paper towels with crayons (been there, done that).

Medical professionals certainly have mixed feelings on them, “There is no model for giving birth and no bravery award for doing it a certain way.” Clemmie Hooper, a British midwife argues against them, while Dr. Ross, an MD and Women’s Health expert says, “It creates an open dialogue between the couple and the health care providers.”

My take? Birth plans can be a fantastic way to familiarize yourself with your options in labor, and after. Many women do not realize that hospital beds can be changed to support a variety of active labor positions, or that they can request a hep-lock, as opposed to an IV line, for example. Writing a birth plan is a great way to learn about standard protocols, why they happen, and if they are necessary. Its a good idea to discuss your preferences with your doctor or midwife throughout your pregnancy, so you and your care team are on the same page, come the big day.

Birth plans can also be a way for you to introduce yourself and your family to the staff when you’re a bit distracted by labor and your new baby. Doctors and nurses typically have several patients to take care of simultaneously, and having birth plans by the door can help them recall which of their patients wanted the epidural stat, and which ones don’t even want mention of it, without a password.

With all of that said, birth can be unpredictable. I believe, very strongly that in most cases, childbirth isn’t an emergency. BUT- as was the case with my second child, sometimes it is. A birth plan that is rigid and unyielding to unforeseeable circumstances can make things that go wrong harder to process. A good birth plan should allow for detours and other paths, or be looked at as an idealized option of how you’d like things to go, instead of your demands and expectations. Birth plans, in general, get a bad wrap from doctors and nurses who have seen dozens of them which have had condescending tones, and not addressed emergency situations.

If you decide that a birth plan is right for you, I would encourage you to use more “Do’s” than “Don’ts” and consider including a disclosure such as the one I include on my birth plan template, which states, “I have prepared for a birth that is as safe and healthy as is possible. I plan to be involved in all decisions related to my birth. While I know that I may need to respond to unexpected situations, this birth plan reflects my current intentions. Thank you for helping me have a safe, healthy and satisfying birth.”

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