How to Create a Helpful Birth Plan

When you are getting ready to have a new baby a written birth plan is helpful. This will allow you to figure out what your desires are surrounding the birth of your new one as well as inform your care givers as to what exactly you wish to happen. Of course there is no way to predict the future so all plans should be tentative with room for change. But if you have an idea beforehand what to expect it will make a possibly hectic time a little bit easier.

To start out it is best to discuss any questions and concerns with your Midwife or Doctor. Your birth plan may depend on your own medical records, how your pregnancy progresses and hospital policies among other things. It would be a shame to have your heart set on something particular and then find out it's not possible in your situation for whatever reason. Your care provider will know the hospital, your history and the nursing staff so it's important to go over any concerns ahead of time and then of course review your final birth plan before your baby is due.

Involve your husband or partner during the creation of your birth plan. It is very important that they are informed of your desires as they will likely be your strongest advocate when you are in the hospital. It's also a good idea to get their input, maybe your husband really wants to cut he baby's umbilical cord or maybe he'd prefer to step out of the room for a minute if a needle is needed. Discussing these issues beforehand will help you both understand what your comfort levels are as well as personal wishes about the birth.

To start a formal written birth plan you can begin by typing important information such as you and your husband's full names, date of birth, address and phone number. That way it's clear as to who's birth plan it is and that the information is provided by you and current. Also include your Doctor or Midwifes name and Practice as well as your childbirth Doula if you have one.

You can include an overall objective or birth philosophy if you desire. This can briefly summarize your wishes and include a disclaimer that you know all plans aren't set in stone and you are open to change if it's in the best interest of mother and baby. If you have something super important that you want you might include it here such as all procedures must first be explained and discussed with myself and my partner before being done. This is just an example but if there is something you feel very strongly about that pertains to the entire birth process it will be clear if it's listed bold and in your intro.

Another important aspect of your birth plan is your wishes during the laboring stage. This could be lengthy, especially with a first baby so if you will be in the hospital during this time you should include any specific things you want to happen. Some ideas are to be left alone with your partner as much as possible or the complete opposite if the nurses and your provider are able to be there. You might want to have the room quiet or soft music playing. It may be that you don't want to have any visitors during this time and if the nursing staff knows this they can help keep eager family and friends updated but out of your room. Include your preferences for internal dilation checks. In some places it's common for the nurses or care provider to check you frequently throughout labor. It can be uncomfortable and unnecessary not to mention increase your risk for infection. You might want to know at some point how far along you have progressed but being checked should be your choice. Do you want to change into a hospital gown when you arrive at the hospital or would you prefer to stay in your own clothes for as long as possible? This should be included and discussed as policies vary by hospital. Do you wish to labor in a birth pool or Jacuzzi? Let your wishes be known so it will be warm and ready for you. Do you want to be free to eat and drink during labor? Again this depends on policy and your unique situation but decide if you would like to have snacks available, water, ice chips, etc so you can be prepared. What about an IV? Some hospitals will routinely prep you for one but if you would like to avoid one let your wishes be known. Do you want constant fetal monitoring? There is external as well as internal ways to monitor your baby so discuss the different options and see what you prefer. Some won't allow you much freedom of movement which may be important.

What are your thoughts on pain relief? Would you like it to be offered to you or only if you ask for it yourself. This can make a big difference especially if you have plans of giving birth naturally without any medication. Or you may want it to be offered as early as it's possible to have. If you do want or decide to have a pain reliever what type? You can ask that comfort measures to relieve pain be offered first. This may include massage, a hot shower, relaxation techniques, acupressure, or distraction. If medication is going to be used decide what you would like to try. There is a variety of drugs that can be given such as Stadol, Nubain, Demoral or several forms of Epidurals. Research and discuss your options before hand so you can be informed of the risks and benefits of each type.

How do you feel about induction? Do you want to wait as long as possible for your baby to choose its birth or are you uncomfortable with going overdue? Talk this over with your health care provider as there are potential hazards to non-medically necessary inductions. If labor stalls do you want to stimulate contractions with nipple stimulation or do you prefer Pitocin? Learn about methods and reasons for induction and let your wishes be known ahead of time. It's hard to make decisions such as this when you are put on the spot and don't know your options.

What types of interventions are you comfortable with? This includes things such as artificially breaking your bag of water and the use of forceps or a vacuum to name a few. Instead of placing the decision in the hands of your nurses or Doctor inform yourself so you can do what is best depending on the situation.

Would you like to be free to push in any position that is comfortable at the time? Would you like to use a birth ball or a birthing stool? Or are you most comfortable flat on your back lying in the bed? Include your preferences even though it's hard to know what you will want at the time, all options should be open. Would you like to push when you feel the urge or do you want to be coached thru this process?

If the baby is not fitting out as easily as desired do you want an episiotomy (cutting) or do you prefer to tear naturally if it happens. Would you like to try perineal massage to slowly stretch before the baby is pushed out? If you require stitches would you like to have pain relief at that point?

Once the baby is born what are your desires? Include information about who touches the baby first and if you want him placed directly on your chest right away. Would you like the umbilical cord to stop pulsating on it's own before being cut and who will do the cutting? Do you want the eye drops/ointment given? They are not necessary in most situations and can irritate baby's eyes. If they are needed consider waiting until you have initially bonded with baby since they will make it hard for your little one to see you.

How are you planning of feeding your baby? If you will be breastfeeding decide if you want any supplements given (including sugar water or formula) and what your preference on pacifier use is. Do you want to nurse your baby right away and on demand? Do you want the help of a Lactation Consultant incase you have any difficulties?

What about separation? If it's important that your baby not be out of you or your partner's sight include this loud and clear on your birth plan. It's usually possible for most routine newborn procedures to be done right in your room so ask ahead of time. Do you want to room-in with baby or do you prefer sending them to the nursery? If they do go to the well baby nursery would you like them to be brought to you at certain times or on demand?

What are your wishes regarding circumcision? If it's something you are against let it be known and insist that the nurses do not retract your son's foreskin. If for some reason you decide to circumcise include details about pain relief and whether or not you and your husband want to be present during the procedure.

If a c-section is necessary or your baby needs special care such as time in NICU (Neonatal Intensive Care Unit) include how you would like this to go. Do you want your husband present during a cesarean, what type of pain relief (epidural or spinal)? Would you like to see your baby right away? A c-section will be a major change of plans if you aren't expecting one so consider all aspects of how it will go.

Include any other labor, delivery, baby and post-partum care that you can think in your birth plan. It should be individualized to meet your personal wishes with freedom to change your mind depending on the situation. Once you have written out your birth plan, go over it with your partner, Midwife or Doctor and make several copies to take to the hospital. If anything at least the thought process of making a plan will be beneficial as there may be some aspects to your baby's birth that you hadn't previously considered. It's rare that things go exactly according to plan but it's still helpful to figure out what you want ahead of time.