Do I have to have a birth plan? #I've got a parenting question!#birth plan#childbirth#grown ups May 13 2011 | Offbeat Editors offbeatbride Offbeat Home & Life runs these advice questions as an opportunity for our readers to share personal experiences and anecdotes. Readers are responsible for doing their own research before following any advice given here... or anywhere else on the web, for that matter. Jess posed this question recently on the site, and we decided to take it down and build en entire post around it. What do you guys say — did you have a birth plan? Photo by Kimberly J, used with Creative Commons license. I know what my options are and am educated on birth as I am in health care (in Canada). I like the hospital my doctor works out of but if I had to go to the other hospital in town I'd be ok with that, too. I don't have plans to either have or not have an epidural. It's my first baby so I just want to see how it goes and make the decision as it comes. I understand why women like birth plans… but I just don't want one. I find that the idea of a birth plan (for me personally) actually to be kinda stressful. It's like putting pressure on myself to perform in a particular way when this experience is completely new to me. I know that most women find the birth plan to be reassuring and really enjoy having one. I think plans are a great idea but I still don't want one. I haven't met any other women who also feel this way. Are there any other offbeat mamas who just aren't doing a birth plan? Reporter Name * Reporter Email * Original text Enter the original text here. Edited text* Enter your suggested copyedit here. Notes You can add a note for the editor here. * Required information. Fix Typo PREVIOUS Theme parties aren’t just for kiddies NEXT Dress your house in the spirit of the Death Star Show/Hide comments [ 76 ] I think it is very helpful to the nurses in the hospital if you have one. Even if all you are telling them is basically "I don't have a plan. Let's see how it goes." Usually its a good idea to have a little introductory paragraph about you and your partner, too. It’s a nice way to let them know a little about you. They really do want you to have the best experience possible, so that's why they ask for one. (if they are asking for one that is) Reply I'm with you, actually. I have a basic idea of the biggies. Otherwise? I know there's only so much I *can* plan, and I know that if I try too hard, I'll just freak myself out at the time when things might end up different. Reply I agree with Beth. I had my baby girl in jan of this year. I planned for a home birth and got a hospital one instead. I planned for no drugs and excepted morphine and nitrous oxide. I didn't write a birth plan for fear that murphy's law might kick in. But as a Doula I believe that for some people writing down their plan helps them evaluate everything in detail, for others it can lead to turmoil when things don't go as planned (keep in mind that this may not be you but could be your birth partner). Think about who you are, who your birth partner is and just go with the flow. Make sure if you don't write it down that your doctor is well aware of your wishes. Reply I had this huge, like 3 page, birth plan. I ended up being induced and forgot to give it to anyone when I got to the hospital that morning. The whole idea is to make you comfortable with your birth; if you already are, don't bother with it. Reply There are several templates for birthplans now that definitely include the option(s) of "I'm not sure". To reiterate what Jessi said, I imagine it's good for the nurses to know that. babycenter.com has a decent one that covers a wide scope, and sometimes looking at one you may see something you haven't thought of that you may feel a certain way about. Never hurts to check one out. Reply I wasn't going to make a birthplan but then at 35 weeks I saw the template on babycenter.com and decided to fill it out. There were some points on the template that I hadn't even thought of! Reply As some one else already said, it's a good idea to let the nurses know your intentions. I didn't really have a plan for my son. I was just like you, it was a new experience, how was I supposed to know? But it did help a lot to let the nurses and doctors know when we got to the hospital which things I was open to and which things I was completely against. It stopped needless questions, but even so, one of the very few things I was completely against going in there, I ended up using. Honestly, it's just what makes you comfortable. If having a step by step, minute by minute birthing plan makes you feel better, do it. If not making one at all makes you feel more comfortable, do that. Just like many things that come along with birth, it's all just a personal choice. Reply Since I live an hour away from where I'm delivering, and my mother had two deliveries that lasted less than two hours, I simply can't get past: GET THERE GET THERE GET THERE. I know I should come up with something else, but I keep thinking that I will just roll with the punches. Reply If you don't have any preferences as to medication/visitors/etc., you really don't need a birth plan. I didn't have one; and yet my nurses still asked me if I wanted an epidural, checked on me regularly, made sure I was comfortable, and monitored the baby closely. At one point I turned to my other side because the epidural medication was pooling on my right, and the baby's HR dropped, so they flipped me back immediately. My point is, they are highly trained. The only reason you'd absolutely need a birth plan is if you didn't trust your practitioners, in which case you likely wouldn't be going to them in the first place. Reply Birth plans make me really uncomfortable. At first, I really liked the idea. But now, after looking at all these different options, I'm totally freaked out about it. There's just so much that I really don't have an opinion on either way, even after doing all the research. However, the big things that I knew I really cared about (things related to breastfeeding) are something that I've talked about with my doctor to see what normal procedures are. Unfortunately, I have no idea what doctor I'll have when I give birth. So we'll probably bring a copy of a very short list of must haves because there are a few things we feel strongly about. And then, I just hope it doesn't become an issue. No one has asked us for a birth plan, and I'm kind of concerned that bringing one will just make things more difficult. Anyway, could be giving birth any day now, so I can update this to let you know how my experience went with a very simple birth plan that probably won't be discussed with the nurses or doctors ahead of time (because there's no way to do that). Oh, and I'm also in Canada (Calgary!). 🙂 Reply i had a birth plan (homebirth with a midwife) and ended up with the absolute opposite (forced unnecessary c-section). so, clearly, my plan went to hell. 🙂 all that being said, i'm in the camp that you should have birth plan. having a birth plan doesn't mean you're type a, controlling the hell out of your birth. it just means that you've educated yourself and you know what you would *prefer*. and if you're in a hospital setting it helps those around you who haven't been with you through your pregnancy respect the pregnant/laboring person that you are. there's no doubt that very few people actually have their births go EXACTLY to plan so i think that it's smart to not form a super strong attachment to your ideal birth, but to have no plan i think is a little bit too relaxed. even if your birth plan solely focuses on the care of the baby after it's born you need to have that. (but i would say it should probably cover a little more than after birth care.) as a doula in training, mama, and huge supporter of pregnant/laboring women in general a mama that felt anxiety about making a birth plan and just opted to avoid it all together would concern me. even though our bodies are built to take on this amazing challenge that doesn't mean you don't prepare for it. my birth plan was short and sweet so i'm not saying a novel is necessary but you need to know what you do and don't want. a mama that avoided a birth plan because it caused her anxiety would make me think that her real anxiety came from giving birth itself. i could be a million miles off base with this because EVERY birthing mama is different but it would seem like she wouldn't have to deal with the fear of giving birth until she was in labor if she didn't have to make the birth plan. when we wound up in the hospital i was a wreck. i knew we didn't need to be there, i knew that my midwife was failing me, and i knew that my baby was going to be born in my worst of the worst case scenarios. it was devastating, but because i had a birth plan, even through all those emotions (DURING ACTIVE LABOR I MIGHT ADD) i was able to cling to the few things that i wanted that could be done in the hospital, i.e. my husband cutting the cord and announcing the gender, my husband holding the baby to his chest after the baby was born, no bath, no eye drops or shots, no sugar water to jump start breastfeeding… but, big BUT, i think ultimately what's important is that a person does what feels right to them. :))))))) Reply I think you might be reading a bit too much into the no birth plan = fear thing. Just because you haven't written a plan on a piece of paper doesn't mean you haven't been thinking and considering your choices. Reply oh of course not! i'm sorry that's what came across as my point. :/ bad wording on my part because that's not at all what i was getting at. jeez, now i feel bad! i never said anything about WRITING a birth plan to be fair though.. my opinion is that deciding what you do and don't want ahead of time is what you should do. and that to me is a birth plan. someone who was stressed out by it would just concern me a little, but i know that what makes me feel good/is right for me has nothing to do with what is right for someone else. having a baby is hectic and having a loose idea of what you would like is helpful. 🙂 that's really all i was getting at. sorry it came across like a lack of typed paper=lack of thinking and considering…because of course it doesn't! Reply Well the thing was I didn't know what I was going to want for the delivery of my first baby. What I knew I didn't want were any restrictions about how I should act or how things should go. For example what if I had said that I didn't want the nurses to talk to me about pain control and then half way through the labor I changed my mind. Then I would have a nurse who was reluctant to talk to me about an epidural because I had specifically asked her not to. Not to mention a husband who would be very confused about how he should best support me. It is things like that that I found stressful about a plan(written or loosely verbalized). The birth itself didn't frighten or stress me out but the idea of trying to premeditate it did. Does that make sense? Reply absolutely! and i think it's very valid. 🙂 I was also undecided about having an epidural and like you wanted to see how the birth would go (I am also in Canada). I think you may be stuck on the word 'plan' – I didn't like it either, but a birth plan is not how the birth will go, down to the letter, but more a list of your desires. You can include things you would like to have (e.g. dimmed lights, less interventions as possible), and those you would really rather avoid (e.g. episiotomy). I think the Drs and nurses will appreciate knowing your wishes. Remember, while in labour you may not be able to formulate the words to let them know. Furthermore, the hospital/birth centre staff know that birth plans change, and will accommodate you and your changing wishes as much as they can. Reply This. As much as anything, I think the process of coming up with a birth plan is about thinking through what could happen, and letting your support person know your preferences, so they can advocate for you. we never wrote a plan, but my husband and I talked through options & he could then talk for me at times i couldn't. We also, as a result of the process, came up with a plan for ourselves re: pain relief – I planned to go without an epidural, but left my options open. we had a safe word, and a rule that if i asked for it, he was supposed to wait five minutes and ask me again. the safe word was great because it meant i could say "maybe i need drugs" without immediately triggering said drugs. (just saying that helped the through, as a matter of fact.) Reply I didn't have a formal birth plan for either of my babies. I made sure my nurses knew I didn't want to be offered pain meds, but would decide if I wanted them as I went (epidural both times). And that I wanted to snuggle my babies skin to skin immediately after. Otherwise, we just kind of let things happen. Make a birth plan if you have a lot of really specific things you want. If not, you're fine without one. Reply Most times, your doctor and nurses will ask you tons and tons of questions. And while you're in labor, making those decisions might be more than a little bit of an annoyance. So just having a vague plan is good. That's not to say that you've got to decide right away DEFINITELY DOING THIS, ALL THIS WAY. That's just to say that "I'd like to make the decision about an epidural when I get into labor… can you be sure someone lets me know when we're getting to the point that I HAVE to decide? I don't want to get stuck being in labor past the point of that being available to me without having made a decision on that." My advice is to write down those stipulations and keep them in your emergency pack. It doesn't matter how many times you communicate your wants and desires along the way, you need to re-communicate them as you check into the hospital. Reply I think that birth plans can be a little overwhelming. This is what worked for us when I had my oldest son at the hospital. One sheet of paper … my name, partner's name, doctor's name and the basics for what I wanted in point form … ie. I would like to try to do it without drugs. If I DO want drugs I prefer gas or epidural. NO NARCOTICS PLEASE. We are open to any pain management tips/suggestions you have. I would like to try to push on my side. I want my partner to cut the cord. I want skin-to-skin contact immediately. Initiate breastfeeding, as soon as possible. In the event of a c-section, I would like skin-to-skin contact, as soon as possible. That was about it. I decided what was REALLY important to me (immediate contact, breastfeeding) and just went from there. It was clear, easy to read and you know what, our nurses actually read it (even at shift changes) and helped us out. We had a great hospital delivery, and it went pretty much how we "planned." I used the plan as a way of sharing my wishes/preferences rather than a minute-by-minute detail of how it was going to go or how I wanted it to go. I absolutely believe that birth is unpredictable and you have to go with it, but I also believe it helps to have a clear idea of what you do want and what you don't want (when possible and safe, of course). With my second son, we had a home birth with a midwife. Because we had discussed what I wanted, I didn't feel the need to have a "plan." Also, I knew who would be there and there wouldn't be a shift change and the need to relay any messages to totally new people. Good luck! Reply Due in one week. Also have no desire to "make a birth plan". Don't feel I have any fear related to labor and delivery…would just prefer to just hop in and see where the flow takes me. In the case that I lack enough control to articulate my wishes, I have confidence in my husband who can be the voice for me. Pland and schedules are my least favorite part of life to begin with! Reply This is very much how I felt about it. I am a nurse and a paramedic so I am well aware of hospital protocol, what info the nurses will be looking for etc. I just didn't want to make any plans (tentative or not) about such a new experience to me. You are bang on by saying you just wanted to "hop in and see where the flow takes me" Reply I didn't have a plan for either of mine. My only goal was to get the baby out the safest way possible. We kept our minds open about what that would mean and how it would happen. I feel better, personally, not having a plan so if it doesn't go according to plan I don't have any negative feelings regarding the experience. I felt more in control of things when I accepted that I can't control things…if that makes sense Reply I like the idea of birth plans. If you're in a hospital, you may be working with several different nurses because of shift changes, and the OB or midwife you started out with may not be the one who delivers your baby. So a birth plan is a good way for the docs, nurses, and midwives to get to know you. It's also a good way to let them know what's important (or not really important) to you. Of course birth is unpredictable, so plans don't have to be written in concrete. If you have a change of heart about something mid-labor, you have the right to change your mind. It's your body after all, and you have a legal right to informed consent and refusal at any time. Reply I felt the exact same way! I went in with no birth plan and rolled with the punches. In the end, I needed Pitocin to jump start my labor, had an epidural, and had an emergency c-section. The only thing I knew I wanted was breastfeeding right after the birth. That plan was shot when they took my baby directly to the NICU. Up until the c-section/NICU portion of the program, my labor went very smoothly and I felt blissfully happy. The epidural was the right choice for me in the moment and my husband and I were able to spend my labor talking about our baby and connecting with each other. I felt comfortable with our nurses and doctors and was able to make decisions as situations arose. While I do not think a birth plan is necessary, I would definitely think over all of the possibilities to prepare yourself. I did not really consider a c-section until it was happening and it was very upsetting. I also realized after the fact just how attached I was to the idea of breastfeeding right after birth. It has been six weeks and I still cry every time I think about my baby being whisked away to NICU. While I outwardly told myself I "had no birth plan", I realized too late that I had an idealized vision that did not work out. I wish I had taken some time to think about all the possibilities and discuss them with my husband. If we had talked about c-sections and the NICU prior to the birth, I think the whole process would have been easier for both of us. I hope the birth of your baby is a beautiful, blissful experience! I would highly recommend talking over your hopes and fears with your partner or other birth support people. Even without a "plan", the feeling of being emotionally prepared is invaluable. Reply My birth plan is very basic- no visitors while in active labor except my husband, Yes please to painkillers, Health delivery no matter what the circumstances, skin to skin contact ASAP, I am breastfeeding. I'm weighing cord donation at the moment. Reply When I had my baby two months ago my birth plan was "healthy mom, healthy baby, epidural and don't forget my wife is becoming a mother today too." We had read about and talked about some of the different options that are included in typical birth plans but chose not to write any of them down. As an anesthesiologist, it seems that the patients that end up at the university hospital with a crash c-section are the ones with the extremely detailed, three-page birth plans. I know my sample size way skewed but I wanted to avoid the crash section. And, at the hospital where I delivered, it is standard practice to do immediate skin-to-skin, start breastfeeding early, etc, so I didn't feel that writing it down would be of any benefit. Reply You're observation about c-sections is spot on. My father is a labor and delivery nurse, and according to him, the more rigid and complex a patient is about their birth plan, the more likely they are to end up needing a c-section. He suggested that birth plans are best as flexible guidelines for the things that you feel strongly about. Having my plan meant that when my midwives came to tell me my options when my labor wasn't progressing, they knew what my preferred treatments were. Reply I didn't have any strong preferences for how I wanted things to go down. I had no idea if I would want medication, didn't care if I got an episiotomy or not, had no strong feelings re fetal monitoring, was totally ok with the idea of a c-section if things got rocky. I was completely focused on the end result and really didn't care about the process; I didn't expect to enjoy it in any event, and I trusted the midwives to make the right medical decisions. So I really felt there was no point to a birth plan for me. I never regretted not doing one! Seriously, it never crossed my mind during the birth. It just wasn't an issue. (In the event, I happily took every form of pain relief on offer; I also had an instrumental delivery and episiotomy, which was no big deal at all — I honestly hardly noticed it.) So yeah, if you don't want to do one, and you don't actually have particular preferences about the birth, then you absolutely don't have to do one. Reply If I were in your shoes, I probably wouldn't do one, except maybe the intro one suggested by a few people. In my own case, I had two. One for my homebirth which was basically a set of principles my MW and I agreed on (which I wrote down per her request) and a super short "If I end up transferring, this is my bare minimum wishes." I had a beautiful (painful, transforming, painful, amazing and yes, painful but so worth it) homebirth. What I wish now that I had had was a "birth plan" for my miscarriage last year (I ended up in the ER bc my midwife was not legally allowed to take responsibility and my husband was out of state on a job interview). I ended up being mostly ok, but it would have been nice to have had something "in place" so I didn't have to keep being asked things. (But probably it still would have sucked.) Reply It's a choice we all have. I have no birth plan up to yet and have no plans to make one. I'm 5 months preggers and will take whatever comes as it's my first baby and I have no idea what to expect. I think sometimes if a 'plan' doesn't go the way you expect it can make the situation more stressful. It's a new experience for me and I'm anxious about giving birth so whatever happens happens. If I need pethadine/epidural, I'll have them, if I don't I don't. Maybe if I have a second I'll know what I want/don't want, etc but for now I'm going to have to expect the unexpected. Reply You don't need to write out a birth plan, but the process of discussing the ideas in most birth plans with your practitioner and your partner is really useful. My partner knew my feelings about epidurals, so when one was suggested to me, he and I were able to discuss it having already thoroughly thought through it. It also made him better able to advocate for me — he knew EXACTLY how I felt about certain things. But make sure you're worried about the right things — some women make requests on their birth plan regarding outdated processes and procedures. If you're planning a hospital birth, take a tour of the hospital and ask questions about their policies. Penny Simkin's book The Birth Partner is my go-to book for this stuff — even though it's aimed at partners and doulas, it's a useful book for pregnant folks, too. Reply I am not a huge fan of birth plans either. I've seen a couple women who set their idealized birth wishes down and then felt guilty when they change their minds. I'm not in healty care but have been by the bedside for four live births. These experiences helped me decide birth is unpredicitable and going to be a new experience for me since I will be in the bed this time. I was also excited to learn my hospital has changed its procedures to incorporate all the things I really wanted. Instant skin-to-skin time, encouraging the first breastfeeding session happen withing the first hour or so, keeping baby in the room as much as possible, etc. As far as drugs, who cuts the ambilical cord and all the other details…well we'll decide what feels right at the time. Good Luck! Reply I didn't have one for either of my two births, since I felt like you and just wanted to let things happen as they played out. The nurses and the doctors were more than fine with this- they know what to do! Both births were great experiences. Reply I never had a birthplan. I knew the hospital I would deliver at because that's the only one where my doctors' delivered. I didn't know which doctor would be delivering me as it just depended on which doctor was on at the time. (I ended up going through 3 since I was in labor for 43 hours). I knew that I wanted to avoid a c-section if at all possible, and I was able to do so. Other than that, I left it up to how I was feeling at that point in time. I ended up having a lot more visitors in there than I ever thought I would, but it was so helpful to me and them to have them coming in shifts since the labor was so long. I personally never saw the point in crafting out a specific birth plan, as nature has its own way of handling things for you. I didn't want to be induced, but my son's heartbeat dropping and having a cord possibly wrapped around his neck forced that, and I was okay (hey it got me out of 2 1/2 weeks more of pregnancy and bedrest.) It's all preference, but I never felt a need to. Nature worked it's magic, and even though I was in labor laying in a hospital bed longer than I would ever care to again, my son came into this world, happy, healthy and on my husband's birthday. 🙂 Reply I had two births in the last three years. The first was a home birth, the second was at a birth center. My partner and I did not have a written birth plan for either deliveries. Instead, we talked extensively with each other about what we envisioned for the experience, discussed back-up plans, and deal-breakers. Once we had all that ironed out with each other, we spoke to our birth team. We were lucky in that none of our desires were denied. My husband used a "birth knife" to cut the umbilical cord – intended to be given to the child upon her first menstruation – the room was dark and quiet, and I did not have a vaginal exam during the second delivery. I believe that the birth plan is a physical document recording the desires of the birth team. If you feel that there is a possibility that there will be circumstances that cause you to make a decision while pain may be clouding your judgment, the paper may help to remind you and those around you of the intentions previously discussed. In the end, we didn't feel that the plan was necessary, and it never came up. However, if the document is important to your peace of mind, it could be useful to you and others. Reply I think the term "birth plan" can be a bit of a misnomer. I mean, it's a bit impossible to say something like, "I will labor for exactly six hours with exactly these people there and there will be no medical complications." Sh*t happens, right? But I think "not having an opinion" is a little iffy too. I mean, someone's going to be making decisions at your birth. It might be the midwife, it might be the doctor, it might be you. If you'd prefer that all decisions be made by someone else, that's valid and worth writing down. If you'd like to give your informed consent to possible procedures (or designate someone to give consent for you) that's a birth plan. If you'd like to give informed consent in some situations but leave it up to someone else in others (for instance, if a doctor thinks something is immediately necessary for your health or the baby's health) that's a birth plan too. I don't think a written birth plan is at all necessary, of course. I just feel like anybody that goes into any situation intentionally leaving it up to other people what will happen just kind of leaves themselves open to things happening that they wouldn't necessarily have chosen. With birth especially, there are a lot of practitioners who, in the absence of direction from the patient, do things that are more for their own convenience than the patient's health. That freaks me out, and I think it's worth avoiding, no matter whether or not you care about epidurals. Reply I had no intentions of leaving my birth up to someone else's discretion. I simply had never been in labor before and wasn't sure what I wanted yet. It's hard to tell if you like red wine when you've never tasted it before. Now that I have had my lovely daughter I am really glad I went without a plan. It allowed me to make the best decisions during the moment things were happening. Reply I'm sorry my post came across that way. What I was trying to say was that all too frequently women in labor aren't given the chance to make informed decisions unless they actively state their right to do so. That's what a birth plan is to me–not a statement of exactly what needs to happen when ("I will drink red wine and like it"), but a statement that we don't leave our rights and humanity at the door when we go into labor ("Don't make me drink red wine without my consent"). I'm glad you were able to make decisions as things happened–I think too many people aren't given that chance. Reply I think there must be a significant difference in the medical system from Canada to the USA. Here it is very much illegal to perform any kind of medical procedure on a patient with out informed consent. You have to sign that you understand what is going on for example if you want an epidural etc. Even for an emergency c section you still havevto understand what is happening, why and the risks involved and then sign that you agree with whatever procedure is about to happen. If you don't agree with the Drs assessment then you sign another piece of paper saying that the dr has given you the recommended treatment options, you understand what and why but that you are declining that treatment. Of course patients can still be pressured into a procedure that they don't really want. But unnecessary medicalized birth in Canada(or at least the part i live in) is pretty rare. Most of our OBG's are women with children of their own who want a good birth for there patients because that is what they also wanted for themselves. Reply Have you read the book "baby catcher"? It is written by a midwife Peggy something who practiced in California for many years. It has these amazing stories and shows how we view birth has changed over the years. It goes from the overly medicalized hospital birth when women had basically no options to when midwifery was atits prime in Caliornia and women could have any kind of birth they chose. It's really one of the best books I've read. If you get a chance check it out. I bet you would really like it! 🙂 Reply I had one and was glad I did although I don't think the midwife who delivered my baby even looked at it. If you have a plan in mind, I think it's great way to outline your wishes. If you don't, I can't see any reason to make one unless it would help your support team. I will say that I know for a fact that I wouldn't have ended up with a drug-free birth if I hadn't specifically made that a goal in the first place. I know it's different everywhere but even the midwife I had was suggesting an epidural. I'm glad my husband knew my birth plan inside and out because just hearing the word 'epidural' threw me off course and made it hard for me to focus when I needed to. Reply I had 2 different birth plans, 1 for if I went into labor naturally, 1 if I decided to be induced due to gestational diabetes. I ended up with a combo, my water broke on the day my induction was scheduled, and labor didn't start after 10 hours, so I was induced. I was incredibly glad I had my birth plan. A lot of it didn't end up happening, but It was so incredibly helpful to have a nurse or doctor be able to say, "I know you wanted X, and I understand why, so what if we did Y instead since it's along the same lines? Your other option is Z." Instead of just, "Okay we're going to do Z now." I think maybe because my pregnancy was so tightly controlled because I was high risk, that I really, really didn't want a super controlled birth and end up bullied into a C-section birth if my baby didn't just pop right out lickety split. It really helped give us (and the nurses and doctors for that matter) the opportunity to share opinions and make decisions much quicker. Instead of a long discussion, they could easily see what kind of people we are and how we wanted our birth to be, so knew right away what we want to be offered. For example, usually our hospital does an automatic internal fetal monitor if you use Pitocin. Since I had in my birth plan that I wanted as unmedicated a labor as possible, they offered an external fetal monitor with an extra long cable so that I could move around the room and use the birthing ball, etc. If I hadn't had a birth plan, I don't know if I would have been in a mental/emotional place to realize that they were going to use an internal monitor, or to be able to refuse it. I started out not wanting to make a birth plan at all, and my doctor insisted. From his point of view, he just wanted to make sure that we had gone through all our options and had educated ourselves for any "just in case" situation. He didn't want us to be confused in the heat of the moment and make a decision just because he said so. The only thing I would change is that my birth plan was way too detailed, if I did it all over again I would make sure it was only 1 page, and offered firm but general guidelines, like "We are intending to have as unmedicated a birth as possible, please discuss any IV fluids or medications with us before administering," as opposed to listing every single thing we didn't want in like a 15 item list. Reply 2 birth plans is such a good idea! I will keep this in mind for #2 Reply I totally get the no plan plan! I've started reading stuff about what things can happen during labor and all I've done is made myself afraid to move. Either the vaginal birth or cesarean dilivery paths have their freaky bits that make me afraid of getting to the finish line. My hubby told me it was in my best interests not to keep reading about it if it was going to make me worry so much. Now I am going with the whatever it takes to safely deliver my baby plan which could be one of a million different options, in the end I'm going to leave it to my body, our baby and the sage advice of my doctor in the moment and not a minute before! Women have babies all over the world in all sorts of circumstances so I don't think it's worth me over thinking it any more! Reply I didn't have a birth plan other than "give birth" and really, I'm glad for it. I ended up in labor for 47 hours, had to get an epidural (for various reasons not only did I *want* it by hour 30, but I was informed that it was pretty much non-optional due to a pre-existing condition that I have), and didn't get to spend a single minute in the tub – all things I never would have included in a "plan." I did write one for the benefit of talking through things with my doula and taking stock of what was important to me, but that was it. I'm really grateful that I wasn't attached to any of the ideas that I wrote down as labor is unpredictable and I truly didn't want half of what I *thought* I would. I had contractions every three minutes for 30 hours before checking into the hospital and honestly, all I wanted was to be on my hands and knees with someone pushing on my back. No soothing music necessary. Reply I've always thought birth plans were a way to make the doctor and nurses stop a second and realize that all women birth differently and that they shouldn't come rushing in with their routine interventions and try to fit me into the hospital birth machine. A more appropriate term would maybe be "List of Things You Should Only Do If It's Really, Truly, Medically Necessary, Not Just Because You Do It To Everyone." So if you know you want continuous monitoring, Pitocin and an epidural, you don't need a birth plan. But maybe I understood it that way because I'm distrustful of maternity care in this country. I was lucky enough to try for a homebirth with a midwife, where it wasn't necessary to list off all of the things I didn't want her to do, because I already knew she wasn't going to do them unless medically necessary. So I didn't have a birth plan. Reading these comments, I think I may have misunderstood the term! Whoopsies. Reply I hate planning things, and the thought of planning something that I had never experienced before? No, thanks. My midwives (my [Australian] town's hospital had a free midwife clinic for antenatal care) asked me to at least think about the basics and let them know, so I did tell them that I wanted to avoid an epidural but I wouldn't be against having one, that I was fine with using other drugs if I wanted them, that my partner didn't want to venture any further south than my head, and that included not cutting the cord (god love his squeamish self), and that I wanted skin-to-skin contact straight away. They were happy with that, just so they had some notes for when I came in, and most of what I wanted was how they liked to do things, anyway. As it turned out, it was all pretty superfluous because my son wasn't waiting for anyone or anything when he came flying out twenty minutes after I arrived at the hospital. I won't be making a birth plan for any subsequent babies, either. Like others have mentioned, I felt better not having one. Definitely think about what could happen and what you would want to do, but for me, a set plan just seems like pressure and a disappointment waiting to happen. Reply i didn't feel like having a birth plan. i heard from my midwives and other mothers that the more devoted one was to the plan, the less likely one was to have it go that way. plus i just don't tend to work well with plans. but then the baby went breech, and i realised i was likely to have a hospital birth instead of a homebirth. so i made a plan, figuring i could ignore it if i wanted to. the baby turned, i had a homebirth, the plan was forgotten. so my advice is to make a plan, then forget about it. that way you have it if you need it. Reply I found that having a birth plan helped me identify the kind of birth I wanted to have. It made me feel more confident and positive about the birth experience. I also made sure I remained flexible on my decisions just in case things didn't go the way I had planned. I also found it to be extremely important for my midwife to know what I wanted as an ideal labour. There are so many different ways to bring a child into this world, and my birth plan ensured that my midwife knew what I hoped for. It gave her the direction she needed to provide me (and my child) with the right kind of care in my situation. As an example, the plan explained that I wanted as natural a labour as possible. This helped her guide me through the various natural pain management options as opposed to initially offering things like epidurals and pethidine. Reply Could you point me in the right direction for researching natural pain management options? I would like to have as natural a labor as possible, too, but i have to admit that i am a big baby when it comes to being in pain and i also have panic disorder and being in a lot of pain can trigger a panic attack, which i recently, unfortunately, have learned. Thanks in advance 🙂 Reply TENS machine, TENS machine, TENS machine. Seriously. I had one when I had my baby, and I recommend them every opportunity I get, especially since so few people have heard of them. As for research, the book Birthing From Within is good in general, and it has a very good overview of the various pain management options for labor, including the not-so-natural ones. Also anything by Ina May Gaskin. Reply I didn't read the rest of the comments, but here's my say. I live in Canada too and just had my first baby. Being an obsessive planner, I was all about the birth plan, but in the end found that I didn't really need it. What was good about it was that it really forced me to research my options in great detail and to be confident about what I wanted. However, once I got down to having the baby, I found three things: 1) I was able to let the nurses know I wanted on the fly. I had expected that I'd be so out of it that I'd need a birth plan for them to know I wanted the lights down low and didn't want an epidural, but it wasn't like that at all. 2) Just talking to my doctors beforehand was a much better way to go. They were all very awesome. If you can't just talk to your doctor (or midwife), you need a new one. (Fortunately in Canada, I think we have much better doctors). 3) Absolutely nothing went according to plan, and it wasn't anyone's fault. This isn't a reason not to have a plan, but you have to be flexible about your expectations. I had wanted a non-medicated birth with a doula, and ended up with high blood pressure, two failed inductions and finally a traumatic c-section and a very difficult recovery. We all pulled through it, but it taught me that you really have to let go and trust yourself and your birthing team. Reply We definitely didn't have one and our birth was natural and smooth sailing. I firmly believe this is because we were so open to going with the flow. If you don't set yourself up for disappointments, you can't have any! Reply I worked in L&D for 3 years and it seemed that those who had pretty set in stone, detailed birth plans were the ones who ended up needing the most interventions, including emergency c-sections. That's just what happens when you try to plan the unpredictable. Sometimes it just good to let whatever happens, happen. I've seen so many people feel so disappointed/depressed when their birth wasn't perfect as planned. Reply Good question. I've been thinking a lot about this as my first baby is due in mid-August. I know that i want to leave specific instructions about a few things, like no bottle feeding because i plan on breast feeding, and no episiotomy. I also want the nurses and drs to know that i have panic disorder. I've asked my OB about creating a birth plan and he suggested that i make an appointment with the birthing center at the hospital to take a tour and a birthing class or two and then decided if i want to create a plan and what to include in it. I think keeping the fact that things don't always go according to plan in mind is good advice as well. Reply I think a birth plan which lets the birthing staff (midwives, doctors, obs) how you feel about key areas is really important – and can address all scenarios in some way. Let's call it birthing preferences, rather than a plan. You may want to give a "natural" birth a good go, for example, before accepting an epidural (which puts you at higher risk of having a caesarean). On my birth plan I addressed the possibility of me having a caesarean (which I didn't end up having) where I might be fully knocked out by a GA (and also with a spinal anaesthetic where you're awake). It was really important to me that my baby had skin-to-skin contact with one of us after being born, and if I wasn't able to, then I wanted them to give bub immediately to my partner to have skin-to-skin contact, rather than being left isolated in a crib & this being their first experience out of the womb. Other things which may be important to you are your partner cutting the umbilical cord. Unless you have a birth "plan" somebody else may automatically the cord, and your partner (if present) then misses out on what could be an amazing experience. Also, for the health of your baby (2 months worth of their iron supply) you might state you'd like them to wait until the cord stops pulsating before they cut it. Stuff like this keeps you somewhat in control of the birthing process – in areas where you can. It's your birth, and I wouldn't leave it up to a medicalised system to medicalise your birth (if you're having a hospital birth, for example) without having some say. Just a single page of bullet points is all you need. Guess I'm just saying try and stay in control of things that are important to you – rather than having things simply done to you and your baby. All the best! Reply I had a birthplan, and I ended up throwing it out and doing what I felt like at the moment. I don't regret my decision at all, but having a birthplan made me feel more in control of the situation. It helped keep me calm going in. Even though I didn't use mine, I would recommend it. Reply Let me add that I think it's important to understand in your mind that you may have to change that plan and to allow yourself to be ok with that if it happens. Otherwise you may end up dissapointed and guilty. Reply There's no word count on a birth plan. You only have to put the things you have a plan for. That said, my wife and I are both teachers, so while we like plans, and we're good at making them, we know that they can readily be chucked out of the window when unexpected things transpire. I'd like to echo what several people have said, in that the act of setting out a birth plan is an important way of letting your birth partner (and yourself) know what you want. When you're sucking gas and air between gutsy moos, it'll be your birth partner who has to talk to the midwives. But then again, if it's stressing you out, don't stress about it. Whatever happens happens, although the hospital staff might like to be told that your birth plan is not to have a birth plan. Show them that you've thought about it, but your happy with whatever happens. James Reply I think if we all started referring to THE BIRTH PLAN as "my wish list" we'd all feel less disappointed if it didn't go the way as planned, or find it easier to negotiate different outcomes if they arise. That being said, I didn't have one, but my husband and I had talked endlessly for months on what we thought was "the right way" and the "no way" so that when we were in labour and it went REALLY REALLY fast we could both react to the situation as needed and remain flexible. I think flexibility is really important but of course it can be very hard for everyone to feel flexible and relaxed when impending birth is on the way! So, do what makes you happy, but think of it as the wish list so that when Baby Santa doesn't bring what you want you won't have to cry like that time you didn't get the Care Bear you really wanted for Christmas 🙂 Reply Hahaha baby Santa Reply I didn't have a birth plan with either of my babies, and just went with the flow with what my needs were at the time and I wouldn't change that for the world. I had a natural birth with my first and had an epidural with my second. I was married with the first one and divorced with the second. They were very very different experiences but both resulted in beautiful healthy perfect little girls so I was happy. All I cared about was healthy babies and that's what I got. As long as you do what you feel is right for YOU and your baby thats all that matters. Reply Wow I really appreciate everyones opinion on birth plans. It's neat to see what works for different people and there is such a variation! Great comments! 🙂 Reply You sound very calm and sensible about this. Why don't you use your own judgement and have as much or as little of a birth plan as possible. I didn't do any. The people I know who did them were utterly disappointed with the unstoppable need for intervention/unavailability of epidural… Without exception. My midwife friend says that when confronted with a birth plan, she nods and says 'okay, okay…' and then does whatever needs to be done. Reply I am also in Canada and had a baby in 2010 at a large maternity hospital. I was very freaked out about interventions. Most of what I read was American; I found it hard to find detailed Canadian information and I had very little idea of the practices and procedures at the hospital where I gave birth. (The pre-natal classes and hospital tour help a bit). To me, the main reason for having a birth plan was that it seemed that everyone I knew who gave birth without a strong stated preference for minimal intervention got the full meal deal, including a c-section. Knowledge helps me to feel more comfortable so I did a great deal of research. I knew I'd be faced with making some potentially important decisions with not much time to reflect so I wanted to know how I felt about the various interventions that could happen and when they might be necessary so that if I did have choices, I could make informed ones. My birth plan was pretty simple: minimal interventions, going to try for no drugs. The only two things I really, really didn't want were an induction (because adding pitocin increases the pain of contractions making it harder to go without drugs, and the continuous fetal monitoring limits the mother's movement which limits non-drug pain relief options), and a c-section (I had laparoscopic surgery about 10 years ago and couldn't believe how long it took me to recover – I wanted no part of a larger incision if I could help it). I didn't state preferences with respect to lighting, music, etc. only the big stuff. Well, my water broke 2 days before my due date and I didn't go into labour naturally, so I did end up with the induction, but I was able to labour drug-free and got lucky – I had pretty much the birth I'd hoped for. I don't know if a written plan is as important as some background knowledge and a general sense of what you hope for and how you feel about the various things that might come up. I think it's also important to understand the consequences of particular choices. For instance, nowhere in my prenatal classes did they mention that having an epidural increases your risk of a c-section. My hospital had a 97% epidural rate for first time moms. If I'd just been thinking, "why feel pain if I don't have to?" I'd probably have gotten one. But because I understood how that would make it harder to stay away from a section, I was able to use that knowledge to steady me through the tough bits of labour. In retrospect, I think it's important to find out what the standard procedures are at your hospital. Then you can focus on those things you want that are different from the usual. The other reason to have a basic plan is that not all moms want the same things and knowing what you'd like helps the hospital staff do their best to see that it happens for you. When I did the hospital tour I thought I wanted what pretty much every new mom wanted: to have my baby put on my chest right after the birth and to breast feed right away. But another mom-to-be in my group said she wanted the baby taken away immediately and not brought back to her until s/he was washed and wrapped in a blanket. It made me realize that labour and delivery nurses have to provide support to moms with wildly different ideas about what they want. I would have been horrified and very pissed off if they'd whisked my baby away for no reason; this other mom would likely have been equally horrified if they'd put her newborn on her chest. I probably spent too much time thinking about it, but in the end I was really happy with how it worked out. Good luck! Reply I used the standard template birth plan that my hospital offers. Most of the answers were "no preference". However, I appreciated the option to specify that I wanted to be the one to ask for pain medication rather than have it offered. I also opted for a stupid long labor in the attempt to avoid a c-section, which ultimately ended in the OR anyway. However, the midwife and doctors were very sensitive in approaching the subject and gave me time to adjust to the idea since they knew my preference. I do wish I has specified that only my husband and necessary med staff attend while I was in active labor. Having the ***inlaws show up while the midwife was digging around like she was trying to get the last bit of peanut butter out of the jar was uncomfortable for everyone. Reply I'm in Canada as well (Calgary) and I took a class through the local health region. One of the exercises we did was to go through a birth plan exercise where we were given about 15 cards that had sort of opposite outcomes on either side i.e. Vaginal birth or c-section? Epidural or no? Lots of intervention or little intervention etc. The most important card said healthy baby or unhealthy baby. We started with all 15 cards but then had to whittle down to 10 cards, then 5 and then finally 3. What I discovered was that I already had a pretty good idea of what could happen, what sort of interventions would be offered etc. but my husband had no idea. Instead of figuring out a birth plan we ended up having a really heartfelt talk about how we both hoped the birth would go and what was really important to each of us. We ended up with an understanding that births can be complicated and as long as our baby was ok at the end of it, we were more than prepared to let go of a lot of our plan if necessary. This talk also reassured me that if I wasn't able to speak up for myself my husband could because he knew what I wanted. So, did we have a birth plan? Not really. Instead we had agreed how we hoped it would go but were prepared to be flexible depending on the situation. I was lucky that everything went pretty much how I had hoped but if it hadn't I think I would have been able to cope. Reply That sounds like such a good exercise to figure out what is really important to you and your partner. I really like that a lot. Reply I didn't have one, but that's because I had a homebirth, so I figured that if I were being seen by anyone who didn't already know what I wanted by dint of being the midwife I'd spoken to for nine months about my wishes and desires, then something already went WAY off plan. If I'd been in a hospital, I DEFINITELY would've written a very detailed and explicit plan. (Also, I've heard it said that provisions in a birth plan are not legally binding unless you use the word "consent", e.g. "I don't want AROM" is not binding, but "I do not consent to AROM" is. May just be a piece of mom lore, but I'd say it's worth writing like a lawyer to get what you want.) Reply I think it's possible to have a birth plan without having every detail planned out. My birth plan is focused on what I know I want, as opposed to what I don't want ie: I want my husband to 'catch' the baby and cut the cord, if he feels up to it. I want to let the cord stop pulsing before it's cut. I want to start with laughing gas and go up drug-wise from there as I want. What's really a bummer though is that I am now past due and we're starting to talk about my midwife referring me to an OB for induction- chances of an OB letting my husband 'catch' the baby are slim to none in my area. So in that sense, making a plan has lead to a slight disappointment, but I still don't regret it. Really hoping that I can at least convince the OB to let the cord stop pulsing… Reply I had a birth plan but it wasnt so intense – it was very basic like – I would like water drawn for me, who I would allow in the room(family and friends wise) and please do an Episiotomy if it comes down to it.. unfortunately none of it was followed even at this stupidly simple level as my wee man came 2 weeks early and arrived 2 hours after my contractions started – it is in a way a piece of mind, and almost a placebo pill in a way – if its written down its okay type of thing Reply With my first child my birth plan was: No epidural, unless I needed one, and ummmm…. that was it. My water broke at 34 weeks 4 days. They put me on pitocin, and I got an epidural. I had a perfect baby boy, and I consider it a very good birth experience. (In part, I think, because I didn't have an expectations, except that it would hurt, and I would get a baby out of it) With my 2nd my birth plan was to make it to 36 weeks. My water broke at 34 weeks 5 days. Both of my children are prefect, non preemie babies, both of my due dates were correct. My OB has this, "maybe you just have a faster gestation" theory. I think it's ok to "go with the flow." None of us can control all that much of the birthing experience. I think to have a very specific plan, is to invite more stress if things don't go according to plan. (Which they rarely do) Good luck!! And don't feel any pressure to make a detailed plan. The baby, and your body, will do what they will do, and in the end, all you can do is roll with the punches. Reply I just made a wish list for my doc with what I'd really like and not like to happen if at all possible. She then knew the key things I'd have a problem with (being strapped to a bed with a fetal monitor unable to walk around) and what I'd be ok with (a c-section if it will be better for both of us). She was so happy to have it, she put it all in my chart on the computer and told me last visit she still has the copy I gave her in my pocket for when I deliver. I have important things listed like my adhesive allergy that is noted in my record but can be easily overlooked in a situation needing quick work. This just drives the point home. I can't wait to meet Peanut, no matter how it happens But I feel better with them knowing some direction for us. Cheers, ~K Reply My midwife encouraged me to write a birth plan, I filled it all in with what I wanted & everything. Three days later I landed in the hospital with premature rupture of membranes at 32 weeks, on bed rest in a hospital room for ten days and then induced at 34 weeks. My daughter was healthy but in the NICU for two weeks because she needed to grow more and learn how to eat. So basically, I'm not feeling the whole birth plan thing. It's so hard to plan anything like this, really–I mean you just never know what's going to happen (and not always bad things happen!! I know my experience is totally out of the ordinary). I think it's less stressful to just go with the flow. But like others have said it's definitely important to talk about all your options with your midwife/doctor. Reply Can I just say that not having a birth plan does not mean you won't have hopes and expectations? I keep seeing comments where people say 'I knew five gals who were so disappointed that the birth plan didn't go correctly, which is why I always say don't make one', but do you think that not officially making a plan will mean you don't have preferences or opinions anyway? I am not a planner, not in the slightest, but there are some things I definitely have an opinion about and I highly doubt that refusing to write those things down will make those opinions any different than they are now. Making a birth plan does not mean that you don't anticipate the unexpected, and not making a birth plan does not mean that things will go smoothly. Reply Join the conversation Cancel Reply Your email address will not be published. Required fields are marked *Comment Save my name, email, and website in this browser for the next time I comment. Notify me of follow-up comments by email. Subscribe me to your mailing list No-drama comment policy Part of what makes the Offbeat Empire different is our commitment to civil, constructive commenting. Make sure you're familiar with our no-drama comment policy.