Detailed Birth Plans
I often wonder what is it about detailed birth plans that make labor and birth so difficult? In my 30 years as a midwife, I have never seen this document improve the quality of care or the outcome of birth. In fact, it is always the reverse. It seems the more detail in the plan, the less likely someone is to birth without intervention.
So the question is WHY? As a yoga teacher, I would assume that writing your positive intentions down on a piece of paper would be beneficial. After all, I often talk in my prenatal classes about affirmations and writing down positive thoughts, successful outcomes. Smart intelligent women research birth plans on the internet and in good faith print them to reinforce their wishes to their provider. Possibly one of the reasons this backfires is because the scripts on the internet microanalyze every facet of labor and birth, giving women scenarios to worry about they never thought to consider. The other issue is that women are encouraged to write birth plans rather than talk to their providers about what their views are on intervention and promoting natural birth.
When my patients ask me if they need a birth plan, my response is usually, “No, because there is nothing you could want that I would not normally do." I tell them that while I cannot control how labor goes, I can control that they be supported throughout the process. I also want them to share with me their views and visions for their birth. For example, whether they are definitely planning an epidural, whether they are going to wait and see, or whether they think they absolutely do not want an epidural. This helps me guide them in labor. If a woman tells me she is absolutely sure she wants one, then I know to suggest the optimal time to take it. If she tells me she would prefer not taking one, then if she is progressing quickly but suddenly feels anxious (usually signifying transition is coming), I know to tell her to wait just 10 more contractions and then reevaluate. However, I also tell them that even if they are absolutely sure they don’t want one, I will encourage it if I believe it is in their best interest. My suggestion is always to visualize the way they would like labor to go, to see it flowing and easeful, and then to accept there may be detours along the way.
Most importantly, I feel that as a society we are not encouraging women to trust their intuition, their bodies, and their ability to birth. I encourage women to prepare for birth through prenatal yoga, meditation, breathing, and childbirth classes. Katie and I started Spiral Path Yoga to give women the information and support they need to fully enjoy and embrace their pregnancies and transitions to motherhood. Both in and out of the office, I work to support and help as many women as I can experience positive, healthy pregnancies and prepare for birth. If a woman tells me she still feels the need to write a birth plan, I suggest she write down on paper her WISHES, a POSITIVE document of what she would like her labor and birth to be as opposed to writing down all the things she doesn't want.
Suzanne Arms wrote in the 70’s, “Childbirth is an experience in a woman’s life that holds the power to transform her forever. Passing through these powerful gates –Each in her own way—Remembering all the generations of mothers Who walk with her. She is alone—Yet not alone.”