"Are you writing a birth plan?"

This is a question I ask every client. A birth plan is an important tool for birthing families, allowing them an easy method of conveying their wishes to their care team. "Why do I need a birth plan?" you may be wondering. "I can just tell people what I want, or don't want!" That's true, of course - you absolutely can! That said, a birth plan is more than just a list of things you want or don't want while you're birthing.  It's an opportunity to explore the options you may have for your birth, as well as decisions you may need to make about your care. The following 5 tips are suggestions, based on my experiences as a doula, that will help you craft a rockin' birth plan.

This is your chance to let people know who you are. A brief statement that identifies you, your partner, and any other support people with you (such as your doula), as well as briefly stating your primary hope for your birth, is a great beginning. If you are using a particular birthing method that has specific language associated with it (such as Hypnobabies), your introductory statement is a great place to mention that, as well as anything that makes your birth special or unique. Are you planning a natural birth? VBAC? Expecting twins? Let people know!

​I encourage my clients to come up with a list of 3-5 bullet points to build their birth plan around. Spend some time considering what your ideal birth experience looks like. What are the things that feel most important to you? This looks a little different for everyone, so spend some time thinking about it. Your 3-5 bullet points are going to be the things that you're willing to fight for, versus things that would be nice, but that you aren't heavily invested in. Definitely ask you doula for feedback.

Once you have your 3-5 bullet points, it's time to evaluate the language you're using. Do you see a lot of negative statements? The words we use are so important, and that's especially true when writing your birth preferences! Instead of focusing on what you DON'T want, focus on what you DO want.

For example, "I don't want to be in bed unless I have to be" becomes, "I prefer to be free to move and change position, in whatever way feels most comfortable." Instead of, "I don't want any unnecessary interventions", you might say, "Please take time to explain any recommended interventions, so I understand, and am able to make an informed decision about my care." Positive language has a powerful impact, not only for the birthing person, but in how your birth plan is perceived by your care provider.

Many birth plan templates available online contain items such as, "I would like to have music of my choice played", "I prefer dim lighting", and "I would like to wear my own clothes." Those are important things for you to know, and it's important for your support people to be aware of your comfort preferences, but they aren't necessarily things your care provider needs to be aware of. In most cases (clothing being the possible exception), environmental comfort choices don't impact your medical care, and adding those items to your birth plan makes it needlessly cluttered. If you prefer dim lighting? Turn the lights off. Want music? Turn some music on! Easy peasy! Many of my clients choose to make a second "comfort plan" that is just for me, with all those little extra details which will impact their overall experience, so I can help them create the environment that supports their vision for their birth.

Once you have your list of birth preferences put together, share them. Email it to your doula. Make copies for your birth bag. Give one to your care provider. Do they seem supportive? Indifferent? Antagonistic? Have a conversation with them about it. If there are specific items they don't feel they can support, find out why. You don't want to wait until you are in your birthing time to discover your care provider or chosen birth place can't or won't support your birth plan.

What does being "on call" even mean?
For this doula, the on call period begins at 38 weeks (when you are considered "full term"), and ends when your baby arrives. Anytime between 38 and 42 weeks is considered normal, so for a 4 week window of time, I am available to you 24/7, whenever your birthing time begins. Having a support system is crucial, and I am grateful to the people in my life who fill that role. It's what allows me to step outside of my life to be present for my clients when they call, saying "It's time!"

I've heard on-call life described as living, "phone in hand, with one foot out the door", and that's absolutely accurate! You eat with your phone. Sleep with your phone. Leave your phone sitting on the sink while you're showering - no matter where you're at or what you're doing, your phone is there! (Fully charged, ringer on high!) Being on call means your friends and family get used to hearing, "As long as I'm not at a birth!" Sometimes it's crazy. You have to make sure you're ready to go at a moment's notice - that your gas tank is full, your bag is packed, and that someone else can pick up the kids from school. It means you may have to reschedule appointments at the last minute. It means only having half a glass of wine with dinner, instead of helping your friend finish the whole bottle. (Sometimes it means throwing a $20 bill at your friend to cover your share of the bill, and heading out the door before dinner is even finished!)

​You're pregnant - congratulations! Among the many decisions you will be making in the coming months, one of the most important is where and with whom you will choose to birth. As they begin to explore their options about birthing, more and more parents-to-be are discovering how valuable a doula can be as an addition to the birth team. Here are some of my favorite reasons for choosing to hire one.

​A doula is a veritable fount of knowledge for you to take advantage of! Many expectant parents know almost nothing about pregnancy and birth, but even a brand new doula who hasn't attended a single birth has likely spent hundreds of hours on education.  She will also have recommendations on resources for you to use to further your own knowledge, whether that consists of recommended books to read, or a list of the best birth childbirth classes in your area, and may also have "insider information" about the hospitals and care providers you are considering.

The sheer volume of information available to expectant parents can be completely overwhelming - your doula can help you sort through it all. (This can be especially valuable for first time parents, for whom pregnancy and birth are a virtual unknown.) Whatever your pregnancy or birth throws at you, chances are good you doula has "been there, done that", and she probably has suggestions or techniques to help you cope. It can be reassuring, when things are intense or you're feeling unsure, to see a big smile on your doula's face, accompanied by the gentle reminder that "Everything is great - this is totally normal!"

The birthing person has a job to do - but what about your partner? Many wonder how having a doula impacts the role your partner plays in your birth experience - does the doula replace them? Will they feel less involved in the proces? The answer is a resounding "NO!" on both counts! 

​Your doula will spend time getting to know you both in the weeks leading up to your birth. She'll tap into your "vibe" as a couple, and help you figure out how your partner sees their role in the birth process, and offer support for that when you are birthing. A doula takes the pressure off your partner, so they can be fully present and involved in whatever way they (and you) feel most comfortable.

A doula is the one person you can count on being at your birth, other than your partner, who really knows you, and what your hopes are for your birth. 

Due to shift changes and on-call schedules, there is a good chance that, over the course of your birth, you may see multiple care providers. There is a good possibility that the doctor or midwife you are used to seeing may not be the person who is there when you are in your birthing time. (It may even be someone you have never met before!) Unlike your doctor/midwife (who has multiple patients to care for, and who you may only see briefly before you are ready to push), your doula's only responsibility is you. She will be with you from the time you call requesting her presence, until after your baby is born and you are comfortable, ready for private time with your baby and your partner.

​One of the first questions I ask prospective clients is, "Tell me what your best birth looks like." 90% of the time, the response is a blank, deer-in-the-headlights look, followed by a stammering, "Uhhh, I'm not sure." A doula will help you figure out what feels most important TO YOU. She will assist you in creating a plan that supports your vision for your birth, making sure you understand your options and alternatives, and possible outcomes for the decisions you make about your care.

Most doulas have an open communication policy, and are happy to answer questions about just about anything relating to pregnancy and birth. Before you Google that question or symptom, reach out to your doula! Chances are good she will have information or resources on whatever the topic is, and will save you the trouble (and anxiety!) of consulting "Dr. Google."

​This is the big kahuna of working with a doula. Your doula works for YOU - not your doctor or midwife, and not your hospital or birth center. She has no agenda, other than to help you have a satisfying birth experience, whatever that might mean to you. She will be familiar with your wishes for your birth (remember that birth plan you made?), and will help you advocate for yourself in the moment. She'll offer reminders if things deviate from your plan, and help you adjust course if a change of plans is desired or necessary. And while a doula can't speak for you, she will help you find your voice, facilitating communication with your care provider, and making sure you have the information you need to feel confident in the choices you make about your care.

The evidence speaks for itself! In 2017, an updated Cochrane review was published on the use of continuous support during childbirth. The data (gathered from 26 trials, including more than 15,000 people) shows that those who received continuous support had shorter labors and were more likely to have vaginal births. They were also less likely to feel a need for pain medication or epidural, and less likely to require assisted deliveries (vacuum or forceps use) or Cesareans. When combined with increased overall satisfaction with their birth experience and reduced risk of postpartum depression, those findings are significant!