Inner Vision Birth Plan

Nowadays, a lot of women write a Birth Plan, an official document they give to their healthcare professionals, describing their desires for the upcoming labor and birth.  In Southern California, many nurses ask for it and expect it, but in most hospitals around the country, we are far from such acceptance. Even though it’s a good idea to put your desires down on paper, I’ve noticed that, depending on the tone of the Birth Plan, sometimes it can actually work against you.  The document is at times mistaken as a declaration of mistrust in the people who will attend your birth. It can also limit instinctual, spur-of-the moment decisions, which might turn out to be more appropriate than a plan scripted several months before the event.

A Birth Plan can be seen as challenging by the medical staff, creating a defensive mindset. Most importantly, it can create a barrier to a deep, personal, and trusting relationship with those who will help you deliver your baby.   I have seen nurses decide to “teach someone a lesson” by making sure that nothing in the Birth Plan was respected. In such a case, each obstacle to a part of the plan was presented as either a matter of “hospital policy” or as “too dangerous for this particular situation.”  What I often tell my clients is to work on going into the hospital with love pouring out of every fiber of their being, love for each individual who cares for them.  I tell them to engage in friendship with the attending nurse by asking her about her own birth and children. If you show her respect, she’ll be a lot more likely to want to help you fulfill your dream of having a natural, drug-free birth without medical intervention.  I also suggest that if you’re going to use a Birth Plan, make sure you add some personal information to it, such as a picture of your family and some short anecdotal phrases to describe yourself.

It’s a good idea to spell out, on paper, what we would like to manifest, but it’s best to approach this document as you would a love note.

Consider these excerpts from my clients’ Birth Plans.

  • I really have a phobia about a hospital setting; I get frightened easily when I don’t understand what’s going on. I would love to have a nurse who will help me understand all the procedures before they are performed.
  • I can relax more easily when the lights are turned down, and I am frightened of needles. My husband and I have worked very hard to achieve a stress-free birth and I prefer to be able to move around during labor in order to manage my contractions. We prefer not to have an IV hooked up, but are willing to have a Heplock.[1] We trust you know what to do in case of an emergency.
  • I have put a lot of effort into learning different techniques to use during labor to manage the contractions. I appreciate your help and suggestions on alternative methods of pain management, and I will certainly let you know if I want pain relief, but I would rather not be continually reminded about the drugs that are available. Please don’t ask me to rate my pain from one to ten as it will distract me.
  • Once our baby is born please help us bond with our child by keeping the conversation around us to a minimum, allowing mother and child to cuddle up skin to skin bundled up in warm blankets.
  • We have been trying to get pregnant for a very long time, and are so happy we finally made it.  We want to touch and hold our baby as soon as possible, and have even created a little song to sing to him immediately after birth.  We feel very strongly about wanting to bond with our child and we prefer that all drugs like the eye ointment and the Vitamin K shot be administered two hours after the birth. If all has gone well, we want to avoid giving the baby a bath until later. Please evaluate our baby’s Apgar[2] score while he is in our arms. Bathing, weighing, and measuring our child is not that important to us: we prefer holding, kissing, and having him suckle at mom’s breast right away.  We understand you have to follow procedure, but we ask that you allow us to enjoy skin to skin contact with our infant newborn as long as possible.  We prefer that no pacifiers or bottle be given unless there is an emergency, and then only after you have discussed the situation with us and the pediatrician.

The more you humanize your desires and approach the hospital staff with friendly suggestions, the more you’ll get what you want and need.  I also encourage the family to attach a little gift basket to the plan for the nurses. This can help them taste the sweetness of your intentions as they read your Birth Plan.

Make sure is not longer them one page.

[1] A Heplock is an IV site (a small catheter inserted in a vein usually on the wrist or the hand) ready in case you need to be given medication or fluids. It’s free-standing and does not need to be hooked up to any IV fluids.

[2] One minute and then five minutes after the birth, a score is given rating the baby’s activity (muscle tone), pulse, grimace (reflex irritability), appearance (skin color), and respiration. If there are problems with the baby, an additional score is given at ten minutes. A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with Apgars of 3 and below requires immediate resuscitation.