Birth Plan or Birth Principle?

Birth plans do not seem to be helpful to 65% of care providers, but 85% of parents believe that they are helpful. Based on these two numbers, why are doctors and nurses at odds with parents on the issue of the usefulness of a birthing plan?

A reason why doctors and nurses are at odds with parents on the issue of the usefulness of a birthing plan is that they have different priorities. Doctors and nurses are primarily concerned with the health and safety of the mother and baby, while parents are primarily concerned with the experience of childbirth and the well-being of their child.

There is a lot of evidence that suggests that birthing plans can help to make childbirth safer and more efficient, but there is also a lot of anecdotal evidence from parents that suggest that birthing plans can be restrictive and cause more stress than they relieve if the plan doesn’t fully represent the dynamic situation that birthing is. Ultimately, it is up to each individual parent to decide whether or not they want to use a birthing plan, and whether or not they think it will be helpful for them. This brings into focus another more moderate approach – A Birth Principle.

Defining just what a birth plan and a birth principle is, is the first step.

What Is A Birth Plan?

A birth plan is a document that outlines a pregnant person’s preferences for their labor and delivery. It can include things like what kind of pain management they want, who they want in the room with them, and what position they want to deliver in. Birth plans are not binding, but they can be a helpful way to communicate your wishes to your care team. The question is, how helpful?

An important component of a birth plan is a step-by-step guide that parents create in order to help them advocate for and communicate what they want during their birth. They may also create an hour-by-hour guide if their birth is very specific. Among the things specified can be the place and time of birth, who will be present at birth, interventions, pain management tools, and what will happen to the baby after birth. 

The issue with a birth plan is that the baby makes the plan for birth and that’s the problem. A birth plan can go awry even with the best-laid plan. It is impossible to predict everything that will happen during labor.

The best thing you can do is to be as prepared as possible. This means learning about the stages of labor and knowing what to expect.

It also means having a support team in place that you trust and feel comfortable with. This could be your partner, a doula, or a friend.

And finally, it means being flexible and open-minded. Things may not go exactly as you planned, but that doesn’t mean they won’t be perfect in their own way.

A birth plan isn’t useless, however. Especially for mothers and birth partners, it can be useful for discussing and preparing for various scenarios that can occur during birth. The mother’s family and all birth professionals should be involved. Consider the scenario of an aunt who is attending her niece’s labor and delivery in a hospital and is very against taking any medication, while the niece is willing to take whatever medication is necessary to keep her pain at a tolerable level. It is essential that there is a clear discussion about the aunt’s beliefs and the niece’s beliefs. Her aunt’s views can cause a ruckus with hospital staff, her niece’s state of mind and progression of labor, and make the mother’s environment unsupportive.

What Is A Birth Principle

An important aspect of the Birth Principle is that a mother decides what she wants for the location of birth, who will be at the birth, interventions, pain management tools, and plans for mom and baby after birth. As well as a discussion of what kind of birth a mother wants, this is also about her beliefs and values.

As an example, you might think about the location and provider of your birth as a birth principle. A home birth or birthing center with a midwife is in your principle if you value the natural cascade of hormones to start labor and use natural interventions.

Hospital births with ob-gyn doctors would be in your principle if you don’t want to feel any pain or have any fear of pain.

Having a birth principle would state all this if you wish to have a natural birth and will do all you can to prepare for it, but also want the confidence that there is medical intervention nearby in case anything should arise.

How To Have The Best Birth Possible

There is no one answer to this question as every birth is different and every woman’s preferences are different. However, there are some general principles that can help you have the best birth possible.

First, it is important to be as prepared as possible. This means learning about the different stages of labor and what to expect. It also means having a support system in place, whether that is a partner, family member, or friend. It is also important to be flexible and go with the flow on the day of your birth, as things rarely go according to plan.

Finally, it is important to trust your body and your instincts. Birth is a natural process and your body was made to do this.

In regard to providing a Birth Principle, as a general rule, nurses and birth providers prefer half a page of written information, not a detailed map of the birth with all destinations pre-mapped.

If you have been in labor for a long time and not progressing naturally after fewer intervening options (movement, positioning), your nurse may recommend Pitocin or another medical intervention. 

A mother who is unwilling to cooperate or who hasn’t considered this option and how they will react before labor begins can have difficulty:

  1.  This change in the birth process requires emotional and mental preparation on the part of the mother
  2. Struggles with considering the well-being of baby when stressed and not pre-prepared with all the information to make decisions
  3. The nursing staff helps the mother and baby cope with something that the mother is either denying or trying to avoid.

When you’re a new mom, it’s important to know your rights and know when to ask questions. It is also important to come to the occasion knowing the range of things to expect and how you will work through the issues if and when they occur.


Evidenced Based Birth

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