Creating a realistic birth plan

During the final weeks of pregnancy, many patients will bring me their birth plan, a list of specific requests that maps out their ideal birth scenario. It is a wish list of sorts for what the mom and her support person want during labor, birth and the postpartum experience. The birth plan usually also includes specifics for what a patient would like avoid or discourage. 

In my experience, this simple list can raise the hackles of obstetric providers, residents and labor delivery nurses in a matter of minutes. I often hear the phrase, “Oh, and she has a birth plan,“ said in a sarcastic mocking tone. 

I understand both sides. When a laboring mom comes to the hospital to give birth, she is putting herself and her baby in the care of many people she's never met.  These strangers will become part of a very intimate and significant moment in this woman's life.   

Childbirth is a process over which women have little control. I acknowledge the need to exert some choice and control over this unpredictable and dynamic experience, but I can also appreciate the care provider's defensive response to a birth plan. Many border on accusatory and convey a general sense of mistrust of the medical community as a whole. 

I encourage my patients to read as much as they can about the birth process, pain management or coping skills for labor, and breastfeeding and newborn care.  I support a patient's right to be an active participant in her plan of care, but I encourage her to do it in a way that conveys willingness to compromise and an understanding of the unpredictability of birth.

When asked, most families really just want open communication with their caregivers and to be part of the decision making process. Most providers will respect the wishes of their patients, and offer options and alternatives whenever possible.

Everyone involved in the labor and birth process really wants the same thing — a healthy mommy and a healthy baby. The awareness of that fact and some mutual respect on both sides goes a long way in creating a happy birthing experience.

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