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Writing a Birth Plan

Updated: Jan 12, 2019

Kaelie Harris, Doula- Huntsville, AL

The power of a birth plan isn’t the actual plan, it is the process of becoming educated about all of your options.”

- Jen McLellan

This is my favorite quote about birth plans because it exactly sums up my feelings on the subject. Creating a birth plan is so empowering, but not because your birth plan is set in stone or because your birth will go exactly as planned. Your birth will take its own path and some aspects may be out of your control, with or without a written plan. The magic of the birth plan is that as you learn about all the different options you will have the ability to own your birth. By researching options, you will know what you do and do not want and you will have the confidence to convey this to your provider. If things change during the course of your birth, you will be able to make decisions more confidently because you will know your options ahead of time.

The other huge benefit of writing a birth plan is making sure that your care provider is on board with the birth you want. I recommend writing your birth plan early and having an in-depth discussion about each point with your provider. This will give you an idea of what they are comfortable with and what they are not, and it gives you a chance to change providers if you discover that you are not on the same page.

Below are my recommendations on your birth plan, based on what I have seen to be effective with my clients.

Please contact me with any questions or to set up your free consultation.

Tips for an effective birth plan:

• If possible, try to keep the actual birth plan to one page. You want the hospital staff or midwife to be able to read it over quickly and retain the information. You can have an additional birth plan for your support team (partner, doula, friend, parent, etc.) that outlines your desires such as dim lighting, music playing, etc.

• Try to use positive phrasing such as “we prefer…” or “I would like…” rather than “don’t…” or “I do not want…”. This supports the team atmosphere you want at your birth.

• Research your options and the pros and cons of each. It is ok to question a routine procedure or intervention if it does not feel right for you or your baby.

• Discuss your birth plan with your doctor or midwife and have them sign off on it. This is a very good way to make sure that your provider is right for you.

• It is a good idea to have a back up plan in the case of a cesarean.

• A doula is a great resource when writing and researching your options for your birth plan. I also highly recommend taking a birth class that is not affiliated with the hospital where you plan to give birth.

Some options to consider (this is not a complete list)

During Labor-

• Pain relief: Do you want an epidural? Nitrous Oxide? Do you want hospital staff to offer you pain relief or wait until you ask for it?

• Mobility: Would you like to be able to get up and walk around during labor? Use a birth ball, tub or shower? You can ask for intermittent monitoring or a wireless/waterproof monitor. You can also ask for a hep lock (or saline lock), to have quick access to a vein without having to be hooked up to an IV.

• Who would you like in your room during labor? Partner, doula or other friends and family? Do you want medical students to attend your birth?

• Vaginal exams: Do you want routine vaginal exams? Do you want to keep them to a minimum or have no vaginal exams? If you would like to have vaginal exams, do you want to know if/ how much you are dilated?

• AROM: Do you want artificial rupture of your membranes?

• Pitocin: Do you want Pitocin to speed up your labor?

During Second Stage of Labor (Pushing)-

• Position: Do you want to labor on your back? Hands and knees? Squatting? Do you want the option to choose in the moment?

• Episiotomy/ Tearing: Do you want a routine episiotomy? Only if emergency? No episiotomy? Do you want to apply a warm compress to the perineum to avoid tearing?

• Pushing: Do you wish to have coached pushing? Mother-led (instinctive) pushing?

After Delivery-

• Cord: Do you want immediate cord clamping? Do you want to delay cord clamping until it has stopped pulsing. Are you planning on banking cord blood? Do you want your partner to cut the cord?

• Skin to Skin: Do you want to do immediate skin to skin with your baby? Would you like for your partner to do skin to skin if you are unable to?

• Placenta: Would you like routine pitocin after the placenta is delivered? Would you like to delay the routine pitocin unless you have signs of hemorrhaging? Are you planning to keep your placenta for encapsulation? Would you like to deliver the placenta spontaneously?

Newborn Procedures-

• Routine Procedures: Would you like for these to be done immediately? Would you like to delay all routine procedures until after bonding/breastfeeding established? Would you like these to be done while baby is skin to skin?

• Bath: Would you like for baby to have bath immediately? To delay bath? No bath at all? Would you like for your partner to bathe baby?

• Eye ointment: Do you want baby to have routine eye ointment? Delayed? None?

• Vitamin K Shot: Do you want the vitamin k shot to be administered routinely? Delayed? None?

• Immunizations/PKU testing: Would you like routine immunizations or PKU testing? Delayed?None?

• Feeding: Would you like to breastfeed? Formula feed? Both?

• Circumcision: Would you like for your baby to be circumcised? Not circumcised? If circumcising, would you like for this to be done at the hospital?

Cesarean Section:

• Drapes: Would you like clear drapes so that you can see baby emerge?

• Room environment: Would you like hospital staff to keep talking to a minimum? Would you like your partner and/or doula to be present?

• Skin to Skin and breastfeeding: Would you like skin to skin and to establish breastfeeding while in the OR? Would you like for your partner to do skin to skin if you are unable?

• Drugs: Would you like your options explained to you? Would you like sedatives or narcotics along with and epidural or spinal anesthetic? Would you like to remain as cognizant as possible?

If you would like to add anything to my recommendations, please comment below!

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