We taught the class on writing birth plans last week. I know my perspective has changed as we have
seen other couples write plans and definitely my knowledge has expanded since
the very first birth plan we wrote as consumers eight years ago.
A birth plan, or your Wish List, is the blueprint for your birth, if you will. What do you expect to happen? What will your birth look like from the outside? Just like a house, you need to lay a foundation first.
The multiple-choice, check the box birth plans are a tool
for the smart consumer. Use it as a
starting point. If there is something on
there that you do not know about, use it as an opportunity to educate yourself
and learn something.
You could have each partner complete their own
multiple-choice birth plan, then use it as a starting point to compare notes
and see what is a priority for each of you.
Once you have that conversation, you can start the process of preparing
your own document to take with you and have a “first draft” discussion with
your care provider.
Or you can read through a book like Henci Goer’s “Thinking
Woman’s Guide for a Better Birth” that outlines many of the choices that a
woman may face in today’s birth settings.
Read through her lists and and educate yourself about the many options. What do you glean from the research she
Read, read, and read some more to educate yourself on
options. Write everything down in a
brainstorming session: what you think you want to do/have/avoid for mom and
baby. Then sift through the ideas and
separate them into three lists: Coach,
Labor & Birth, Newborn Care.
The Coach’s list consists of things that the coach and
assistant coach or doula need to be aware of:
environment, music, your preferences as far as massage, labor relaxation
scripts and tools, food, drinks, snacks, etc.
What are the things that you want to have at hand during your labor?
The Labor & Birth list will be comprised of things like
whether or not you are going to have an IV or a heparin lock, how often you are
going to be monitored, will your doctor/midwife allow you a soft diet? Basically, the kind of information your nurse
will need to know if you are having a hospital birth or if you are transferred
to a hospital from home or a birth center.
The Newborn Care list will outline your preferences for baby
care – immediate or delayed cord cutting (this may also be on your birth list
since it overlaps – whoever catches the baby typically takes care of the cord),
what to do about vernix (rub it in or wash it off), which newborn procedures
you want done and which ones you want delayed and what you are declining, along
with a request for the paperwork to sign for all the things you want to say no
- It was
confirmed again in class, by another student who works in the hospital setting,
that you could say no to anything that is being offered or recommended. As this student put it, “They cannot tell you
what to do – that would be prison.” If
you have done your research and you feel confident that you want to decline
something on your or your child’s behalf, ask for the appropriate form, whether
it be a waiver or an Against Medical Advice (AMA) document so that you or your
baby do not receive the treatment and/or procedure you want to decline.
Blueprint: Your Plan aka Wish List
Once you have separated all your ideas into the appropriate
list, you are ready to start writing the plan you want to present to your care
provider. Keep in mind that you want it
to be as short as possible – one of our students made a great analogy, “as if
you are writing a resume”. I love that
idea! We suggest keeping the Labor &
Birth Plan on one side of a piece of paper, and printing the Newborn Care plan
on the second side. If you are really
good with words and the revision process, you could probably keep it to one
page by separating into the top/bottom of the sheet or into two columns on the
We have found that care providers are receptive to the idea
of calling this document your “birth wishes” or your “wish list” for your
birth. It conveys the idea that you are
preparing for the best possible outcome while at the same time being open to
the idea of allowing them to make the suggestions they may need to make when
you are in labor. I think at the end of
the day, it conveys the sense of collaboration instead of a demand for a
particular type of care.
Take your first draft into your care provider. It is a good idea to make sure the
appointment scheduler knows that you need extra time to review your birth
wishes so that you aren’t rushing through the appointment. Some care providers even have that talk
worked into their care plan already.
Listen to what their feedback is.
If they are saying, “No” to something it is not always because they are
against a natural birth. It may be that
something in their experience or their colleagues experience is driving that
answer, so be prepared to ask questions and get more information. Your final document will be a collaboration
and hopefully something they are willing to sign so that your wishes are
respected once you are in your birth setting.
The last piece of information to include as part of your
final document is mother and father’s name and birthdates, and if you have
them, the parents’ blood types should it become necessary for mom or baby to
need blood during the hospital stay. We
never needed this information during labor, however, knowing it did come in
handy when one of our children was in the PICU as a 3-month old.
What have we found to be the keys of a well-written birth
- Clear – The first line is a summary of your birth
wishes. It states exactly what you
expect as long as labor is progressing with a healthy mom and a healthy baby.
- Concise – Keep in mind that your care providers are skimming
this. They probably do not have time to
read down for detail. Use as few words
as possible to express your wishes for a healthy mom and healthy baby labor.
- Names Specific Actions – Care providers want to do things and
they want to help. What are the things
they can do to help you achieve your birth wishes?
- Written In Your Voice – If they were to line up all the
birth plans on the counter at shift change, would the nurse you want/need for
your birth be able to pick you out from all the pieces of paper she is looking
at? Be sure that your personality comes
across when you write your birth plan.
I will close the same thought we share in class. A great birth is not a result of the birth
plan – it is your ability to be flexible that will contribute to your perception of the birth experince.
Trust in everything you have done up to this point: great exercise, good
nutrition choices, educating yourself about the process, learning to trust your
instincts, choosing a supportive care provider and one that trust. Even if nothing goes
according to your wish list, you will not regret taking the time to research
your options and the procedures available to birthing mothers. If and when you are faced with decisions that
veer off the course you planned and prepared for, you can make those decisions
with confidence because you have the tools to evaluate your choices through a
“Healthy Mom, Healthy Baby” filter.
No matter what the plan looks like, or whether they follow their "blueprint" or toss it out and go with the birth their baby needs, we want all of our families to have a Healthy Mom, Healthy Baby outcome.
What are your birth plan/wish list writing tips?
material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical
advice. The reader should always consult her or his healthcare provider to
determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC
accept no liability for the content of this site, or for the consequences of
any actions taken on the basis of the information provided. This blog contains
information about our classes available in Chandler, AZ and Payson, AZ and is
not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or
the American Academy of Husband-Coached Childbirth®.