Creating A Birth Wish List Instead Of A Birth Plan
Very often I hear people say, "My friend told me her birth plan was a waste of time because the birth went the complete opposite." And yes, a birth plan will not guarantee your perfect birth. The main reason for that is the wild card you can't account for, baby. To be honest I don't like the term "birth plan", as soon as you label it a plan, it is guaranteed to disappoint you and that's because the only thing predictable about birth is that it is completely unpredictable.
But none of this means you can't have hopes and wishes for your birth and if you are flexible with your wants and needs, you don't have to be disappointed. This one page list of what you feel is important to you to have in your birth is a culmination of your education about your birth and immediate postpartum period. Also it is a discussion page to have with your care provider to make sure that everyone is on the same page. I also think that having these discussions with your care provider can show them you are looking for more than the status quo, snap them out of the "this is what we always do" mentality. To be clear though, many care provider do try to make birth as personal as possible. But it never hurts to just have the discussion and throw these wishes out into the universe.
What to include in creating your birth plan or wish list?
To start, it's best to educate yourself on the various medical procedures that can occur during labour. Learn about the benefits and all the risks that can occur. Based on that research if there are any that you may be less open to or adverse to altogether add that to your wish list. From that, ask your care provider under what circumstances would they use any of those particular procedures.
NOTE These procedures are often called medical interventions, they can also be seen as supports that can help facilitate your birth to be more comfortable, support baby's health and aid in getting your birth to ending vaginally and not surgically.
The medical procedures that you may wish to focus on include:
An IV
Electronic Fetal Monitoring
Amniotomy
Vaginal Exams
Episiotomy
Instrumental Deliveries - Vacuum and Forceps delivery
Many of these can be absolutely avoided. Maintaining flexibility though, as occasionally one or more of these procedures, may be necessary. Depending on how baby tolerates birth, what decisions you make with regard to pain management and your own health, you may require one or more of them to maintain that journey toward a vaginal birth. Even if you are opposed to any of them and they become necessary, if you are educated on their benefits and risks, you can are able to make an informed decision about using it in your labour.
The next section of your wish list to consider is your pain management. What are your thoughts on managing your discomfort in labour? Are you 100% on board for having an epidural as soon as you can, or do you know you want one but want to see how far you can go before getting one?
Are you aware of any other pain management options available at your place of birth. These may include analgesics such as morphine or demerol and possibly nitrous oxide or more commonly known as laughing gas, though I've never seen anyone laugh in labour while using it. Again, educating yourself on the benefits and risks of all these medical options and discussing them with your care provider can help you make an informed choice.
Perhaps you do not wish to have any medical pain support at all and would rather use non-medical pain management options. Investigating what that might look like at your hospital is a great way to plan for that. For example, did you want to labour in a tub for an extended period of time or use a shower, knowing if your hospital has these options will determine if that is even an option for you. And planning and preparing for an unmedicated birth with support will need to be considered. Including if you can have a second support person with you in your labour. You may also want to include on your wish list that you do not wish to be asked if you want an epidural if you want an unmedicated birth. Stating that if you want one, you will ask for it.
Consider also any tools and items you may need, for your own comfort and if the hospital will supply them or if they will have any objection to you using them. For example, one hospital in my area does not supply birth balls due to an incident where a patient fell off one, however they will allow you to bring your own.
Next, while you may not want to consider it, you will want to educate your self on surgical birth. What is the procedure like, how often does your hospital do them and under what circumstances. Be honest with your care provider on your hopes and wishes regarding a surgical birth. Or if you have chosen to have a planned surgical birth, you may want to include in your wish list, your hopes for skin to skin with baby immediately after birth and getting body feeding going right away. Also, talk to the care provider about what recovery may be like.
Next you may want to have a section on medical inductions. Some care providers offer them routinely as a matter of choice at 39 weeks and sometimes a medical induction is necessary if there is an issue with your health or that of the baby's. How do you feel about having an induction for a non-medical reason or would you prefer to wait to go into labour on your own. Having this as a section on your with list will allow you to educate yourself on the process and discuss with your care provider the benefits and risks of starting labour through medical procedures.
Finally, you will want a section on your wish list that discusses how you want the first few hours to go after the baby is born and your stay in hospital during your recovery. This section could include how you wish to manage baby's newborn procedures, including if you wish to have the cord delayed in clamping or if you are choosing to cord blood bank. If you wish to have the eye ointment or vitamin K delayed until baby has had an hour of skin to skin time and their first attempt at body feeding. Also, you will want to highlight if you are choosing to body feed or bottle feed and discover what you will need to bring with you and if you will receive any support or education on either of these choices.
And you will also want to investigate what the hospital will supply for you and baby. What will you need to pack? Diapers, pads, breast pads, formula or bottles, your breast pump if supplementation is necessary? If your hospital has lactation consultants you will want to add that you wish to be connected with them after the birth.
Once you have put together a one page wish list, you can bring it into your care provider and discuss your hopes and dreams for your birth and have an honest discussion and open negotiation with them about what your options are. After that, and some tweaking of the list if it is necessary, you would bring a copy of two to the hospital with you and give it to your nurse once you have been admitted. They will also help you facilitate the achieving these wishes for your birth.
For more information on a birth wish list, and a copy of one you can see, check out my Free pre-recorded webinar on How To Create A Birth Plan.
