This document discusses creating a birth plan to help manage anxiety during pregnancy and childbirth. It recommends thoughtful preparation of a birth plan through realistic and trusting communication between expectant parents and medical providers. The birth plan should be flexible to adjust to any unexpected circumstances that arise to ensure a safe delivery for both mother and baby.

1. APPROACHING A BIRTH PLAN

3. Pregnancy is an exciting time for expectant parents, and
childbirth is a miraculous event. Nevertheless,
due to the innate unknowns, it can result in considerable
anxiety and sense of loss of control.
One means of combating these feelings is through
thoughtful preparation of a birth plan based on realistic
and trustful communication among all the parties who will
be involved.

5. Since the early Roman period,
pregnant women in labor had been
attended by friends, relatives, or
others experienced in aiding with
childbirth. As time progressed, the
management of the laboring
woman became more involved and
the advancement of technologies to
better monitor the unborn child
and the mother required a change in
the birth place and the sophistication
of the caregivers.

8. In association with these changes came the option of
operative delivery (cesarean section) which in
2012 accounted for close to 30% of all births in the
United States, according to the Centers for Disease
Control and Prevention (CDC). Cesarean sections are
known to be medically indicated for a number of
reasons to safeguard the well being of baby and/or
mother. At the same time, for most pregnancies that
are low risk, cesarean section may pose greater risks
than vaginal delivery, especially risks related to
future pregnancies.

11. Due to the recent rapid increase in the cesarean section
rate and concerns that operative delivery is overused
without clear evidence of improved maternal or
newborn outcomes, the American College of
Obstetricians and Gynecologists (ACOG) issued in 2014
new recommendations targeted at preventing women
from having cesarean sections with their first birth and
at decreasing the national cesarean rate.

13. Pain management is a significant component of the
birth plan. Although most mothers report only mild
discomfort during early labor, as contractions become
stronger, longer, and more frequent, pain
intensifies and may require relief with either spinal or
epidural anesthesia. Although the medications are
generally considered safe, very rare complications can
occur. For those women opting for a more
natural childbirth, the participation in a yoga program
during pregnancy or the use of hypnosis have
been described.

15. Whatever birth plan is developed for
an individual pregnancy, it should
always be tempered based on
the saying “the best laid plans of mice
and men often go awry”. The
overriding goal should always be a
safe birth for both mother and baby. If
communication and trust exist among
all parties, childbirth can be a
magnificent process.