Most people who give birth in a hospital are meeting their medical care team for the first time. Because of the circumstances, the staff do not have the time or bandwidth to get to know their patients in-depth.
A good birth plan, which I prefer to call “Birth Preferences”, can build bridges with your medical team. It can help them get to know you and quickly understand what you’d like in your ideal birth. It’s also helpful to learn about the policies and practises at your birthplace, so you know what to put on your wish-list.
Your Birth Plan document should be only one page with lots of white space and an easy font – at least 12pt. Use respectful and positive, but firm language. “I prefer….” is wishy-washy for something that really matters to you.
I recommend you use language that reflects who you are. If you have a great sense of humour, feel free to insert fun and levity in your plan. “If Jamie takes a nap, please kick him when he starts snoring.”
Checklist for an excellent Birth Preferences document
This section includes examples. Feel free to copy them or use your own language.
- Start with an opening paragraph that includes:
- An opening statement that encompasses your attitudes or overall vision e.g. “We’ve prepared for a natural birth” or “An epidural is part of my plan” or “We’re using Hypnobirthing as a tool.”
- A statement about consent, such as “We’re open to changes after discussion with the medical staff so we can make informed choices.” or “I will ask questions whenever a procedure is recommended and then need a few minutes alone to think.”
- A kindness to the staff. “Thank you for supporting us through our birth process” or “We appreciate the work you do.”
- An additional opening paragraph if there are special circumstances:
- Medical conditions that need to be known urgently, such as “Lucy is allergic to penicillin”.
- Mobility issues or cognitive considerations.
- Sensitive issues that may affect your birth, if it feels safe to share. (It’s been my experience that this level of personal sharing makes for better treatment.) “Due to previous trauma, no one is to touch me until I am aware of who they are, understand why and what’s involved, and have verbally agreed.” Or “Robin faints at the sight of blood, even one drop.” Or “We’ve had a previous loss and do not want to discuss it. Please see the prenatal records.”
- Then a short list of points for your wishes. It could be titled, “These are our wishes”:
- If anyone is joining you, name them. E.g. Your doula or “plus-one” such as a friend or mother.
- The environment you’d like, such as quiet with dim lights, loud rocking music (bring your own), window blinds open for sunshine, privacy.
- Continue this section with points that are unique to you. Here are a few of my favorite things from the hundreds of birth plans I’ve seen:
- I must wear my purple socks at all times.
- Do not offer pain medications; I’ll ask if I want anything.
- Please run a bath and encourage me to get in.
- Minimal cervical checks and only by experienced staff.
- I will eat if I’m hungry; please provide a waiver.
- Please provide the squatting bar and recommend positions to keep labour moving.
- Please coach me through pushing.
- I will breathe my baby down and appreciate quiet during the bearing-down stage.
- Essential staff only; no observers or learners.
- Students are welcome.
You get the idea!
- Cord and placenta plans, if any. E.g. We’d like 3 minutes of delayed cord clamping. Or We’re keeping our placenta. Or Please show me the placenta before disposing of it.
- Some people add an “In case of Caesarean:” heading, with things that are important to them such as playing a certain song, delayed cord clamping, requesting someone to take photos if possible, keeping family together as long as possible in the OR.
- A closing sentence such as “Thank you for taking time to read this page” or “Thank you for being part of our big day!”
Do not include:
- Disaster planning language e.g. “… unless something goes wrong.” or “… unless it’s needed”. It’s a given.
- Things that aren’t issues. If your local hospital has a policy that all babies are held skin-to-skin by a parent immediately upon birth and for the first hour (that’s the policy in my local hospital), then there’s no need to ask for that.
- A shopping list of all the things you don’t want. You don’t have to tell your medical team that you don’t want an episiotomy or a caesarean – they know that. (Well, unless you’re in a place where episiotomies are routinely done – then add that to the list! In almost every Canadian hospital, episiotomies are not routinely done.)
- The interventions that are only done after discussion, such as induction, which requires a conversation and signed consent form.
- Postpartum care of the maternal or newborn patient. “I will breastfeed” or “I will use formula” do not belong on the birth plan.