by Ren Lorio-Dominguez
If you attend homebirths, you have likely witnessed a family prepare a long, detailed birth plan that addressed all of the common local hospital routines they would face if birthing in one of those hospitals. While extensive, these plans likely included very little helpful information about their wishes for a homebirth.
Homebirth families typically come to this choice of birth location through extensive research. The result is that many are well versed in hospital birth standards of care. In choosing to birth at home, they may have a notable list of things they want to avoid. While being well informed about the available choices is always a positive, excessive focus on the practices clients want to avoid can create a lack of clarity about the ways they do want to be supported.
Clients may need some help in designing a birth plan for homebirth that will help them have the birth they envision. Most available birth plan worksheets and online birth plan generators are targeted at hospital births. They may focus on things like not pushing medications that are outside scope of practice in a homebirth setting anyways, or not taking baby to a nursery that is not an option at home. Point this out to homebirth clients. It may even be worth creating your own worksheet with questions more relevant to homebirth.
Misinformation and ignorance surrounding what homebirth is actually like abounds even among many who choose to plan one. Birth plan discussions can also create a platform to explore client expectations. It is also a means to improve informed consent by making the client more aware of their options before they are in labor. Discussing what is routine or protocol in the setting they have planned for and with the midwife they have chosen both addresses expectations and builds a foundation for further discussion of the client’s preferences.
If a clients is comfortable with the routines and protocols their midwife already has in place, many may not know what else to include in a birth plan. A little guidance can go a long way. Consider what you would find helpful to personalize their birth support. A few questions to ask might be:
- Who will be at the birth and what are their roles?
- Will baby’s siblings be present? Who will be responsible for them if they need something?
- Is touch desired during labor?
- Are there specific words or phrases the client does or does not want to hear?
- Is photography desired?
- Are there plans for the placenta?
While these are not the questions most birth plans focus on, they are likely to be far more helpful in a homebirth setting. Help your clients ask for what they want. The more information the birth team has about what kinds of support will be helpful to the client, the better that support can be.
Ren Lorio-Dominguez (they/them/theirs) is an aspiring midwife, two time gestational surrogate, and beginning gardener presently living in the Atlanta area.