Birth Plans

The birth plan debate has been interesting to me. I have seen both sides yelling back and forth. To me birth plans just makes sense. Especially if you’re giving birth in a hospital, attended by L&D nurses you’ve likely never met. Having a short document which indicates your preferences regarding pain management, IVs, movement, and more, as long as it has been discussed and cleared by the OB, only makes sense. Not all women want the same birth, and knowing what your patient wants should help you help them better.

But if you say anything in favor of birth plans, you always hear, “Don’t be too strict in your birth plan, you’ll just end up with a c-section!” or “People with birth plans are crazy, they need to understand that birth is unpredictable and things may not go as you plan!”

Which yes, I get. But I don’t think most women with birth plans are looking to outline exactly how their birth will go. They are looking to express their preferences, and to stay included in the decision-making process. They want to be viewed as an active and respected participant in the birth, rather than just someone (or something) in the way of the baby being out who has to be dealt with.

Through My OB Said What?!? I found a link to this blog post. Which is, quite possibly, the best expression of birth plans I have ever seen. I mean, exactly.

 

I have heard some argue that a birth plan is trying to control the uncontrollable (the birth)…that it is almost guaranteeing that you will have problems because you are trying to dictate the way the birth will go.

First off…I can not disagree strongly enough – although, as I stated above, I concede that my definition of a birth plan is different than most are currently using. To me, a birth plan has nothing to do with controlling the birth or how the birth will unfold…it is ONLY about how you are treated throughout this journey. I haven’t read a birth plan yet that addressed the BIRTH (“I want to be in labor less than 10 hours” “I will feel it only in my hips and cervix, not in my thighs or back.” “My contractions shall not become closer than 5 minutes apart”)…..NO! The birth plan is addressing the choices and actions of those around you!

[…]

This in no way states anything about how the birth will unfold or trying to control events – it’s about how you are treated and the respect you are given in the process as an adult autonomous human with rights and freedoms. We aren’t treating a pathology…we are overseeing a biological function.

Yes, exactly. And if I go to a small midwifery group and know and trust all the people who may be attending my birth and spent 9 months of long appointments discussion my preferences with them…then there’s no real need for a birth plan. They already know it. And my husband and I will have discussed it, and he can remind them.

But I may write one anyway, in the event of hospital transfer. Because I do want my autonomy respected during birth. That was my earliest uncomfortable feeling with the whole traditional hospital birth, before I even knew other options existed. It felt like the birthing woman was treated as hysterical and unable to make decisions or really be a helpful part of the birthing process, and so things just had to be done to her to manage the negative experience she was going through. I don’t want to be treated that way. Others might want the control taken from them so they just have to listen and not think or decide. GREAT! That is where birth plans come in! They can express that there. But if I don’t, I at least want an expression of my desires while I’m still “calm and reasonable” given to them, in the hopes that they’ll listen to it.

Do I think I can plan my birth exactly? Of course not. I am not naive. I have no idea what the experience will be like or what will work best for me. But that doesn’t mean I don’t have an idea how I would like things to end up, and at least a starting point of my preferences. If I change my mind during labor, that is fine.

I just want to be the one to change my mind.

I don’t want someone else to decide a different way is better and either pressure me to do it their way or force it on me without consent.

And that is all a birth plan means to me.

You will treat me with respect at all times and I will maintain the autonomy that I had before entering your hospital. Before you touch me or intervene in the normal course of my labor/delivery, you will discuss it with me and obtain informed consent.

If this was a given in hospitals, there would be no need for birth plans. But since it so often isn’t, if only because you likely have never before met the people attending most of your birth and are meeting under extremely tense circumstances, I still maintain that respectful birth plans are often necessary for truly satisfying birth experiences today.

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3 Comments

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3 responses to “Birth Plans

  1. From my experience, it’s more important to have an advocate with you (husband, midwife, mama – whoever) who is aware of your birth plan and will speak up for you when you are in the midst of a hormonal melt-down and can no longer remember why you ever cared about natural childbirth in the first place.

    I had a birth plan. I even printed it out. My husband and I were not communicating well when I was pregnant, so he was useless as an advocate. I had briefly discussed my preferences with my mama, but never talked about her stepping in to ‘talk me down’… I ended up pretty heavily sedated for 14+ hours on the ‘advice’ of my doctor and my nurses because I was freaked out, and nobody stood up to me or for me :-/

    A birth plan is useless without someone to help you implement it.

    • DEFINITELY agree. I don’t think a birth plan is a magic bullet that fixes everything. But I also don’t think it’s an evil paper that guarantees you a c-section :-P

      My biggest thing with birth is picking a provider I trust. Which in and of itself rules out a hospital, since I cannot pick my L&D nurse. If I have to go to a hospital I want a midwife or doula there who I trust, so there is someone with some continuity, even though they are often very handicapped in what they can do or say.

      *sigh*

      It feels awful that I feel like it’s a battle to get the birth I want. I’m not sick. I’m not trying to harm anyone. There are many good paths through this normal process. But since I don’t want a typical hospital birth…it’s a fight, and I can’t just relax in a hospital. Sad.

  2. Hmmmm okay, to start I agree with all you are wanting. In short, all good.

    Additionally I have to say I had very positive experience with my L&D nurses. They were very there for me. So much so, I’ve wondered if a job working with pregnancies isn’t my calling.

    I lucked out in that my favorite OB in the practice delivered both of my babies, but I had appointments and got to know the practice as a whole. Trust was built and you know the importance of that. For you that means midwifery, and that’s absolutely your choice.

    I think being open with your heart and open with your plan, with a partner at your side who speaks for you both beyond a doubt means you are likely to have exactly the birth your dreaming of.

    You read Tulpen @ Bad Words right? If anyone can tell you that the first lesson in motherhood is that we do ehay it takes, it’s certainly her.

    I wish all good things for you

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