If you are the author of a five-page, laminated birth plan that specifies you want no fluorescent lighting, your contractions referred to as “uterine surges,” and Emmylou Harris singing “Calling My Children Home” right when the baby is crowning – oh, and a Diet Dr. Pepper and two chocolate doughnuts when it’s over – you should be aware that your nurses are amused.
Taped to the wall of the public bathroom in a birthing center in Colorado Springs is extensive documentation of how nurses really feel about your birth plan. It comes in the form of a pages-long parody of a birth plan in which a labor and delivery nurse presents herself as the pregnant mother. Across the top, another nurse has scrawled, Great bathroom read! It’s funny, and a little mean, but should be required reading for anyone who wants to write a birth plan. It says, in part:
[Insert Name] will be referred to as “The Laborer” for the duration of labor, delivery and recovery. [Handwritten by a colleague: And forever after, too.]
The Laborer has been practicing perineal massage on her cat and will bring in her own bottle of extra-virgin olive oil for use in labor.
The Laborer wants absolutely no visitors. With no exceptions. Under no circumstances. Except for [long list of friends and family], Miley Cyrus, Phineas and Ferb, Michelle Obama, Oprah Winfrey, Ellen DeGeneres, Easter Bunny, Tooth Fairy and Edward Cullen. Other people may be added at The Laborer’s discretion.
The Laborer wants Buffy the Vampire Slayer to be playing on the TV at all times. As such, she will be bringing her collection of DVDs and will expect a staff member to switch the discs periodically.
The Laborer would like minimal vaginal exams. Not more than one every twelve hours. But The Laborer will frequently ask how far dilated she is.
It goes on in this vein for five typed pages. Obviously, it’s a piece of satire and isn’t meant to be taken seriously. But satire is instructive and can go a long way toward teaching us what not to do. Fortunately, that’s simple: You don’t want to do anything that causes your nurses to see you as “difficult” or requiring “princess care.” What you do want is for them to take your wishes seriously and to treat you with the utmost care and attention.
How to write a smart birth plan:
1. Language matters.
“It’s a wish list, not a plan,” says Elisabeth Almond, a nurse in Colorado. You want your team to know that you know these are outcomes you hope for, not certainties you expect. Almond suggests writing something like: These are things I am hoping for. If it’s appropriate, and you can help these things to happen, it would mean the world to us. “Any nurse would be so receptive to that,” she says.
2. You’re all on the same team.
Don’t set up an us vs. them mentality, with mother and family on one side and the medical establishment on the other. Your nurses and OB are trained professionals who want a healthy mom and a healthy baby. They are not your enemies – or your waitresses. Acknowledge their skills and their goodwill: We trust you and we trust your care. We know you want the best for me and for my baby.
3. You are more work for them.
Most hospital births are intervention-heavy, and the fact is that interventions make life easier for the staff. If you want to have a different experience, it will be more work for everyone, the nurses in particular. Say so! I know that this is more work for you, and I want you to know I’m deeply grateful for your efforts.
4. You are not special.
Of course you are special. So is your child. And labor and delivery nurses believe that deeply, or they wouldn’t be in the field. But what feels to you like an unspeakably rare and beautiful experience is something they see every day – and they have seen the best and worst possible outcomes. So write your birth plan with a sense of humility rather than a tone of command. You might actually be the most important person who ever lived; just don’t act like it.
5. Everyone likes junk food.
The care you receive will not be any lesser if you don’t bring in chocolate (or coffee, or flowers) for your nurses. And it won’t be noticeably better if you do. But who among us isn’t the tiniest bit friendlier to someone who gives us snacks? So take the Diet Dr. Pepper and chocolate doughnuts out of the plan, and instead, hand them out with the plan. Unlike giving birth, it can’t hurt.