Let families write a birth plan

Education on choices helps

Families delivering babies at Evergreen Hospital Medical Center in Kirkland, WA, aren't told what to expect during labor. Instead, they are educated about their choices, so the birth is a positive experience.

Once decisions have been made, families create a written birth plan that is shared with their physician or midwife. Also, they bring a copy to the Family Maternity Center to show the labor nurse, who is exclusive to the family.

The birth plan helps parents clarify what they expect, says Tamara Fitzgerald, NAC, ICCE, LE, lead facilitator in childbirth education at Evergreen. Articulating one's dreams and visions can be a real revelation to partners, she adds.

There are a variety of choices to make. For example, parents choose who they would like to have present during the birth of the baby, and they also set their own visiting hours; so any time day or night, they can choose to have their families visit.

The hospital provided education about the various ways women can seek relief from pain and discomfort during labor is provided. For example, women can sit or bounce on a physio ball to relieve back pain during labor.

Pain medication and relaxation techniques are covered during classes, so preferences can be included in the birth plan. The birthing rooms have showers and tubs that can be used by families during labor.

Also discussed are religious, cultural, and family traditions the couple may wish to follow. For example, what makes the birth special to a particular family may be an event that takes place at the time of the birth.

Fitzgerald says staff make note of what other parents have said made their birth special and use the information as examples in class.

Birth is not entirely predictable; therefore, sometimes a family's wishes must be adjusted. For example, a couple may want the lights dimmed or special music playing during the birth, but the mother must have a cesarean delivery. "We would try to preserve as [many] of their wishes as possible," says Fitzgerald. For example, they may wait until they return to the room with the baby in their arms and have the room dimly lit as they enter.

Without a menu of choices, it is difficult for families coming to the hospital for the first time to envision what kind of experience they would like to have. The education helps them form their ideas, says Fitzgerald. The birth plan ensures their wishes will be followed.