This week, Dr. Regina Cho shares her perspective on Birth Plans
One of the most frequent questions I receive during a pregnancy is, “Do I need to write a birth plan?” A birth plan is a formal document that you would share with your medical team that lists your preferences in managing your labor. After researching pregnancy blogs and websites, you will likely find recommendations to write a formal birth plan, with many templates ready to download from the internet. My answer to this question is always more complicated than a simple “yes” or “no”.
My first response to this question is to counsel patients that the term birth “plan” is a little misleading. None of us can plan exactly how a labor will progress, so while we can make plans for every step of your baby’s birth-day, mother nature will always throw us curveballs and surprises. Breech presentation, worrisome fetal heart tracings, lack of progress in labor, excessive bleeding, fever and infection are some of the many unpredictable ways that labor can deviate from the norm. We can’t “plan” for these events, but we can be prepared and ready to adjust our management at any given moment. With each step of the way, your team will always keep you informed on what is happening.
It may help to answer some of the most common points we see in a typical birth plan:
- Pain medication - Whether you choose to deliver without any pain medication, have an epidural or anything in between, it is your choice. Your nurse and doctor will present you with your options, and will support you in every way possible.
- Labor and Delivery - Your labor and delivery nurse and your doctor will explain any procedures or interventions throughout your labor. We will always discuss our recommendations with you before breaking your water, starting pitocin to strengthen your contractions and using internal heart beat monitors
- Episiotomy - Our physicians do not routinely perform episiotomy. There are circumstances in which it is necessary to perform episiotomy in order to expedite the delivery, and your doctor will discuss this with you prior to performing the procedure.
- Cesarean section - This is the most unpredictable event when it comes to delivering babies. We use cesarean section cautiously, judiciously, and only when medically necessary.
- After your baby is born - We encourage skin-to-skin snuggling as soon as your baby is born and we allow the umbilical cord to continue to supply blood, oxygen and nutrients to your baby for the first minute of life. This will help your baby maintain a healthy body temperature and will promote breast feeding. If your baby requires extra attention such as oxygen supplementation or suctioning of fluid or meconium from the lungs, we may need to clamp and cut the umbilical cord and bring the baby to the warmer that is in your delivery room. Whenever possible, we allow your partner or spouse to cut the umbilical cord.
- Breast-feeding - At Fairview Southdale and Fairview Ridges hospitals, the newborn nurseries support breastfeeding moms by not offering formula unless requested and encouraging you to keep your baby in your room at night. We also have outstanding lactation consultants who will be visiting you soon after you deliver.
So, in response to the questions, “do I need a birth plan?”, my complicated answer is: if you have specific requests or preferences that you feel are not listed above, or if you have concerns that you may not be able to communicate your preferences during labor, then absolutely, yes, you should write a birth plan. We welcome you to bring it to your prenatal visits so that we can read through it together. We also encourage you to keep in mind that while we can’t plan how your labor will progress, we will work with you to be prepared for life’s unexpected surprises and to communicate with you through each step of the way. If you have more questions about a birth plan, we look forward to discussing them with you at your prenatal appointments.