Many couples dream about the birth of their child, looking forward to having the event unfold according to their preferences. Often, they are disappointed to learn that their preferences cannot be honored because their healthcare provider has objections, or hospital policy prohibits certain procedures, or simply because no one knew of the couple’s wishes. By preparing a birth plan well in advance of your delivery date, you will have plenty of time to overcome obstacles to having the birth experience you desire.
Keep in mind that the well-being of mother and child are the primary goal of every hospital and health care provider. Certain routines and procedures are in place to ensure patients’ health and safety. Under the right circumstances and with advance planning, however, it is often possible to have your preferences worked into the established routine.
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Educating yourself is essential. You are undoubtedly reading as much as you can about pregnancy, labor and delivery. Be sure that you understand what is happening to you and your baby, and be involved in your prenatal care from the beginning. Learn about common treatments and procedures so you will be able to discuss options with your healthcare provider. Obtain as much information as possible so you will be able to make decisions based on solid facts, and discuss those facts intelligently when the time comes.
Draft your birth plan as soon as you have an idea of what you want and don’t want. Divide your preferences by stage of labor: first-stage labor (while you’re dilating), second-stage labor (while you are giving birth), and after birth. First-stage issues might include use of fetal monitors; augmentation of labor (such as pitocin); use of pain medication; freedom to move around during labor; use of an I.V.; and environment (lighting, music, presence of family members).
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Second-stage preferences include everything that affects the birth itself, including position; episiotomy; and your partner’s role (such as cutting the cord).
Your preferences for the moments right after birth might relate to examinations and bathing of your baby; how soon you will be able to breastfeed; other routine procedures; your partner’s presence; and your discharge.
Visit the hospital in advance and ask for a tour of the labor and delivery area. Be prepared with questions about the issues that matter to you, and learn what procedures are routine and which are required. Ask if the hospital has different rooms from which to choose, so that you can make a request for a particular room if it’s available when you arrive. Don’t hesitate to make a second visit if you wish, until you are comfortable with what you have learned and all your questions have been answered.
Review and revise your draft based on the new information you obtained. Then bring it to your obstetrician or midwife for discussion. Remember that you, your partner and your healthcare provider are a team, so concerns of each party should be addressed. Listen to any objections your healthcare provider voices, and find more information on the subject. Perhaps you will reconsider your request; perhaps you will uncover studies or statistics with which your doctor/midwife is not familiar. Keep an open mind and discuss these issues thoroughly until a compromise is reached. Remember that while you must be comfortable with the plan, it won’t work without the support of your healthcare provider. It is in your best interest to find a solid compromise.
Present a copy of the birth plan to your doctor or midwife when the final version is ready. Have it signed, then send a copy of it to the maternity ward of the hospital, along with a cover letter explaining who you are, how to reach you, and your due date. Follow up to determine whether there will be any problems with your requests. If so, discuss any objections and work toward a reasonable compromise. Put the revised agreement in writing and deliver it to the hospital to be filed along with your original birth plan. When you arrive at the hospital to deliver your baby, tell the nurse who attends you that you have a birth plan on file. (Be sure to pack one in your suitcase, so it will be available in case the hospital misplaces their copy.)
It will be your partner’s job to be your advocate while you’re in labor. If your preferences are not being honored, he should address this with your healthcare provider and the labor nurse. Since your birth plan was already agreed upon by all parties, it should be a simple matter to correct any oversights at this point.
Barring complications, your birth experience can proceed as you envisioned it by planning ahead. Making a birth plan requires time and effort, but it helps ensure a more positive, memorable experience for you, your partner, and your new baby.
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