Characteristics of Effective Birth Plans

If your decide to use a written birth plan, you want it to be read and respected.  Here are some tips to help you create a birth plan which will maximize your chances of getting what you want.  Good birth plans are:

SHORT.  Most doctors hate long conversations, and this feeling carries over to things they read.  The more concise and pithy you make your plan, the more likely it is your doctor will respect it.  Nurses are very overwhelmed with paperwork already, and they will appreciate a birth plan that is short and to the point.

REALISTIC AND RELEVANT.  Only request items that are available at your birth place, and that your wishes are appropriate to your personal situation. 

POSITIVE.  Avoid a negative tone; try not to include the word "no".  Instead of a long list of things you don't want, write a short statement about what you do want.  For instance, "Our goal is as natural and non interventive birth as possible" or "We would really like you to take extra time to explain risks and benefits to us to help us come to a decision."

PERSONAL.  Your caregivers would rather read something you write yourself than a perfect birth plan you get from a book or the internet.  The more individual you make it, the more likely it is to catch attention and be meaningful.

FEELING-BASED.   It is best not to refer to studies or books, but to talk about your own feelings and experiences.  No medical professional likes to have it implied that you know their business better than they do (even if you think you might); but no one can argue about your feelings.

WHAT TO AVOID:

INFLEXIBILITY: Doctors are frightened by plans which state that certain procedures absolutely will not be done.  The best plans assume that communication will continue during labor, and that no options are entirely off limits, even if for you they are.  It's alright to be opposed to some procedures entirely, but do not convey that in a birth plan, just indicate that you'd prefer something else.

IMPLICATIONS OF UNETHICAL BEHAVIOR. Birth plans often contain a statement such as "I do not want a cesarean unless medically necessary."  This statement implies that the doctor regularly does unnecessary cesarean, and is justifiably offensive.  Instead, stick to statements of feeling: "I would be terribly upset and disappointed if I had a cesarean."

HOSTILITY.  If you start with the assumption that the medical staff desire to help you have the experience you desire, you are more likely to make friends who will advocate for you.  Starting with the attitude that the medical team are enemies will create unnecessary defensiveness and anger.

A NOTE TO CONSIDER:

The majority of birth plans are useful only in hospital birth environments, simply because for homebirth couples, they will not encounter any strangers that don't know or won't remember their wishes and interventions are automatically avoided unless truly medically necessary.  Many couples want  the non-intervention based experience of a homebirth in the hospital, and that is certainly obtainable in most circumstances. 

You must accept, though, that when choosing a hospital birth, some degree of intervention will be part of the game.  If you choose to argue points of minor intervention, such as wearing a hospital gown, and become labeled a bad patient, you may of won the battle, but lost the war in that you will be treated with hostility and come away with a negative experience. 

Medical personnel become such because they believe it is the safest way to have a baby.  If you disagree with their values and beliefs about childbirth but still choose to birth with them, hope for, but please don't expect a homebirth like experience.  You've subjected yourself to their belief of safety and may be fought on many points that you think are unsafe and thereby put yourself at risk for the very complications you wish to avoid.

  Bottom line:  If you want a certain birth experience, and believe a certain pathway to be the safest for you, choose the birth environment and birth attendants that will support that.