You’ve been waiting for this moment for the last nine months. The goal: As smooth and seamless a delivery as one can expect, given that approximately 6- to 8-pounds of flesh is going to be squeezed out a tiny opening in another human’s body. The miracle that is childbirth can feel overwhelming. It is also a master class in improvising when the unexpected occurs. That’s why doctors often advise their patients to formulate birth plans, or “birth preferences” as many now call them, in advance.
“We really don’t call them birth plans anymore — the ‘plan’ is that everyone is OK,” says Suzanne Gilberg-Lenz, M.D., an OBGYN in Beverly Hills. “We call them preferences because it’s really a tool to explore what the options are for monitoring the mom and baby during this critical time.”
More than 50 percent of Dr. Gilberg-Lenz’s patients use them, and she finds that they’re effective ways to ease anxiety over the big moment. “You have a lot of first-time moms and dads realizing, ‘I have no idea what’s going to happen when we get to the hospital,’ and that’s really stressful,” she says. “Exploring your birth preferences gives you information that can reduce anxiety and fear, which is important because we know feeling anxious lowers the mother’s pain threshold and can negatively impact labor.”
While there is no one-size-fits-all blueprint for a successful childbirth, there are some key guidelines for all parents-to-be, including:
Keep the birth plan to one page or less.
You may see templates online for birthing preferences that run three, four, or even 10 pages. That’s not necessary or helpful, says Dr. Gilberg-Lenz. “For some people, it starts to become about control,” she says. “You can’t control every aspect of the birth process.” Focus on the bottom line—everyone is healthy—and don’t obsess over every tiny permutation of “What to do if…”
Use the birth plan as an information-gatherer.
“The list should be an investigative tool for new parents,” says Dr. Gilberg-Lenz. “It’s your chance to ask questions in advance about what your hospital offers. There are a lot of unknown for first-time childbirth, and this helps you organize your thoughts.”
There are important questions to include.
Who do you want to be present? Do you want to hold your baby immediately after birth? What birth position do you prefer? What will you do for pain relief and do you want medication if necessary? Do you want an epidural? These are some of the questions the American Pregnancy Association suggests including in your write-up. Resolving them in advance will avoid any potential drama once you arrive for the delivery.
Use the birth plan document to review normal hospital policies.
“Will there be an IV or not? What is your hospital’s approach to fetal monitoring?” says Dr. Gilberg-Lenz. Anything you prefer to be handled differently than routine hospital policy should be addressed verbally first, then written into the plan. (Although Dr. Gilberg-Lenz points out that if you find yourself disagreeing on too many points, it may be a sign you should pick a different delivery center.)
Keep one section of the birth plan for troubleshooting.
If things don’t go according to plan, it’s comforting to think through the alternatives. Write down what you and your partner want to do in the case of a C-section, or difficulty pushing, or an emergency procedure. “This is your chance to communicate to your doctor how you would prefer these situations be handled,” says Dr. Gilbert-Lenz.
Share the birth plan with the pit crew.
Once you and your partner have created your list, share your preferences with everyone who will be directly involved in the labor’s success, suggests the American Pregnancy Association. Giving copies to your doctor, the nurses, doula, family members, or anyone else who will play a role in the big event can help avoid unnecessary miscommunication during the hectic hours surrounding labor.
The bottom line: During the months leading up to labor, you and your partner should have found a doctor you trust, and a hospital or birthing setting that you are comfortable with. While it’s helpful for everyone to make a compact list of requests that will help you and your partner get through this experience in the most positive way possible, you also need to relinquish some control to the experts you’ve “hired” to make the big day a success. Remember, they do this for a living. It’s OK to follow their lead.