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Do I need a birth plan?

 In Ask an Expert, Midwifery, OB/GYN & Women's Health, Pulse Blog

Q: What’s a birth plan and do I need one?

Me: “So sweetheart, you want to catch the baby?”

My husband: “Uh, that’s why I hired a midwife.”

Even two babies in, my husband and I didn’t have the same vision for how the birth of our newest bundle was going to go. It was an amusing and valuable moment for us, driving home the importance of having a birth plan and revisiting it every time.

In general, a birth plan tells your providers what is important to you during your baby’s delivery. Plans can range from simple to detailed, and can be communicated verbally or written out. Most birth plans include decisions such as:

  • Where you want to have your baby
  • Who will be your care provider
  • Who will attend the birth as your support person
  • What non-medical comfort measures you wish to use
  • What pain-management options you want (nitrous oxide, epidural, etc.)
  • Who will cut the umbilical cord

Sometimes birth plans include more subtle considerations, including preferences for:

  • Temperature and room lighting
  • Delayed cord clamping
  • Immediate skin-to-skin contact versus drying the baby off first
  • Length of stay in the birth center

They can also include things that you don’t want or that are annoying to you. For example, my own husband was barred from talking during a contraction.

When creating your birth plan, find out what your provider or birth center normally do during births. That information will allow you to opt in or out of some routines. It’s a very good idea to discuss your birth plan with your provider several weeks before your due date. This allows you to talk through items that are particularly important to you. It also gives your provider an opportunity to explain what situations might require them to divert from the plan to best protect you and your baby.

Providers often keep a copy of a birth plan for their patient’s chart, but it’s a good idea to take it with you to the birth center as well. Your nurses will typically review it upon your arrival.

Discussing what you want and don’t want with your partner, family, and provider—long before labor begins—helps you become aware of what’s important to you and enables the people who will be with you during this experience to know how to best support you.

If you don’t know where to start with your birth plan, there are lots of online resources that can get you going. Or you can just dive in and write it freehand. No matter how you approach your plan, I always advise my patients to write it in pencil—if only figuratively. Being flexible will allow you to roll with the glorious unpredictability that is childbirth.

Oh, and if you’re wondering? My husband didn’t catch any of our seven babies. That’s what we hired our midwives for.

—Patricia Kartchner, CNM

Patricia Kartchner earned a master of science in nursing with a specialty in midwifery from Oregon Health & Science University.

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