The Importance of a Birth Plan

by Tessa Vasiliadis, Doula ​
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Expectant parents have a never ending to-do list to prepare for a new baby. Somewhere at the top of the list should be creating a birth plan. During birth, the frontal lobe - aka the decision making and logical thinking part of our brain - turns off. The majority of brain activity is focussed in the back of our brain - the mammalian part. Which is convenient that our bodies inherently know how to birth offspring and will naturally do so, but unhelpful when an array of modern medical procedures and interventions are presented to us without the ability to think critically. A birth plan provides the opportunity to review the evidence for various birth procedures prior to labor, while the ability to think critically and rationally is still functioning. 


What is a Birth Plan?
A birth plan is a list of preferences for your ideal birth. Your birth plan should include your desires about early and active labor, medical intervention, pushing, and newborn care. Birth plans are not set in stone, as many variables change throughout the entire process. Birth plans are unique to each birth - so you should rewrite one for each pregnancy. Most doulas have their own checklist or outline for formatting a birth plan, but some hospitals have premade birth plans their staff are more familiar with. It’s best to check with your obstetrician or midwife to see what is routine for their practice. 

A successful birth plan is maximum one page in length. It can seem overwhelming to shorten all this info into a single page, but a doula can be helpful in discussing where your birth plan specifics differ from routine practice. 


What’s the Importance of a Birth Plan?
A birth plan is less a concrete, unchangeable outline of your labor, and more an educational resource for the birther. The process of creating a birth plan allows the birther to explore evidence based information regarding birthing procedures and interventions. This provides an added layer of advocacy and autonomy for the birther, so they can be better prepared for the options that will be given to them during labor. A birth plan will inform the labor and delivery staff of your preferences. Some birthers who want to achieve natural labor would prefer the staff doesn’t offer an epidural or narcotics. This can be specified in a birth plan. Additionally, if your obstetrician is not available for your birth (which is common unless in the case of a planned induction), the obstetrician delivering your baby will be more familiar with your preferences. 

Birth plans can also include trauma and sexual trauma history. These topics are essential to birth, but rarely included in medical history. It is a safe, unspoken, non triggering way to disclose your trauma history with your medical team. Additionally, having a doula who’s aware of your previous trauma can help advocate for you in a safe and respectful way. 

Creating a birth plan also gives the partner of the birther the ability to be included in the decision making process for their child. Even though the partner is not birthing the child, establishing a mutually agreed on birthing plan involves the partner in the first decisions being made in their child’s life. 

Why Should I Create a Backup Birth Plan?
I can almost guarantee your birth will not be identical to how it was envisioned. Every labor is unique, each baby presents differently, and there are hundreds of variables in a single labor. Creating a backup birth plan prepares the birther to advocate for themselves in an unpredictable scenario. If the birther was planning a vaginal delivery, but an unforeseen cesarean is unavoidable, a backup birth plan could include preferences for a cesarean delivery. This makes the change more palatable, and leaves the birther and their partner less overwhelmed. Having a backup birth plan can also help in reflecting and honoring the birth. At least one thing is set to change from your initial goal for labor, and having a backup plan or alternative possibilities can help the birther feel more confident in their birth even though their initial desires had to be adjusted. This can be extremely useful in the months to come as the birther reflects on their birthing experience. 

Topics / Procedures Included in a Birth Plan:
Your birth plan should include your preferences sorted into three sections: background details, labor & giving birth, and after birth. 

Background Details:

• Birther (and partner’s) name 
• Baby’s due date
• Obstetrician / Midwife / Doula / Pediatrician 
• Medical Issues (both related and unrelated to the pregnancy)

Labor & Giving Birth:

• Support team present during labor (ex: if you want your children or best friend present)
• Ideal birthing positions *
• Induction preferences *
• Use of epidural 
• Birthing Tub *
• IV / Hep lock *
• Fetal monitoring *
• Nitrous oxide *
• Episiotomy *

After Birth:

• Skin to skin 
• Baby in nursery or constantly at bedside 
• Breastfeeding (do you want a lactation consultant?)
• Cord clamping / cutting *
• Cord blood *
• Vitamin k
• Eye ointment
• Circumcision 
• Immunizations

(* check with hospital or birthing center about policies regarding this topic)

A doula can help provide you the unbiased education and evidence based studies for procedures and interventions that could take place during birth. Scheduling a prenatal visit with a doula can help you and your partner discuss the best options for your birth plan. 

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