Birth is paradoxical: a very predictable yet unpredictable human passage. On one hand, almost without fail the vast majority of human females spontaneously begin labor, progress through increasingly intense stages of labor, feel like pushing, and give birth, at approximately 40 weeks after conception. On the other hand, reliably predicting birth in any greater detail than this is basically impossible. We cannot know the day or week labor will begin, how long it will last, exactly how it will feel, how we will react, or the health and sizes of our babies. What we can do, however, is educate ourselves about the vast array of possibilities and learn which are more likely to occur. We can decide what is ideal and what we will strive for, what are the means to creating the most conducive environment for such a birth, and which people can best help us to attain those birth arrangements. Finally, we can prepare our own bodies and hearts for the process.
Many mothers, midwives and obstetricians today favor a written birth plan as a vital tool in fostering the safest and most fulfilling birth experience for the family. Leah Terhune, a certified nurse-midwife with Midwives Care, Inc. in Cincinnati, explains that a birth plan is important "because it is a written record that shows the goals and wishes of the woman giving birth. At a time when she is especially vulnerable� when it is difficult for the woman and her spouse to make decisions, it is important for everyone involved in the birth process to know how the woman wants her birth to unfold." The birth plan, Terhune maintains, "is a great communication tool for working with your provider, and a sign that you've educated yourself." Terhune believes that in hospital settings, birth plans enable continuity of care. Where numerous nurses doctors can be working with a mother, referring to the document can give everyone similar expectations. She adds, "A birth plan communicates to the birth place, so that [its personnel] have an understanding of a woman's expectations." (Terhune was quick to note, however, that choosing a care provider mindfully makes a significant difference in the outcome of a hospital birth.)
Many decisions need to be made during labor, some of which come as a total surprise to the laboring woman. While writing a plan, a woman will have the opportunity to discover and consider these choices. Karen Crick, mother of two and certified doula (defined and discussed below), explains, "A birth plan is a very good way of exploring all the options that are available. It is a good way to start early on, before labor begins, communicating with the people who will be at the birth� The woman will feel more clear about her options if she has time to review them before the birth."
For women giving birth in birth centers or at home, a written birth plan is less crucial. "A birth plan is not a must for out-of-hospital births," says Terhune "because there is more self-education done by the mother, and most people come into the situation with the same philosophy: childbirth as a natural process." She adds, "In a really good relationship with a midwife, it should be understood by the end of the pregnancy what the expectations are."
The more medical the birth setting, the greater the need for a birth plan. In a hospital, the possible interventions are numerous and it is wise to be aware of these methods, their usefulness, their risks, and in some cases, their misuse or overuse. It can be easy to forget that in most ways birth is reliable, and that in the case of most healthy women, it can be trusted to produce a healthy baby with no more intervention than encouraging words, soothing hands and watchful eyes.
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