Exploring Your Birth Philosophy

Katherine Pacovsky, a registered nurse at Saint Joseph's Hospital in Marshfield, Wisconsin, says that when she started out as an OB nurse over 35 years ago, women had very little say in how their babies were born. But much of that has changed, in large part due to education, information available on the Internet and in the media, as well as the women's rights movement.

Even now, however, Pacovsky shares that many of her patients neglect planning for labor. Instead, their focus is on the pregnancy and then on the baby. "Couples often fail to think about what would make the labor and the birth itself a mountain-top experience for them," says Pacovsky. To help couples explore their feelings and their options, Pacovsky has the couples in her childbirth class fill out birth plans.

Developing Your Birth Plan

"I think by filling out a birth plan and talking about some of the items on the birth plan, people think about what's important to them," says Pacovsky. "Once they have a grasp on that, they're able to have that mountain-top experience because they know what they want."

Pacovsky's birth plan starts with a disclaimer explaining that sometimes, despite the best intentions and preparations, interventions such as C-sections are necessary for the health of the mother and baby. Then, the birth plan prompts the couple on various subjects, including:

• What types of techniques do you want for labor pain? (Do you plan on having an epidural or other medication, or are you aiming for a natural birth?)
• Would you like medical intervention?
• What positions do you want for labor and for pushing?
• How do you feel about the doctor starting an IV?
• Under what conditions would you feel good about the doctor inducing labor? How far past your due date?
• Do you want anything special in the delivery room (for example, special music, or a mirror so that the mother can see the baby's head crowning)?
• Do you plan to breastfeed? If so, please explain that here so that your baby will remain with you (if medically possible) immediately after birth.

In all her years' experience, Pacovsky has yet to meet a doctor or nurse who can read minds—that's why it's so important to spell out your goals. Even if your practitioner or birthing facility doesn't require or even offer such a birth plan, it's your right to make one up yourself and make copies for the doctor or midwife, nurses, and other medical personnel.