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Writing a birth plan gives you an opportunity to think about and discuss with your partner and your healthcare practitioner how -- ideally -- you'd like your baby's birth to be handled. Even though there's no way you can control every aspect of labor and delivery, a printed document gives you a place to make your wishes clear. Just remember that you'll need to stay flexible in case something comes up that requires your birth team to depart from your plan.

A written birth plan will also help refresh your practitioner's memory when you're in labor. And it will bring new members of your medical team -- such as your practice's on-call practitioner and your labor-and-delivery nurse -- up to speed about your preferences when you're in active labor (and probably not in the mood for drawn-out conversation). 

Know your options

The first step in writing a birth plan is to find out what your options are. Different doctors will give you different options for handling the same situation. Different hospitals will give you different options and have different policies. Differences in health between pregnancies can impact the options that are available.

 If possible, make several copies of your birth plan and tour several hospitals. You may find that some hospitals appeal to you more based on the services they provide.

Find out what you want

Once you know what options are available to you, it is important to determine how you feel about the options. Some things will be very important, and others will seem small or unimportant. There is no right or wrong, it is simply a matter of understanding who you are and how you want things handled.

You may find that there are several options that you feel very strongly about. In this case, it might be necessary to try to decide how the options rank in importance to you.

Can you get what you want?

After you have decided what you want, you need to take a hard look at the reality of your situation. Are the choices you have made realistic given your health? Does your caregiver and hospital support your decisions? Do your birth partners (doulas, spouse, friend, family) support your decisions?

If you have made choices that are not possible you need to reevaluate your decisions. Do you need to change your plan, or do you need to change your care team. Can you increase the support for your choices by changing hospitals or midwives? Or would you prefer to change your decision about the options and stay with the practice, hospital and birth partners you’ve chosen. Only you can make that decision.

Start the Dialog

With your choices written out, talk with your doctor or midwife about what choices you have made and why. If your caregiver has concerns about an option, find out what they are and where he or she recommends you go to do further study.

Be sure to be assertive, but not aggressive when discussing your options. Do not allow your caregiver to brush off your decisions or suggest that this is unimportant. At the same time, don’t assume your caregiver will be hostile or uninterested in hearing what you have to say.

Talk first about how you want to handle a normal, uncomplicated labor. Then move on to your decisions in case of a complication. Be sure to let your caregiver share thoughts and opinions about your decisions. Listen carefully to what is said. This will be your first real chance to determine if this is the doctor/midwife for you.

Be Flexible

Remember, you did not write the birth plan for the normal, uncomplicated labor. You wrote it so that those attending you understood your decisions about how to handle unexpected situations. When an unexpected situation arises, remind your caregivers to refer to your birth plan and work together through the plan you wrote.

Some women get to do EVERYTHING on their birth plan. They get to try every position and pain relief technique and when complications arise, they get to have a cesarean done the way they wanted.

Other women get to do very LITTLE from their birth pan. The nurse keeps the right atmosphere, but labor moves so quickly that you don’t get a chance to try the tub and walk the halls.

Regardless of the circumstances of your labor, use your birth plan to help you determine how you will react to labor.

If you would like a birth plan but have no idea how to make one please e-mail me for a copy of the birth plan I have made.