What’s Your Birth Plan?
Sarah Rae Easter, MD - Division of Maternal Fetal Medicine, Brigham and Women’s Hospital; Assistant Professor, Harvard Medical School
Many of my patients ask me whether or not they should have a birth plan. The reality is my birth plan for all of my patients is the same: healthy mom, healthy baby, and vaginal delivery. That plan comes with two important footnotes. First, if that third goal of vaginal birth compromises the health and safety of mom or baby it is the first part of my plan to go. Second, the details of my “birth plan” are based on my knowledge of medicine and clinical experience which may be inadequate for some patients. Though I like to think of myself as a good doctor, my obstetric skillset isn’t always equipped to deal with the complexity patients face in their lives.
When I say ‘healthy mom’ that means not only physical but mental health. While I try to get to know all of my patients as people during prenatal care, developing that kind of relationship takes time. This is where a birth plan can be helpful. Your birth plan can be a place to share medical or personal preferences or highlight what is important in your birth experience. For patients with a history of anxiety, trauma, or distrust with the medical system this can be a clear way to communicate goals of care without having to relive negative experiences on such an important day.
This complex interaction between life and medicine may culminate on labor and delivery but is a key part of all obstetric care. A healthy pregnancy goes beyond the office, ultrasound suite, or labor and delivery. For most patients, pregnancy is a defining moment incorporating a not only medical history but lived experience into one concentrated time period.
The truth of the matter is that delivering babies is the best job in the world. Guiding patients through complex pregnancies as a maternal-fetal medicine specialist makes that even more personally and intellectually rewarding. But the privilege of being present for this momentous occasion comes with hard work and tremendous responsibility.
My initial interest in Modelo was to help bridge the gap between patients and providers. I view the app as a way to call attention to high risk issues—medical and otherwise—that patients and providers need to discuss to achieve “my” birth plan. In many ways Modelo is a birth plan that evolves alongside your pregnancy journey. A way to help achieve not only the obstetric trifecta of healthy mom, healthy baby, and vaginal delivery but to do so in a way that acknowledges that your health extends far beyond what takes place inside the hospital.
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