by Karen Bruce, AAHCC, CD(DONA)
A birth plan, or care preferences document, is a statement of your preferences for your birth and it demonstrates to your birth team that you intend to take an active role in the decision-making process of your labor and birth. Your doula can help you prepare this document, and you should share it with every member of your team in advance in order to address any questions or concerns in advance of your birth or to catch any preferences which cannot be accommodated at your birth place or in your particular medical situation.
Keep in mind that your audience is your care team (OB or midwife, nurses and other medical staff, and your labor support people), and be specific to your birth place — it shows you did your research when you are familiar with specific hospital or birth center protocols. If you are planning a homebirth, you might have a plan for home with a back-up birth plan in case of hospital transfer. These two documents should look radically different because of audience and options available in each setting.
Consider the specific options available to you in your birth place and do your research as to the risks and benefits of each option. What does your intuition tell you is right for your family?
Once you have explored your options, you have an opportunity to communicate your hopes and dreams for the labor, birth, and immediate postpartum period. What should you include in your birth plan and how should you organize your thoughts? I recommend you find a few sample birth plans to get you started — ask your doula or childbirth educator for an example or two, or find some online, keeping in mind that online birth plans may not reflect the practices in your birth place, and should be edited carefully.
Here are some basic guidelines for preparing your birth preferences document:
- Make it personal — use your own voice and language whenever possible, and include information or photos that reveal something of your family’s personality.
- Keep it to one page. If you really can’t keep it to one page print it back to back.
- It’s OK to plagiarise. If you find a well-put statement on a sample birth plan and like how something is stated, don’t reinvent the wheel.
- Be succinct.
- Say it clearly and get specific — don’t be vague.
- Bullet, bold and highlight your priorities. It should be obvious what is most important to you.
Whenever possible, make positive statements of what you do want to happen rather than gathering of list of “don’ts”. Birth plans that demonstrate a cooperative attitude and flexibility will be well-received by your birth team and show your willingness to work together. Your birth plan does not replace your conversations for informed consent/informed refusal, but can remind you and your partner of your preferences when decisions must be made. If the circumstances of your birth take you down an unexpected path, writing a birth preferences document will have been a valuable exercise in educating yourself as to the risks and benefits of various birth options, even if you change your mind along the way.