[boysmom2]

I'm just curious to get others' opinions on this. I'm working my way through the Birthing From Within book (on my own, no class). I just read the part where she says she doesn't think birth plans are a good idea. I guess I agree with her that it can be counterproductive if you think all you need to do is write down what you want and think you're done and everything will go according to plan, but I don't think they're useless either. For example, I have great midwives and I don't expect to have to fight with them. But, I would like for either myself and/or DH to catch the baby. I know that they wouldn't have a problem with this (I caught my sister's baby when she birthed with them), but I just want to make sure they know and remember that that is how we want to do it. Also, again my mws are great, but the hospital still has standard procedures that I'd like to avoid. The MWs will be fine with my choices, but having something for all the other people there would be helpful, right?

I guess I'm just not sure I agree that they're all bad, but I'd like to hear what other people think, especially those of you who have read the book/taken a class (if you haven't, I'd still love to hear your thoughts!).

 

[JamieCatheryn]

I found that book a wonderful starting point for thought and discussion on a lot of different topics, this was one of them. I totally agree with her that pitfalls of writing a plan include loosing flexibility and an open mind for labor, as well as setting yourself up for a us vs them fight with your care providers. But there is a lot of value to it as a reference sheet on how best to support you and getting some things you are set on communicated once and for all, so long as you stay open to variances in how the birth may go. I wrote one for my home birth just reminding everyone how to help me out, knowing they're all on my team, I just won't want to talk and give details when the time comes.

 

[BtotheG]

This is a timely post for me - I've been really mulling over the issue of birth plans lately.

The conclusion I've come to is, if I need to write a birth plan, I am birthing in the wrong place with the wrong people.

I would like my care providers to be hands-off and low intervention - and so I've realized that I need to birth in a place where that is the norm (for me that's at home with midwives who share my philosophies on birth) rather than birth where that is NOT the norm, and then fight against it the whole time.

If I have to write down my wishes and dictate all the things I want done or don't want done - I would simply be birthing in a place that's not right for me. I don't want to have to focus on fighting with people or policies at a time when I should be concentrating solely on bring my child into the world. I should instead be birthing where I know people aren't going to be making decisions I don't agree with in the first place.

For example, I need to birth where people are supporting me as an individual - not trying to push interventions on me because "that's the policy." I need to birth somewhere people aren't going to be trying to cut me open, or come between me and my baby. I need to birth somewhere I don't have to spell those kind of things out - because they would never dream of doing it in the first place.

 

[melamama]

I think part of the issue with birth plans is that the pg mom may put a lot of energy into writing it (and investment in the exact path), then the hospital or care provider may not take it seriously (as in they have their policies and procedures, and your birth plan is a series of requests that they do not have to honor). Or the birth plan becomes a place to "get stuck" when the birth goes in an unexpected way.

I do think it is important to have many discussions about what you want included in your birth plan, become knowledgeable about what are different options for the mom during labor and birth, and after, and what is in the realm of standard newborn testing procedures, and to become very familiar with your care provider's views.

If you are birthing in a hospital I think it is very important to find out what their policies are. There are too many stories of people having birth plans that the hospital staff disregards.

I wrote a birth plan when I was pg with my first (I think it was an assignment for the Bradley class we took). I discussed it with my mw, then I relied on her expertise when I was in labor. By the time I was pg with my second I was getting much more from the BWF view.
I haven't written one since and I'm pg with #4.

 

[the_lissa]

Quote:

Originally Posted by BtotheG The conclusion I've come to is, if I need to write a birth plan, I am birthing in the wrong place with the wrong people.

This is how I feel. I am pretty anti birth plan. My opinion is that you should be on the same page as your caregiver and have discussed everything. I know that it isn't possible for every person, but in general, I think they are ineffective at best.

 

[Italiamom]

I wrote an "in case of transfer" birth plan. More or less, if we end up in the hospital it will be in a worst case scenario. There are things in that worst case scenario that I would be flexible about, and things that I wouldn't (like double layer sutures or sedatives). I think in a big way the list is for the hubby While I can remember little details, he's not as good at it, and in case of a transfer he and the docs will have a short, sweet, "this is the most important stuff" list.

But if you're worried about small and simple things like being prevented from moving around, getting into the tub, eating or drinking during labor... I know that I'll be able to do those things, so I don't need to plan them out. It's all fine and well to just say, "to heck with it," but if you're birthing in a place where these may not be options, then you'd be wise to at least write them down. If nothing else for your partner, or whoever you choose to attend your birth. People can't read your mind. If what you really want isn't a given, then ask for it! You might not get it, but not asking just because it will create an "us/them" scenario is hogwash.

I think the point that Birthing From Within was (hopefully) trying to make is that you shouldn't get attached to a birth plan. There will be things, maybe lots of things, that will deviate from whatever you attempt to plan out, and that even if nothing goes according to plan YOU are still birthing YOUR baby.

I personally hated that book. I know it's the "gold star" but I thought a lot of it was poorly written and ridiculous.

 

[boscopup]

I guess I can see the usefulness in some instances, but also agree that if you need one, you might be birthing in the wrong place or with the wrong people. But if you HAVE to birth in that place or with those people, you might need one.

For example, a friend of mine has placenta previa, and if it doesn't move, she'll have to have a C/S. She's already written a birth plan for her C/S, since in that case she would have no choice to change her birth location.

And in there, she has just some basic things, like not wanting her arms strapped down during surgery, not wanting eye goop and other stuff for baby, things like that. In that case, I think a birth plan is a really good idea.

I've never written one personally, as I've always planned my births out-of-hospital with midwives, and the one that ended up in-hospital was a premature birth and the labor itself went so fast that a birth plan wouldn't have mattered anyway (I met my L&D nurse as they were racing my bed down the hall to L&D, since I was ready to push - no time to hand her a paper and say what I wanted!).

 

[MamaMonica]

Moved to Birth and Beyond

 

[annekh23]

I think even if you are confident with your caregivers, there are still enough things that it's worth putting pen to paper on, like you might be totally in agreement about delayed cord cutting, but do you want to do it when the cord has stopped pulsing, or wait until after you've actually delivered the placenta? You can be totally in agreement on general birthing philosophy, but still have preferences which it's worth having them know beforehand.

If you're not fortunate enough to be in a situation where you have that kind of agreement with your caregiver, then it's probably even more important, particularly if you are going against hospital policy, but your doctor has overridden it, that kind of thing.

 

[Sk8ermaiden]

Quote:

Originally Posted by BtotheG This is a timely post for me - I've been really mulling over the issue of birth plans lately. The conclusion I've come to is, if I need to write a birth plan, I am birthing in the wrong place with the wrong people.

I totally agree! My midwife wants one, but I don't know what to write! I mean, she already works the way I want her to. Sure, I want DH to catch and we want to delayed cut the cord, and I can put those on there, but other than that it's basically "tell DH to turn the water heater all the way up" and "remind me not to clench my jaw".

HOWEVER, my birth plan in case of non-emergent transfer to a hospital, despite my trying to make it as "nice" as possible, could basically just read: "I DON'T TRUST YOU. DON'T TOUCH ME."

That can't be good for my "us vs. them mentality".

 

[dogmom327]

I haven't decided yet if we are going to have a meeting or if I'll write something up. Not for my MW (I trust her and we are talking everything out) but for DH and my best friend who will be there. There's some stuff I want done, not forgotten, etc. that will be a little different than last time. We're having a homebirth so I think it's easier.

ITA though...if I actually *need* a birth plan, I'm birthing with the wrong people!

 

[Yuba_River]

I could see why you might not need one for a home birth. I had a fairly intervention-free birth in a hospital, and for that, our birth plan was really helpful. It was fairly short and simple, and we certainly didn't rely on it in place of talking with our caregivers, but we had three nurses over the course of day, so it was nice not having to completely go through everything every time we had a shift change. For example, I put down that I did not want them to offer drugs for pain relief--I would ask if I wanted them. I think I would have had a hard time saying no if they had been continually offering an epidural.

 

[Jane]

Here's a link to a blog post from a midwife. She talks a lot about issues with birth plans and has a lot of different posts about not being able to change the ride with a piece of paper.
I'd recommend checking out a few of her posts, if you have the time. The one I linked to has her thoughts on the plan.

I do recommend writing out a long birth plan for your birthin' minions. It's great for your husband, best friend, doula, MIL, etc. to know the run down. The typical minion's reminder for an average MDC mama might say: no vax, no eye goop, no circ, BREASTFEEDING, no episiotomy, no pain medication, let me walk around, no IV, no baby in the nursery. But that's not for your care providers. It's so anyone can answer for you, and is on the same page on your team.

For the providers - I recommend something hand written on a single side of paper. You want it to be read, after all, and they are busy. Also, I wouldn't recommend outlining the above list. They should ask you for each thing and you'll just give your answers.

Here's a copy of a birth plan I have - it's in big, colorful font:
Birth Plan
Please give a full informed consent before all procedures
Requests
Sounds -keep the music playing
Lights -keep the lights low
Smells -use only mild types of things - no essential oils
Photography - take lots of photos - I don't think I'll mind the flash at all
Laughter -I really like the sound of happy people, let's see how this goes…
Labor
Please listen to heart tones with a fetoscope for as long as possible.
Birth
Please don't push on my legs too much - I have a sore hip joint
Lots of warm perineal compresses, please
I would appreciate lots of counter pressure to slow the descent of the baby's head
I am planning a lotus birth - if all is well, leave the cord until after the placenta delivers
Postpartum
Colostrum & Breastmilk only - no pacifiers or formula
No hepatitis B vaccination and no circumcision
Ask me about Vitamin K for the baby
In case of Caesarean Section
Anesthesia - please limit mediations that cause drowsiness
Breastfeeding - permission granted for anyone to help get the baby latched!

 

[sapphire_chan]

Why not just ask the midwives about you or dh catching the baby? Birth plans are really a way of getting out of talking with your care provider about your wishes for the birth.

I mean, think about how they're usually written. "If at all possible, we would prefer to please have Sue or Bob catch the baby." Translation "I don't think you have my best interests in mind, let me beg you for consideration, but I'm scared to face you in person about this."

Either sit down with the midwives and discuss things or get new midwives that you're comfortable sitting down and discussing things.

 

[Limabean1975]

Quote:

Originally Posted by Apricot Here's a copy of a birth plan I have - it's in big, colorful font: Birth Plan Please give a full informed consent before all procedures Requests Sounds -keep the music playing Lights -keep the lights low Smells -use only mild types of things - no essential oils Photography - take lots of photos - I don't think I'll mind the flash at all Laughter -I really like the sound of happy people, let's see how this goes… Labor Please listen to heart tones with a fetoscope for as long as possible. Birth Please don't push on my legs too much - I have a sore hip joint Lots of warm perineal compresses, please I would appreciate lots of counter pressure to slow the descent of the baby's head I am planning a lotus birth - if all is well, leave the cord until after the placenta delivers Postpartum Colostrum & Breastmilk only - no pacifiers or formula No hepatitis B vaccination and no circumcision Ask me about Vitamin K for the baby In case of Caesarean Section Anesthesia - please limit mediations that cause drowsiness Breastfeeding - permission granted for anyone to help get the baby latched!

Thank you so much for sharing this!! I've been mulling over a birth plan, and I really do want to write one, because I don't think I can expect all 3 of the potential midwives who may be at the birth to remember everything the discussed with me, in the moment. They have alot of clients; I'd like to think I am special to them, but they are busy busy people and I don't expect them to remember my thoughts without a little reminding - and I don't want them to have to flip through notes by what is now 4 different midwives in my file.
And I want my DH to have something to refer to if he has to make any decisions/ give any consent.

Anyway, I really like the plan quoted above for it's directness, simplicity, and brevity. Thanks!

 

[boysmom2]

Very interesting thoughts, everybody! Keep them coming!

Quote:

Originally Posted by the_lissa This is how I feel. I am pretty anti birth plan. My opinion is that you should be on the same page as your caregiver and have discussed everything. I know that it isn't possible for every person, but in general, I think they are ineffective at best.

See, I really feel good about the MWs I've chosen. It's not at all that I feel like I'm going to have to fight them on anything. It's more for the nurses and just a reminder of the specifics.

Quote:

Originally Posted by annekh23 I think even if you are confident with your caregivers, there are still enough things that it's worth putting pen to paper on, like you might be totally in agreement about delayed cord cutting, but do you want to do it when the cord has stopped pulsing, or wait until after you've actually delivered the placenta? You can be totally in agreement on general birthing philosophy, but still have preferences which it's worth having them know beforehand. If you're not fortunate enough to be in a situation where you have that kind of agreement with your caregiver, then it's probably even more important, particularly if you are going against hospital policy, but your doctor has overridden it, that kind of thing.

: Like I said, I know they're totally fine with having someone else catch, but probably that's not how all their patients do it. So, I'd like to have a reminder in there.

Quote:

Originally Posted by Apricot Here's a link to a blog post from a midwife. She talks a lot about issues with birth plans and has a lot of different posts about not being able to change the ride with a piece of paper. I'd recommend checking out a few of her posts, if you have the time. The one I linked to has her thoughts on the plan. I do recommend writing out a long birth plan for your birthin' minions. It's great for your husband, best friend, doula, MIL, etc. to know the run down. The typical minion's reminder for an average MDC mama might say: no vax, no eye goop, no circ, BREASTFEEDING, no episiotomy, no pain medication, let me walk around, no IV, no baby in the nursery. But that's not for your care providers. It's so anyone can answer for you, and is on the same page on your team. For the providers - I recommend something hand written on a single side of paper. You want it to be read, after all, and they are busy. Also, I wouldn't recommend outlining the above list. They should ask you for each thing and you'll just give your answers. Here's a copy of a birth plan I have - it's in big, colorful font: Birth Plan Please give a full informed consent before all procedures Requests Sounds -keep the music playing Lights -keep the lights low Smells -use only mild types of things - no essential oils Photography - take lots of photos - I don't think I'll mind the flash at all Laughter -I really like the sound of happy people, let's see how this goes… Labor Please listen to heart tones with a fetoscope for as long as possible. Birth Please don't push on my legs too much - I have a sore hip joint Lots of warm perineal compresses, please I would appreciate lots of counter pressure to slow the descent of the baby's head I am planning a lotus birth - if all is well, leave the cord until after the placenta delivers Postpartum Colostrum & Breastmilk only - no pacifiers or formula No hepatitis B vaccination and no circumcision Ask me about Vitamin K for the baby In case of Caesarean Section Anesthesia - please limit mediations that cause drowsiness Breastfeeding - permission granted for anyone to help get the baby latched!

Thank you! This was very helpful. And I do plan on writing something more specific for DH. I attended my friend's homebirth and she did this for us. I really liked reading ahead of time what she thought she might like, what her concerns were, and having that to refer to. I felt a lot more comfortable helping her. My DH is great, but I know I may not be the best at communicating at the time, so I think his own list to refer to would help.

Quote:

Originally Posted by sapphire_chan Why not just ask the midwives about you or dh catching the baby? Birth plans are really a way of getting out of talking with your care provider about your wishes for the birth. I mean, think about how they're usually written. "If at all possible, we would prefer to please have Sue or Bob catch the baby." Translation "I don't think you have my best interests in mind, let me beg you for consideration, but I'm scared to face you in person about this." Either sit down with the midwives and discuss things or get new midwives that you're comfortable sitting down and discussing things.

I definitely plan to ask them about everything. I am not at all uncomfortable about talking with them and don't expect any problems there. I just know they're busy and may not necessarily remember all of the details of what we discussed weeks earlier. Also, there are 2 of them, and I don't know who I'll get. I love them both, so that's not an issue, just more people to try to remember stuff.

I guess right now I think I'll probably do one, but I'm still thinking about it. This is just all very interesting. This was really the first time I'd heard mention of them being a bad thing from a natural minded source. Thanks for all your thoughtful responses!

 

[Comtessa]

Quote:

Originally Posted by Sk8ermaiden my birth plan in case of non-emergent transfer to a hospital, despite my trying to make it as "nice" as possible, could basically just read: "I DON'T TRUST YOU. DON'T TOUCH ME."

I started to write my HB-transfer-birth-plan last night, and seriously, that's exactly what it looked like. My (very HB-unsupportive) DH was so pleased that I was finally writing a birth plan, he thinks it's me admitting that I'm going to be ok with a hospital birth after all... he obviously has no idea that it currently says things like "if you say the word 'epidural' anywhere in my hearing, I will throw something at you" and "if you come anywhere near me or my baby with anything sharp, I will personally stab you with it."

And I'm generally a nonviolent person, really...

It's a good thing I trust my HB midwives!

 

[Novella]

Quote:

Originally Posted by BtotheG The conclusion I've come to is, if I need to write a birth plan, I am birthing in the wrong place with the wrong people.

HOW TRUE!!

I've written four, and decided they are pretty useless. The last one got to be absurdly long (for our twins) as we were refusing all kinds of stuff and the freaked-out doctor wanted everything documented to cover her butt.

If I ever was birthing again in a non-UC environment, I probably wouldn't bother writing a birth plan a all. I think the nurses are highly mocking of them in many respects because they are so smug that they know better and pain will have you begging them for mercy.

If I was writing one for whatever reason, it would say only this:

• This birth plan is worded for strict clarity - it is not intended to sound impolite.
• I will almost certainly refuse anything you consider an "intervention" and will also be refusing many interventions that you consider nothing more than standard routine. I will allow interventions only in the very gravest of circumstances and it is likely that my threshold of this is a lot higher than what you usually see.
• I expect that any and all measures of care will be discussed with me or my husband in advance of being performed and that you will obtain our specific verbal consent for each action.
• We are not beyond reason. We simply wish that our beliefs will be honoured, despite being very very different from your normal standards of care.

 

[Sarahstw]

When I worked as a doula I would discourage my clients from writing birth plans. I saw too many people come up with paragraph form, two page stories about how they wanted the birth to go... which, of course, it never does. But any care provider who bothers to look at it has their eyes glaze over.
So I changed my tune to "list the most important things to you that people need to be reminded of"
Things like "no IV" are not of use on a birth plan. Because it will need to be discussed anyway - the nurse is going to come at you with the IV kit and you need to say "no thanks". Even if it is on the birth plan. Same thing with "arm free" for c/section, the discussion is going to happen anyway and it needs to be said in the moment "I'll keep this arm free, thanks."
It's the little routines that are better off stated on paper as reminders, like the timing of cord clamping or eye prophylaxis, baby washing after a c/section... things that happen while your attention is divided, or that may happen if baby goes out of sight.
I agree that if you have care providers that you trust and are well matched with, a birth plan is a little redundant, but it can serve as a good reminder, and just in case your care provider is not available... with things like "let DH catch the baby" "don't call me by my nickname" "we will be having a lotus birth" or whatever.

 

[rosedoe]

I'm almost 17 weeks pregnant with my first child. I've been struggling with writing a birth plan. I feel I need one because I'm birthing at a hospital. My OB is really great and I'm not worried about him, but I am worried about the nurses I'll be stuck with prior to the pushing phase and his arrival. I personally want to have an UC, but NO ONE in my family supports me in this. Not my husband, my parents, my sisters, none of my friends. No one. So I thought I'd do a home birth which after weeks of arguing just...I got tired of the arguing. My sister is a neo natal nurse at a level three hospital and sees all sorts of bad things, so she has filled everyone with these stories and...I just can't argue anymore. I'm too tired to argue. Given no one supports me I'm going to deliver at the hospital that's three minutes (if I hit the one red light between us) from my home. My current plan is to wait as long as I feel I can before going to the hospital. My husband has promised me a million times that he'll be strong and fight off the nurses if they try to do anything to me. To top it all off no one wants to be WITH me when I give birth. I know my husband. He got nauseous when the nurse came to our home to give me an IV (I was very sick my first trimester) and I fear he's going to faint. My mother and both of my sisters don't want to be there when I give birth (even though they live five minutes from the hospital). So I feel like I'm going in on my own. So writing a birth plan has been really difficult for me. I'd like to write "Don't touch me or the baby." and be done with it, but I don't think that'll work. I agree that some people may not need it, but for me I find it a necessity. I wish it wasn't. Thank you for this post. It's been very helpful.