Birth Plan or Birth Preferences?
That is the Question...
Depending upon the area in which you live, some care providers and places of birth may frown upon (or outright detest) Birth Plans.
This can happen for many reasons, only some of which are within your control.
In my opinion, any care provider or place of birth that is not receptive to Birth Plans will not be supportive of your choices once you're in labor. They tend to prefer the status quo and while they may tell you what you want to hear while you're pregnant, once you show up in labor, you could be in for a not-so-pleasant surprise.
The second reason why Birth Plans aren't always well received is sometimes how they are written. Remember, you are writing your best case scenario, not a manifesto written in stone. You must be willing to stray from the plan if circumstances so dictate. Some couples use aggressive language which is a big turn off to hospital staff. Remember, it's not just what you say, but how you say it. Sometimes the word "Plan" is just taken too literally and hospital staff fear they'll be in for a fight to get you to stray from it, which neither side wants (but for different reasons;-)
In the first situation, there are two courses of action: either find a new care provider and/or place of birth or develop an alternate type of Birth Preferences list. It's up to you to decide which one is within your comfort zone.
The first option is to find a new care provider or more supportive place of birth. It's never to late to switch, even in the last weeks of pregnancy. It's not convenient, but doing the right thing often isn't.
If this isn't an option for you, then consider making an alternative type of Birth Plan, such as a list of Birth Preferences. Sometimes just renaming it "Birth Preferences" will be enough.
If the second reason is an issue, then you can help your cause by using a shorter plan that highlights your main points. Take the time to find out what is standard practice in your area and what sections are not an issue. For example, if full rooming-in is the standard of care at your place of birth, then there's no need to specify that in your plan. Also, if shaving and/or enemas are not performed, then those options can also be cut from your plan.
One of the best ways to find out what's needed and what's not is to take a private tour of your chosen place of birth. (If you've picked a homebirth, then this should be a snap;-) Ask as many questions as you can about what options are available and what is routine procedure. You can also ask for a copy of your care provider's standing orders to see what the real deal is in terms of interventions such as routine monitoring, etc.
The next few pages give examples of how these Birth Preferences can be written. Feel free to copy and paste these suggestions into a Word document to help you tailor it to your own needs.