You have it all planned out. You have picked out the colors for the nursery, your baby registry is complete, you know the car seat you are going to buy and there is a list of baby names you have in mind. But have you written down a birth plan yet?
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During my first birth, I had a general idea of how I wanted to labor and give birth, although I never had anything specific in mind. I always thought I would have a natural birth.
I assumed the doctors and nurses would guide me through the process and everything would go according to plan. Well the plan I thought about, but never wrote down.
Let me tell you, trying to communicate during labor was anything but easy.
My first birth did not go well or how I wanted it to go. I really wish I had taken the time to create a birth plan.
What is a birth plan?
A birth plan is a written guideline of your wishes and goals before, during and after birth for your birth team to refer to.
It clearly spells out your preferences when it comes to things like pain relief, movement during labor, pushing positions, newborn care, feeding choices and more.
This is one of the best communication tools you can use with your healthcare team. It lets everyone know what kind of birth you want and helps everyone to get on the same page.
This tool will communicate your mindset about birth and how your team can best support you.
Why you need a birth plan.
Birth can be unpredictable. It can be scary going into a situation not being sure of what the outcome will be.
That is where a birth plan comes in. Studies show women who felt they had choices in labor and delivery remembered having a more positive experience.
A birth plan not only improves a mother’s experience of labor, but may also help labor progress smoothly. The physiological process of labor is governed by hormones, as Erica Tempesta, a doula in Northwest Arkansas, explained to me: “Oxytocin helps your uterus contract and your cervix dilate and efface. Adrenaline interferes with this process.” If you are stressed out, labor can slow down. “Having a sense of control and choice can therefore facilitate the progress of labor by keeping adrenaline out of the picture until the appropriate time, and letting oxytocin do its work,” Tempesta said.
What should be in your birth plan?
When you are writing you birth plan you want to be clear and to the point.
To make your plan easy to read, you can break it down into three sections: Labor – Birth – Postpartum.
During labor you may want to consider things like:
- Natural birth vs. Medicated birth
- If medicated- IV pain medication vs. epidural
- If labor stalls will you want treatments or medications to help speed things up such as : Pitocin or artificial rupturing your membranes (breaking your water)
- Who will be your support person?
- Will you want anyone else with you during labor besides your support person?
- Will you have a birth photographer?
- Would you like to a shower or tub for pain relief during labor? Will the hospital you are delivering at offer that?
- Would you like to be allowed to move freely during labor?
- Does the hospital you are delivering at require fetal monitoring all the time or will they offer intermittent monitoring?
- Will your MD require you to have a saline lock? (a plug for the IV catheter)
- Your environment (lighting, sounds, scents)
- The clothing you wear
- Do you want to eat or drink in labor, if possible?
During birth you may want to consider things like:
- Who would you like to be present for the birth? (Dad/Doula?)
- What positions would you like to birth in?
- Would you like to push on your own or be coached?
- Do you want to have a mirror to watch your baby being born?
- Do you want to catch your baby? Dad?
- Where you want your baby to go immediately after birth- skin to skin with you or to get measured and weighed?
- Do you want to breastfeed right away?
- Delayed cord clamping?
- Who cuts the cord?
- Will you collect the cord blood?
- If necessary, do you prefer to tear naturally or have an episiotomy?
- If necessary, how do you feel about vacuum assisted birth or forceps?
- What do you want to do with your placenta after birth?
- Plan for c-section if necessary.
During postpartum you may want to consider things like:
- Breastfeeding vs. bottle feeding
- If bottle feeding – formula of choice
- Will you use a pacifier?
- Do you want to delay your baby’s first bath or do it on your own?
- Do you want to use the hospital nursery or have your baby in the room at all times?
- If the baby has to leave your room for any reason do you want Dad to accompany the baby for any procedures or test?
- Erythromycin/Vitamin K administration (typically given at delivery but in some cases can be delayed)
- Will your baby receive the Hepatitis B vaccination in the hospital or at the first pediatrician’a appointment? Or you may choose to not vaccinate.
- If your baby is a boy, will you circumcise?
- If you choose to breastfeed, do you want to see the hospital lactation consultant?
- Would you like visitors to be limited while you are in the hospital?
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While you are writing your birth plan make sure to include what you would like to see happen as well as what you would like to avoid.
Try to keep it on one page and use bullet points to make it easy to read. Avoid using language that is demanding or having a “know it all” attitude.
This makes it easier for doctors and nurses to ignore a your preferences.
Be flexible but maintain your “bottom line”. Always keep in mind these two questions:
- “Is it necessary?”
- “Is there an alternative?”
So many times when a patient writes their birth plan, they write it with an expectation that because they are putting their plan in black and white this is how IT IS GOING TO HAPPEN.
Writing down what you want is not a guarantee that it will happen.
No one can give you the perfect birth and ultimately your birth plan is NOT the ultimate decision maker.
Your body and the health of your baby will determine the final outcome.
Choose a birth team that will have your back.
Your healthcare team is there to keep you safe and collaborate with you based on all factors present during delivery.
One of the biggest factors in your birth plan being a success is who you choose to take care of you.
For me, I knew that if I 100% trusted who I chose to take care of me and my baby, NO MATTER what happened during birth, I could trust they were doing what was best for us.
If I did not have confidence in that, I knew I would be afraid and questioning every decision they made.
Trusting my doctor allowed me to relax during birth, knowing me and my baby were taken care of and my choices were respected.
I knew if something needed to happen that didn’t align with my birth plan I could trust it was for our well being.
When you get done writing it, talk with your doctor about it. Make sure your desires are reasonable and within hospital policy. Ask if there is anything you have left out.
This is also the time to ask any questions if you have them and practice communicating with them about the big day, now.
Writing a birth plan doesn’t mean your delivery will be free of surprises, but at least you’ll be ready for them!
Comment below with your best tips for writing a birth plan that was helpful for you! If you wrote a birth plan did it go exactly as you hoped? If it didn’t how did you handle that?