How to Create a Birth PlanYou may want to create a birth plan to avoid having to make certain decisions amidst labor contractions. You may want to plan ahead of time about what kind of birth you want, by writing your childbirth preferences down on paper. Creating a personal birth plan is essential to outline your ideal vision, as well as your expectations of labor, delivery and the postpartum period. A birth plan is basically a written “wish list” for what you consider to be an ideal birth experience, created to help the people who will be involved in your labor and delivery know more about your preferences and wishes. A birth plan is an effective way to help ensure that you and your partner’s wishes are known to the doctor, midwife, doula, medical staff (including nurses) and other family members.

Writing a Birth Plan

By writing a birth plan, you will feel more in control of your birth. Also, by designing your birth plan, you become more engaged in the birth experience and it may help you to feel more empowered. In addition, you may want to consider working on your birth plan with your partner. This will help give him an active role in the decision-making process, before labor begins, and become familiar with your wishes. This will also allow him to assist in implementing your plan, when the time comes.

Try to keep your birth plan flexible and undemanding, because there’s no way to predict every scenario and possible complication. Sometimes an emergency situation arises in which medical intervention is necessary, therefore everything on your birth plan may not be possible at the time of delivery. To help make your birth plan as flexible as possible, you may want to use words like “prefer” or “if possible”, when writing it. This makes your plan appear less like a complicated set of orders and more like an organized communication tool to share important preferences pertaining to your birth experience.

You should make copies of your birth plan and share it with everyone who will be involved in your labor and birth experience. You should give copies to your partner (or labor coach), support people (family, friends, doula, etc), your doctor or midwife and also you may want to have one included in your office chart and hospital records. Bringing a copy with you in your hospital bag, to keep in your birthing room during labor, may also be a good idea. You may want to present your birth plan to your doctor or midwife about 4-6 weeks before your due date, to allow time to discuss issues and make changes to your plan, if necessary.

Birth Plan Topics

There are many types of birth plans, some being very extensive in detail and several pages in length, while others consisting of only a few short paragraphs. Birth plans can vary widely from woman to woman, depending on individual preferences. To create a birth plan, you must start by researching what exactly occurs during labor and delivery and all the possible complications that can arise. It will be very helpful to educate yourself on the advantages, disadvantages and alternatives to various options you may be considering, as well. You can get ideas for writing your birth plan by talking to your doctor or midwife, doula, childbirth educator, friends and family, as well as on-line. Some topics you may want to consider when writing your birth plan include:

Labor

  • Where your baby will be born and when you prefer to go
  • Labor induction preferences: if you only want an induction when it’s medically necessary and the techniques you’d prefer (stripping membranes, breaking your water manually, Pitocin, prostaglandin gel or breast stimulation)
  • Activity/mobility level: whether you prefer to move around, walk, stay in one place (remain in bed), take a shower, change positions, etc
  • Pushing and preferences for positions: use of squat bar, birthing stool, stirrups, etc
  • Preferred comfort measures: relaxation, breathing, massage, hot or cold packs, visualization, shower or bath, use of a birth ball or rocking chair
  • Atmosphere preferences: listening to music, lighting, if you want it quiet or if none of those things are important to you
  • Preferences about wearing your own clothing or a hospital gown
  • Eating and drinking during labor (or if thats not possible, clear liquids, ice chips or light snacks)
  • IV or Heparin/Saline lock preference (which are routine with epidurals and sometimes medically necessary)
  • Who will be present during labor and delivery and if you’d prefer you and your partner not to be separated at any time
  • Electronic fetal monitoring (intermittent or continuous, external or internal)
  • Vaginal exams and if the number and frequency are important to you
  • Prepping for delivery and your preferences regarding shaving, enemas and routine catherization
  • Episiotomy preferences: whether you’d like to avoid one and prefer to possibly tear instead (also preferences regarding warm compresses, massage to stretch the perineum, etc)
  • Your pain medication preferences such as an epidural or whether you’d like to avoid taking any medications

Delivery

  • Medical procedures you’d prefer to avoid such as use of forceps or vacuum extraction
  • Preferred delivery position
  • Preferences regarding viewing the birth in a mirror
  • If you prefer the option of touching your baby’s head as it’s crowning
  • If someone will be video-taping and photographing the birth

After Delivery

  • Preference as to who cuts the umbilical cord and whether you want the clamping and cutting delayed
  • If you prefer to bank your baby’s cord blood
  • Delivery of the placenta: time limits, pushing, avoiding routine shot of Pitocin, etc
  • Seeing the placenta (your doctor or midwife may not show you, unless you request it)
  • Length of hospital stay you prefer and any special requests regarding visitors and phone calls

Baby

  • Contact after birth: immediate skin-to-skin or would rather baby be placed under a warmer
  • Breastfeeding preferences and whether you want to nurse immediately
  • Preferences regarding newborn care: whether you want procedures done in your presence (such as weighing) and if you prefer it to be delayed until after bonding time
  • Preferences about procedures such as Vitamin K shot, eye drops, Hepatitis B vaccination, PKU/Newborn screening test and if you don’t want your baby receiving certain ones
  • Bathing baby: if you want the first bath done in your presence or if you want it done by your partner or yourself
  • Preferences regarding your baby rooming-in or staying in the nursery during the night
  • Feeding preferences (breast or bottle) and artificial nipples/pacifiers, supplementary bottles and whether you’ll be feeding on demand or have a schedule
  • Circumcision or not (if you have a boy) and if you want it done at the hospital or afterwards, if you or your partner prefer to be present and if you want to request anesthesia to be used

Cesarean Birth (if necessary)

  • Preference as to who you want present
  • Choice of anesthesia (general or possible epidural)
  • Preferences regarding holding your baby and breastfeeding in the recovery room
  • Video-taping and photographing preferences
  • If you would prefer the screen lowered, so you can view the birth

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