Have you ever considered how a birth plan might differ according to where you give birth? Whether it's a home birth, hospital birth, or birth center birth, a birth plan serves a similar purpose across the board -- to help you better research and understand your choices, prepare you for different scenarios in birth, and to help communicate your preferences to your birth team. Some would argue that outside of a hospital, birth plans aren't necessary because a family's wishes and preferences are automatically honored (like no routine IVs, skin-to-skin with baby, etc.). This is not always the case, and even so, it's still helpful to communicate certain preferences in advance. Also, it's important to document preferences in the event of a transfer to the hospital. A birth plan will allow you to share preferences with care providers outside of your intended team. So let's take a look -- with examples -- at what would be different on your birth plan, depending on your place of birth.
Home Birth Birth Plans
When preparing a home birth plan, it's important to work closely with your midwife when discussing your preferences. Different than in a hospital, your midwife and perhaps a midwife's assistant are the only professionals with whom you will be working with to care for you in birth. Key differences for a home birth will be the role you prefer your midwife to take (more directed or more hands-off unless in an emergency), the choices for pain relief, information on the environment in your home (my partner, children, mother, doula, etc. will be present), and information that details specifics on what you would like to happen should a transfer to the hospital be necessary. For more information and examples, take a look at this home birth planning resource, step by step from Homebirth.org.uk.
Birth Center Birth Plan
Birth centers vary in what is offered and the kind of environment available. Some hospital annexes refer to themselves as a "birth center" but operate much like a typical hospital labor and delivery unit. But in general, a birth center is built to emulate and make available many of the comforts of home (in terms of atmosphere), but provide the level of medical care available in a hospital. When creating a birth center birth plan, as when creating a birth plan for any location, it's important to know the choices available and the routines in place. For example, it is probably unnecessary to include on a birth center birth plan "freedom to move around as desired during labor" as a less restricted, low-intervention birth is usually one of the hallmarks of a birth center. On the other hand, you'll want to know about require or typical routine interventions in place. If your birth center requires a hep lock (IV port) in place whether or not you require an IV, you'll want to know ahead of time as it may be difficult to request otherwise/refuse during labor. This checklist of options from the Health Foundations Birth Center in St. Paul, MN, show options and choices that are more typical with a birth center birth.
Hospital Birth Plan
The hospital birth plan is likely the reason why birth plans came into popularity. Having a birth plan when giving birth in a hospital can help for the same reasons as those for birth centers and home birth -- to better understand your choices and communicate those choices and preferences to your care provider team (doctor, midwife, nurses). The primary difference in the hospital setting for birth is the amount of standard practices/routines and interventions that can occur, some of which are important and/or necessary and others that are over-used or unnecessary. While a birth plan could help prevent some of those routine practices, it's not a fail-safe measure to ensure the birth preferences you want. It's important to investigate both your care provider and hospital in advance to know what's typical for that facility and what they are likely or willing to accommodate. You can learn more about communicating and using your birth plan in the most effective way with this article on our blog. There are many templates and examples all over the net for hospital birth plans. In general, it helps to include only the most important preferences, keep it simple, and keep it to one page. Check out this free birth plan template from Lamaze for a simple, easy-to-read birth plan you can fill in online and print out.