Birth Plan...to write or not to write???

luvmom53 · January 2015

With my last pregnancy 14 yrs ago I made out a Birth Plan, which wasn't used at ALL. I'm wondering if I should bother or not. Does anyone plan to write a Birth Plan, and what sort of things would you include in it??? TIA!!!Cautiously awaiting baby#3(June 2)

musictchr25 · January 2015

There's an app I downloaded on my phone that has a "build your birth plan" tool in it. It's pretty helpful in getting me to think about things that I haven't thought about previously. The app is Pregnancy+, although I think the Pregnancy + Lite version has it also, that way you don't have to pay for the app.

blu-eyedwife · January 2015

Some people like to write out birth plans, have all their thoughts in one place. Other people don't. I don't think there's a right or wrong to this one.

For me personally, I think it's most important to have an idea in mind as to what I want and communicate that to the people around me.

For my first, I really wanted to avoid a C-section if possible, because I was signed up for a half marathon 3 months later and wanted to be able to train. Which is obviously ridiculous. But as ridiculous as it was, I spoke about that with the nurses and each on-call doctor and each was supportive of doing whatever to help avoid a c-section (no internal checks, letting me labor as long as possible as long as there was no risk to me or the child, etc.)

I also wanted to avoid an epidural as long as possible (needle-phobia) but upon finding out I was going to be induced, I wanted to get that started rather quickly. I had spoken with an anesthesiologist friend about my options and avoiding the epidural and he advised the epidural and not to mess around with the Fentanyl (which many choose to "dull" the pain instead of the epidural) because those that start with that end up with the epidural anyway. So I expressed that to the nurse. Well Fentanyl is given to "numb" the epidural area first and the sweet sweet nurse tried to fight the anesthesiologist on giving it to me because I "just wanted the epidural." So expressing your wishes can be effective.

I also wanted delayed cord clamping and for DH to announce the sex. Well, due to the cord being wrapped around my son's neck so many times, his cord was cut immediately so he could be taken over to the warmer. But my DH did get to announce the sex.

AmyCee · January 2015

My birth plan went out the window and my son was delivered via c-section to the worst song ever written (Ring my bell) -- this time I'm scrapping the birth plan but will have music ready to go!!!! Ha. Although it does make a great story as they got me prepped for an emergency c, I said, "stop he can't be born to this song!" They said, "congrats, mama its a boy!"

leenziepops · January 2015

luvmom53 said:

With my last pregnancy 14 yrs ago I made out a Birth Plan, which wasn't used at ALL. I'm wondering if I should bother or not. Does anyone plan to write a Birth Plan, and what sort of things would you include in it??? TIA!!!Cautiously awaiting baby#3(June 2)

I'm not sure yet and have been doing some light research into this topic. So far what I found useful about writing a birth plan is: No more than one page, Keep it simple and concise, always keep in mind that things may not go to plan.

laurendutch · January 2015

I have heard that some L&D nurses joke that when a Mom presents a birth plan, they get the OR ready.

I think it's great to have a plan going in but know the best plan is to get baby here safely!

cnoelle92 · January 2015

I actually made a thread a few months ago about this same topic. I was going to go in with a birth plan and I actually had made one. But as I got further along in this pregnancy, I realized that my only true "birth plan" was to have a healthy, happy baby. That's all you can really ask for.

klkonwi · January 2015

Yes. We nurses do joke about that........ You are so right. Most nurses will respect your wishes if you just say so. Birth plans are like life plans..... God laughs at our life plans....

JTA2426 · January 2015

My birth plan: get the baby out safely. Go from there.

No snark intended.

Katerina&Baby · January 2015

I think if it helps you to organize your thoughts and force yourself to consider different scenarios then go ahead and write one. That being said, I don't really see much value in bringing it with you to the hospital since A. you and your SO should already be on the same page about the plan and be able to advocate for yourself and baby, and B. since you can't anticipate every scenario, your plan might fly straight out the window.

ksimo6 · January 2015

Write it. Then rip it up. Get you and your baby through the process safely.

CMSullivan326 · January 2015

I see no point in a detailed birth plan. When I had my son NOTHING went the way I wanted it to (no, I didn't write one). Of course there are a few things I want to happen this time around but if they don't, its ok with me. Sometimes we get lucky and things turn out the way we want but I've learned that one thing we can't predict or control, is labor & delivery.

NirvanaGreen · January 2015

My birth plan is to not die in labor. Whatever the doctors have to do that promotes that goal, I'm all for it.

Schnurette · January 2015

I had "wishes" when I was pregnant with DD but my underlying plan was "have a healthy baby" which roughly translated to "do what the doctors say".

My local hospital, no med, wonderful birth turned into an ambulance, city hospital, induction, epidural, c-section, wonderful birth and as a result I'm not going to try to plan anything this time. (Although I am going the "scheduled c-section" route this time, in the city hospital...so I'm kind of by-passing any opportunity for a birth plan lol

Bednarova · January 2015

I think writing the birth plan to help you organize your thoughts is angood idea, but I agree it shouldnt come to the hospital with you.

My goals for birth- wait as long as I can before I get an epi (but I want one), and then delayed clamping and immediate skin to skin with baby.

Only one of those happened with DS1 (the epi), bc he was in distress. I'm quite happy with the outcome of his birth, bc he's alive and healthy. (and I am too)

brynne11544 · January 2015

I wrote one but honestly everything I wanted and was my first option didn't happen. I think by the third time something I had "planned" wasn't going to happen I had a mini melt down and then got a pep talk from my doctor. I won't do one with this baby but I will have things voiced that I would really like to happen.

thelittlestbee · January 2015

We're not planning on writing a birth plan. My Dr didn't suggest it and I just want the baby to arrive safely without complications. I'll let the doctors and nurses do whatever they need to do to make sure that happens for us.

edited because I can't spell today

mamahawk12 · January 2015

Writing out a birth plan is like writing out a plan for a plane crash. You have NO IDEA how it's going to go down and no amount of "planning" will change that.

BabyList · January 2015

Mine was not used at all with my last pregnancy. I would talk to your OB and see what the standards are, and if you want things done differently, I would write it down.

cnoelle92 · January 2015

pickles26 said:
My OB recommends it, but I think it is more for his patients to think about what happens during L&D and what they would like to happen. He did say that the L&D nurses weren't going to run around with your birth plan making sure everything happens the way you wrote it out. It makes sense to me. He just gave a tour of L&D and there were some really basic questions that people asked, I was pretty surprised. Seems like nobody reads pregnancy books anymore.

Yeah they download pregnancy apps and ask their medical questions there, thinking we have our medical degree.

Ana0927 · January 2015

Honestly I wouldn't bother. If you have any wishes you can tell the nurse when you get there.

With my first I wrote one and then ripped it up when I had to have a c-section. With #2 (also a c-section) I only had three requests and I told the nurse when I checked in.

deutschbaby · January 2015

I won't be writing a birth plan, but I WILL have a baby care plan. I didn't have one with DS and I should have.

Things we will include:

-We will delay cord clamping (if possible, emergency exceptions may apply)

-Our son WILL NOT be circumcised during our hospital stay under any circumstances. A parent will supervise the pediatric examination of him, and under no circumstances will his foreskin be forcibly retracted.

-Baby will room in with mom, and will be accompanied by a parent whenever leaving the room (except in emergency, when not possible).

-Baby will not be given a pacifier or bottle of any kind (including sugar water) without the the written consent of a parent.

-Visitors will not be allowed unless mom is notified first and gives permission.

Yes, these all come from experience. Our hospitals we have a choice of delivery at are very "assembly line" like, and often do thins "just because this is how it is done". I have some relatives I don't want visiting, and they just let people up during visitor hours (ugh).

The circumcision one comes from a recent case in our state. A baby boy was circumcised without his parents permission in the hospital last year. His parents sued and were awarded a measly $60K. But still, it happens. Not my kid, just no.

deutschbaby · January 2015

Also I'll add that assisted birth outside of a hospital is illegal in my State, so my options are limited. Which royally sucks. Birth Centers, Home Birth, etc don't exist here. Because of this, there is an extreme sense at our hospitals that you (the mother) are not in control of the situation at all. The thing we have to remember, is that after he is born, we have the right to leave the hospital at any time with our son. We are not prisoners. Assuming all goes well, we hope to stay less than 24 hours.

I'm jealous of those of you who have birth choices.

ajgerber · January 2015

Writing it down is not necessary unless it makes you feel better. I think it is more important to make sure your SO or anyone who will be there at delivery understands what you want since you may not be in the position to answer at the hospital.

Another note, your ob may ask you during your appts but I hardly saw my ob at the hospital the entire stay, maybe 15 minutes tops including stitching me up! So you will have to tell the nursing staff when you get there what you want as well. And then again at shift change.

mommacandi · January 2015

I think it's important to think of things you would like to happen/not to happen (epidural, baby's care after delivery, etc.), but also important to remember that things do not always go to plan. With DD, I had no plan at all. I was determined that however it happened was how it was going to happen and as long as I had a healthy baby, I didn't care how she was delivered. The only thing I was sure of was that I was getting an epidural. I ended up with an emergency C-section after 36 hours of labor, and because I had no plan, I was not disappointed about the C-section and was just grateful to have a healthy baby. My BFF vehemently pushed back about needing a C-section due to a blood clot, and still feels disappointed in her delivery experience because it wasn't her "plan."

gingerbabe · January 2015

I wrote out a birth plan mostly for myself and my husband, so I could think about everything beforehand and he could be on the same page as me. I did not hand over my birth plan to the attending labor/delivery nurse. I kinda just would tell them what I wanted as we went.

I think it depends on your hospital and dr or midwife. My midwife is with me practically the whole time I am in labor at the hospital and they are the ones who communicate a lot to the nurse. Also so much can change during labor that a birth plan is really just a rough idea of what you prefer.

sschwege · January 2015

Just lurking.

My MWs encourage their patients to write up a birth plan. I bring it to one of my appointments for them to review, then they put one in my chart, and ask us to make two more copies, one for us and one to be presented to the nurses at the hospital.

Here's what I suggest. Keep it brief, less than a page and use bullet points. Ask ahead of time for hospital policy regarding things that are important to you, this way you are not repeating yourself. If eating and drinking is encouraged, no need to write that you want to be able to eat. If they encourage use of the bath and shower, just get in when you want to, no need to document your desire to use water. Also keep in mind these are your wishes in an ideal world. Things may not go according to plan, so be flexible and open minded.

Mine was worded nicely of course, but here are the main points I remember from mine, again this is not the wording i used, my birth plan was much more pleasant sounding. And obviously had everything gone south then my birth plan would have meant nothing.

No IV or saline lock

Free of blood pressure cuff between readings

Refrain from asking about pain scales and using words such as 'pain' 'hurt'

No offer of pain meds

Limited cervical checks and NOT to be told how dilated I am

Intermittent Monitoring using the doppler

Mother directed pushing

For Baby:

No formula/pacifier/first bath

Immediate skin to skin

Delay all non-essential procedures to allow bonding

I also had a brief c-section birth plan which was in my chart and had a mental list of what my birth plan would be if I had to be induced.

Ladymouse · January 2015

I do. Hospitals make me nervous (bad past experiences), and labor is, well, kind of a distracting time to be making decisions. It will be less than a page, nothing about music or lighting, and based on my past experience with this hospital. DH and my doula are just as likely to reference it as hospital staff.

tinybugsmom · January 2015

The hospital I am delivering at has a "birth concierge" who sits down with you when you register and writes up your birth plan. They are very natural and mom focused.... Encouraging delayed cord cutting, skin to skin, and breastfeeding.

So I will be making one, and it will be ready and waiting in the system for when I deliver....

lilitaliangirl · January 2015

ksimo6 said:

Write it. Then rip it up. Get you and your baby through the process safely.

So This! My sister has been a L&D nurse and I talked with her a lot before my delivery of DS. I put complete trust in my nurses (and lucked out with awesome ones, too). Hell, I never took a class or even toured L&D prior to delivery.

laurendutch · January 2015

I never toured L&D when I had my twins. But I was there twice a week for NSTs...so I became familiar with all the nurses and procedures.

HayesRN13 · January 2015

If you deliver at a hospital I would say no to the birth plan... Most traditional OBs won't look at them and most OB RNs think they are a "curse".. as the ones that come in with lengthy birth plans seem to be the ones that end up in a c-sections... If you do a birth plan, deliver at a birthing center they will be more focused on your birth plan, advice from experience.. Good luck!

aliciaspinnet · January 2015

I don't think I'm going to bother with a written birth plan. My main concern is getting the baby out in a way that does as little damage to them and me as possible. Everything else is a bonus. I'll probably have a chat with my husband beforehand about what I want so that he can be my advocate if needed. We're both doctors (not obstetricians) so I'm guessing we'll be taking an active interest in what's going on (and will understand the jargon

Joolschweetheart · January 2015

Every mom I've asked about this has giggled knowingly and politely told me that babies make their own plans.

For me, I'm going to write one because
a) I love to make a good list and for some odd reason it soothes my anxieties.
b) the apps that you can enlist are helping to consider things that as a clueless and nervy FTM I would never have thought of.

I don't intend to give this to the drs or nurses, I want to do it to organize my own thoughts.

littlebear&bugbug · January 2015

I think it is 100% worth knowing and thinking about (and talking about with your ob/dh) beforehand what your wishes are. When it comes time, everyone is stressed and it's hard to remember what you talked about in cooler times. DH was NO help first time around because he was just like, "babybabybaby!!!!sldkfmaoivserj"

That said, obviously things don't go as planned always. When I went in with both, my ob/dh/nurses knew what I wanted but I also made it clear to them (well, everyone but dh) that they were medical professionals and I would trust their advice if something went awry. I think it's as important to have an ob that you trust as it is to have a birth plan.

So anyway, I think the biggest concern is getting so attached to it that one deviation will make your birth feel like a "failure." So if that's your personality type, maybe it's better not to have one. However, if you feel like not having one will stress you out more, make one. Just know yourself and your ob and trust that they are looking out for your best interests.

And, as it happens, I had two birth plans and no OR. So whether or not the nurses joke, that's not always what happens!

tahitiandreamin · January 2015

Have a few things in mind that you would like but be willing to abandon them if necessary. I've met too many moms who have PPD because their birth didn't go to plan. At the end of the day the only thing that really matters is that you have a healthy outside baby.

WifeDeAngel · January 2015

This time I plan on just telling the nurses to keep things crunchy. I'm delivering at one of the busiest delivery hospitals in the US, so they'll know what I'm talking about.

dancegurl1118 · January 2015

The nurses I work with, myself included, would never tell someone not to write a birth plan.

I have had some crazy birth plans though where it made me question if they did any research on birth or just became terrified by horror stories and chose to believe them.

My favorite personal examples:

-"My baby and I are NOT your lab animals to do tests on" - wait, what?
-"We do not want to be cared for by anyone with less than 5 years experience at any point" Welp, looks like you are going to be alone for your stay until the 5 seconds the doctor comes in to deliver the baby
-"Do not give my child any vaccines or circumcision without my consent" crap, there goes my plan of whisking your child away to give them a thousand shots! Also..your baby is a girl.
-"We only want to be cared for by people of [insert] faith." Not gonna even start in on this..

If I am being honest, reading things like that devalue the job I love and the earnest work I do every night. I have the greatest (and sometimes hardest) job in the world, and being demonized is tough.

Birth plans are GREAT to give nurses and doctors an overall idea of what you are looking for in your birth experience. I find the happiest births come from patients that say "ideally we would like this, but are open to what's best for healthy mom and baby". I always ask patients if they have any particulars, and remind them that those particulars aren't set in stone and they can change their mind

the best laid plans....

sschwege · January 2015

dancegurl1118 said:

The nurses I work with, myself included, would never tell someone not to write a birth plan. I have had some crazy birth plans though where it made me question if they did any research on birth or just became terrified by horror stories and chose to believe them. My favorite personal examples: -"My baby and I are NOT your lab animals to do tests on" - wait, what? -"We do not want to be cared for by anyone with less than 5 years experience at any point" Welp, looks like you are going to be alone for your stay until the 5 seconds the doctor comes in to deliver the baby -"Do not give my child any vaccines or circumcision without my consent" crap, there goes my plan of whisking your child away to give them a thousand shots! Also..your baby is a girl. -"We only want to be cared for by people of [insert] faith." Not gonna even start in on this.. If I am being honest, reading things like that devalue the job I love and the earnest work I do every night. I have the greatest (and sometimes hardest) job in the world, and being demonized is tough. Birth plans are GREAT to give nurses and doctors an overall idea of what you are looking for in your birth experience. I find the happiest births come from patients that say "ideally we would like this, but are open to what's best for healthy mom and baby". I always ask patients if they have any particulars, and remind them that those particulars aren't set in stone and they can change their mind the best laid plans....

@dancegurl1118 I first just wanted to say 'thank you' for being a nurse. My mother was (still licensed) a pediatric nurse and it is a tough, tough job, not to mention it can be a thankless one. So thank you!

I have one more to add to your list of over the top requests. My SIL is a pedi and used to work in a hospital. One woman came in with a birth plan that read,

"If baby needs to be resuscitated, please do it on mother's chest."

What, your child is not breathing and you are worried about skin to skin bonding?! Just crazy! My SIL said luckily the baby was born with no problems, but she was like there was no way you could do that!

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