The Best-Laid Plan | Fit Pregnancy

The Best-Laid Plan

Creating a birth plan can help you decide what kind of delivery experience you really want. Just don't get too attached to it.

Research your baby's birthplace
Once you choose a doctor or midwife and the hospital or birth center where you'll deliver, do a little research into its policies to find out if they're basically OK with your wishes. But be realistic: "Every hospital has their own way of doing things, and nurses—the ones who are there with you throughout your labor—do their best to articulate between the patient's wishes and the care providers' orders, while staying within the bounds of hospital policy," says Lindsay Rogers, C.C.A., B.S.N., R.N., a labor nurse at St. Mary's Hospital in Knoxville, Tenn.

If you do have a detailed plan in mind, Rogers suggests taking it in ahead of your delivery and discussing it with the charge nurse to see where the sticky parts might be. And have your doctor sign your plan prior to admittance. "Your doctor might say it's fine for you to have no IV, but unless he writes that as an order, the hospital policy will win out and you'll get one anyway," Rogers says. "If it really matters to you, get it in writing."

Watch your language
What you do write down, write with care. "Care providers appreciate language that lets them know you're working together as a team and you respect their professional judgment," says Bruce Flamm, M.D., a clinical professor of obstetrics at the University of California, Irvine and spokesman for the American College of Obstetricians and Gynecologists. "You should express your goals and desires in a way that's not contentious so that it doesn't set up a boxing match," Flamm adds. "Would you like it if somebody with no training in your field did some Internet research and then came in to tell you how to do you job?"

Take it with a grain
New York City midwife Elizabeth Stein, C.N.M., M.S.N., M.P.H., has delivered more than 2,500 babies in her 22 years in practice and estimates she's seen it all. In her opinion, birth plans are best viewed as a wish list. "You have to wait and see how labor goes to have any clear idea about what you really want or need," she says. "You may think you don't want any pain medicines, but then find you really need them. Don't start motherhood out feeling guilty, or feeling that your expectations weren't met." Instead, Stein encourages her patients to aim high and focus on what's most important: "We always shoot for a healthy mom and a healthy baby."

What mom doesn't go into the delivery room thinking the same way? I did—and offered up my 11th-hour birth plan in the sincere hope that it would somehow help ease my labor and my baby's transition into the world. It was literally too little, too late—not that it mattered much anyway. I ended up needing a C-section, a disappointment but—in hindsight—far from a disaster: Truman and I are safe and healthy today.

5 Key Questions
Sample birth plans offer the illusion of control over everything from the light level in your hospital room to whether you'll have a C-section. The reality of childbirth, however, seldom lines up with these neat little boxes. New York City midwife Elizabeth Stein recommends avoiding yes/no questions and writing open-ended answers to these five crucial questions:
1) If labor begins naturally, when would you like to be admitted?
2) Are you willing to be induced?
3) What is your attitude toward pain relief?
4) Who do you want in the room with you when you deliver and/or need a C-section?
5) What are your desires in regard to breastfeeding?

To create and print a birth plan based on "5 Key Questions" in this article, go to fitpregnancy.com/birthplans.

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