By Lori Mork

A birth plan is a tool to help you get educated and organized on your options and preferences BEFORE the big day. It’s your “personalized wish list and ultimate road map through the entire process”.

I love birth plans because it assists the person giving birth to:

• Educate themselves on options.
• Weigh the benefits, risks, alternatives, and doing nothing (BRAN)
• Realize they have the power of CHOICE. You are the boss of your own birth! 
• Are prepared for anything that might be presented in the busyness of labour and birth. No surprises, it helps to plan ahead JUST IN CASE.  

Birth plans also help to create open dialogue. Between you and your medical provider. You and your partner or support person. You and your Doula. Also just allows you to tap deep within to find out what is really important to you on this magical journey into parenthood. 

Okay, growing a baby is hard work! You are busy! Writing a birth plan shouldn’t be a 10-page novel with all of your hopes and dreams in it. A little secret, the medical providers take a “glance” at it, especially the longer worded documents. You really do need to be short, clear, precise with your words, and just take out all of the “fluff” and lay out it point by point for how you want or vision your birth to me. 

Remember it’s not all the “fluff”, more of a MEDICAL DIRECTIVE. “A cheat sheet for the medical provider, for your support person, your doula, and for you to have at the birth.” 

It’s a way to communicate your wants or vision in terms of all things birth (even if you mention these things during medical appointments they might not remember.) 

Try not to be too wordy. Write it down, then back it up with a short “WHY” often is more helpful to everyone.  Keep it SHORT and TO THE POINT.

Now, this doesn’t mean it’s a contract, legally binding. There are a lot of moving parts that are out of your control, and the medical provider’s control. You can change your mind at any time. 

In the event of a medical emergency no one will be asking your opinion, and we wouldn’t need that in those circumstances. But for the most part, BIRTH IS SAFE. In labour, we often have time to weigh options, and be ready for any detours to the plan. Slow enough we are often able to take time to process all of the options. 

In the event you don’t get your usual medical provider and someone else steps in, they can get a short recap of all that is important to you!

So, I invite you to look at the components of the birth plan and don’t write a 5-part Netflix series or no one will read it. SHORT, SWEET, and MAKE YOUR POINT. It doesn’t have to be on beautiful stationary. It doesn’t have to be your final say. It’s a vision, a tool to look back to when you are in the thick of labour, to remind you of the things that were important to you when you had that quiet and calm down time to decide and plan it. 

COMPONENTS OF A BIRTH PLAN (this can vary, you may include all, some, or other stuff too)

The Basics

• Your full name (pronouns)
• Your Partners/Support Persons Name (pronouns)
• Your Doulas Name
• Your Medical Care Provider (doctor or midwife)
• Location of Labour and Birth (ie. Home, hospital) 

Labour Augmentation

You are approaching your due date, and everyone is starting to wonder “when is this baby coming?” Impatience. I get it! Excitement! Anticipation! But it can also be daunting when presented with ideas of induction (bringing labour on with outside measures). Inducing can also happen within the labour stages. Perhaps if the baby is in distress or labour isn’t progressing according to “Friedman’s Curve – how labour progression is “supposed” to look”. 

Some methods used to induce are:

• Cervical “sweeps” – stripping the membranes.
• Prostaglandin Gel
• Pitocin 
• Rupturing of membranes (breaking your water)

It’s always best to keep it clear and say what you might be okay with, and what you aren’t wanting to use. 

A line on the birth plan could read:

“If the baby is past EDD at 42 weeks I will consider induction methods.”

Or “I don’t want any inductions methods used unless there are emergencies or distress. At EDD I will be patient and wait for the baby to birth when they are ready without intervention.”

LABOUR

Environment of the room

Who will be with you? Your partner, support person, do you have a Doula? Your Aunt Georgia. Lay out all of the names of people who will be with you in the room for labour. This can be short and sweet.

“In the Labour room I will have my Partner (Jeff), My Doula (Lori” (At BC Women’s Hospital in Vancouver it’s one on one nursing support, so often the nurse is also in the room. But this can be a request if you want alone time or not. 

You have stated WHO, and also other requests, and the WHY.

Music, Lights, Food, interruptions

Keep it simple. 

“I don’t want music playing, and I want all talking to be at a minimum. I only want medical providers when there is a need to monitor me or the baby, and it has to be kept to a minimum to not overwhelm me.”

Or “I want loud music, bright light, and tons of people interacting, I want a Party!” lol

Under labour you can also include any positions or locations you want to be. For example:

“Home birth – I want to move freely and on my own. I don’t want anyone telling me what positions to get in unless I ask them. I want to be left alone and checked as little as possible. I have a birth pool I would like to use for the pushing stage.”

“I will be staying home as long as possible in Early labour and as Active Labour progresses. At the hospital I want to be able to move freely, and choose my own positions to labour in.”

Or “I will be laboring at the hospital during active labour and want my Doula to help me find comforting positions. I would like to labour in the shower at times if I so desire.”

At BC Women’s Hospital some of the rooms have an amazing tub – Like AMAZING! So, this might be something to include in your plan as well.

“I want the option to deliver the baby in the tub.”

Other things to research and decide on:

Vaginal Checks and Cervical Exams 

Baby’s Fetal Heart Rate Monitoring 

Pain medication and management options

I’m not going to use this blog to break down the why, how, what, risks, benefits, etc. I will just mention them to plant the seed in your mind to include some thought on each of these. Then educate yourself on all of them in order to make your own decisions. 

• Narcotics 
• Epidural – BC Women’s Hospital in Vancouver has an 80% Epidural rate. So this is an important one to research and be clear on for yourself. 
• Laughing Gas

Also to note any other thoughts or feelings around being offered pain meds when not coping. You might be asking for them. Have a CODE WORD with support person and Doula, that oftentimes never gets used even when birthing person is saying to me (I can’t do this anymore I want drugs!) distraction and time often mean it never gets mentioned again. If the code word comes out it means at your final straw and serious. 

So, on the birth plan it might read:

“Don’t offer me pain medication or the epidural unless I ask for it and say the Code Word of “PICKLES.””

Or “I want to use an Epidural but only when I ask for it, do not offer it to me.”

Other things to think about and clearly lay out:

• Pushing (spontaneous, directed, without time limits (although medical settings have set policies, you can ask, doesn’t mean you will be allowed)
• Forceps and Vacuum
• Having your Water manually Broken or not
• Who will catch the baby? You, your partner, etc. 
• Episiotomy 
• Cord Clamping
• Placenta Delivery – delivery (active or physiological management) (are you keeping Placenta? Or not?)

Caesarean (C-Section)

Sometimes it’s necessary. It’s really important to feel comfortable enough to be present in that process, if it has to happen. Of course, you may have a feeling of defeat in a moment, but I want you to be prepared to embrace it if it happens. Having the space to ask questions, ask for time to talk about it, process it, then move forward can be so empowering to the person birthing. 

“In the event of a c-section, if possible, I would like time for my partner and I to process and prepare. A few minutes to accept this. This is important to me.” 

Who do you want in the Operating Room – OR with you? Support Person? Doula? You have to write it down. 

“In the event of a C-section I want my husband and doula present and by my side in the operating room.”

Baby/Postpartum

• Vitamin K shot – yes, no, when, how 
• Eye Cream for the baby – Acetaminophen
• Breastfeeding or Formula – Supplementing for baby
• Time alone with baby before medical checks need to be done.

Okay, this was meant to keep it simple. It looks like a lot. But it really isn’t. If you start during pregnancy whether in prenatal classes, or with your Doula, to learn all of the benefits or risks of anything that could arise you are just taking that proactive approach to your birth.

Remember none of this is set in stone. This is just inviting you to do some research in terms of your options. Lay out your preferences and vision for the birth. Then have it with you so others can also clearly see what you want and need. There may be unexpected obstacles or turns of events, but this just helps you to be educated on some things that might happen or be presented and be ready for them in such cases. 

Happy birthing!

Lori