With Mayo Clinic certified nurse-midwife Mary Murry, R.N., C.N.M.

Many of us are planners. Planning is how we keep our many responsibilities and activities straight. It makes sense that we would plan for our births.

A birth plan has nothing to do with when we deliver but rather how we deliver. A birth plan serves two functions. First, it helps us to educate ourselves about all the options available during labor and birth and clarify our preferences in our minds. Second, it acts as a communication tool between us and our caregivers, in the office as well as in the hospital or birth center.

The things you might consider including in your birth plan can be as simple as wearing your own clothes in labor (I did. No naked behind for me.) to more complex issues involving fetal monitoring or allowing students or residents to participate in your labor and birth. Pain management option availability and your preference is important to include in your birth plan. While making your birth plan, it is a good time to find out what options are available for you in the site you have chosen for your delivery. You may find that something that is important to you, such as a water birth, is not available. It is possible that your facility does not allow more than one support person during labor or that residents are involved in all labors and births. Some things you can possibly change, but others you may not be able to. It is best to know that before you arrive in labor.

Include your labor support person during the creation of your plan. There may come a time when you are unable to voice your needs or preferences and your birth plan enables your support person to act as your advocate or voice. You also want to share your birth plan with your health care provider. All of our patients receive a birth plan and we ask them to take it home, fill it out, and then review it line by line with them at their next visit. It helps to ensure we are all on the right page.

There are many samples of birth plans available on the Web, so you don't have to start from scratch. When you have finished it, put it in your bag for the hospital so you don't forget it in the heat of the moment as you leave for the hospital. Be sure to share it with your labor nurse. During the whole process of creating and sharing your birth plan, decide your ultimate goal, the one thing you want most from the experience. Then remind your self of the serenity prayer, serenity to recognize the things that can't be changed, courage to change the things that can and wisdom to know the difference.

On a final note, I want to thank those women in the early 1980's who were the pioneers of the birth plan. They dealt with disbelief, condescension, and derision, but they persisted. It is thanks to these women that birth plans are almost a standard for all women today.

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