Know your options
The first step in writing a birth plan is to find out what your options are. Different doctors will give you different options for handling the same situation. Different hospitals will give you different options and have different policies. Differences in health between pregnancies can impact the options that are available.
Your first job is to find out what options are available to you. If you are not sure yet what possible options might be, review the birthplan. It is an exhaustive list of options you might have. It is a good tool for beginning conversations with your caregiver too. Read through the list and determine what options appeal to you, and what options you don’t think you want. Use this to find out what options your caregiver feels comfortable with.
Take the birthplan on a hospital tour to find out how the policies may affect your options. If possible, make several copies and tour several hospitals. You may find that some hospitals appeal to you more based on the services they provide.
Find out what you want
Once you know what options are available to you, it is important to determine how you feel about the options. Some things will be very important, and others will seem small or unimportant. There is no right or wrong, it is simply a matter of understanding who you are and how you want things handled.
You may find that there are several options that you feel very strongly about. In this case, it might be necessary to try to decide how the options rank in importance to you. The Ideal Birth Worksheet can help you work through your feelings about the options.
Are your chioces available?
After you have decided what you want, you need to take a hard look at the reality of your situation. Are the choices you have made realistic given your health? Does your caregiver and hospital support your decisions? Do your birth partners (doulas, spouse, friend, family) support your decisions?
If you have made choices that are not possible you need to reevaluate your decisions. Do you need to change your plan, or do you need to change your care team. Can you increase the support for your choices by changing hospitals or midwives? Or would you prefer to change your decision about the options and stay with the practice, hospital and birth partners you’ve chosen. Only you can make that decision.
Start the Dialog
With your choices written out, talk with your doctor or midwife about what choices you have made and why. If your midwife has concerns about an option, find out what they are and where he or she recommends you go to do further study.
Be sure to be assertive, but not aggressive when discussing your options. Do not allow your caregiver to brush off your decisions or suggest that this is unimportant. At the same time, don’t assume your caregiver will be hostile or uninterested in hearing what you have to say.
Talk first about how you want to handle a normal, uncomplicated labor. Then move on to your decisions in case of a complication. Be sure to let your midwife share thoughts and opinions about your decisions. Listen carefully to what is said. This will be your first real chance to determine if this is the midwife for you.