You can’t plan a birth. They’re too unpredictable. Birth plans won’t change what’s going to happen… will they? Birth Expert Cheryl Sheriff, founder of Ideal Birth, explains the power in preparing your birth plan and how it can influence your birthing outcomes.
Why Are Birth Plans So Important?
Birth plans are very helpful for the key reason that to actually have a birth plan means that you have researched all your choices, that you have an understanding of what might happen during your labour, and that you are communicating that to your care providers on a piece of paper. This then means that you don’t have to speak at a time during labour when you are quite vulnerable and probably not able to communicate as effectively as you normally would do.
The power of the birth plan isn’t even the actual plan, it’s in the process of becoming educated about your options; and usually in most of the Brisbane hospitals now, the midwives will ask: “Do you have a birth plan?” “Because we wouldn’t want to give you something that you don’t actually want.” So that’s a very positive move forward. It helps them to understand what your preferences are, and how effectively they are able to support you with those preferences. Going with the flow is great, (and that is really important when you are actually in your labour, to be able to go with the flow and relax!) but going with the flow without any preparation, without a plan, without any strategies, means that you usually go with the hospital’s flow.
Hospital Policy Will Influence Your Birth Outcomes
With hospitals there are so many choices and so many options about what can happen during your birth that it can really influence the outcomes of your birth. Also, as you’re going through your labour and your birth, it’s difficult to know “What do I actually need?” or “What do I need to support me through this?” “Is what is being offered what I actually need?” “Is this the best option for both me and my baby?” and “What is being offered?” or “Is it being offered because it is routine?” “Is it the way the hospital operates, or is it just hospital policy?” and is it, overall, something that is offered to everyone, and you're not being treated individually or being able to make the choices based on your set of circumstances.
What About If You Need a C-Section?
There are always options, even if you're having a c-section. It is all about having a positive birth experience. There are times when Caesarean sections are necessary. We are talking about 10-15%, according to the World Health Organization, and it is, at the moment, 1 in 3 women are having Caesarean sections in our hospitals, which is higher than the recommended level.
A birth plan is a flexible document. You’re not rigid in what you’re wanting, that yes in a perfect world, under perfect circumstances, this is what I would love to have and if things are not going according to plan, then let’s work with that, let’s make the choices along the way, but let’s know how to ask the questions, and know how to get the information we need, to be able to have a positive birth; and we can have very,very positive Caesarean sections – even elective Caesarean sections – which are Caesarean sections which are planned.
They may be planned for many reasons whether they are medical reasons, whether you have a baby that is breech, whether you are feeling that you don’t want to have a normal birth, that there are certain circumstances that come into play there, and so I think the choice of – it is still a Caesarean section – it is your birth and I think you need to have certain choices around that.
Certainly having a Caesarean section contingency plan, just a small part of your birth plan, at the end of it, is a really good idea. Usually the midwife who has been looking after you during labour, if you were to be labouring and to go for a Caesarean section, will go with you as she already knows what is important to you and she will be able to continue with that continuity of care.
What Should Be On A Birth Plan
It's important to keep it really simple. A birth plan, most importantly, should just be a one page document that is easy to read at 3am when perhaps your midwife has already worked 8 hours!
It’s normally dark because we have a lot of dim lighting in a birth suite and the midwife’s light is the only one on. We want text that is easy to read. We don’t want a novel because what will happen if we have it too long is that things that are really important to you will be missed. Or someone will read over those things because there is a lot of unnecessary content in it.
So be very specific – it actually shows that you’ve researched your choices really clearly as well and you’re likely to stick to what you want when you’re in the intensity of a labour where you’re questioning your ability. When you have already prepared well, you’ll have a stronger mindset to continue with the things that are important.
Making it an easy read and making it relevant is also important. Every hospital and birth center is different. If your hospital doesn’t do certain things because of policy, you don’t need to ask for those things, so having an understanding either through your midwife, your Obstetrician, or your Doula, as to what the normal – what to expect during labour – what would be the normal care that would be given.
It's important to keep it positive too, because you’re enlisting your care providers support to help you achieve the birth that you want. Being defensive or aggressive is not a good idea. We know that our care providers are there to support us, that they are well-intentioned. They want us to have the birth that we would like to have and they are there usually because they love helping people. So, it’s important for us to remember that they will work with us within the limits of safety, within the limits of the medical care that they are providing.
In a hospital, medical staff are often looking for problems, they are looking for anything they are concerned about as well, during a labour and a birth, and that is their role. Letting them know that you are flexible, that you would like things explained to you, although that should happen automatically – remember that often care providers are very busy, they are caring for more than one woman at a time, and they are in and out of the room. So sometimes they will bring that energy into the room if they are busy, and your birth plan is a reference point that they can keep going back to as well. Also, if they are on a break for lunch or it's a change of shift, then whoever has taken over can just quietly read your plan without having to ask you a lot of questions again.
Keeping Your Birth Environment Calm and Purposeful
It can help to keep the birthing environment really calm and purposeful and everybody on the same page.
This is particularly important when you’re a labouring mum because it is such a sensitive period, and even though you might think that you’ll be screaming and pushing and everything, you’re actually really very sensitive to everything that is being said around you. Very, very sensitive. All your senses are heightened. Your sense of smell if someone is wearing fragrance. The sound if someone is whispering in the corner of the room – you will hear it, you will hear every word because, you know, you’re trying to subconsciously protect your environment, your birthing environment and your baby so all of those senses are heightened as well.
Consulting With Care Providers During Pregnancy
As you do your research to prepare your birth plan you can also talk to your Obstetrician or Midwife about your choices leading up to the birth and that gives them an opportunity to voice any concerns they may have or to let you know about any particular hospital policies that you need to be aware of. The birth plan actually pulls everyone in into the same page literally, that one page document, because it is very clear on the preferences that you would like.
What is a Positive Birth Anyway?
Some people will say that a positive birth is a healthy baby and healthy mum at the end of it. However there is much more of a spectrum of outcomes to be aware of. We want mother and baby to be emotionally healthy as well. You may hear some care providers say “well, we need to do this because we want you and your baby to be OK”, but sometimes there are still other options as well.
For women to have their feelings and their preferences acknowledged is very, very important. When you are treated dismissively, that can create negative feelings later. It’s important to acknowledge your feelings, your needs, your desires because they’re very primal. You’re very vulnerable during your labour and so you need to feel nurtured and loved and totally supported and safe and understood, and have privacy and so many things, that we can still achieve within the hospital environment to have that.
It is more difficult than if you’re having a baby at home, a lot of women are having hospital births these days; but they should also be able to have the birth that they desire, and have everything down the corridor, to feel that resources are there if they need it in an emergency. But otherwise that room is their space and their environment and they are able to feel comfortable in that. Like a mother cat who is having her kittens, who seeks out a safe, enclosed space.
Are you writing a birth plan? What questions or thoughts do you have?
About the author
Cheryl is a birth professional who has delivered thousands of babies. With an extensive background in midwifery and now working as a doula in Brisbane, Australia, Cheryl has dedicated her life to helping women have positive birth experiences. You can find out more about Cheryl Sheriff here.