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How to Write a Birth Plan

How to Write a Birth Plan

A birth plan is a great tool to help prepare for labor – especially for first time moms.   Discussing the birth process and the type of labor you hope to have prepares you mentally, physically and logistically.  It helps the hospital staff and your personal support team to understand your wishes and to support you effectively and respectfully.  It helps people understand their roles so that you get the help you need without people overstepping their boundaries.  It works out logistical details ahead of time (who’s driving? what do you need to bring with you? who’s watching the other kid(s)?) which helps you to stay calm and focused when the day arrives.

I’d recommend writing your plan 4-6 weeks ahead of time and discussing the details with your doctor or midwife.  It’s also helpful to place a copy in your file for day of support staff to review when you go into labor.  When writing your birth plan please keep in mind that this is a flexible document.  Every labor is different and your ability to adjust to the changing needs of your baby is essential.  This element of unpredictability discourages some women from writing a birth plan.  However, I think it makes a plan even more important!  The process helps you consider different scenarios that may come up.  It helps you prepare mentally, weigh your options and make educated decisions at a time when you’re feeling really vulnerable.  Although there are no guarantees, a well thought out plan increases your likelihood of having the type of labor you want and will help both you and your team team respond appropriately if/when your labor demands it.  Here are some guidelines to help you draft your own plan:

Birth Plan Guidelines:

Things to do/consider beforehand:

  • Pack a labor bag (Suggested items include: http://youngmotherhubbard.com/http:/2968/labor-bag-checklist/)
  • Tour the hospital and familiarize yourself with the location of Labor and Delivery.
  • Ask what resources are available during birth.  Ex. birth ball, squatting bar, mirror, shower, tub, etc.  Which ones are you interested in and how do you request them?
  • Take birthing classes – this is the single most helpful thing we did.  You learn what to expect (which makes birth less scary), learn helpful tips and advice and best of all meet other couples/women who can totally relate to all of your questions and concerns.
  • Familiarize yourself with the signs of labor.  Your doctor or midwife should give you specific guidelines about when you should call.  Keep their phone number handy!
  • Who will drive to the hospital?  Who could be a back up driver?  Do they have directions?
  • Who is watching the kids? Pets?
  • Can you preregister for the hospital?  If so, how?
  • Inform your doctor/midwife of any allergies, physical or medical conditions that could affect your birth.

ATTENDANTS

  • Who do you want present during labor?
  • Do you have a back up if they cannot be there?
  • Will you have a doula?
  • Is there anyone you do not want to be in the room?

LABOR – Assuming your baby is doing well:

  • Do you want to have intermittent or continuous electronic fetal monitoring?  Intermittent gives you the ability to move much more freely and is considered very safe.  Hospitals typically allow this unless if you have complications or if you receive an epidural.
  • Do you want the freedom to walk, move and change positions at will throughout labor?  Again they typically only allow this without/before an epidural.
  • Do you want to hydrate by drinking clear fluids or would you like an IV?
  • Do you want to be allowed to eat during labor?  Many hospitals restrict eating just in case you need a c-section in which case a full belly could increase your chance of regurgitation.  However, most midwives and some doctors now encourage light meals during labor.  Light eating has been associated with improved energy, healthier blood sugar levels, more efficient contractions, shorter labors and lower rates of cesarean deliveries.  Ask for your hospital’s policy because they may require a note or waiver to be signed beforehand.
  • What labor tools would you like to try?  For example: a birth ball, squatting bar, mirror, birthing tub, shower, etc.

LABOR AUGMENTATION/PAIN RELIEF

  • If your labor is slow, do you want to be allowed to progress naturally or would you like help speeding things along?  The most common tactics are artificially rupturing your membranes (breaking your water) and administering pitocin.  There are pros and cons associated with both.  If you’re hoping to go natural, it’s important to educate yourself about the birthing process because you’ll probably be pressured into speeding things up.
  • Do you want an epidural or other pain medication?  If so, how and when do you request it?  If not, do you want it to be offered?  I wanted drugs to be available during labor but did NOT want them to be offered or suggested because it made me doubt myself.
  • Are there other pain management techniques you’d like to try?  Ex. Acupressure, bath/shower, breathing techniques, hot/cold therapy, massage, etc.
  • Do you want an episiotomy?  This is considered an outdated practice that most hospitals no longer perform unless medically necessary but they still might ask.

C-SECTION

  • If you need a c-section, who do you want present during the operation?
  • Who do you want the baby given to immediately after birth?  (they typically won’t give him/her straight to mom because she’s pretty drugged)

POSTPARTUM – Assuming your baby is healthy:

  • Do you want to hold your baby right away (sometimes they’ll clean and monitor them first)?  Do you want to breastfeed as soon as possible?
  • How long do you want to wait before cutting the umbilical cord?  (Many moms like to wait until the umbilical cord stops pulsating before it’s clamped and cut).  Who do you want to cut the cord?  Will you be banking your baby’s cord blood?
  • Do you want your baby examined and bathed in the room or in the nursery?
  • Which common treatments do you want administered: Eye ointment?  Vitamin K shot?  Hepatitus B Vaccine?  If any are declined, do you need to sign a waiver?
  • Do you want to deliver the placenta naturally or do you want it to be induced?
  • If you have a boy, do you want him circumcised?  If so, on what day?
  • Do you want your baby to room in with you or stay in the nursery?
  • Will you be breastfeeding or bottle feeding?  Do you want the nursery or NICU staff to give your baby formula? Sugar water? Pacifier?

 

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