Birth Plan Strategies

Prepare for the Unexpected

As you gather your ideas, be open to the unpredictable nature of labor, suggests Kathleen Slone, a certified nurse-midwife in Baltimore. You may have firm ideas about holding your baby right away, for example, but you should avoid sounding adversarial or overly demanding. Always preface each statement with "All things being normal, I'd prefer . . . "

Pam Cass, a certified doula from Warrenton, Virginia, suggests opening with a statement like "I realize that any birth may take unexpected turns. These goals reflect my idea of a model birth, and I thank you for your support in helping me achieve as many of them as possible."

Then emphasize one or two of your most important objectives, she suggests. (You might underline them or put them at the top of your list.) Focusing on the issues that mean most to you can help you feel good about your labor -- no matter what happens. "I attended a birth in which the mother needed several interventions that she had wanted to avoid," Cass says. "But because she wasn't separated from her baby after delivery -- her top priority -- she felt everything was great."

A good birth plan, however, should be more than a list of preferences; it should convey a sense of who you are. For instance, you might write, "I've never been in a hospital before except when my grandmother was dying, so I'm a little fearful" or "It took us nine years to get pregnant, so we want every bit of technology you've got to ensure that our baby is born healthy."

"Disclosing a little personal information can make the hospital staff more likely to rally around your plan, because they'll see you as a person, not just a patient," Simkin says. You should start thinking about what to include in your plan as early as your second trimester, though you needn't put it down on paper until the 32nd through the 36th week of pregnancy. Bring up your questions with your obstetrician or midwife, and negotiate any areas in which you might have different viewpoints, suggests Slone. Once you've written your plan, give a copy to your doctor and schedule an appointment that will be slightly longer than usual to discuss it. Make sure the plan is part of your medical records, which are automatically sent to your birthing site.

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