As a part of our Bradley class, we had to draft a birth plan and go over it with our health care provider. Although birth plans are probably more important with hospital births than with birth center or home births, it’s still a good idea to write one in case complications should arise and transfer becomes medically necessary. Now that we’ve written a birth plan and given birth, I thought I’d share what I was glad we included in our birth plan and what I would emphasize more the next time around when writing a birth plan.
Focus less on little details, and more on the big picture. I had a sort of romantic picture of how our birth would go (although I knew it would be hard work), so I included things like having the room darkened, noise levels kept to a minimum, music playing if we wanted, etc. In a hospital birth these things might be more important, but since I have not given birth in a hospital, I can’t really speak from experience there. At our birth center, these things didn’t end up being important at all. I don’t really remember how dark the room was or how noisy it was. I was noisy, but I was in labor. We brought my mp3 player with a labor playlist but I never even got it out of my bag. I’m a big believer in positive visualization about your labor as it approaches though, so some things to think about including on your birth plan are who you want present at the birth, where you’d like to deliver (water birth, etc), freedom to move around as feels comfortable, freedom to vocalize as feels comfortable, freedom to eat or drink during labor, etc. But know that when the big day arrives those things might not be important to you, and that’s okay.
Focus more on the medical intervention you’d like to avoid: episiotomy, intermittent fetal monitory with a Doppler or fetascope as opposed to continuous electronic fetal monitoring, no Pitocin, no epidural, no being pestered about “are you sure you don’t want an epidural?” etc. I think this is especially important if you want a natural birth in a hospital setting where many of these things are standard procedure. In a birth center or home birth, these things are usually a given, but it’s still a good idea to talk about them.
Focus more on the time immediately following giving birth. I think I spent so much time focusing on actually pushing the kid out that the time immediately after Sam was born kind of got shoved to the back burner, and I wish I had talked more with my midwife about breastfeeding immediately with skin-to-skin contact, everyone leaving the room for an hour so the three of us could have just bonded as a family, waiting to have Sam weighed and poked, etc. After all, the reason I wanted a natural birth was not because pushing a 9lb 4oz kid was super fun and enjoyable, but because a natural birth interferes less with the time immediately after birth, but I kind of forgot that as most of my mental energy was just focused on getting the child out from inside of me.
Include a section about your wishes should a transfer be medically necessary. Our Bradley instructor said it was a good idea to write those things down and talk about them your midwife just in case. Some things we included in our birth plan were that I wanted to be awake should a need for a c-section arise (as opposed to under general anesthesia), skin-to-skin and breastfeeding right away after the birth, no separation from the baby at any time, no bottles, pacifiers or artificial nipples of any kind while breastfeeding was getting established, waiting until after the cord stopped pulsating before cutting the cord, etc.
Be sure to go over your birth plan with your doctor or midwife when you are around 30 weeks pregnant. That way if your OB starts balking when you talk about how you would prefer to tear rather than have an episotomy or whatever, etc you have time to switch health care providers. Or maybe getting an episiotomy isn’t a dealbreaker for you. Know what is important to you and make that clear. Hopefully, if the lines of communication with your HCP have been open during your prenatal visits the whole time, there won’t be any big surprises, but it never hurts to just make sure everyone is on the same page.
Make sure your husband or other labor support person know what your birth plan says and can refer to it often. Obviously, you’re going to be a little preoccupied, so having someone on your side to be your advocate in labor is really important. Tim and I wrote our birth plan together as part of our Bradley class, so I knew he knew what it said. With the next kid, he will have a more proactive role in making sure we breastfeed immediately after birth (as opposed to the nurse trying half-heartedly to get the baby to latch and then whisking him away to be weighed when he didn’t latch right away). We were both so Whuuuuuu?? right after Sam was born that neither of us spoke up about leaving us alone for a while, and we both wish we had. Oh well. Live and learn.
Did you write a birth plan? What did you include? What would you do differently if you were writing it knowing what you know now?