5. Make a Birth Plan: What Your Hospital Birth Team Needs to Know and Why

As an expecting parent, do you actually need a birth plan to prepare for your hospital birth?

In today's episode, I’ll be breaking down birth plans and why they are so much more than just a piece of paper. Many expectant moms may wonder why they need a birth plan or think it's unnecessary, but in reality, a thoughtful birth plan is an invaluable tool to take to the hospital with you to communicate your birth preferences to your support team.

I’ll discuss how to create a birth plan that reflects your values and priorities, and why it's important to consider all aspects of your labor and delivery experience, from pain management to postpartum care. 

Join me as we dive into this important topic and explore how a birth plan can help you feel more informed, supported, and in control during your pregnancy and birth.

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👋 WHO AM I?

Welcome, friends! I am Beth, a certified nurse midwife, doula, and childbirth educator. My philosophy is rooted in autonomy, informed decision making, and positive mindset to help expecting parents plan for a beautiful, stress-free  birth. I am here to provide value to YOU through tips and practical advice, either to guide you through pregnancy or to help you prepare for childbirth, postpartum and beyond. There’s no fluff here - only info that adds to your positive experience and saves you stress and uncertainty.

Transcript

Welcome back. You’re listening to Episode 5 of Your Birth Bestie: The Pregnancy Podcast for an Autonomous Hospital Birth. Thank you so much for tuning in today and if you’re not yet subscribed to the show, don’t forget to do so so you get updates every Tuesday when I publish a new episode.

Today we are breaking down the birth plan and why it’s more than just a piece of paper. I’ve been a part of hundreds of births as both a labor and delivery nurse and a midwife, but I can count on one hand the number of birth plans I have been given to review in the hospital. The intentions are always there, I totally get it! But I would love to see more moms actually have birth plan documents! And this isn’t because I think you NEED a physical copy to prove anything at all, because you don’t… but I think it is a really good way to keep yourself accountable to prep for your ideal birth and actually make it happen. Because without goals and plans to reach for, it’s so much harder to actually get what you want. That’s truly what I believe. 

So in this episode I want to talk about why birth plans aren’t prioritized by moms or really in the hospital system in general and also about how much more a birth plan is than just a piece of paper, because it represents SO much more. And of course my tips on how to make yours and what to include!

And before we get started, be sure to go to bethconnors.com/workbook and download the free guide that walks you through every decision you’ll have to make during pregnancy, labor, immediately postpartum, and for your new baby. 

There is a place at the end of that workbook to use the info and check boxes for your own birth plan, but that is not at all the main intention of that resource. And once you download it you’ll totally know what I mean and it will make planning your hospital birth so much easier!

Hey there! I am Beth Connors, a midwife and mom of 2, but also, Your Birth Bestie. In this podcast, we’ll dive deep into everything you need to feel confident, prepared, and in control from baby bump to delivery room. From practical tips to personal stories, we’ll cover it all so you know exactly what to expect every step of the way. Let’s get into it!

Have you ever heard someone say something along the lines of “you know if you make a birth plan it’s not actually going to happen that way right?” To which I want to say… first of all what a silly superstition to have about one of the most important moments of you life… but also if you just go to your prenatal appointments and not prepare whatsoever and expect to go with the flow, you’ll likely just be another statistic in the medical cascade of unwanted interventions.

That probably sounds kind harsh, especially if that’s your plan, I mean genuinely I’m all about going with your intuition, so of course I support you. But also, I want to challenge you to consider at least some of the basic decisions of labor and how you feel about them before you’re already at the hospital. Everyone has an opinion and the majority of women want to have a healthy and non-medicalized birth, so we can absolutely prevent anything unnecessary from happening with some education and support from me, your virtual midwife.

And for those of you who haven’t made a birth plan or don’t intend to. Here’s a few things to think about. Is it the birth plan you don’t want to think about or is there something else going on.

First thing that is actually more common than I thought. Many women don’t know about birth plans or why they are used, just really think that the hospital staff will take care of everything. A lot of people don’t realize that they have the right to express their preferences and make informed decisions about their care.

I feel like this is something that is very commonly seen on social media. Things like sharing videos of insensitive nurses or statements taken out of context about what an OB said during their delivery. It makes it sound like no matter your plan, the hospital dictates everything, which isn’t true!

 If you’ve seen these, they sound really, really bad. And of course these things happen even though they shouldn’t, but I also think there is a lot of misunderstanding that comes from the lack of communication from providers to patients. 

For example, there was a graphic going around about manual placenta removal which is a really invasive procedure after delivery if the placenta isn’t delivering by itself. There are a few instances where this is seriously important for your provider to know how to do and being able to perform that can literally save your life. But if it’s done without consent or the mom knowing why or how, you bet that’s a traumatic experience and that story can be told as if a medical provider is going to do this “every time” or “just because they want to and it’s faster for them” or whatever reasons I saw. This is definitely not the case, but those stories can really take things out of context.

But I digress, this wasn’t the point, but I guess I now want to make the point that birth plans are important just for the aspect of communication alone even. It allows you to think about things beforehand, ask educated questions, and create a discussion on something you are concerned about before it were to happen during labor. So it’s absolutely more than just a piece of paper.

Many expecting moms also are unsure about where to start or have no idea what they want or will need during labor and delivery. They may worry their preferences will change during their labor and don’t want to necessarily commit to a specific plan. And I want to share with you why this is literally an amazing reason TO create a birth plan. But I want to also clarify that by saying you’re making a birth plan, that doesn’t mean you have a template in front of you and there are 3 choices of pain management for example, (epidural, IV meds, unmedicated) and you have to pick one and stick to it. Just think hey, I want an unmedicated birth and I’m going to try “xyz” to do that, but I’m open to the epidural if “this or that” happens and I’m okay with that. 

It’s a way to prepare your mind for what is going to happen and allow you to think of all the ways it could unfold and how you’d react. This is so important because birth is unpredictable, but the way you prepare will allow you to overcome any obstacle. The workbook I mentioned at the beginning is great for this too.

Another common reason moms have told me they don’t want to plan for their birth is because they’ll say “that’s what you’re for”. And of course I’m flattered to have gained a mom’s trust to care for her during such an important time and make the best decisions for her, but birth is soooo individualized. Of course I’ll provide my best care to you and do everything in my power to make sure you’re safe and your baby is safe, but what I can’t do is know your values and opinions on how you will make decisions for you and your baby. 

I don’t know how you’ll be able to be the most relaxed or how hands on you want me to be or what decisions and procedures you’re okay with for your baby… unless you do! … and are able to communicate those things to me! And of course in the moment you can make that decision, but it does feel better to make these choices before and weigh your options to see what really is the best choice for you. Otherwise, the standard care of the hospital comes into play and birth is too individualized to want to let that happen.

I also hear so often, “I’m gonna try to go natural but I guess if I need the epidural I’ll be open to that too.” While that’s great to be open and flexible to change, do you really want that unmediated birth and you’re protecting your heart by convincing yourself it’s okay if it doesn't work out. Because I can tell you if you’re in the hospital and you’re not 100% going for that unmedicated birth and know it is going to happen without a doubt, there is a 70% epidural rate because the medication is available within a very short amount of time. Going through your options and deciding while you were planning your birth to go unmedicated but changing the plan doesn’t make you a failure at all, it just means the plans changed and nothing more. You knew what you needed at the time and that’s perfect, so don’t shield yourself for having birth goals due to the fear of disappointment or letting yourself down. 

People say “there’s no trophy for going unmedicated” sure, but if there’s something you absolutely want, don’t be afraid to dream it and go for it. And even write it down on paper because I think that makes it that much more real and attainable. And if it doesn’t work out as you planned, you did all you could, and now have a unique birth story that you were in control of. This goes for epidurals, cervical checks, antibiotics, not breaking the bag of waters, pitocin, literally anything you feel you strongly want, write it down and figure out how to make it happen.

The last thing I wanted to mention was many moms have negative first hospital birth experiences in the past and may not want to relive those experiences by creating a birth plan or maybe they had a plan the first time and it backfired, so they feel out of control from the start.

And when you have this previous experience, it can make you feel like childbirth is unpredictable and that a birth plan is unlikely to make a difference. So what’s the point?

It really comes down to hospitals and expecting moms not prioritizing birth plans because of how maternity care culture is right now. There is so much standardization and an incredibly underwhelming amount of support and education that is easily accessible to moms and families. It is a lot of forced intervention or just non-informed or non-consented intervention, which needs to change, but you have the ability to change that too as a patient too, which hopefully is empowering to you!

Birth plan are a great tool to communicate your preferences and desires for labor and delivery to your healthcare provider.

So let’s quick go over my top 10 tips to think about when creating your comprehensive hospital birth plan.

1. Learn as much as you can about labor and delivery options, procedures, and interventions. 
2. Be as specific as you can be about pain management, delivery positions, and really any special requests you might have.
3. Prioritize your values. Think about what is most important to you. Examples are a calm and quiet environment, your support person, or avoiding the epidural.
4. Talk about your plans early on with your provider to make sure there is a mutual understanding and accommodations can be made. Some systems allow for electronic copies, but I always recommend paper copies be taped on the wall or computer for everyone to see in the room.
5. Be flexible and open to change in your birth plan. Get excited about your ideal birth plan because it can totally become a reality, but also be aware of plan B or C in the way way back of your mind.
6. Include a postpartum plan. Labor and birth is important, but it doesn’t end when your baby is born. Being educated and supported through the transition of having a new baby is so important.
7. Involve your support person so you both are on the same page in the delivery room!
8. Keep your birth plan to a page or two if possible. Making it easy to read and understand with bullet points would be my suggestion. 
9. Use positive language when talking about what you want. Instead of saying, “I don’t want an epidural…” List out what coping strategies you’d rather try.
10. Keep changing it as you learn new things throughout your pregnancy!

Everything that can be included in a birth plan is listed out in my free Navigating Hospital Birth workbook at bethconnors.com/workbook, but here’s an idea of what you’ll find there.

• Labor preferences–environment, comfort tools, support and staff, fetal monitoring, cervical checks
• Delivery preferences–pushing positions, coached or maternal led pushing, delivery of the placenta options, delayed cord clamping, immediate skin-to-skin
• Postpartum preferences–feeding method, visitor preferences, circumcision if this applies, pain management, discharge plans.

It's important to note that while some women may choose not to create a birth plan, others may find it helpful to do so. Ultimately, the decision to create a birth plan is a personal one, and it's important for women to make the decision that feels right for them.

You have more say than you think in how your birth unfolds. It all comes down to your preparation, education, support, and confidence really. It may sound like there’s a lot to do and think about, and there is…. But it doesn’t have to be overwhelming or cause more stress. That’s actually the opposite of what should happen!

If you’re an expecting mom due in July of this year, it’s 2023 when I’m recording here, you definitely should check out a sneek peak of my comprehensive hospital course available in July. Founding members that purchase during my presale starting May 22nd will get 50% off and extra bonuses as well. Join the waitlist at bethconnors.com/birthcourse where you can also see each module and lesson breakdown so you know exactly what info to look forward to. 

It is everything I wish I would’ve known before my first birth, a resource I wish all my patients had when I was working in the hospital, and something that will be super special and important in your birth prep too! Thank you for listening to today’s podcast. I hope you found this information helpful and if you have any questions at all, please reach out!