YES, I did use a birth plan! I think birth plans are very valuable tools. I gave birth nearly a year ago (June). And my plan was only two pages long (and even that because I used large font for easy reading). I was interested in having the most non-invasive and natural birth I could in a hospital. Most hospitals and doctors are trained to "deliver" babies in a certain way. My birth plan helped easily describe what I wanted. My husband and I created our birth plan and discussed it with our doctor and our doulas. It included every step of the birthing process and what I wanted: delayed cord clamping, no IVs, no Hep-Loc (which I had to sign a waiver), no pulling on the baby's head, no episiotomy. It also included what I wanted for my newborn: not to remove the vernix, to have my baby placed directly on my bare chest, to delay bathing and weighing until at least one hour after birth, to delay vaccinations, etc. etc. (I did choose to add a section containing food/number of people/music/lights/and the like because, as Heather mentioned, this hospital had 'rules' for those things. By talking to my doctor early - and getting her to SIGN my PLAN - she was agreeing to allow certain things to happen.) We also asked that no one offer me (or my husband, for that matter!) any drugs. :) At the top of the plan, we also asked for our hospital team to include only people that were excited and comfortable with a natural birthing mama. This was a great help. We got a WONDERFUL nurse that actually CARRIED MY PLAN around in her pocket!! She was fantastic and really took to heart our wishes. I think the most important part of the birth plan is to open up a converation with your care provider. If Nancy was comfortable with a verbal plan, that's great! It seems she wanted a fairly standard birth. Good for her. I had certain things that I wanted to see happen during my baby's birth. The plan helped me make those wishes come true. I had a wonderful birth experience. Heather, I'm so glad that you are writing a birth plan! I think having a vision of your ultimate birth is important to achieving it. TIP: Give your plan to the hospital staff with a plate of BROWNIES!!! Then everyone will read it! I understand why some women think birth plans are silly. They think the doctor will do only what is best and needed. Hopefully this is the case, but some have been delivering babies one way and one way only for years and might need a written reminder of your wishes. (This is where a doula is SO VALUABLE!! She can be insistant about your plan while you and your husband/partner can focus on the birth at hand!) Also, for anyone else out there planning a natural birth, be "gentle" with your words. These days so many women seeking a natural birth are thrown into the category of "freak" or "granola" or whatever... I actually heard one of the other nurses say "Oh, it's gonna be a long night." because I chose to walk to my birthing room (instead of in a wheelchair). (She did not attend our birth.) But being pleasant, polite, and POSITIVE (as well as assertive) with your choices can take you far!

Birth plans are great, so long as you realize it's exactly that...a plan. Life gets in the way of plans, so as long as you're ready to drop your plan and do what is best for your child, you'll be fine! I was the last of my group of friends to have a baby and had heard all of the wonderful (and not so wonderful) birthing stories. One friend was terribly bitter because she had to have a c-section even after several miscarriages with chromosomal abnormalities - a healthy baby is what's important, right? She felt cheated and was depressed for months about it. I decided that I would step back from my type-A, hyper planner, control freak personality and not set myself up for disappointment when it came to my birthing story. My doctor provided a brief one page birthing plan that was super easy to complete. Did I want drugs? Sure, if there was time for them. Who did I want present? Hubby and mom. This is easy! Did I want a mirror available? Nope, no thanks! Did I want the baby right away? Umm....make sure she's ok and then give her to me! Pretty cut and dry. My plan was laid out. Vaginal birth if possible, drugs if possible, everything else we'd figure out along the way. Bottom line, as long as I walked away with a healthy baby I would be thrilled! At 34.5 weeks, she stopped moving. I did everything I was supposed to make her move. Nothing worked. I knew something was wrong and simply couldn't relax. The on call nurse had us go in to the hospital. After several hours of non stress tests, ultrasounds and a bit of Pitocin to see how she did with contractions, the on call doctor determined that she needed to come out. NOW. One emergency c-section later, my tiny little bundle of joy had arrived. All 4 pounds of her. A few weeks in the NICU later, she was home and perfectly healthy. (Turns out, the cord was wrapped nicely around her little neck). Would I have liked it to be less stressful? Yes. Would I preferred that my family hadn't been scared out of their minds? Of course. Would I liked to have had pictures of her being born? Absolutely. The hospital staff did everything they could do to keep me calm, include my husband at every step and provide amazing care to my child. Given the situation, that's the best we can ask for! And I'm glad my expectations weren't set in stone....or on a 8.5 x 11 piece of paper. My doctor said, 'had you waited until your appointment (2 days later) we would likely be in a very different situation. I wish more of my patients would listen to their instincts.' Today, I have a gorgeous, spunky and perfectly healthy 3.5 year old who fills my heart, makes my life brighter and is terribly entertaining. That is all that matters to me. My birth plan for baby #2 = I'd love to have some pictures. :)

I didn't have a written birth plan. I had a loose version in my head that I wanted to follow, but it didn't work out that way at all. After going into labor, I wasn't progressing as quickly as the hospital staff would have liked, so they suggested giving me Pitocin to speed the process along. I didn't want the Pitocin, but felt very pressured by the nurses. I was told that it was dangerous to be in labor for too long after your water broke and "We really need to get this process going." After being frightened and made to feel like I was making the wrong decision, I agreed to the Pitocin and, all hell broke loose. I was contracting so hard that it was sending my son's heart rate into distress. My blood pressure kept dipping dangerously low every time they would give me more Pitocin. At one point, my BP dropped to 80/30. After a few very stressful and scary hours of the Pitocin and bad reactions from both me and baby, I still was only dilated to 5 after being in labor for 12 hours. My Dr decided at that point that I would need a c-section b/c of my son's heart rate. The surgery went well, but I didn't get to hold my son for almost 3 hours b/c of the fluid in his lungs that didn't get pushed out since he was delivered by section and didn't travel through the birth canal. To say the least, I was disappointed with how it turned out. Of course, I can't help but think that if I had stuck to my guns and wasn't bullied into getting the Pitocin, things would have gone differently. Shortly after my son was born, I watch Rikki Lake's documentary, The Business of Being Born, and just cried my eyes out b/c they described my experience exactly. I felt pressured by the staff to make choices I didn't want to make and in turn, it had a negative effect on myself and my baby. The next time around, I will most certainly have a birth plan. I know for sure that I don't want Pitocin anywhere near my veins.

From the perspective of a labor and delivery nurse, I think that birth plans can be a positive and reassuring addition to a woman's experience with childbirth. It is true that there are a lot of nurses who will roll their eyes when they see the pages of 'plans' come into triage with the, immediately labeled, 'granola' moms-to-be. This is certainly not the right attitude to take towards a birth plan, but I understand why some nurses feel this way. Some women come in so determined to have what's in their plan carried out, that if any part of the plan veers down another path, then we become the evil and invasive medical staff that ruined everything. The problem is that some people come in without understanding that there are some situations that make what they planned unsafe or not possible. When I have a patient who brings in a birth plan, I will always sit down and read it with them. If they have taken the time to think through what they would like, then it is my duty to take the time to understand and respect their wishes. I also do my best to carry out their wishes. Every nurse/doctor should. I can see how one may feel a loss of control over their experience once they enter the hospital delivery room. It is YOUR child and YOUR body and so you have every right to want to have a say regarding how you would like things to go. However, I also read the birth plan with the family to bring a dose of reality to the situation. No, not all people need this 'reality-check', but some do. So as to not encourage false hope that the birth will go exactly as planned, I go through each request. I reassure them that I will do my best to carry out their wishes or remind the doctor to do so, but then I also say "Here are some situations where this may not be possible for the safety of you or your child......" Despite this, I also say that, ultimately, this is your body and your choice. If you are the type of person that finds a birth plan reassuring, then by all means, make one. If you have a doctor who is willing to take the time to go through it with you, then take the opportunity! This will help you to know and be prepared for the things on your plan that might need changing during the birth. If not, as soon as you get to the hospital, show your nurse and ask them to go through it with you and discuss each request. The point is, don't be too inflexible with it. Labor and delivery can be so unpredictable and every single situation is different with every pregnancy. So have a plan, but be open too! From my experiences, I have seen so many come in with their birth planned to the hilt, only to be devastatingly disappointed when things just couldn't go their way. That's even after telling them many times that we had to change the plan in order to have a positive outcome. I feel sad for these women. When I have a baby, this will be my birth plan (based on 7 years of witnessing births): 1. Let me labor and support me as long as I can handle it, but when I say 'Epidural' get me one stat!-Please! 2. I would like a vaginal delivery, if possible. However, if there is any indication that my child is in distress, may get stuck in the birth canal or rip me to shreds coming out from below, I would like a c-section. -Please! 3. Episiotomy- No thanks! But if it looks like, upon crowning, that my kid's head is going to rip me from clitoris to anus, I would like a right-medial lateral cut. -Please! 4. I want to avoid an instrumental delivery at all costs! I would prefer a c-section over a vacuum and a vacuum over forceps. However, if in the last moments of the delivery my baby needs to come out STAT, then do whatever you need to do-safely- to get them out. -Please! 5. Skin-to-skin and leaving the cord uncut for one minute are things I would really like, however, if my baby comes out limp and blue, do not waste a moment. Help them, STAT! -Please! The rest - music, lighting, labial massage, etc., are mere details. Details that, if you want them, then you should be allowed to have them- so long as they don't interfere with the safe delivery of your precious little baby or with keeping mom as healthy and intact as possible.

LouEffie, I am sorry to hear about your experience with Pitocin. It can be a very helpful drug, but I have also seen your situation as well. Out of curiosity, did they try turning the Pitocin off for a while or reducing the dose to see if your baby's distress was eliminated?

I kept reading about birth plans in all the books so I went online and printed one out. When I started filling it out I was thinking, this is really complicated. And I got a little anxious. I went to some online forums to ask what people did, and I got an onslaught of "you do NOT need a written birth plan, it's a waste of time" responses. So, I wrote down all the basics: epidural, no epesiotomy, no pitocin, c-section only if necessary, etc. and I went over it with my husband. I talked to my doctor about the pros and cons (I don't know where Maggie delivered, but I too live in San Francisco, and yes I think we have it a lot easier here, docs are way more open to letting things happen naturally). But, I wanted someone to be my advocate in the delivery room since I knew I'd be...preoccupied. And it worked out fine. Just know the basics, and be sure your birth partner and doctor know them too. I ended up needing forceps, but hadn't thought of that before. But, the doctor very calmly told me after three hours of pushing, you have some other options. And he let me decide what to do. I'm so thankful for that.

I would guess that you'd *know* if you wanted/needed a birth plan. For example, I wanted to try to go without an epidural, but I did want somebody to tell me if the window of opportunity for using one was about to close, as I've heard people deciding "ok, no more!" and being told it's too late. Similarly, I wanted to be allowed to tear, rather than have an episiotomy, because it's supposed to heal better, etc., so I made sure to specify that. As for the other silliness on the form, I think it's more to give you things to think about that you might not have (like the music) rather than actually guide your doctor. But it would be helpful if they broke those out -- here's a worksheet for you, and here's a page for things you want to tell your doctor on The Day. Dooce's final points about checking on hospital policies are also apropos, but again, I suspect that most people have little or no plan, and thus don't really worry about coming into conflict -- the default in this country is more passive (I'll do what the doctors tell me to do) than individualistic...

Thanks for your insight. No, they never did. They stopped giving me any more Pitocin, but they never took me off of it or reduced what they had already given me. We asked them and they said that it wouldn't make a difference since administering more seemed to be the culprit that would send his heart rate and my blood pressure into distress. It was a scary experience. I know some women do just fine on Pitocin, but I'm definitely not one of them. The next time, I'll most certainly steer clear of it. Leslie

Heather's point about a birth plan allowing us to know our options is a good one. I didn't do the official birth plan form, but I talked with my OBGYN about what I wanted, and my husband and I did write down what my preferences were just so we could get them clear in our heads. Shared 'em with the doula and left the rest up to the universe. If I had the opportunity to have another baby, I might prepare myself a bit more than I did the first time around, but in the end (36 hours of labour, epidural at 30 hours, 4 hours of pushing) I had a healthy baby girl and the memory of that 36 hours is thankfully fading into a distant memory.

I have two perspectives. As a birthing woman, I think birth plans perhaps are most useful as a tool to understand, educate yourself, and consider all of your options. It helps you to think through the birth experience you wish for. It is ALWAYS understood that it is simply a plan. And plans may deviate. That said, I doesn't hurt to fill one out as a reminder to yourself, your support partner, and the staff. As a doula, I recommend birth plans for my clients for the above reasons but mostly as a tool for ME. As their doula, I never speak on behalf of my client's wishes but can refer to the birth plan as a way to respectfully remind staff of their wishes. It is a low-stress way to communicate between my client and the hospital staff. That way, I'm not speaking for them nor overstepping boundaries. :) What's most important in your plan, in my opinion? Strong, educated, loving support people. Your birth team. Get those on board early, develop deep trust, and know you are all on the same page.