Writing A Birth Plan

The thing about childbirth is, you can never be certain what’s going to happen, for it can get out of control at any time and that’s where a well-established birth plan comes in helpful. As women become more aware of their rights to choices, even the atmosphere and procedures during labor can be pre-discussed in some hospitals.

What’s a birth plan anyway?
A birth plan will help ensure that certain aspects of your childbirth experiences, such as pain medications you wish to use or avoid, people allowed in the delivery room, episiotomies and cord-cutting are all planned out the way you want it.

How it works is, firstly, you establish your wishes in writing. Next, talk them over with your doctor as well as hospital staff including your midwife, and then see to it that you, your doctor and the hospital staff each have a copy. It’s actually really important to discuss your birth plan with your doctor and hospital staff to ensure that everyone is on the same page with you on all your wishes. Keep in mind too that some of your wishes may not be in line with the hospital policies too, so early discussions will help you sort out these issues.

Times have changed and so can birthing experiences
Many hospitals have geared up to accommodate patients’ demands for comfort during labor. More and more hospitals are now allowing women to walk around during labor, and even birth in positions more comfortable for them — while squatting, sitting up, in a pool of warm water and so on. It is not uncommon now to be able to make requests which you think will be more favorable to your birthing experience. However, these options vary among hospitals.

Procedures during labor: What is your wish?
It used to be that hospitals practiced the same procedures on all women in labor, but many now show increased flexibility in how they handle their patients. Some examples include:

• Enemas. Popularly used to clean out the bowels, enemas used to be routinely administered when women were admitted. Now, you may choose to have one or to skip this procedure.
• Shaving the pubic area. Once routine, shaving is no longer done unless a woman requests it, so if it’s not your cup of tea, state it in your birth plan.
• Inducing labor. At times, labor may need to be induced or sped up for medical reasons, however, some practitioners these days are willing to give women the option of getting some help to move things along naturally, or giving labor a little more time to progress on its own. State your wishes regarding this in your birth plan after discussing it with your doctor.

Point to remember
And remember, birth plans are not legal documents — they’re more like basic guidelines. The health and safety of mom and baby always come first, so plans may have to be changed if needed.

Pain management
Although many women feel that they will be able to give birth sans pain medication, this is one area that women are advised to keep an open mind and not to be too rigid with their plans to the point of not being able to enjoy their birthing experience. In any case, many women who think they will be able to withstand the pains of labor only end up changing their minds asking for an epidural when they’re too far along in their labor.

Pain management is something worth discussing carefully with your doctor while taking into account all the possibilities during labor. Even if you opt for a natural birth and intend to forgo the pain meds entirely, know that you can change your mind during labor, no matter what you have stated in your birth plan. Doctors and staff are not going to judge you! Be well-informed too of alternative forms of pain relief, including massage, relaxation, breathing, and hot tubs. Know your options and make your wishes known to your doctor.

Birthing position
Slowly but surely, the days of giving birth in just one position, that is lying down with legs apart or on stirrups, are becoming passé. Many hospitals nowadays are open to allowing women to try a variety of more comfortable or favorable positions during labor, including lying on the side, squatting or sitting up. It’s just a matter of early discussion and planning with your doctor and hospital staff.

Cesarean section (C-section)

Regardless of whether you already have a scheduled C-section coming up or just planning ahead of a possible emergency, this is one topic that will be worth discussing meticulously with your hospital. If you do have a C-section:

• Do you want your partner present?
• Do you want to view your birth?

Episiotomies
Doctors perform episiotomies when necessary. (An episiotomy is when the perineum — the area of skin between the vagina and the anus — is partially cut to ease the delivery.) You may need to have one in medical emergencies, such as if your baby is in distress, or if there are risks of really bad tearing. If you are strongly against it, do discuss your preference with your doctor.

Who will be allowed in the delivery room?
Not only is this an important thing to include in your birth plan, but also, how will they be allowed to witness the birth? Will they be standing at the head of the bed, the side, or foot of the bed?

If it’s your wish that the whole family is welcome as long as they stay near the head of the bed, state it clearly in your birth plan. Or, if you’re totally fine with a relative witnessing the birth of your child at close range, state it too! Just establish all these early and don’t assume that your partner or hospital staff knows what you want.

Post-birth
Post-birth decisions to be made beforehand should include:

• Whether your partner is going to cut the umbilical cord.
• Does your partner want to hold the baby when the baby emerges or
• Do you want immediate contact with the baby, or
• Would you like the baby to be cleaned off first?
• How would you like to handle the delivery of the placenta? Would you like to keep the placenta?
• Do you want to feed the baby right away?