When you first become pregnant, labor seems a million months away. But a few ultrasounds later and you’re sporting a watermelon-sized bump. Even if you’ve gone to classes, read books and talked to friends, nothing can truly prepare you for labor. And that’s scary, right? Enter: The birth plan.
It’s a document you’re supposed to draft and hand off to your nurse when you arrive at the hospital. It tells your medical team exactly how you’d like childbirth to go down – relaxing music, dim lights, breathwork and massages, immediate skin-to-skin contact, and the list goes on and on. Writing it up can make you feel more in control and calmer about your impending due date.
The problem? Birth plans don’t work. At least not like you’re hoping they will.
Birth Plans Aren’t Effective
During my first pregnancy, I mentioned to my OB that I was getting ready to write my birth plan. His response in a nutshell? Don’t. He indicated that some nurses get offended by birth plans and that handing one off to the staff could set up an adversarial tone.
Offending people when in throes of labor shouldn’t really be your top concern though, right? Who cares if a nurse thinks you’re woo-woo for wanting to listen to acoustic guitar tunes while panting like a labradoodle in the desert. But there’s another, bigger reason that writing a birth plan is a waste of time:
Birth plans don’t get followed.
I don’t know a single person who said that their doctor or nurses referenced their birth plan even one time during their delivery. When it comes to bringing a baby into the world, things can move fast. There isn’t time to look up your thoughts on episiotomies and forceps as your little one’s head starts to emerge. And, if you or your baby’s vitals drop, you’ll be sprinted off to the operating room for a C-section in under 60 seconds flat. No joke – those hospital peeps don’t mess around when lives are on the line.
And even during labor, when you wrote in your birth plan that you didn’t want any pain-management medication or to have your mom in the room, you could (and probably will) change your mind. Because you don’t know what you really want until you’re in the situation.
When I had my first child, we packed massage tools, magazines and music to use during labor. I asked for a certain type of fetal monitor that would allow me to walk around. I was 100 percent certain this baby was coming out vaginally and that I wouldn’t need an epidural. After all, my mom had me after six hours of labor at a birthing clinic with no pain meds. She even went home that same day.
But nothing went as planned. My little girl was turned the wrong way and got stuck in the birth canal. After three hours of pushing (with her head so close to coming out!) we ended up in the operating room. We never touched the stuff we brought with us and I did ask for and receive an epidural during labor (because back labor is the stuff of nightmares).
The bottom line: The unexpected is bound to happen. Being open to things not going exactly as you planned will keep you from feeling disappointed. It’ll also make it easier for your medical team to give you the best possible care.
What’s Better Than a Birth Plan
Even though there’s no point in giving a written birth plan to your doctor or nurses, thinking about and knowing your birthing preferences is still important. Here’s why: You can tell them to your husband, doula or another support person. Your support person can communicate your wishes in real-time to your medical team.
It can be difficult to make decisions or express them yourself in the heat of labor. But if your labor-room advocate (i.e. husband, doula, mom, etc.) knows your concerns and preferences they can speak up for you.
For example, your doctor might want to give you Pitocin to speed up labor. If that’s an intervention that you didn’t want, your advocate can question the recommendation. Perhaps ask the doctor why it’s important right now? Is it possible to hold off? Are there any natural alternatives?
Since your support person is clued into your desires, they can see if there are options that better align with your wishes. And if not, at least you’ll have an understanding of why the intervention is crucial.
What You Should Tell Your Advocate
During my first labor, my husband was like a deer caught in headlights. He just nodded when the doctor or nurses told us what they wanted to do, and I was too wrapped up in my contractions to say, “Hold it. Hold everything!”
So I made sure that for the second delivery, my husband knew exactly what I wanted him to do. I even typed up a cheat sheet for him.
Here are some of the things to discuss with your support person:
- The best ways to encourage and motivate you (even give your support person the language to use like, “you’re doing great!”)
- Your birthing preferences on things like pain management, interventions, immediate skin-to-skin contact and newborn care
- When you want your support person to question the medical team about recommendations that go against your preferences
- When to intervene (e.g. shutting down the negative, “you’re not pushing hard enough” comments from nurses or doctors or telling family you need time to rest)
- The type of support you’d like in the delivery room like doing breathing exercises with you, holding your legs, turning off cell phone notifications and not leaving your bedside to talk to family in the waiting room (because, inevitably, that’s when the doctor or nurse will come in to discuss something)
Go into labor with the expectation that a healthy delivery is the top priority for you and your medical team. Know that doctors and nurses want you to feel good about your birth experience, too. It’s ok to question their recommendations and to choose something different (but still safe!) than their initial suggestion. That’s where having a well-informed, assertive and questioning in-room advocate can make the entire experience smoother, happier and more empowering for you.
Having a voice who cares only about you and your concerns is stronger than any piece of paper.
P.S. Want to make life with a newborn easier? What about labor and delivery? Girl, I got your back! Just grab my free (and printable) Due Date Checklist to find out what you need to do during the third trimester to be fully prepared.