Birth Plan

ImageYour birth plan is basically a ‘plan’ for your birth experience. Yes, contrary to what you may think, you can actually have a say in your birth experience. Your birth plan basically incorporates your preference for every aspect of your birth experience, e.g. whether you prefer to have epidural or other forms of pain relief, whether you want to have your waterbag burst or not, who do you want to be there, etc.

My Birth Experience

My birth experience with Dominic was completely beyond my control. I was scheduled for inducement of labour because Dominic did not arrive on the expected due date. Because my labour was induced, I had to be strapped down the whole time by the fetal monitor. I couldn’t move around when moving around is actually a better way to speed up labour. I had countless vaginal examinations done by every Tom, Dick and Harry, which I think is absolutely unnecessary. Not to mention the feeling of being violated. 1½ days later, I had epidural and was given the ‘drip’ and had my waterbag burst to further speed up my labour. As a result of the rupturing of membrane (bursting of waterbag), an internal fetal monitor, which is a spiral-shaped needle, was stuck to Dominic’s head (ouch!). Dominic was finally born about 2½ days after I was first admitted for inducement of labour, with the help of forceps. Needless to say, as part of the common practice, I had episiotomy.

At that time, I didn’t know much about things and basically went along with what the doctor said, assuming that the doctor and the hospital know what is best for me. Before you start thinking that my doctor must be a terrible one, let me assure you that he is a wonderful doctor and I am very happy with him. However, I wish I had more knowledge then and participate more by thinking through what I really want. I probably wouldn’t have felt so powerless over the whole situation, like an animal sent to the slaughter.

Why a Birth Plan?

The advantage of having a birth plan is that it gives you a say in the matter and hence, more control than you would normally have without a birth plan. It forces you to sit down, research and think through in detail what kind of birth experience you really want. Without a birth plan, you will basically be subject to the ‘default settings’, or standard practices, of your doctor and hospital, regardless of whether you like it or not.

A birth plan should not be confrontational. It is a communication tool to help you communicate your preferences with the various parties involved including the doctors and other hospital staff. You should discuss with your doctor about your preferences before putting everything down in writing. Your birth plan should not sound like your orders but should just state your preferences under normal circumstances (labour without complications). You will not know for sure what is going to happen during your labour. Understand that under certain special circumstances, certain ‘un-preferred’ procedures need to be done. Your birth plan will not override medically necessary procedures. So, be flexible.

Having something written down in black and white and filed in your medical file is also helpful in the event that your doctor is not able to perform the delivery and another doctor has to take over. You won’t have to go through your birth plan with the relief doctor while in the midst of labour.

How to do a Birth Plan

  1. Do your homework. There is really no short cut. First, you have to read up on how to do a birth plan. Then, you need to do your homework and find out more about giving birth, the various medical procedures and their complications both to you and to your baby, what are your hospital’s standard practices, the options that are available to you, etc. Read books, surf the net, talk to people.
  2.  Think through. Having done all that research, you will have to think through the entire birth process and decide what you want. It may help to visualise the whole process.
  3. Discuss with your doctor. Let your doctor know what your preferences are and get his agreement. You may have to do several revisions before you get an agreed birth plan. Sometimes, you need to compromise on certain aspects. You may not be able to get all of what you want but to be able to have a say in even just some aspects is good enough. However, if your doctor has completely no regard for your preference, you may wish to consider changing to another doctor who will be able to accommodate your preferences.
  4. Write it down. Have writer’s block? Have no worries. These days, you can write your birth plan with the aid of online interactive birth plan maker. These sites either supply templates of birth plans or provide interactive, step-by-step guide. They also have sample birth plans for your reference.
  5. Don’t sweat the small stuff. Focus on the big issues. It may be nice to have candlelights, soft music and aromatherapy in the labour ward. But what’s the point if you have all these and not the more important issues like whether to have an episiotomy or not? Sometimes listing too many things down may work against you in that your doctor will also lose focus on what kind of labour (overall) you really want.

On the Other Hand….

A birth plan, though signed by you and your doctor, is not a legally binding document. The good news is that you need not worry about situations like ‘what if I decided to have epidural even though I stated that I don’t want it in my birth plan’. The bad news is that when the day comes, the doctors, nurses and midwives attending to you may not follow your birth plan to the dot. Your birth plan may become nothing more than an unfulfilled wish list.

Nevertheless, having a birth plan allows you to be aware of the possible options opened to you. In the process of constructing your birth plan, you become more knowledgeable and knowledge empowers you. If you do not know your options, you basically have no options.

In my opinion, knowing what is going on will enhance your ‘enjoyment’ of the whole labour process. It is possible to enjoy the birth process (despite the fact that the media always portray women who are giving birth screaming in pain and agony). Minimally, with greater knowledge, you know what is going on and what to expect. This reduces your fear and anxiety level during labour and you will be more able to relax during your labour.

2nd Time Wiser?

For my 2nd baby, I did my research, went for childbirth education classes, and did my birth plan. It took several discussions with my doctor to get it fine tuned and finalised. Although there was a laundry list of things that I wanted, I was also very clear what was the really important thing to me – to wait for labour to start on its own and delay induction until 42 weeks (provided no fetal distress). The others are secondary priorities.

I got what I wanted most of all. I went into labour on my own (without being induced) 10 days after EDD. I had to sign indemnity, of course. As for the rest, well, it didn’t quite went according to plan but that was partly due to the fact that I found my preference changed there and then and because there was something I overlooked when doing my birthplan and so one thing led to another, and the rest is history. Overall, I enjoyed the 2nd time more because I was more aware of the whole process. I knew what I wanted. Even though in the end, I chose differently from what I originally planned, it was still good for me because at least I made those decisions and not someone else made those decisions for me. In summary, I got the most important wish, I got some of the other wishes, and didn’t get some other wishes and changed my mind about some. Overall, it was much better than the 1st time.

Birth Plan Websites

Birth Plan.com

Birth Planning

Birth Plan – Taking A New Look

Baby Center : Create Your Own Birth Plan

A Birth Plan – What is That?

http://www.thelaboroflove.com/forum/attachment/2.html

– This website (at the bottom of the page) has also a wealth of links to information on childbirth, which would be a good place for you to start your research.

Lastly

What I have covered is just an overview of birth plans. There are some technical details on writing birth plans which I did not go into – e.g. the length and the tone of the birth plan, who should sign the birth plan. Do check out the websites above to learn more about birth plan.