Unlocking Birth Plans

When I was pregnant, I thought of a writing a birth plan for a hospital birth was like a cafeteria, you had choices--you could take and leave what you wanted. That's when I developed my birth plan based on the real life example of others. I wrote all the things I wanted with provisos about all the things I didn't want. It was three pages, complete with a very nice letter to the nurses, midwives and doctors I would be working with.

Then after I discovered what hospital birth is really like, I heard birth plans being maligned. I learned that birth plans aren't typically read but are often scoffed at before they are thrown in the trash. But information still promulgates that birth plans are useful tools in having individual desires, wishes, cultural and religious values being respected; while others state that birth plans are useless.

I've been trying to figure my through this chasm of opinion. I wasn't quite prepared to throw away the birth plan idea all together, but understood how they often do not have the effectiveness that families desire. One solution I've heard touted is a birth plan should take up no more space than a 5 x 7 index card with easy to read font (no 7 pt business). I didn't understand how that was possible, based on the number of birth plans I'd read and the one that I too composed in preparation for birthing in a hospital.

Recently, in the book "Pregnancy, Childbirth and Your Growing Latter-day Saint Family" written by a registered nurse and certified childbirth educator, I read an example of what a index card birth plan would look like and I began to see how this would be plausible. I will attempt to reproduce what I found:

Room: Labor, deliver, and recover in same room at local hospital
Other people present: husband, doula (a woman who provides professional labor support), and maybe mother
Food and drink: light foods, juice, water as desired
Fetal Heart Rate: intermittent, with initial 20 minutes electronic monitoring, then hand monitored every 15 to 5 minutes as needed.
Pain Relief: relaxation, breathing, comfort measures, shower, hug and kisses from husband!
Labor Stimulation If Needed: walking, changing positions, nipple stimulation
Labor and Birth Positions: mother's choice
Pushing Techniques: short (limit to six seconds), spontaneous bearing down
Perineum: try to prevent tearing with support, gentle pushing, no episiotomy
Cord Cutting: father cuts cord after pulsating stops
Immediate Baby Care: baby held by parents for first hour and given opportunity to breastfeed
Feeding and Contact with Baby:feeding on demand with 24 hour rooming-in

I had to see it to believe it, but that fit on a 3 x 5 index card (admittedly with probably 8-9 pt font). It concisely described a family's desire to have "as natural a hospital childbirth as possible." Having seen the example, I can see how it can be adapted to an individual's wishes. In the space remaining on the line regarding immediate baby care, I would make a note refusing the Vitamin K shot, vaccines and erythomycin). I would make use of those blank lines and add no artificial nipples of formula supplementation; supported squat, upright pushing positions; warm compress and counterpressure on perineum, etc.

But there you have it, a short, concise, fit in the palm of your hand birth plan. They do exist.