Having a birth plan for labour and delivery can have its advantages. A well thought-out birth plan can help to provide you and your health care providers with a good understanding of how you would prefer to have your labour and delivery experience unfold. However, the most important point about the birth plan is the understanding that your preferences may not always be possible.
Why a Realistic Birth Plan is Important
There are many unforeseen circumstances that may occur during your labour and delivery experience that are uncontrollable and that may prevent you and your physician from following the initial plan. What is crucial for any labouring patient to keep in mind is that deviating from "the plan" does not means failure. Many women/couples somehow feel as though they have "failed" labour and delivery if things don't go as planned. They may feel weak if they are unable to endure the labour without analgesics or an epidural. Some women feel disappointment with themselves and their bodies if they require a caesarean section (C-section) and are unable to deliver vaginally. Realistically speaking, the only thing about labour and delivery that is certain is that, one way or another, there will be a baby in the end!
Creating Your Birth Plan
Start by jotting down a list of things that are important to you. Do this throughout your pregnancy as you receive and learn information about labour and delivery events and options available. For example, should you hear a personal recount of a specific event such as the process of an epidural and decide for certain that you do or do not want to receive an epidural, jot it down. If you learn about the process of bonding through breastfeeding immediately after birth and decide it is an option you would like, jot it down. As your delivery date draws nearer, you will have jotted down things that you might not think of with the anxiety of your nearing due date.
Keep it simple. Begin with your thoughts on early labour. Would you prefer to labour at home during the early stages of labour or would you feel more secure labouring in hospital? Who would you like to have present? Consider your partner, other family members, doulas or midwives, and hospital staff. Keep in mind that your doctor and nurses will be present from time to time whenever necessary; however, you are entitled to refuse the presence of students.
Next, consider active labour and what you would like to have occur during what is often the more difficult stage of labour. Who would you like to have present? How would you prefer to manage your pain? What, if any, analgesics would you like to be offered? Would you consider having an epidural if the pain becomes unmanageable? Would you like to have the reassurance and support of your nurse(s) at this point or would you prefer to be supported by your spouse or doula?
In reality, your doctor and/or nurse(s) must check in on you from time to time. This is not intended to be an intrusion. If they did not check on you from time to time or on the status of your baby, this would be considered neglect and it is their job to do so. Keep in mind that, in most cases, the hospital staff will not perform invasive procedures such as IV insertion or vaginal examinations unless it is necessary. But you do have the right to ask questions as to why these procedures are being carried out and if you do not feel satisfied that these procedures are absolutely necessary, you may discuss it with your physician.
Next, consider the delivery. Would you prefer to be instructed by the nurse(s) and physician on pushing techniques or are you most comfortable listening to your spouse or labour partner? Who would you like to have present for the delivery? Would you like a mirror in place so that you may watch your baby being born? Would you like to avoid an episiotomy unless it is considered absolutely necessary? Who would you like to have cut the umbilical cord? Do you wish to nurse your baby immediately following delivery unless he/she requires immediate medical attention? These are questions that are appropriate and realistic.
Keep Yourself and Your Birth Plan Flexible
As mentioned earlier, there are a lot of uncertainties associated with labour and delivery. Things may not always go according to plan. Go easy on yourself! So what! if you were unable to tolerate the pain and cried for an epidural when it wasn't in the "plan". Most first-timers don't have a clue what they are in for and they are taken by surprise. Each individual's pain tolerance and pain threshold varies and you cannot base your own experience on what your friends or family members have been through.
If you require a caesarean section to deliver your baby, though unexpected and unwanted, sometimes it is necessary. This may be because your baby is too big to be delivered vaginally. Perhaps your baby wasn't tolerating labour well and needed to be delivered quickly. This is an occurrence that is beyond your control, otherwise, it would never happen. So don't feel as though you "failed" labour and delivery. There is always a chance that your next labour and delivery will be very different.
The bottom line is that although it is nice to have a written plan as to how you would like for things to take place, it's not always possible for things to go as perfectly as planned. So take your plan lightly, use it wherever possible, but expect the unexpected and, with the help of your support persons and the medical staff, you will come through it with flying colors! There is no "right way" to have a baby! Enjoy the experience!
Source:
Society of Obstetricians and Gynaecologists of Canada. "Pregnancy: Birth Plan" (accessed March 8, 2011).
Cindy Stafford - I am a 39 year old mom of two girls; one six going on sixteen, the other three, whom I am certain has had many previous lives...she's an ...
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