Here are the three steps to developing a birth plan.
Birth Plan Checklist – Pregnant Parent and Partner
Find a checklist such as http://www.pcnguide.com/wp-content/uploads/2016/03/2-Preparing-Your-Birth-Plan.pdf. The pregnant parent should go through it with either their partner, doula, or anyone who will be key in providing labor support.
Walk through it together, discussing each option. If you realize you don’t understand any of the options, then learn more about it, by reading Pregnancy, Childbirth, and the Newborn: The Complete Guide or using online resources such as Childbirth Connection or Lamaze. Or, I highly recommend taking an in-person childbirth class where you will learn about all these options and have an opportunity to ask questions and get information about current local practices.
For many decisions, you may be in complete agreement with each other. Where you’re not, take time discussing it – what are your reasons for your preference. If you can come to consensus, that’s great. If not, then the choices of the person who will be giving birth take priority over the other person / people’s choices. Some families realize it would be helpful to bring in additional labor support people (such as a doula) who actively support those choices.
This checklist has way more details than you need to share with your care providers, and may have many things which are obvious to caregivers (e.g. most people do not mark that they want an episiotomy). You should plan to have the detailed checklist in your bag at the birth in case a decision comes up and you can’t remember what your prenatal preference was on that option.
Top Priorities – Discuss with Care Provider
Different things are important to different people. You may already know what the most important things are to you in terms of having a satisfying birth experience. Or you you may discover what your top priorities are while completing the checklist.
Make a list of 3 to 5 things that REALLY matter to you. Then discuss these with your care provider at a prenatal appointment. Make sure that these choices will be options for you during your birth process. (If they’re not, then it’s best that you know now so you’re not disappointed later! Or so you can change your plans as needed.) Ask what you can do to increase the likelihood of reaching those goals.
Written Birth Plan – Share with Nurses
When you give birth at a hospital with a physician, most of your care is overseen by a nurse, who is typically someone you don’t meet until they are assigned to you in the midst of labor. And you may have multiple nurses over the course of the labor. A birth plan is the primary tool for communicating with nurses about the family’s goals and priorities, and what kind of support from them would be most helpful to you.
If you’re planning an out-of-hospital birth, plan to write a birth plan for transfer, so that if transfer were to become necessary, you would increase the chance that the birth would be as close to your desires as possible given the situation.
Have a few copies of the birth plan with you so when you arrive at the hospital, you can hand it to the charge nurse and ask that a copy be put in your chart.
A written birth plan should never be more than one page long (in a easily readable format.) One format is to have three sections. The first describes who you are as a family and who will be at the birth and what you have done to prepare for this birth. The second gives the big picture of your preferences for labor support, pain medication, and interventions, emphasizing your top 3 priorities.
The third paragraph is optional, and explains any special information that you think “if the nurse only knew this about me, they could better support me.” This is a good place to address religious or cultural preferences, history of sexual abuse or other personal history that may affect you during the birth process, any particular worries you have about the birth.
Sample birth plans are available at http://www.pcnguide.com/wp-content/uploads/2016/03/2-Preparing-Your-Birth-Plan.pdf. They will give you lots of ideas while also showing that there’s no one right way to write a birth plan.
It’s important to remember that things don’t always go according to plan! A birth plan is really your description of what your preferences are if things unfold as you hope. Sometimes they don’t, and that’s why you’ve also gone through the whole birth plan checklist and discussed all the options. That also why you’ll want to know about how to ask questions about the benefits, risks and alternatives to proposed interventions so that you can make informed choices.
Also check out Lamaze’s guidance on birth plans.