So, at the dawn of birth plans, the industry of having babies was in a transition.  We were leaving the 1950’s model, where moms just showed up to the hospital, did what they were told, and never really expressed an opinion on their own birth experience – to the present day, where many moms are very informed, well-read, and no longer accept the “do whatever you want to me” mentality of birth.  Somewhere in the early 2000’s entered the birth plan.  It was created by a new movement of women, who were saying, “I want to have a say in my own birth.”  They needed to be able to show up to the hospital in the throws of labor, and have a document that acted as a buffer between their wishes and hospital/physician policies.  The problem was, these documents were sometimes 4 pages long, and no nurse or physician had time to read them.

When I was training to be a doula in 2012, through DONA International, they taught us to create a 5-bullet birth plan.  Basically, list the 5 most important things that you want your nurse to know about your wishes and demands for this birth during labor, delivery, and postpartum.  Typical notations are “I am having an unmedicated birth, please do not ask me if I want an epidural.” “I do not want an episiotomy under any circumstance.” “I do not wish for my child to receive the Vitamin K injection.” And so on.

As a practicing birth doula, I work mostly in a hospital setting.  From my experience, I like to think it’s almost safe to say, that hospitals are changing with the times.  I have helped women in small towns, and have been shocked that there is a full natural-birthing suite set up – complete with a regular bed, birth balls, peanut balls, extra-large showers, birthing tubs, intermittent monitoring, and sometimes set apart from the other rooms, so as to have a quieter space to birth.   (My disclaimer should maybe be that I live 45 minutes south of Austin, so our industry here is competing with large and very natural-minded birthing facilities.)  Still, I have even greater things to say about the nursing staff that I encounter on a regular basis.  I rarely come across a lead nurse in a birthing room that is not overly-enthusiastic about a mom who 1. wants the most natural birth possible 2. has hired a doula.  A doula makes less work for the nursing staff, especially the lead nurse, who would typically be checking on patient more frequently if a doula were not present.  So normally, they seem pretty happy to see me (plus I always bring Snickers bars to the nursing station).  I’m not saying there’s not a Nurse Ratched every once in a while, I’m just saying in general, I think most L&D nurses are pretty awesome.

Back to birth plans.  I would say if it were me and I had any kind of specific ideas for what I wanted or didn’t want to happen during my birth AND I was not being accompanied by a birth doula – I would definitely type up a short bullet-list of wishes and hand it to the lead nurse.  I would also ask her to read it before I answered any of her 1000 questions.  BUT if I were bringing a birth doula, I don’t think it’s completely necessary.  The presence of the doula is like mom saying, “hey, I want this to go a specific way, and I care so much, I’ve hired an extra person to help me do that.” I think these days, most hospital staff are with-it enough to get that.  And if they’re not, well, that’s what the doula is also there for – to help them get with it.  – Sarah McDaniel, CD(DONA)