Birth Planning vs. a Birth Plan
Aren’t birth planning and having a birth plan the same thing?
Yes.
And no.
It’s true that without doing some birth planning you won’t have a birth plan, but doing the planning doesn’t necessarily mean you have to write a plan down.
So what does it mean to plan your birth?
This can look like many different things, and should always reflect the unique circumstances that each family finds themselves in. Much like planning a wedding, birth planning should take into consideration the people, the environment, the overall experience, and the details that you will have control of. Also like weddings, births will rarely go exactly according to plan.
Which is why a written birth plan isn’t always needed!
Let’s use the wedding analogy to paint a picture.
When planning a wedding you choose the venue, the menu, the colours, flowers, ceremony details, maybe even the vows. You ensure transportation, you know who your officiant will be, and who you want in your wedding party (if you have one). You will likely deal with friends and family members who have opinions.
Birth, and birth planning, is very similar to planning a wedding. You can plan for the venue (planned birthing location), who you want there (such as a friend, relative, or doula), transportation to your birthplace, and perhaps even what you will wear. And there will definitely be friends and family members with opinions.
However, just as all the meticulous planning in the world cannot account for weather, traffic delays, missing flower deliveries, or any other challenge, you cannot plan for every single aspect of birth. You can’t plan for your waters breaking but contractions not starting. You can’t control for a baby that doesn’t tolerate labour well. And birth happens on its own timeline, not a carefully crafted schedule of events.
Not being able to plan for every outcome and contingency plan doesn’t mean you shouldn’t do some planning. And by planning, we mean discuss your thoughts and preferences with your support team. This could be your partner(s), a family member, a doula, or a friend.
Things to consider when you are planning your birth:
who will be your support team? When do you want them to join you?
what kind of environment do you want (is it a birthday party/more calm and soothing, lots of movement or sound, or quiet?)
do you have any religious or cultural observations or traditions that need to be incorporated?
specific fears or worries, and how you want to approach conversations if they need to happen (i.e. being afraid of an induction and discussing what happens if one is recommended because you go past your EDD)
are there things you can bring with you that you feel will help during birth (blanket, pillow, pictures, iPad, etc.)
So why don’t we think a written birth plan is necessary?
Well, to start, nurses and doctors are human beings who love their jobs and are there to help. Discussing your birthing preferences with them is always going to have a better response than handing them a neatly typed document. And, in our experience, the important details are remembered and shared with relief staff and the next shift more when you’ve talked through your needs!
Another reason that written birth plans may not help is because many of the suggestions of what to include are based on an American medical system (and an older one at that). In Ontario, we use a hospitalist system, which means doctors are not being called every time a patient is in labour. The birth will be attended by whichever doctor is on call that day. Because of this, the stories of births being rushed for a doctor that wanted to get back to their holiday party isn’t reflective of our system!
Many of the other recommendations you see are standard in Ontario:
induction is done for medical reasons only
caesareans are done for medical reasons only
vaginal birth after caesarean is encouraged for those who meet the medical requirements
only babies requiring Special Care support (NICU) go to a nursery, all other babies room-in with parents
Oxytocin is gradually increased (and maintained once a strong labour pattern is established) to prevent hyperstimulation and distress to the baby
Discussing your birth preferences, hopes, and wishes with your support team is an invaluable process. It can help you to boil down your priorities and help to get everyone on the same page. Regardless of whether you write a birth plan down, making sure those you will have with you know your needs is important.
If having a written birth plan is important to you, that’s great! But you still want to make it concise. If you need to have a longer and more detailed plan that you make with your support team, do that, but make sure the one you give to your medical providers is just one page. On that page, we recommend you include the following:
any specific details the staff should know (cord blood banking, history of loss, triggers, religious or cultural observances, etc).
the atmosphere/environment of the room
anything “out of the ordinary” i.e. if you do not know the sex and want someone in particular to announce it
your preferences in case of an change in plans (designated decision-maker, preferences during a caesarean, etc. (just remember that they may not be able to accommodate these requests, depending on the situation)
important information about your family such as names and each persons relationship/role
