03 Aug 2010

Birth plans

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Many couples are happy to plan labour with a “wait and see how it goes” approach while others prefer to write a more formal birth plan. There is no right and wrong about this, it is simply a matter of personal preference.

I think birth plans – while far from compulsory – are quite a good idea for a couple of reasons:

  1. In formulating a birth plan you formally sit down and think (and write) about the things you would like (or not like) during your labour and birth. This means that you assimilate all of the information you have picked up during your pregnancy and you then translate that information into your plan, and
  2. Anyone caring for you in labour who has not met you before – usually the hospital midwives – can rapidly bring themselves up to speed about your wishes (remembering you are likely to be in active labour and not your most coherent at the time).

Obstetricians can feel a little negative about birth plans because we know how things can change rapidly in labour and it is almost impossible to cover all eventualities in a prospective birth plan. To use a military metaphor the World War 2 general George Patton once said something like “Plans are all very good until the first shot is fired.” You get the point.

Birth plans can also sometimes be a little negative in themselves – “We don’t want this and we don’t want that” – and a negative tone can be a little off putting for your caregivers.

By far the best birth plan I have come across is this one developed by my patients Colleen and John. It tells us about them as a couple and its tone is very positive. I like the “Ideal situation” (above the line) and “In case of complication” (below the line) approach which shows that they have considered the possibilities of problems occurring. They document the things they would like to avoid rather than using absolute language and they acknowledge the possibility of needing a caesarean.

Besides any plan that quotes Monty Python (“Always look on the bright side of life”) has to be great.

Colleen gave birth naturally without needing any of the “avoid” procedures and with no complications.

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