Preparing For Birth

With the majority of women heading to the hospital to birth their babies, planning for the impending birth has become an important aspect of preparation in the United States (though the percentage of out of hospital births is rising).  Standardized, highly medicalized, non-individualized perinatal and postpartum care has really led the way to this being a need. Sadly for most women, attaining evidence-based and individualized patient care going into the hospital environment is not often simple or accessible even with a well thought out, communicated, and researched plan.

In light of the care women are likely to come across for themselves and their babies, below is a list of the common information that needs to be addressed during pregnancy for labor and birth  (for a comprehensive pdf, please email me at desirre@prepforbirth.com):

• What level of care is needed – low-risk (the most common) or high risk
• Eating and Drinking Orally
• Saline-Lock, running IV or Neither
• Fetal Monitoring – continuous or intermittent
• Pain Management Options
• In the event of Labor Induction
• In the event of Labor Augmentation
• Pushing and Delivery Options
• Cord Clamping Options
• Immediate Postpartum Baby Care, Assessments, Interventions & Treatments
• Immediate Postpartum Mother Care, Assessments, Interventions & Treatments
• In the event of a Cesarean
• Infant Feeding Options
• In the event of Mother/Baby Separation or NICU Stay

Once the information is gathered women are often urged to write it all down in document format.  The most recognizable term is Birth Plan. The very word plan though can be a stumbling block for both mothers and staffers alike.  It can come across hard line and lacking flexibility. Unfortunately, this can be construed by a staffer or care provider that a woman is telling them how to do their jobs or that she has very set even unrealistic expectations. Don’t kill the messenger here, that is really how it can be looked at and thought of by the medical professionals receiving it. I am not saying it is the “right” thinking.

The idea that the term “Birth Plan” may very well be outdated is intriguing to me.  Upon research, I have indeed found so many other ways to name this document.  I highly encourage a pregnant woman to try many different titles on for size to see what best suits her communication style and personality.

A birth plan by any other name list (please send me any other titles to add that are missing):

• Birth Preferences
• Birth Map
• Birth Dreams
• Birth Vision
• Birth Wishes
• Birth Needs
• Birth Desires
• Birth Wants

Be aware that whatever the document is called, it should be no more than a single page that speaks to the current practice culture in any given area. For example, if Cytotec (misoprostol) is never used for ripening, then saying it isn’t to be used is moot and can negate the other portions of the document to the reader because the reader may think the writer is out of touch with what goes on. Do the research on the birth location practices and protocols along with the care providers standing orders so the details are up-to-date.

By no means though should cookie-cutter care be what defines a woman’s options, desires or needs for her written “Birth Plan”.  Always discuss with care provider ahead of time. If a provider uses responses like, “You can try that but…”, “Just get the epidural because….”, “Why would you want to do that?”, “Having a natural birth doesn’t make you a hero.”, or anything similar, these are giant red flags. This could be the first insight that a woman and her provider do not share the same philosophy or idea of expected care. Red flag responses may very well be leading to a serious compromise to the provider’s desires no matter what is agreed to. Well crafted and designed lip service is how I see it. Please listen intently to the answers to questions.

Writing a “Birth Plan” is a valuable and pretty necessary undertaking when birthing in the hospital in my opinion and experience.

As a last thought, a “Birth Plan” document is not legal, but rather a communication tool and values clarification vehicle for a woman, her provider and the staff she will come in contact with.