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The Birth Plan

Is a Birth Plan Helpful or Troublesome?

By Marie Fellenstein Hale

Schedule a time to discuss your preferences with your medical provider, birth partner, and other support people. Find out where you agree and disagree. For example, if your caregiver routinely does episiotomies and does not have experience in avoiding episiotomies, then it may be unrealistic to ask to avoid an episiotomy. However, if you express a wish to protect the perineum and your caregiver is willing to help you toward this goal, then you can work cooperatively. You may want to ask what you can do to prepare and how the situation will be handled if your doctor or midwife cannot be at your birth and a backup will attend you.

After a discussion about your birth plan, you should have a good idea if your wishes will be respected or not. A birth plan is not a contract designed to guarantee you the birth you want—it is an expression of preferences and must take into account special circumstances. The goal is to have a birth plan that is simple and clear. Strive to keep your plan to one page—there is not always time for everyone to read a longer plan. Also, if you have discussed your preferences with your caregiver and support people, the birth plan can be seen as a simple reminder.

You may want to make several copies of your birth plan: for your chart, your medical provider, the hospital staff, your support people, and for yourself to bring in your labor bag. Bringing a few extra copies is a good idea in case there is a backup medical provider, a change in nursing staff, or a backup doula (professional labor support person).

Sometimes a birth plan can be seen as a challenge to hospital staff — some people write their birth plan as a listof demands. Often the staff may feel the birthing woman is just setting herself up for disappointment. You may want to keep in mind these ways to keep your birth plan more open and adaptable: For some hospital staff, the term "birth plan" is associated with rigid elements. Perhaps you want to call it by some other name, such as "Birth Preferences" or "Our Wishes for Childbirth." Take time to add flexibility and cooperation into your plan. For example, adding clauses like "as long as birth progresses normally" or "unless there is an emergency" shows you recognize that what is appropriate for one situation may not be appropriate in every case.