Labor and delivery can involve a lot more decisions than you expect. Or not. It all depends on what happens from one contraction to the next. While birth plans aren’t set in stone—and safety is always the priority—a birth plan can certainly help you and your doctor create a unified vision of the type of labor and delivery you want.
Things to consider when creating the perfect birth plan
The following topics will help you write a birth plan that resonates with you and your partner and that you can share with your doctor or midwives. Make multiple copies so they can be posted on your door, by your bed and at the nurses station – ensuring your plan is always visible if/when there are shift changes.
Who will be there?
Make a list of names and contact numbers for anyone you want to be present during your birth or who should be allowed in your delivery room.
When do you want to go to the hospital or birthing center?
When you’re in labor, of course – right?? In fact, things may be more difficult than you think. What if you are 10 days late? 14 days late? Many OBs start to get upset with late moms, even if there is no sign of fetal distress. This often leads to induced labor, and induced labors have higher cesarean rates. For this reason, it’s worth discussing your doctor’s protocol when it comes to late babies or a labor that hasn’t progressed after your water breaks.
What kind environment you I want?
Think about the type of environment you want. Some women prefer to have it quiet, dimly lit and with minimal interruptions. Others don’t seem to care about the chaos and distraction of conversation, a TV or small talk between the work group and delivery.
Make a list of the music you want to play or the personal items you want in the room. Want a mirror to see the birth for yourself? Want to take photos or videos?
Creating your birth plan will also help you create your list of things to pack at home and bring in your birth bag.
Interventions; No interventions; Somewhere in the middle?
This is one of the most critical parts of your birth plan and one of the reasons why it is so important to have a labor and delivery team you trust. Labor interventions are a very controversial issue in the world of natural versus assisted births.
Some of the more common interventions include:
- The use of Pitocin to induce labor
- Water breaking (most women’s health care providers agree that labor should be induced or assisted if a woman does not go into labor within 24 hours of her water breaking to minimize the chance of infection).
- Pain relievers – both oral and intravenous
- An anesthetic injected directly into the spine.
- C-section (currently the World Health Organization considers the ideal C-section rate to be between 10% and 15%).
- Episiotomy. This is a procedure where the doctor cuts the perineal tissue to make more room for the baby.
- Forceps or suction. These procedures are used to help deliver the baby when the mother’s pushing isn’t doing the job.
Your labor and delivery team should provide you with a list of the interventions and their risks and benefits. Read these carefully and do some research yourself. For example, most women who take an epidural during active labor are fine, but research shows that if given too early in labor, epidurals increase a woman’s risk of cesarean section. Also, women who have a C-section are at greater risk for post-operative infections and breastfeeding difficulties.
Knowing the risks means you can have a plan in place in case you need one of them, despite your best laid plans.
After delivery Plan
Think about how you want things to go after delivery. Things to consider include:
- Direct skin-to-skin contact with the baby before APGAR, weighing and measuring (assuming the baby looks healthy).
- Breastfeed before taking the baby in for weighing, measuring and APGAR (assuming the baby looks healthy).
- How long do you want to wait before the cord is cut (assuming the baby looks healthy)?
- Do you want father to cut the cord?
- Interested in banking cord blood?
- If there is concern about the baby, will dad be allowed to accompany the baby every step of the way?
And if things don’t go as planned Planned?
Sometimes, the inevitable happens. The most dedicated natural birthers can end up needing a c-section, and this can completely throw off your birth plan if you’re not prepared.
Have a backup plan “just in case”. This should include topics such as:
- Allowing you and your partner a minute together before signing any consent forms for surgery.
- Maintaining respect and quiet during the operation.
- Using a c-section curtain that faces the family so you can see the baby as it is pulled out. Better yet, campaign for a skin-to-skin drape that allows the baby to be passed to you immediately while the surgical team finishes.
- Having contact with the baby as soon as possible after a caesarean section.
- Let the father stay with the baby no matter what.
- The father should hold the baby, if possible, for any examination, vitals, or other diagnostics that need to be done if the mother is not available.
Again, having the right labor and delivery team is key to creating a birth plan that is respected and also correlates with hospital or birth center policies.
Looking for a Midwife who will respect your birth plan? Schedule a prenatal appointment and women’s health partners and work that thrives on providing empowering birth experiences for our mothers and babies.
