What is a birth plan? This concept appeared in the Perinatal Care Standards introduced in Poland. It refers to a type of document created by the mother in labor, in which she includes all her expectations regarding the course of labor and preferences regarding medical treatment, procedures performed, etc. The birth plan also includes information about the patient’s wishes regarding her newborn baby.
A birth plan is not mandatory, but women have recently been taking advantage of this privilege and taking it to the hospital along with medical documentation regarding the pregnancy (medical tests, pregnancy booklet, etc.). It is worth emphasizing that the document is created for the purposes of natural childbirth after uncomplicated pregnancies, including those ending with a planned cesarean section.
How to prepare a birth plan
A birth plan is a document that is usually prepared several to several weeks before the due date. The baby may be born earlier, so it is worth being prepared, preferably at the beginning of the 3rd trimester. You can find a birth plan online (just type “birth plan – template” into the search engine). It is indeed a kind of template in which you circle the appropriate options, but instead of using a ready-made one, you can also write it yourself. In both cases, it is worth completing a birth plan with a specialist. This can be done together with the doctor supervising the pregnancy or the midwife, who is available to every pregnant woman from the 21st week of pregnancy. If a pregnant woman wants to give birth in the presence of her own midwife or doula, she can use their support. A specialist can indicate and justify why certain points are worth emphasizing due to the benefits they bring, and which ones should be omitted.
What should be included in a birth plan?
The birth plan covers the period from the moment a woman reports to the maternity ward, through all stages of labor, up to the hours immediately after birth, when the plan covers not only the care of the woman in labor, but also her baby.
The first part of your birth plan provides information about preparing for labor. It is worth noting whether the patient intends to give birth alone or with a companion, as well as which procedures she does not want to consent to and which ones she wants to have performed (e.g. enema before delivery, insertion of an IV cannula, etc.). Next, the future mother indicates what her expectations are regarding the course of labor: possible induction (i.e. administration of oxytocin or puncture of the amniotic sac), use of anesthesia or not (if so, what type: natural pain relief or pharmacological), as well as whether she wants to eat and drink during labor, listen to music, take a bath, be able to move around, use devices that facilitate cervical dilation (e.g. a sac bag), etc. An important element when preparing the list is information about the episiotomy – whether the patient wants to consent to it or not.
The next part of the document contains the patient’s expectations regarding the first hours after delivery, i.e. care for the newborn after birth. In the birth plan, she may express the desire for the baby to spend 2 hours with her after birth in skin-to-skin contact (also after a cesarean section) and to breastfeed the baby immediately, or, on the contrary, for the baby to be measured and examined first. Other expectations include the father taking kangaroo care of the baby, using hospital or own clothes, and support after birth – psychological care, assistance with breastfeeding, bathing, changing diapers, etc. It is worth noting whether you agree to have your child vaccinated immediately.
When can the birth plan not be implemented?
The birth plan is designed for a physiological birth, but sometimes problems occur during labor. The Standards of Perinatal Care state that any medical procedure performed on a patient or her child may only be performed after her consent. Staff must also comply with her wishes as outlined in her birth plan. The exceptions are situations in which the life or health of the woman or her child is at risk. In such cases, the staff is not obliged to ask for consent, nor is they obliged to comply with the birthing expectations included in the plan. However, the mother must inform the laboring woman of her intention to perform a given procedure during or after delivery and explain why she must do so.
