You’ve decorated the green nursery, purified the air in your home, and stocked up on eco-friendly toys and baby gear, but have you written your birth plan? Writing a birth plan is one of the most important things you can do to prepare for your labor and for the delivery of your child. Doing so affords you the opportunity to go over your hopes and expectations for baby’s big arrival with your doctor or midwife, and it gives you a clear voice via the written word when contractions begin and you’re hard at work bringing your baby into the world. Whether you’ve never heard of a birth plan, or you’re wondering how to write one, here are our 5 top tips for writing your birth plan from an experienced mom, and mom-to-be at work on writing her second birth plan for an upcoming August delivery!
1. Keep it Short and Sweet, Like Your Baby-to-Be
I’ve spoken to doctors, delivery nurses and doulas who all advise the same thing when asked about birth plans: keep it concise, and no longer than one page. Be specific and focused on the factors that are most important to you. Write in an easy to understand, direct and polite fashion.
2. List Your Labor Preferences
- If this is your first birth, it is very important for you to empower yourself to learn about how labor works, so you know what to expect and have already decided on what options you would like in different scenarios. For example, if your labor is ‘not progressing’ fast enough, think ahead of time about how you want to try to jumpstart your labor if your doctor wants to induce you (acupuncture, walking around, standing up, membrane ‘sweeping’, pitocin). What sort of pain relief do you want to be offered if things get hard-to-bear?
- If this isn’t your first birth plan, learn from your past deliveries. For instance, I now know to request that I don’t want five medical students observing me every time my doctor examines me, and that I want the anesthesiologist himself to administer my epidural if I require one, as opposed to training a student on me during such a delicate procedure. If you had negative experiences because you didn’t know what to expect the first time around, you can do your best to learn exactly what to expect and set up subsequent experiences for greater success.
- Discuss with your doctor ahead of time whether you’ll be able to eat, drink and move around freely during labor (which makes a big difference), given your birthing preferences (ie: drug-free, epidural). Write your wishes on your birth plan according to what you agreed upon, and ask your partner, labor-coach or doula to support you and help you stick to your choices.
- Which position would you like to labor in/deliver your baby? Ask your doctor/midwife what your options are: birthing tub, squatting, birthing bar, standing, balance ball, etc. The positions available to you will depend on many factors such as baby’s status, and whether you are on pain medication. Constant fetal heart rate monitoring can also be restrictive to movement, which can slow the process of labor, so ask your doctor whether you can be monitored intermittently, which will also depend on a variety of factors when the big day arrives.
- Are you hoping for a drug-free birth, or would you like to be administered pain medications or an epidural?
- What medical interventions do you want or want to avoid? To have a clear opinion on this, you really need to understand how various interventions work biologically and what the unintended consequences might be. For example, continuous fetal monitoring and epidurals, and IV drips can impede labor, which can lead to the diagnosis of ‘failure to progress’ and the need for Pitocin or an emergency C-section. Pitocin can make labor more painful (leading to more pain medication and more slowing down of labor). Discuss your stance on labor induction and use of Pitocin, episiotomy, C-section, breaking of your water bag, stripping of membranes, use of forceps or vacuum suction during delivery, etc. Note your birth plan accordingly with which measures you’d like to avoid if possible, and think about what alternatives you would like to explore if your labor gets to a point where some sort of intervention is necessary.
Note: Preferences on mood lighting, music, photography, video-taping, ambiance etc. may be discussed with your labor coach so he/she can help make your environment atmosphere comfortable. There’s no need to share these requests with your doctor or add them to your birth plan. They’ll take up space on your one page!
3. Baby Care Instructions
List the vital aspects of your baby’s care once he or she is born.
- With regard to cord cutting: who will cut the cord? Would you like to wait until the umbilical cord stops pulsing? Will you be banking your baby’s cord blood?
- Would you like to bond with your baby skin to skin before he is rushed off and bathed? Ask to delay bathing, eye drops, the Vitamin K shot and immunizations while you connect with your baby. You may also opt out of having your baby immunized at the hospital and wait to see your pediatrician. *We are also taking our own non-toxic baby shampoo and soap to the hospital for our son’s first bath.
- Address whether you’d like to breastfeed exclusively, and if you do, make sure nurses know not to supplement your baby with formula, bottle feed him, or give him a pacifier.
- Note whether you would like your baby boy to be circumcised.
- Would you like your baby to room-in with you at all times, or go to the hospital nursery?
4. Give a Copy of Your Birth Plan to Your Doctor and Take Extra Copies to the Hospital for Labor & Delivery Nurses
Give a hard copy of your Birth Plan to your doctor or midwife, and she will put it in your chart (which is important in the event she’s not on call when you go into labor, and another doctor will need to get up to speed on your wishes). Additionally, take 3 extra copies of your birth plan to the hospital to distribute to the nurses. They will go over it and decide which nurse may be the best fit for you based on your preferences. (Some nurses work better with drug-free laboring mamas, etc.) It’s good to have extra copies in the event there are nurse shift changes during your labor and the new nurse on duty needs a copy!
Share your birth plan with your labor coach and in-room support team so they can help encourage and back you up on your goals and wishes, and so you’ll all be on the same page, literally.
5. Realize that a Plan is not a Guarantee
I look back on my first birth plan and laugh at how naive I was with some of my requests. Others were right on the money, and I’m so glad I included them. But the most important thing to remember is that even the ‘best laid plans’ sometimes go awry, and labor is a force of nature – it is very hard to control how it goes. It’s best to keep an open, flexible mind and to roll with the punches, because labor and delivery are as good at delivering the unexpected as they are at delivering a baby. Your birth plan is a well thought out list of your preferences and beliefs, but sometimes in order to attain everyone’s ultimate goal, to deliver a healthy baby from a healthy mom, different measures must be taken. An honest discussion with your healthcare provider, via a concise birth plan, will put you on the best path to achieving your desired birth experience.