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Get with the plan: the role of birth plans for expectant moms

Category: Patient Stories
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Dr. Claire Mallof, St. Luke's OB/GYNPublished in Moms & Dads Today magazine, September/October 2015

Get with the plan:

the role of birth plans for expectant moms

Molly Anderson is pregnant. Very pregnant. It’s two weeks before she is scheduled to give birth to her second child via a cesarean section at St. Luke’s. And Molly is, well, a little nervous. “I gave birth to my son, Ethan, over eight years ago. As I was in labor with him, his heart rate started dropping, which prompted the physicians to do an emergency c-section,” she explained. “Because everything had to happen so fast, I was put under general anesthesia. When I woke up after the surgery, I felt like I had missed so many of those first moments with my son.”

This time around, Molly will be awake throughout the procedure. And while she is looking forward to bonding with her baby during those first precious moments after delivery, the whole “being awake throughout the procedure” part was causing some anxiety. “In talking about my delivery with my OB, Dr. Susan Goltz, she suggested I put all of my wishes and expectations for the birth experience into a birth plan,” said Anderson. “Doing that really helped me organize my thoughts and alleviate some of the anxiousness I was feeling.”

The rise of the birth plan

Lori Swanson, RN, nurse manager of the Maternal Child Health Department at St. Luke’s Hospital, observed that birth plans are becoming more popular with expectant mothers. “Birth plans have been around for decades, but we’re seeing more and more women fill out birth plans prior to delivering,” said Swanson. “Birth plans have become more mainstream. Women are invested in having the experience they want. All the information that is available to expectant moms is empowering them and giving them a larger voice in their care.”

Another reason for the rise in the popularity of plans at St. Luke’s is the system-wide launch of About Baby, St. Luke’s comprehensive approach to empowering women to become more engaged in their care. A key component of About Baby is a proprietary birth plan. “A woman spends nine months building a one-on-one relationship with her provider—then she goes into labor and meets an entire team of people. We created the About Baby Birth Plan to make sure that mom’s preferences were clearly translated to everyone who would be involved in her care,” said Swanson.

At St. Luke’s, the birth plan becomes a part of a woman’s medical chart. A copy of the plan is physically placed in the patient’s room, and for added measure, a sign is placed on the door of the patient’s room alerting staff that she has a birth plan in place. “There are so many decisions to make through every step of the birthing experience,” says Swanson. “The atmosphere in the room, cutting the cord, baby’s first bath—it can be overwhelming. A birth plan helps make a lot of those decisions ahead of time, which can help bring down the stress level.”

What it is—and what it is not

A birth plan, broadly, is a document that records expectations for labor, delivery and aftercare. It provides expectant mothers with a way to communicate their desires without having to repeat themselves, and ensures that everyone is on the same page. And while a birth plan is fairly detailed, it also needs to be flexible.

St. Luke’s OB/GYN Dr. Claire Mallof, who was instrumental in creating the About Baby Birth Plan at St. Luke’s, said that it is important to remember that the one goal that everyone has is the health and safety of mom and baby. “One thing I tell my patients is that there can be many fears or anxieties about labor, delivery and after care. While the ‘birth story’ will not be revealed until the moment of delivery, many women’s anxieties can be decreased by using a birth plan and discussing them before the onset of labor.” She added, “We don’t want our patients to make real-time decisions if they don’t have to. That’s why it is so valuable to take the time to think through all the details ahead of time.” Typically, said Mallof, the birth plan is introduced during the patient’s first trimester, and is filled out and in her chart by her third trimester.

“If there is one thing moms should know about birth plans, it’s that we want you to be heard. We care about you being happy, and this is one more way for us to show our support,” said Mallof.

Ready for delivery

For Molly Anderson, filling out her birth plan brought clarity to a very complex process. “There are so many details about preparing for delivery,” she said. “One of the things I really appreciated about the plan is it helped us to make decisions, including things I never would have thought about. Like, there is a section about giving your baby her first bath—I didn't even know that was an option.” She added, “Having a birth plan in place has given me a real peace of mind. I know everything is subject to change based on my health or her health, but this is what is important to me. And even having a c-section, it is great to know that I can still have a say in every part of the experience.”

You can download the About Baby birth plan at