Writing a Good Birth Plan

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Have you thought of making a birth plan, searching for a birth plan worksheet, or a birth plan template?  This post will help you in writing a good birth plan — or, it may make you consider just leaving the birth plan at home. :)

Have I written this blog before?

Will your birth plan give you what you want?  This is written by a labor nurse who has seen many birth plans and how they affect your labor.  Come see waht they do!

Maybe so, it’s something I hit quite often in my profession.  Although, not as often as some people think.  I would guess maybe 5% of our patients have a birth plan where I am now.  Maybe 10%, I would think the number would be closer to 2% at my last hospital.

I just have to say this is one area where you need to just be prepared to take what comes {this coming from someone who LOVES a good spreadsheet}.  Sure, have in your mind that you don’t want an epidural but if the pain is truly more then you can successfully take without going out of your mind with pain, then get an epidural.

So, you want to know how to write a good birth plan?  Let me tell you what a good birth plan template usually includes:  No c-section, no pitocin, no episiotomy.  Newsflash, I don’t want any of those for you either.  I avoid each of them as well as I can while mother nature takes her toll on your body.

Sure, say that you don’t want a c-section, but really — who does?  By saying it, I swear you increase your chance of getting it 3 fold.

But, my final plea is that if you want a home birth experience, give birth at home.  We just have SO many rules at the hospital that we HAVE to follow that can’t give you a home birth experience.  We HAVE to monitor, we have to follow what the doctor says.   It’s just the way of the hospital.  And we take so much risk by letting you have your way with things.

I constantly wish I could just deliver babies without policies or charting or worries.  But, our friends lawyers have made that a thing of the past.

Just remember that your nurse is on your team.  She wants the same thing you do — a healthy mom and baby.  It’s no good trying to fight it. 😉

** After reading this post I think I sound really anti-natural birthing.  And I’m not.  I went 12 days past my due date with Princess P and I’m not usually an advocate for pitocin.  BUT, I’ve just heard some crazy things lately about pitocin use and I’m not sure where people are getting it.  Also, I just want my patients to realize I am ON their team.  100%.

Other posts you might like:
5 Basic Labor Terms
5 Medical Things to Think About Postpartum
Things to Do Before Having a Baby
What to Pack to Have a Baby
Is My Water Broken?

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  1. says

    Well said. As a crazy person whose done it FOUR times, I think some of the reality makes it easier to plan. That plan usually involves getting the baby out of my body, and not dying. Really those were my only two goals with my last two. There were a list of bonus items: epidural (fail), saline block (fail), my own pretty gown (dumb idea), no vomitting (success!), just me and hubs in the room (success again!), and an OB who I’d met before (fail on all four!) – then you hold your baby and you know that you did that, however you did that, and it doesn’t matter any more because now you have a list of other things to worry about, and you can control most of those.

  2. says

    It looks like “Natural Mom” deleted her comment. A few thoughts on mean doctors and nurses:
    1. We are ruled by policy which is ruled by the law. The end. You have no idea how easily we can be sued and for how long, and for millions, and millions of dollars.
    2. If your doctor doesn’t jive with your wishes, I’d leave. She shouldn’t have to kick you out. But, she has probably had patients die who were unwilling to use Pitocin and she just don’t want that again. Simple as that.
    3. You didn’t have a natural birth because you wrote a birth plan, you had one because you were lucky. Many women are not that lucky. Their uterus doesn’t contract, their hips are too small, their baby has a defect.

    **I am 100% for education. I TEACH prenatal class, and I am very honest and open with our practices. I LOVE patients who are educated and wanting to participate in their care. Your words would be really hurtful to women who were unable to have a natural birth even WITH a birth plan. I hate to mention the fact that I have seen thousands of births and you’ve seen… what? one? I’m glad you have a healthy mom and a healthy baby. That is always my goal, and I hope it’s my patient’s as well.

    • says

      I think luck only plays a small part of having a natural birth. I would say that education is the biggest factor. Yes, sometimes things don’t go as planned but preventing getting to that point can greatly increase your chance of a natural birth. I remember telling my nurse during my first labour that contractions slowed down as I was moving around so she told me to stay in bed. Well as I learned later on they weren’t slowing down- they just didn’t hurt as much when I had gravity on my side. The snowball effect during labour can happen quickly.

      • says

        Education can’t give you a bigger pelvis or unwrap the cord like a boa constrictor…. but yes, being educated on best practices is certainly important. :)

        • Jennifer says

          Hilary, I love your posts! I am also an OB nurse, I welcome birth plans and certainly I also feel that education on the patient’s part is crucial. Another thing that is super important to me is finding a physician or midwife who is patient and whom you can trust. My own doctor and I had developed a wonderful working relationship, she was with me through years of infertility and miscarriage and when I finally gave birth to my daughter, she gave me a fighting chance! I had to be induced at 38 weeks for severely high blood pressure, my body was not ready to have a baby, but my doctor stuck it out, ripened my cervix for over 24 hours and then started pitocin. Low and behold my water broke on its own and I ended up a precipitous delivery! Any other physician would have sectioned me for sure. I am so glad that she trusted my body and will forever be grateful to her for that!

          • says

            Jennifer,thanks! I completely agree with getting a doctor that is on the same page! Glad your story has a great ending!

  3. Heather says

    I would totally agree with you. When you step foot in the hospital, you release any control you have over your birth. It is a completely different model than a home birth.

    I have so much admiration for women who go to the hospital. It is very rare that you get the birth experience you want and the likelihood of intervention is almost certain. Like you said, it is all about what the doctor and hospital wants to do.

    My one sister had her three at home and there is no way that a hospital doctor would have been able to help her deliver vaginally without complications or intervention like her midwives were able to do. It took a lot of time and the help of an experienced midwife who knew how to work with the body. She would have had 3 c-sections for sure.

    Every woman needs to make the decision of where she feels most comfortable giving birth and then realize that it will simply look different.

  4. says

    At the end of the day, how your baby got here and how much medication or not you needed to deliver is not nearly as important as having a healthy babe in your arms, the strength to recover quickly and enjoy your baby is what really matters. I love natural Child Birth, I enjoyed less is more, but one of my births was lead by our daughter surviving not by the plan or desire! Thankful for a brilliant Physician and a flexible attitude. Birth is a process, more often it go’s as planed and Natural is doable, but at the end of this journey it really won’t matter after you hold your baby, and years down the road, it will just be part of your personal story! HAPPY BIRTHING

  5. says

    I so admire ob nurses. Dealing with hormonal women??? Yeesh.
    I have had 2 babies at home, one at a birthing center(midwife) and two in the hospital -one of which was an emergency c-section. (tranverse breech)
    My home births were my favorite, since they were perfectly normal, yada, yada, but boy was I thankful for the hospital when I needed it. Never wrote a plan–figured they were gonna have to do certain stuff anyways, and what could be personalized i could verbally choose at the time. Which I did.
    Great perspective.

  6. says

    I have two healthy children and both were born in the hospital with various forms of intervention. My second child was far from a seamless birth and included the bed about to be rolled into the OR so that I could have a C Section and me begging to please let me push and by some miracle getting that baby out in 3 pushes. (I’m sure the doctor wanted to strangle me at that point, but I think he was less persuaded by me than by the fact that the baby’s heart beat had come back up from a big dip). That being said the only place I would ever choose to give birth is in a place where in the event of something catastrophic, in a matter of seconds my child and I would have access to every possible intervention to keep my baby and me alive. My living room does not accommodate that. I dislike hospitals as much as the next person, but in the words of Casey Affleck, “What, there are people that like it there?”. I can’t imagine choosing to have a home birth and then something going wrong and living with the what ifs for the rest of my life.

  7. Kate says

    Unfortunately, I am not able to have a home birth in the state that I live (Alabama). It is illegal for a midwife or doula to practice birth outside of the hospital. They can have their licenses suspended or revoked and fined thousands of dollars. The nurses at my hospital are very happy to accept birth plans and ask for them. They even ask that they be as detailed as possible so that they don’t have to continually ask a laboring mother what it is she wants. All they ask us that you are open minded when it comes to emergency situations.

    • says

      I dont’ mind birth plans at all. Ilove knowing what my patient wants…. I just think when people are set in their ways God always finds them a new plan. 😉

  8. Ali says

    I had my first baby in the hospital. I did write a birth plan — the hospital representative told me prior to being in labor that I could “birth in any position” I was comfortable in and the birthing rooms were all equipped with birthing bars, balls, jetted tubs, etc. When it came down to it, that was a bunch of BS. The doctor told them to put me on my back and I had to push that baby out like nature did NOT intend. I wanted a limited number of people in the room during L&D. The hospital rep said they enforced their “3 support people” rule very carefully, but when it came down to it, they laughed about my husband’s grandma also being in the room, “what? I don’t see anyone sitting over there…” I did not want students involved in the birth. But when it came down to it, three students took turns delivering the baby and stitching me up afterwards with the doctor leaning back, his arms folded, saying, “Just keep doing what you’re doing.” I wanted to listen to calming music and look at pictures of those I love during difficult contractions. But when it came down to it, I had to beg for the music to be turned up (which got turned back down after about 10 seconds) and for my picture book (which got put away after one contraction) and my nurses kept telling me not to listen to my body, to breathe or not breathe, to push or not push, to stop being scared, etc.
    So I decided to have a home birth for my second baby. All the things I wanted, I didn’t have to put into a “plan” because I got to birth the way women have been birthing for thousands of years. My midwife stayed in the background until I was ready to push. She gave me the freedom to listen to my body and push when I felt I needed to. That birth was far less traumatic both physically and emotionally, I feel because I was treated with respect as a person with wishes that were also respected.
    In the hospital, my wishes really were not even listened to. They had their agenda and my delivery was going to look however they wanted it to, however it was easiest for them, whenever it was easiest for them. I remember my nurse telling me to stop being scared of the pain and just push through it. I listened (foolishly) to her instead of listening to my body. It was that push that caused a 4th degree tear deep inside that required 45 minutes of stitching afterwards.
    At that point during my second delivery, I paused in my pushing, the baby’s head out, but body still in. My midwife waited. She encouraged me to push again when I was ready. And I did. And I had a tiny tear that took about 3 stitches.
    Just my two cents… I’m a super advocate for birthing at home if at all possible. Unless you know something is going to be an issue where a hospital is required, home is a great place to welcome your little one! I’m sure nurses and doctors at the hospital want a healthy baby/healthy mommy, and that’s great, but many don’t seem to care how that result happens. It’s like, as long as no one dies, it was a job well done. Birth can be so positive and empowering and doesn’t have to leave emotional scars! I still get uptight when I think of my first daughter’s birth and all that surrounded it. But I love remembering my second daughter’s birth because of the way I was treated.
    Sorry such a long comment!

    • says

      Uh! It does sound like you had a bad birth. I must admit it’s always a balance between the patient and hospital policy. Add doctor’s who have particular and it can be quite a tug of war. I guess the main thing I can think of is making sure your doctor is on board with your wishes from the beginning….. they are all SO different. I have a blog coming up about home vs hospital births. Be sure to check back for that one — i think it publishes on Nov 23.

      • Ali says

        It was tricky because it was a high risk pregnancy — several unrelated factors all happened that made it so, so my prenatal care was handled by a team of 15 doctors. I never really knew which doctor I’d see at my appointments — just whoever was available. I think I ended up meeting about 10 of them and I loved 2 of them, really liked the rest except one, and of course, that one doctor I didn’t really gel with was the one on call when I went into labor. :(
        Because I did not go all “labor-hormone-pain crazy,” the intake nurses didn’t take me seriously (they wouldn’t put me in a room until I was like 6 cm dilated, were rude to me, talked about sending me home behind my back (in front of one of my support people), and the whole experience was just frustrating! I SO wish I had had a doula that time around! I had one for my home birth and even though I didn’t really need an advocate at home, she paid attention to what I wanted, made sure I had music going, suggested positions to labor in, etc. I feel like a doula would have been so helpful in the hospital in making sure that as many of my desires as were feasible were accommodated instead of making jokes out of how many people they could fit into the room, etc. So if a hospital birth is the only way to go for whatever reason for any future children, I’m DEFINITELY bringing along a doula and I recommend that to all of my pregnant friends!

        • says

          Yeah, large groups make that really hard. I’m sorry. No one should ever talk rudely. The fact is — it is a job and people have “off” days — but it sure isn’t fair to the patient. I think doulas can be very helpful, but I have also seen them be a huge waste of money — so pick one who will make a good use of your dollar. :)

  9. says

    I live in Canada and I am so grateful for the maternity options that we have here. Midwives are highly trained, experienced and regulated. You can have a midwife and give birth in the hospital here. When you do so you are just “borrowing the room”. No nurses come in, no one ‘checking in on you’ or bugging you, no rules about how many people you can have with you or what equipment you need to be hooked up to or what you have to wear. You don’t even wear a hospital bracelet. Yet, all emergency services are literally right outside the door incase an emergency occurs. This allows you to have a home like birth within a hospital setting.

    It also allows you to discuss what you want your birth to look like, a verbal birth plan if you will, and because it is just two midwives with you that you have been seeing for months they know what you are requesting and do their best to honour that.


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