November 5, 2019

Low-intervention labor and creating a birth plan: What are my options?

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A pregnant couple speaking to provider on creating a birth plan.

Everything you need to know about creating a birth plan and taking charge of your birth experience. 

Both the American College of Nurse-Midwives and The American College of Obstetrics and Gynecologists support low-intervention labor practices. You may be wondering what low-intervention means and the philosophy as you create a birth plan.

“Low-intervention in the labor and birth process promotes the belief that childbirth is a natural, healthy, physiologic process,” said Alexandra Speros, CNM, FNP, at Vanderbilt Midwives at West End and Melrose. “Because every labor and birth is different, taking a low-intervention approach requires that providers and support teams view each woman as an individual and support her specific needs throughout the process.”

Making a birth plan

“The most important thing that a woman can do is find a provider who supports her autonomy and makes decisions with her, not for her,” Speros said. “Enough emphasis cannot be placed on good communication and trust in the patient-provider relationship.”

Creating a birth plan either for your provider to review or with your provider’s guidance, helps facilitate communication that is vital to that trusting relationship. It also sets the tone that you are at the center of all decision-making.

A birth plan is a patient-authored document that encompasses your goals and visions for your delivery. You take it with you for your birth, and you can discuss it with your midwife in the months leading up to your due date. The birth plan helps guide you, your support team and your care providers through the process.

“Writing a birth plan gives women a time to think, ‘OK, so this is what I think I’m going to need,’” Speros said. “It just sets expectations for everyone.” You can use various apps for making a birth plan or talk to your care provider for details.

She suggested that you think of the plan as a philosophy or a general roadmap rather than a rigid set of rules. “Low-intervention doesn’t mean no intervention,” Speros explained. “It means no unnecessary intervention, and all of that looks very different for every woman.”

Options regarding low-intervention birth plans

Remaining at home during early labor while keeping in touch with your care provider is an option if you have a low-risk pregnancy. “If a woman wants low-intervention,” Speros said, “then trying to labor at home for as long as she can, or feels comfortable, helps a lot with decreasing unnecessary intervention.”

Intermittent fetal monitoring is also safe for low-risk pregnancies and helps keep you more mobile during labor, which Speros said can aid the labor process.

Moving and positioning yourself in a way that is natural to you is all part of low-intervention labor. “You can be sitting on a birthing ball, walking, changing positions,” Speros said. Birthing tubs also offer therapeutic options for managing pain and discomfort. During labor and delivery, you can choose your breathing patterns and opt for pushing as it feels natural.

Ultimately, low-intervention labor is about managing the process intuitively and in a way that feels right for you. There aren’t any hard and fast rules about it.

A doula can also support you through low-intervention labor. A doula will be familiar with your birth plan, help facilitate communication between you and your support team and support you and your partner during labor and birth. You can either seek out a doula or take advantage of the Vanderbilt Volunteer Doula Program. This service is free to all women who labor at Vanderbilt.

When to start creating your birth plan

You can start thinking about your birth plan at any point in your pregnancy. Find more information or attend childbirth education classes to learn more about options and see what resonates with you.

Vanderbilt Midwives at West End and Melrose provide information and guidance at your very first pregnancy clinic visit. They then revisit it in the third trimester.

“The best thing that a woman’s support team can do is truly support her and her baby, as appropriate and healthy, of course, in her decisions,” Speros said.

The Vanderbilt Nurse-Midwives have a combined 250 years of experience in caring for women throughout their lives. We educate and empower women to make the best decisions for their own health and that of their babies. Our midwives can help you have the birth you desire. We also have access to OB-GYNs and Vanderbilt’s world-class neonatal care, should you or your baby need it. To learn more about Vanderbilt Midwifery, call 615-936-5858.