7 Things to Consider for Your Birth Plan

Birthing centre
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Creating a birth plan is a good way to think through what you want for your birth and to communicate those wishes with your birth team. Many birth plans are verbally shared with a partner or doctor, or simply written down on a piece of paper, while others are more formal—typed up, signed by your practitioner, and placed in your chart (although these are not legally binding documents).

Though it may be tempting to use a pre-written birth plan that you get from a friend or find on the Internet, it is best to go through the process of drafting one that is unique to you.

Examples can be helpful in getting you started, but copying them word for word can lead to you including things you're not even sure you want or need.

Use these topics as inspiration and add any other ideas that come up as you go.

1. Your Philosophy of Birth

This doesn’t have to be a three-page treatise on why you chose your childbirth class or doula, but it should be a short statement that allows anyone who may interact with you during your birth to quickly understand your main wishes. For example, if your goal is to avoid pain medications, state that up front. Likewise, if your goal is to get an epidural as quickly as possible or, say, avoid a C-section (if possible), say so.

2. Surroundings in Labor

Labor is stressful, and your surroundings can affect how you feel as you go through it. While those around you might not be able to adjust your environment too much, it's helpful to note what might make you feel more at ease in the event that they can make a change that would be helpful to you.

That can include what the room looks like, if you'd like music playing, whether or not you prefer as few people in the room as possible, etc. You can also note coping skills you intend to use (positioning, breathing, relaxation, water use, etc.) and what you might require to perform them.

3. Fetal Monitoring

Do you have to have fetal monitoring done electronically, or can you use a stethoscope or fetoscope?

Can you use intermittent monitoring, assuming baby is tolerating labor and that you are not moved into a higher risk category because of interventions like Pitocin or pain medications? Ask questions of your practitioner and those at your place of birth before you are in labor, as official policies can vary. Express what level of monitoring you desire.

4. Pain Medications

This is where you will talk about what you would like in terms of pain management. Note, however, that your wishes may or may not align with the policies of your birthing facility. You can also talk about whether or not you'd like your support person to stay with you during the administration of an epidural, or when you’d like to try an epidural versus IV medication or another option.

5. Back-up Plan

It would be nice if our "best laid birth plans" always went according to, well, plan. Of course, that's not the case. Use this part of your birth plan to discuss what you would like to happen if your first choices become non-choices, say, due to an emergency procedure. Who should stay with you? Who should communicate what to your family? Do you want your doula to go to the ER with you? 

6. Baby Care

Once your lovely baby is born, there are more things to think about in terms of your preferences.

Do you want to hold your baby immediately? Do you want skin-to-skin contact? Would you like to request any special testing after the initial hours after birth? Do you want your baby to stay with you in your room? Tip: You may want to consider arranging for a "room in" situation so that your baby can overnight with you (if your birth place allows it). If you change your mind, you can always send the baby to the nursery.

7. Feeding Your Baby

The vast majority of mothers begin breastfeeding at birth. Studies show that moms who are able to have skin-to-skin contact and latch in that first hour after birth have fewer breastfeeding challenges later.

That said, you may already know that breastfeeding is challenging for you, or you may not wish to do it at all. Express your wishes in your birth plan. Some questions to consider: Do you want your baby to be brought to you to nurse on demand? If you are not planning on breastfeeding, do you have specific needs that you need met? Similarly, do you want your baby to have a pacifier? 

Remember that birth plans are ultimately communication tools and not scripts or legal documents. Having an idea of your preferences is always a good idea, but so is keeping flexibility in mind.

Sources:

Ina May's Guide to Childbirth. Gaskin, IM. Bantam; 1st edition.

The Labor Progress Handbook. Simkin, P and Ancheta, R. Wiley-Blackwell; 2nd edition.

The Official Lamaze Guide. Lothian, J and DeVries, C. Meadowbrook; 1st edition.

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