So you've decided to write a birth plan, which is great because a birth plan can be a helpful tool and resource in the process of preparing for your birth. But now what? What do you do with a birth plan once you print it? How do you use it and when? Writing a birth plan is a great first step, but the next -- and perhaps most critical -- step is to share it with your care provider(s).
Birth Plan Timing
Before we dive into the particulars of discussing your birth plan with your doctor or midwife, let's address the optimal time to create and share your birth plan. Many couples only begin to really think about the actual birth of their baby in the third trimester. It's ideal, however, to start thinking about your choices and preferences in birth much earlier. Why? Because the earlier you can have that conversation with your care provider -- to make sure you're on the same page (ie, your preferences match up with her routine practices) -- the more time you'll have to consider an alternate provider if don't feel comfortable. When possible, start the process of creating your birth plan early in your second trimester. To write an informed birth plan, take a quality childbirth class, hire a doula, and talk to your care provider.
Communicating Your Birth Plan
Once you have written up your birth plan, take it to your care provider during your next prenatal appointment. If you find that your prenatal appointments are rushed and leave little time for question and answer, call in advance of the appointment to let the scheduler know you would like more time with your provider, or tell your provider at the beginning of the appointment, that you would like to take some extra time at the end to review your birth plan. Ideally, you will discuss your birth plan "with your pants on" -- in other words, your provider won't be mid-exam, and the two of you can have a discussion across from each other, face-to-face, at eye level. Many midwives and obstetricians will take patients back to their office for a consultation/discussion.
Tell your provider that you have created a birth plan and would like to share it with him for input. Upon reviewing your birth plan, your care provider will be able to point out any items that may not be possible or that do not align with her practices or hospital policies. If your provider brings up areas of concern, be sure to ask: 1) why; 2) what are the alternatives; and 3) if his recommendation does not line up with evidence-based practices for birth, inquire about the contradicting information you've found (consider showing online/printed resources if necessary).
After discussing your birth plan with your provider, you should know: 1) how your preferences and needs were received/treated; 2) if your provider will respect your preferences and wishes; and 3) if hospital policies align with your desires for birth. This information helps to provide you with insight on your expectations for birth and whether your provider and place of birth is the best choice for your needs.
Other Birth Plan Uses
Most care providers will take a copy of your birth plan and include it in your file (which will be present at your place of birth during your birth). Additionally, be sure to make a couple of copies of your birth plan to bring along with you when you go into labor. Upon arrival at your place of birth (hospital or birth center), provide a copy of your birth plan to the nursing staff.
Your birth plan also serves as a reminder/informational tool for those on your birth support team, including your partner, friend/family member, and doula.
The birth plan is a valuable tool to help inform and prepare you for your birth experience -- answering the questions of "what's important to me?" and "what are my choices and alternatives?" -- as well as to help you learn more about your chosen care provider. It will either reinforce the fact that you made a good choice of OB or midwife, or bring to light the need to change care providers (it's almost never to late to do so!).