Step 1: Don’t write a birth plan.
Let me explain.
Giving birth is arguably the most intense, intimate thing we humans do. The desire to make a plan is only natural; plans make us feel safe. So we painstakingly agonize over every detail of our birth plans, and then proudly hand them over to our midwives/doctors/nurses, only to be met with a less-than-enthusiastic “okkkaaayyy…” And we’ve all heard stories about truly the insensitive ones rolling their eyes and giving a smug little laugh as they patronizingly say, “Let me see that thing.” (I hope that guy isn’t you’re provider. If he is, maybe it’s time to consider looking for a new provider.) But I confess, we do get a little uneasy when people hand us their elaborate birth plans.
It’s not that we don’t care about what you want. We care tremendously. At least we should.
The problem with birth plans is that they are plans.
Our bodies (and babies) are really good at birth. But just like any force in nature, birth is unpredictable. When you write a detailed plan, chances are good that at least part of it won’t go exactly as you had planned, for better or worse. And when that happens, you might feel bad. Like, really bad. Discouraged, disappointed, or worst of all, you might feel like you failed. And how awful is that? You have just birthed a baby. You are a goddess, no matter how it happened.
My friend made plans to labor in a bathtub; instead she had a fast labor and didn’t even have time to get into the tub before she effortlessly pushed out her beautiful, healthy daughter. Sounds perfect right? Not for her. She felt robbed and spent a long time mourning the labor that she had envisioned but didn’t have.
All that said, your desires and values are hugely, immensely important, and absolutely need to be communicated to your caregivers.
So instead of writing a birth plan, write your birth preferences. A plan details the step-by-step itinerary of your birth while your birth preferences let us know what’s important to you, and allows you to be an active participant in your care as your unique birth story unfolds.
Here are some things to consider when writing your birth preferences:
- Where do you want to give birth? A hospital? A birth center? Your home?
Consider this early in your pregnancy as it will help you determine who your caregiver should be.
- Who will attend your birth? And who won’t? Your partner? A doula? Your mom/friend/sister/mother-in-law/uncle/neighbor/2nd grade teacher? They’re probably all insisting that they should be there.
This is of course no one’s decision but yours. Birthing places have different policies about guests so do be sure to ask. FYI, there’s a saying among midwives: every extra person in the birthing room adds an extra hour of labor. Just sayin’.
- What will be in your relaxation/coping bag of tricks? A birth ball? Fake candles? Music? Relaxation scripts?
Maybe you took a childbirth class where you discussed ways to help you cope with contractions. And maybe, in class, you loved the idea of being massaged by your partner. And then along comes your birth, and so-help-you-God-if-s/he-touches-your-leg-one-more-time-you-are-going-to-use-said-leg-to-kick-them-in-the-face! Learn about (and practice) a variety of coping mechanisms, so that you have options when it’s show time.
- How should pain medication be offered to you? The first moment possible? When you ask for it? Never?
It can be hard to make the epidural decision before your birth. Some women feel very strongly one way or the other, while many women take a “I’ll wait and see how I feel approach.” Both are completely fine. Just make sure to communicate your thoughts with your birth team ahead of time.
- How do you want to care for your baby? Immediate skin-to-skin? Delayed cord-clamping? Rooming in? Circumcision? Breastfeeding?
It’s overwhelming to think about, I know. But it can be even more overwhelming right after you’ve given birth, if you haven’t thought about it before. Pick 1 topic a week, do some research, and think about what feels right. Consider taking a newborn care class during your pregnancy. Then let your provider know. They may be wearing the white coat, but YOU are the PARENT. And there’s nothing more powerful than that.
- Do you have traditional and cultural considerations?
(Most) providers receive cultural sensitivity training, but in the moment, they may not remember to address your personal needs (it’s not right, but it happens). So, if there are things that are important to you, let them know. Who cuts the umbilical cord? Do you want to take your placenta home? Are there religious traditions the team should be aware of?
- Is there anything else we need to know?
We all have a history. And sometimes, parts of that history can have a profound effect on how we approach experiences like birth. Maybe you have experienced violence that makes vaginal exams feel incredibly invasive and upsetting. Or perhaps your partner is transgender or gender noncomforming and you want to relay their pronoun ahead of time. Please don’t feel like you have to tell us anything. But do think about the important stuff that could have a true impact on your experience.
This is your birth. You are the customer. You wouldn’t pay to eat at a restaurant where the server brought you food you didn’t like, simply because “that’s how we do things here.” It’s the same thing with your birth. I am trained to be your guardian of safety and I will be your guide on this crazy adventure. But it’s your adventure. It’s my job to make you feel awesome about what you’ve just done. It’s your job to show me how.