Blueprint for your Birth Plan
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Sweet Peas, Pods & Papas: All About Birth, B@@bs & Babies

Blueprint for your Birth Plan

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.

Foundation: Research
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 presents?
 
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 to. 
 
  • 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 same side.
 
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 plan?
  1. 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.
  2. 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.
  3. 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?
  4. 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?
 
Disclaimer: 
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe 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®.

 

3 Comments to Blueprint for your Birth Plan:

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KParker on Tuesday, October 23, 2012 12:01 PM
We ended up forgetting our birth plan on the counter as we ran our the door and tried not have the baby on the freeway. I would say the most important part of developing a birth plan to talk to your coach in advance and make sure you are both clear on what is most important to you, so he/she is able to advocate for you if you are unable to speak for yourself. As mentioned above, it is also important to talk with your provider ahead of time to make sure he/she shares your views and will work with you to make your birthing experience a pleasant one. In the end, nothing goes exactly as planned, but as long as mom and baby are healthy, you did a good job!
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Erin Rudd on Tuesday, October 23, 2012 12:15 PM
I had a birth plan, gave a copy to my Midwife, my doula, my parents and had 3 copies in my hospital bag..... However I had several red flags from the early stages of labor; no one even considered the birth plan once we got to the hospital as the baby was in distress. Yet because we spent the time to write the plan, my husband and I researched all the different out comes we had a much greater understanding of what was going on when did vere off the plan. Having the knowledge is what kept us calm and keep clear communication open with us and our midwives. Dispite the fact that our labor story is not what was written in the birth plan, we are 100% comfortable with the choices we made and most all we ended with Healthy baby healthy mom!!!!
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Larina Staggers on Tuesday, October 23, 2012 2:15 PM
We went over our brith plan with our midwife but most of the things on our plan were things the midwives already do. The best part was writing the plan and thinking through each phase of labor and what we wanted to happen. That gave us a clear picture of our ideal birth story. Doing the research to write the plan was the most helpful of all. I would say to put on your plan if you want the hospital to do or not do vaccinations. The nurse was actually looking at our plan and asked what we wanted because we didn't have it written down!
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