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How to Create a Birth Plan

“When a baby is born, so is a mother…”

The quote by Julia Jones, author and doula, touches on a topic sometimes left out of the conversations had about the path to motherhood. Yet the truth is, from the moment you discover you are growing a child to the first few minutes and hours (and months) after bringing them into the world, you endure a whole gestational period, too. Your body and heart swell in size to carry and love this child, your brain chemistry is fundamentally altered, and body parts that once belonged only to you become shared – all in preparation for the final act of selflessness: Giving birth.

It’s no wonder that a woman’s birthing experience can have a deep impact on the future of the entire family.

And that’s really where birth plans come in. For some moms-to-be, their plan is simply to have a happy, healthy baby. For others, they find meticulous preparation to be cathartic. Either way or in between, what it comes down to is choice.

The Modern Birth Plan, Defined

“Typically, a birth plan is thought of as an outline of your preferences,” says Lacey Pezley, Certified Birth Doula – CD(DONA), Lactation Educator, and Registered Dietitian Nutritionist in the Greater Chicago area. It’s essentially a document designed to prepare expecting parents for both the physical and emotional aspects of birth and the birthing process. It helps them plan ahead for how different scenarios could play out and gives them the ability to make decisions about each possibility prior. A birth plan also offers a means of communicating with birth partners, caregivers, and hospital staff. On the surface, it’s an approach to labor.

“But for me,” Lacey says, “the essential purpose of a birth plan is to guide mom through her options surrounding birth so she can make an informed decision. The true value is not just the plan itself but the process of being informed and making educated choices for yourself.”

The Controversy of Birth Plans

For parents, a birth plan can be an empowering tool that reflects your body, birth, and environmental values. Yet for many reasons, for caregivers and hospital staff, it can sometimes become a frustrating interference throughout. As both a practitioner and doula, Lacey has walked in the shoes of the patient and provider and understands the needs of each.

“The birth plan [has] been stigmatized. Some of the stigma is that requests are being made of providers that require exceptions to policies. That can be really hard for care providers to accommodate; they individually may not be able to do anything, which can be frustrating for them.”

Providers need to care for their patients with procedures and best practices in mind and parents need to feel heard and valued. How the birth plan is approached can bring the patient and provider together. “If we can change the conversation, change how people perceive birth plans [on both sides], they can actually do so much good.”

And that starts with early planning – before you even choose your final healthcare provider.

Rethinking the Birth Plan Approach

The average time moms first reach out to interview Lacey for the doula role is about 20 weeks. “They typically have a general vision for their birth. That’s actually part of the interview process; they’re telling me what they envision to ensure I am comfortable and in-line with their approach.” This type of interview-based approach to choosing providers is important for moms to ensure they’ll end up working with the right people.

Which means that the information moms are finding early on in the pregnancy can have an impact on their understanding of their options, their choice in provider, and ultimately, their birth experience. “Ideally, if you have an idea of what you want, it’s important to find a care provider who considers your choices and values early on – which is another benefit to creating your birth plan. And, if nothing else, they can explain to you the reasoning why it is they can or cannot do these things, so you feel like you are being included in the conversation.”

If you don’t know where to start, Lacey recommends reaching out to a wider range of birth team members, such as doulas, midwives and OBGYN practitioners, and in some cases, earlier on in your pregnancy. This way, you can ask questions of your potential providers to begin formulating your ideal birth experience.

Some questions include:

  • What is your pregnancy and birth philosophy?
  • How many members are on your team and will I meet all of them?
  • Are you available by phone or email for questions?
  • What is your approach to prenatal nutrition and health?
  • What are my options for the labor and birth experience? For example, can I eat and drink and move around?
  • What is your approach to fetal monitoring during labor?

This article is a great start or a comprehensive list of questions to ask midwives and OBGYNs. To interview a doula, check out the DONA International’s Guide for Parents.

Another benefit to starting the birth plan as early as possible is for insurance purposes. Depending on your policy, Lacey says, you may not be able to change care after a certain period of gestation. So, being solid about your chosen facility from the beginning is important.

Creating Your Birth Plan

Your birth plan is an on-going conversation with your birth team and can vary as you get closer to term. Lacey, herself, encourages two parts to the plan: One that is your own more extensive and detailed version, and one that is whittled down to give your birth team as you draw near to your estimated due date. Ideally, the shorter version is a one-page bulleted-list document that can be uploaded into your medical record at one of your last prenatal visits. This more succinct version is likelier to be read in full and put into effect, as it’s more manageable for your care team.

The Birth Plan Outline

When Lacey creates a birth plan with her clients, it is typically separated into three sections, as she approaches labor and birth as unique experiences. It’s called “My Plan for Labor, Birth, and Transition into Motherhood,” and includes everything from environment to mental health needs beyond the hospital.

Your personal birth plan will be entirely unique to you, but regardless of what does or does not make it in, it’s important to remain flexible. Lacey reminds us that, “As your pregnancy progresses, different things may come up that require the plan to be adjusted; for example, finding out you have gestational diabetes. Being open to change is important.” This is also the case for sudden adjustments, like the need for an emergency C-section. Including these potential experiences in your birth plan will let you work through it prior.

Use this infographic as a starting point for creating your own birth plan and always discuss any questions or concerns with your birth team.

How to Create a Birth Plan

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