Why I threw out my birth plan

February 15 2010 | Guest post by Amy Wynn
week 15 (5)
Thanks to firefly_photos_0788 for submitting this to our Flickr pool!

At the beginning of this current pregnancy, I was more prepared, more focused, and much more ready than I was for the birth of my daughter seven years ago. Rather than the pregnancy itself being the focus of my life as it was then, I was already thinking ahead to the arrival of the baby, and working out the logistics of birth and newborn care. I wasn't very proactive about the birth of my first child, my fear of the entire process led me to just do as the doctor told me- and while I in no way felt he misled me or did a poor job — I felt strongly that being more active in the process could have saved me some pain (and possibly a few extra stitches) in the end.

Long before we made that 'end-of-the-first-trimester-safe-zone' announcement, I set out to arm myself with information. I bought twenty or so different books, ranging topically from c-sections to homebirths, joined every pregnancy website I could find, pored over every birth story I could get my greedy little hands on, and began deciding just how things would go this time around…

I would be in control. I would be one of these powerful, birth-goddesses I kept reading about. I wouldn't let people bully me about my ideas, I would be strong. I would be ready.

I talked with my husband about each aspect of the plan, just in case something were to happen and I needed him to speak up for me. Everything was clear, from the point at which I would consider pain relief to the amount of time spent on perineal massage, to the absolute necessity of rooming in. Every aspect of the entire process, from check-in to discharge, was clearly decided and backed up with my own extensive

As I discussed 'birth plan' plans with other expectant parents, I began to notice a trend. While none of these mamas went into labor thinking they knew exactly how it would go, many were shocked when the course of events necessitated great deviations from 'the plan'. Some even felt they had failed at childbirth, despite bringing beautiful, healthy, thriving babies home with them. Depression over not achieving their ideal birth followed women who I had seen to be brave, strong, and otherwise reasonable about their expectations.

Logically, we know that a plan is just that — an idea of how you would like things to play out under ideal circumstances. Then there's back up plans, and contingency plans, and alternates… sometimes we think we can cover all our bases and avoid the element of surprise.

But babies have a special way of dodging all your best-laid plans, by entrenching themselves in a breech presentation, arriving early, or even making their debut in the backseat en route to the birthing center.

So I sat down and thought about it for a good long time, and deleted my birth plan from the interactive planner, tore up the copy waiting to go in the hospital bag, and expunged it from my hard drive.

I still have my ideas about what I want, and my husband and doctor are aware of them. I still have choices and options, and know which way I'll likely decide in a given situation. But I have given up the idea of planning from beginning to end something as intrinsically spontaneous as labor and childbirth.

My birth plan? To have a baby, of course.

  1. As someone who has seen successful, strong women grieve years later over not having their planned-for birth, I totally agree. I once had a midwife friend tell me that when they saw women coming in with fully written out birth plans, they started taking bets almost immediately on her getting a c-section, etc. It just seemed to never fail; Murphy's law. So I went into each of my two births just figuring we'd take what came at us. We did, and I had a great experience both times, even though I was hooked up to magnesium/oxygen/had preeclampsia/ the baby had swallowed meconium with my first birth. The second one was totally normal.

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  2. ooo you hit home with this one!! i'm a planner, a list maker and everything else. so naturally my birth plan included a long list of 'stuff'. 10 days past my due date was certainty not on any list, but that is where i stand right now. i've been working the past few weeks about throwing out my birth plan lists and meditating on just being in the moment and going with it…however it goes.
    -here's to having a plan to NOT have a plan-!!

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    • Good point. I've said out loud "when I get pregnant, I'd rather have a natural birth, but if I don't it's not a big deal. I'll still have a baby at the end of the day." It's the truth. I do think it's OK to hope for what you want (home birth, natural birth, water birth, whatever) as long as you can accept that you don't always get what you want.

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  3. I didn't actually write out a birth plan, but I certainly had one. And nothing turned out like I had planned, except for the going-home-with-a-baby part. I was glad I had at least started out with a plan, though, since it gave me (and my caregivers) a common starting point from which to move on through plan B, C, D, E and so on!

  4. I am eating well and working out to keep my probability high for a home birth but with that said I know it is a numbers game with a lot of factors out of my control. I am also educating myself for the X, Y, and Zs of medical intervention and if we have to transition to the hospital because probability still exists in that realm no matter how good I eat and workout. Good luck to you and your pregnancy, I hope the numbers are on your side so you get a birth you want.

  5. Perfectly put. Going in with an idea and what you'd like to see happen is the best way to put it. "Planning" can make flexibility for those unexpected moments hard to come by.

  6. YES!!!!
    What a relief to hear someone else finally say it! I'm on a few pregnancy/parenting sites and it irritates me to no end to see how many women are dead set on having exactly what is in their birth plan and are devistated when it deviates. You can't think of everything, problems happen, and as long as you get that beautiful bundle home, it was a success.
    I'm pregnant with #2 and won't have a birth plan. My dr and my husband will know what I want (such as a mirror this time. I want to see!), and will do their best to help me get that, but I don't expect it all to go as planned.

  7. Hunny, your story was one of those that inspired me. I was so bummed to hear how you struggled after having Lyra. Sharing your story helped me change mine.

  8. Love it!!! There is absolutely no way that having a plan, thinking positive, or"just relaxing" is going to give you your ideal birth. I was one of those women that looked forward to giving birth and was going to give it drug free in a pool with birds chirping… okay maybe not the birds part, but it was going to be drug free for sure and all natural. Well, things didn't go exactly as planned and I ended up being in prodromal labour off and on for a week (full on contractions with slow progression – wouldn't want to wish it on my worst enemy), only to be induced ob my due date and given an epidural, and when that failed to produce said baby after 20 hours, we went to nerve block and forceps. I felt miserable for a long time after giving birth because I felt that somehow I could have done something differently. Well, I have come to terms with the fact that having a very healthy, thriving little baby is what matters, not the birth. I am sorry to add that I believe that too much emphasis on natural childbirth can often make women feel like losers if they aren't able to have a natural childbirth.

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  9. Love it!!! There is absolutely no way that having a plan, thinking positive, or"just relaxing" is going to give you your ideal birth. I was one of those women that looked forward to giving birth and was going to give it drug free in a pool with birds chirping… okay maybe not the birds part, but it was going to be drug free for sure and all natural. Well, things didn't go exactly as planned and I ended up being in prodromal labour off and on for a week (full on contractions with slow progression – wouldn't want to wish it on my worst enemy), only to be induced ob my due date and given an epidural, and when that failed to produce said baby after 20 hours, we went to nerve block and forceps. I felt miserable for a long time after giving birth because I felt that somehow I could have done something differently. Well, I have come to terms with the fact that having a very healthy, thriving little baby is what matters, not the birth. I am sorry to add that I believe that too much emphasis on natural childbirth can often make women feel like losers if they aren't able to have a natural childbirth.

  10. I totally agree with you that very prescriptive birth plans (ie invisaging the baby born to your special labour music cd, just as the sun rises…) are unlikely to become a reality- yes, birth is rarely how you imagine it in your head!
    However, many women write birth plans so that anyone caring for them understands that they have made certain choices when it comes to birthing, and won't necessarily follow all 'usual' labours e.g epidural and monitoring. Sadly, though, it is true that many of these choices are ignored, as doctor 'knows better'.
    Women are left traumatised by the lack of respect 'care providers' show for their choices regarding their body, baby and beleifs. Women suffer birth rape and physical and emotional trauma at the hands of doctors and midwives who tell them that what they are doing – e.g an examination, episiotomy, induction – is necessary (when all too often it is not), ignoring the fact that women DO NOT want it.
    Of course women may experience birth trauma regardless of whether she had a birth plan or not, but to dismiss a woman's pain, her emotional and physical scars, saying 'oh she's just pissed cos her birth wasn't like the one she had in her plan' totally disregards the real depression/PTSD she may be experiencing following a traumatic birth. And to say, 'at least she has a healthy baby' is a disgustingly dismissive of women's feelings and experiences.
    I feel that it is important to recognise that its not just 'unrealistic expectations' that lead to postnatal depression following a traumatic birth, but neglect and abuse on the part of the medical 'care' system when it comes to respecting and listening to what women need and want.
    I work in a maternity unit, so I have seen this happen time and again, as I am not always in a postition to advocate for the woman's wishes.
    I stayed home for the birth of my baby (would have transferred in to hosptial had it truly been necessary) having seen what happens in the hospital system. Unfortunately, many women learn 'the hard way' that hospitals will not necessarily support them in the way they wish, and
    have then to cope not only with a new baby, but with the trauma of the birth too.

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    • I have a different perspective on this medical vs home birth. I have watched many babies be birthed at home with no problems but I think our global south perspective really devalues the fact that birth is dangerous and that women and children DIE from having unassisted births in developing nations. There is something to be said to leaving intervention to when it is actually necessary but calling it birth rape and negating the fact that our current medical system was set up to actually SAVE the LIVES of mommies and babies is really a disservice to all the wonderful medical staff who do a good job. It also indicates a sort of "developed world arrogance". I work in development in west Africa and I see it as my duty to take advantage of all the medical care I have access to (before, during and after giving birth) as a way of illustrating that I don't take that medical care for granted.

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      • I realise the term birth rape is uncomfortable for many people to hear or contemplate, and would prefer to beleive that this term is simply inappropriate or OTT.
        However,it DOES happen; it happens when someone puts their fingers/scalpel/instrument inside of you without asking or when you have told them NO – that is rape. Just because it happens in a hospital does not make it okay.
        This is not about hospital vs homebirth; women can experience trauma from their homebirth too (though it is a rarer occurrence than in hospitals); this is about acknowledging the fact that women's experiences can damage them deeply, physically and emotionally, and deserve support and understanding – not just that they need to 'get over it- at least you and your baby are alive'

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  11. Amen! With this second pregnancy, I am definitely older and wiser. The hospital where I am delivering has all mothers fill out a form that basically amounts to a birth plan, but I've vowed to be flexible and accepting of changing circumstances.

  12. Yes! Yes! Yes!

    My birth plan flew out the window when I had to be induced for pre-e, the epi failed, my daughter was sunny-side up, and I had CPD (my pelvis was too small for her to come through) resulting in a c-section. At that time I was super glad I was in the best hospital in the area, rather than at home, like I had originally planned.

  13. My OB (a DO) actually discouraged me from having a written out birth plan. I had more of a "birth philosophy". I wanted to avoid getting an epidural if I could (I hate needles, and I had a spinal fusion to correct for scoliosis that would make getting an epidural difficult), but that was pretty much it. I was able to give birth vaginally without any pain medication. Yeah, so it was a 33 hour labor, and I had an episiotomy and a vacuum assisted delivery, but I was able to avoid a c-section under general anesthesia (due to my spinal fusion) . Oh, and the part about bringing home a beautiful baby. Yeah, it was a success. 😀

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  14. Oh, and I had a doula, who was instrumental in helping me (and my husband!!) though labor. The nurses kept out of the way, since I had a doula, but at the very end, the nurse I had was awesome and a comforting presence, so I had my doula go out and ask that she be by my side as well. 🙂

  15. Posie- I totally see your point of view. I am lucky to have a doctor who believes above all in the ability of the mother to birth her baby and that I trust him and my husband to advocate for me should I come upon the need. I do not mean to dismiss the validity of creating a birth plan, or educating yourself, partner, and cargivers of your wishes. Absolutely I think women should be aware of their rights and options, and their feelings should not be dismissed, plan or no plan. If it's important to a birthing woman to have a written plan, by all means I support that so her wishes may be clearly communicated. In my case, however, the plan was setting me up for expectations I would likely not be able to meet, and I only found the liberation I needed by freeing myself from my own ideals.

  16. I love this post, because I felt the same way, kinda. I tried to put together the complex and detailed birth plan, but when it came down to it, I really just wanted to go in and have a healthy baby. There was nothing so special about my plan that I needed to make note of it.

    I was lucky to give birth in a very comfortable and homey hospital, with a doctor and nurses who took great care of my baby and I. I think knowing that I trusted everyone involved made it was easier to set my planning aside and just go with it.

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  17. Sorry Amy, I didn't set out to discount your experience, and the fact that you've found getting rid of your birth plan to be freeing for you; that's fantastic.

    I just feel that the 'you have a healthy baby- what's the problem?' line isn't useful, and can be very upsetting; and I guess I wanted to point out that birth trauma is real, and damaging.

  18. I wish I were as strong as that! I had preferences rather than a plan, I knew anything could happen – and it did. I was taken from the birth centre and the relaxing pool with 1 on 1 care and transferred to hospital strapped to a bed hooked up to monitors/drips/catheters unable to move around Hubby struggling to look at me (he doesnt do needles/medical stuff well) and left for hours. I ended up in theatre without hubby as he couldnt watch – a lonely experience if the theatre team like mine dont talk to you.

    As much as my emergency section has given me the perfect son I still struggle daily with the delivery, not helped by very unthoughtful hospital staff in theatre and on the ward.

    When baby 2 comes along I know where my focus will be – on the final product – the baby! How they arrive isn't nearly as important and them arriving safely.

    But it still doesn't stop my mind working overtime trying not to feel like I failed to give birth and considering demanding a VBAC to prove I can do it. I still talk about my babies delivery rather than birth as I didn't give birth to him, trying ti integrate my experience into my pregnancy/labour/birth schema is proving difficult.

    I never expected to need counselling because of the 'birth'.

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  19. My OB for my first pregnancy laughed when I gave her my birth plan. Not a good-natured laugh either, a "silly little you, ha ha ha" evil laugh. Of course NOTHING went the way I had it on my birth plan, (I was induced at more than 42 weeks and from the moment I got my IV cath it was all downhill), but I think she could have had a better approach, like saying "thanks, I'm glad to know where you stand on XYZ, but keep in mind that births don't usually go as planned."

    I made a "birth plan" this time around too, but it wasn't for my doctor or nurses to read like the first one was. It was for my husband and me to remember what we'd read about different options (letting the cord stop pulsing, etc.) because we knew we'd be overwhelmed and forget things once the big moment arrived. And good thing, too, because from the time labor started to the final push was about 2.5 hours, and nothing we planned for fit into that time. Getting to the hospital and pushing barely fit into that time, and then my baby was signed up for heart surgery by the next day. Bye bye, expectations!

  20. My only plan was to be far away from our local slice-happy OBGYNs and their big epidural needles (AGH SO scary, anyone who thinks homebirthers are ballsy hasn't been present for an epidural, omfg) and to get the baby OUT. I was not one who enjoyed being pregnant, either time. I knew certain comfort things I might like, but aside from that, I never thought I had any power over a literal force of nature – it'd be like trying to work out a plan for what direction the river should flood in the winter, you can plan all you want, but it's gonna do what it's gonna do. You only get a rough guess of what that's going to be.

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  21. My plan is no plan as well. Setting myself up for the unknown is much more comfortable (to me) than having to deal with being let down or even potentially depressed about the birth afterwards.

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  22. Excellent post. To me, it's more important for a woman to feel like she's a part of the process and decision-making — not to believe that she has full control, because your body is going to do what it's going to do, but that she is in control of the choices she makes given the situations she's in. That truly applies to all of life, but it's especially important in childbirth. Even though I'm looking to have a homebirth, I know that I may have to go to the hospital should problems arise. That's just how things go. I'm grateful I have that back-up option, because the most important thing is to have a healthy baby in the end. Kudos.

  23. what a fabulous post. i live in an uber-progressive city, and i feel like the groovy natural hippie side of things sometimes feels judgemental. understanding that we have options and trying not to get mowed over by Western medicine? that's a good thing. feeling like we're not perfect and shiny and new agey enough, that we somehow missed out on 100% of "the" birth experience because we needed medical intervention or chose an epidural? it's bollocks.

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  24. Perhaps we should all stop focusing on what OTHER women go through and simply focus on what each of us goes through ourselves. To say that someone is silly because they're upset their birth didn't go the way they planned is to marginalize their feelings…to say that YOUR feelings about how SHE should be feeling about HER birth are more important. i.e. the whole "Just be glad you have a healthy baby!" idea. If one more person says that to me (and I'm 17 months out from my birth rape by doctor/hospital), I will seriously go postal on them. A healthy baby is NOT all that matters. A healthy mother also matters because without a healthy mother, baby will not be so healthy. We need to recognize that "healthy" does not just mean physically. Someone who is suffering from PTSD because of their birth trauma, or PPD because they had a c-section (forced, emergency or whatever) and their hormones weren't allowed to kick in the way they should is NOT healthy and will have a much harder time taking care of that wonderful, healthy baby everyone talks about. Mom's mental and physical state is JUST as important, if not more so, for taking care of baby and making sure baby stays healthy. Please let each mother have her own experience and feel the way she does about her own experience without attempting to marginalize it!

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  25. I agree. Nix the birth plan, and instead find a care provider who agrees with you. A birth plan is pointless in terms of its real mission–to tailor the way your OB practices. That just ain't gonna happen. For most American women, a care provider who is like minded won't be an OB.

  26. I didn't write a birth plan for either of my children. I'm not an advocate of them, as how can you plan something so unique and reactive as labour especially for your first one. Before both labours I talked with my husband about things I felt comfortable with and things I didn't, but we both went into our childrens births with open minds and luckily I had two fairly straightforward births. I think that's important; communicating before and during labour so that mum is happy with everything as its happening.

    For my daughter the midwife just asked some questions and made some notes as I was labouring. It was very instinctively lead and we dealt with things as they happend. With my son I was induced, but again the midwife asked me what I wanted and I again requested little intervention and so she only broke my waters which was fortunatly enough.

  27. I have a document in which I've written down my insurance information, blood type, and other basic details. It also says "husband in room with me at all times. If husband is somehow unavailable, mother will be in room with me. As a rule, please avoid spinal anesthesia. If I hurt badly enough that I get over my lifelong fear of needles in my spine, then give it to me. You will know this because I ask." I have no plans for how I want my baby fed, if my husband will cut the cord or give it it's first bath. What will be will be.
    At the top of the page is the ancient proverb "man plans and God laughs."

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