1. Be mindful of making a plan that will feel good no matter what.
Too often I hear about people who wrote a birth plan only to painfully watch each thing they wanted be taken away from them, one after another. Labor at home as long as possible - ended up needing an induction. Epidural around 8 centimeters, please - pressured into one after 4 hours at 4cms. Immediate skin-to-skin after birth - baby whisked away because there was meconium.
Part of the benefit of birth plans is also one of the drawbacks: You know what you want. And then you know when you don't get it.
Having desires that felt etched in stone be washed away by the intensity and mystery of birth can feel demoralizing. And each time you watch one of those wishes go down the toilet with your bloody show, a part of your birth and body trust dies. All that denial of dreams is exhausting. And something else exhausting is the last thing you need.
So what to do?
It's important for you to understand your options and have a direction. Let's not mince words about that. Taking a birth class, reading and planning, watching and hearing good birth stories...these are absolutely necessary. What's even more important is that you have a birth place and provider you trust.
People who feel good about their birth experiences know that they did everything they could to have the birth they felt was safest and best.
Even when things go 'wrong,' you'll likely feel much better about the experience and what happened to you and your baby if you felt you did what you could, were supported and respected, and were able to make the decisions yourself.
A couple who thinks out-of-hospital birth is foolhardy and dangerous and then ends up delivering in the car at 80 miles per hour may hope for a different experience next time, but they don't feel like something was taken from them or wring their hands with 'what if.'
Feeling good about your birth, both during and after, comes down to mutual trust and respect between you and your caregiver. After that, it is largely a matter of planning, doing what you can, and being open and flexible with what happens.
2. The secret to immortality (and birth...and life) is infinite flexibility.
This ancient Sanskrit saying rings true. Keep it in mind as you write your birth plan. If you want to have a low-stress birth, pick a provider you trust, prepare for the intensity and common occurrences of birth, and then be unattached to the process. Increased stress and stumbling blocks often come when you are keeping a vice-like grip on a certain outcome.
Let it go. Let go and let God. Be still. Release. Relax. Whatever works for you. Be only in the moment. It's all you can control, anyway.
The stress of having to hold on to what you wanted can only get in the way of your birth. Having a doula and a partner to pay attention to the process is helpful in keeping providers on the same page as you. You shouldn't have to think of it while you're in labor. You should be letting go and resting internally.
The small bump of despair when something you were holding on to falls out of your hands can rock your birth. If you feel attached to specific steps or processes, the disappointment has a negative effect on the hormone production that keeps your labor going.
3. Remember that being on the same page is more important than what you write down.
When you start thinking about your options and the direction you want to go, the most important thing is for the people who will be with you to be on the same page as you are. I just addressed the importance of a doula and partner who can pay attention and notice when your choices aren't being respected. You should not be paying attention. Your attention makes your labor harder and longer.
Better than having what you want written down, posted on the door, and distributed to everyone in triplicate is having everyone who supports you knowing your preferences. Talk about what you want in detail with your team beforehand.
4. A birth plan doesn't mean you don't have to advocate for yourselves.
This may go without saying, but just because you list what you want doesn't mean anyone will read it or remember or follow it. Hopefully you have a supportive partner and doula who know what you want and can notice when things are going awry.
There are two ways for things to go awry, and they aren't always distinguishable, even to professionals. The first is when your wishes are not being taken seriously. The second is when something occurs that calls for your birth to go off-plan.
If you have asked not to have people suggest an epidural or ask about your pain levels and then people keep coming in reminding you that an epidural is available, that's blatant disregard. If your blood pressure skyrockets and they want to induce you, that's a birth that calls for going off-plan. Unfortunately, for most things it's very difficult to tell the difference between what is a necessary departure from plan and what isn't.
When an intervention or departure from your wishes is suggested, ask questions. Specifically "Are me and my baby OK right now?" and "What other options do I have?"
Ask your doula to point out when something is going a direction you hoped to avoid and support you and your partner in asking questions and discovering options.
5. Plan for the best. Expect the best. Prepare for everything.
I belong to a group called Homebirth Cesarean. It's made up of people who planned home births and ended up with cesareans. We planned the most low-intervention births and ended up with the most interventionist births. It's difficult to process, even sometimes after years. Because anything can happen in birth, everyone should have a plan C.
It's not unreasonable to expect your birth to be wonderful. You can and should plan for that. I've had an ecstatic birth. I'd be happy to do it again. It can happen to you, too. Part of the reason it went so well for me, I think, was that I had a much more flexible mindset. I had a provider I trusted implicitly, a Plan C, and the emotional and mental pathways for going there.
You need to prepare for things that you think of as bad. What don't you want to happen? What can you do if it does? Can you get to a place where whatever needs to happen is OK?
6. Only you can make the right decisions for yourself and your baby because only you know all the factors and influences.
I'm fond of telling my birth class clients that the best birth plan looks something like this:
I will make all the decisions about my body and that of my baby after considering advice from you as my hired professional.
It doesn't matter how much research you've done, how many classes you've taken, or how much you understand about birth. You get to make the decisions.
Having a birth professional there to guide and inform and advise you can make the experience much safer and easier. Or it can make it harder and less safe. This is why your choice of provider makes so much difference in the direction your birth takes.
After listening to the input of a provider you trust, you have the responsibility and the right to make the decisions about what happens to your body or your baby's body.
If you don't want that responsibility, a doctor will gladly take over for you. This is part of what you pay them for, and it is a load off. But it's important to remember that whether you want them to make the choices or not, you do not give up your bodily autonomy just because you are pregnant.
Happy researching, planning, and decision-making!
Happy Birth Day to you!