“Do what works best for you and everyone else will hopefully do their best to support you in that,” Dr. Leonard says.
2. Focus on flexibility.
When Standard talks about birth plans with her patients, she refers to them as “preference lists.” “A plan doesn’t leave room for ‘but’—a ‘preference list’ does,” she explains.
Here’s an example: On a traditional birth plan, you may feel inclined to include something like not wanting IV fluids during an uncomplicated vaginal delivery. A preference list would take something like that desire and phrase it differently. It may state, for example, that you’d prefer not to have an IV if you don’t need one, leaving room for the unknowns of labor and delivery.
It seems like a small difference, but thinking about things this way may help you consider alternatives. Maybe you’d be open to having your care team place an IV with no fluids in the event you may need one, for example, Standard explains. The sample birth plan ACOG provides even includes this as a potential option. “Plans need to be fluid. The person making a plan needs to know that a birth plan is a starting point because birth is forever changing,” she says.
Flexibility—and giving yourself grace throughout your birth experience— will also help remind you that it’s not your fault if things change course (which they likely will). Setting yourself up for success from the start by reminding yourself that flexibility and fluidity are part of the process can help ease any negative emotions that may arise if and when things change.
“The purpose of the plan is to have shared decision-making and to have your voice heard—it’s not that everything goes exactly as you planned,” Dr. Leonard says.
3. Talk about your plan well in advance.
You don’t want to be making your birth plan as you’re driving to the hospital or when you start to realize contractions are regular. “You want to discuss it with your provider or providers; you want everybody on the team to be a part of it,” Standard says.
After all, that shared decision-making is the key part, she says. Especially if you’ve experienced birth trauma or past negative birthing experiences, you’ll want to bring up preferences early on to begin conversations and voice any fears you may have. This leaves time to review things with your team and work through any challenges.
When speaking with your care team, Standard always suggests remembering the acronym BRAIN:
- What are the Benefits?
- What are the Risks?
- What are the Alternatives?
- What is my Intuition telling me?
- Do we need to do this Now?
4. Do your research.
Making sure you have quality, up-to-date information is an important and often-overlooked aspect of creating a birth plan.
An example: You may want to list something like “I don’t want an episiotomy” on your birth plan. But Standard notes that while an episiotomy, a cut from the vaginal opening to the anus, used to be a routine part of birth, it no longer is. The Mayo Clinic notes that an episiotomy might only be recommended if the fetus’s shoulder is stuck behind the pelvic bone, the fetus has an unusual heart rate pattern, or forceps or a vacuum are needed.
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