Coming up with a birth plan is a great idea, regardless of where a mom is delivering her baby. However, if she is delivering at home, she only has to discuss her preferences with the midwife who probably has no issues with anything she decides. If a woman wants to deliver at a birthing center, there might be a couple of restrictions here and there, but generally a birthing center will allow a woman to labor and deliver however fits her best. You especially need to have your birth plan handy when you are delivering at a hospital. There are so many people taking care of you, so it’s important that everyone know your goals for labor.
Hospitals get a bad rap for pushing interventions and pain medication on mothers, but I delivered twice at a hospital and I had the exact opposite experience. I went into labor wanting to deliver without an epidural. My doctor had delivered her own children naturally and was completely on board with my plan. One of the nurses I got was excited because she didn’t get to help many mothers without an epidural. I had another nurse who was a previous midwife, so she had a ton of knowledge about pain management techniques and helped me as much as she could.
It’s possible for a pregnant woman to have the delivery she wants at any place she wants. But it’s important to discuss your birth plan ahead of time with your caregivers. Here are 15 things to consider when creating a birth plan.
Picking your labor coach or the person you want to be in the delivery room with you can be one of the most important decisions you make. This is going to be the person who supports you and helps you get through some of the most difficult times of your labor and delivery. If your partner is scared of blood or passes out when he sees needles, maybe he should be part of the experience, rather than helping you get through it. If your partner really wants to be there for every part of the delivery and is trying to learn everything he can, he might be a great person to help you through labor. If you are opting out of pain medication, it will be important to pick a labor coach who can help you with different pain management techniques. Make sure you pick someone you can trust and someone you really want to be with you.
One of the first questions you will be asked when you get checked into you room is about your paint management preferences. Some women will want an epidural as soon as they get to the hospital. This is a very important decision, and it will shape many of the other items on your birth plan. You can opt out of the epidural but still get pain medication that will help dull the pain a little. You can also opt out of all pain medication and instead try natural pain management. There are different breathing techniques or ways for your labor partner to massage you that will help with your pain. Some women find music or aromatherapy relaxing and choose to go that route. Whatever you decide, you need to make sure that your hospital is on board and okay with any decision you make. You want to make sure your doctors are onboard, too.
Some women don’t have a preference when it comes to being able to move around during labor. However, some women despise the thought of being tied to a bed. This is one of those items on your birth plan that is going to be affected by your choice of pain management. If you choose to have an epidural, you are going to be stuck in bed. Another thing to think about is if you would like to forego an IV as long as possible. If you want an epidural, an IV is another thing you aren’t able to opt out of. I opted out of pain medication and an IV when I first got to the hospital. However, I was throwing up and getting so dehydrated that my doctor told me that I needed to get an IV. Luckily I could still move it around with me wherever I wanted to go.
Cervical checks and continuous fetal monitoring are both things that are usually routinely done at hospitals unless you specifically ask otherwise. While it seems weird that someone would want to decline cervical checks and continuous fetal monitoring, there are reasons. Both of these are thought to disturb the natural rhythm of labor. Some people think that by checking the mother’s progress too often, it allows her to be more susceptible to infection. It also makes you more concerned about the numbers rather than just letting labor work it’s magic. As far as fetal monitoring is concerned, you can have continuous or intermittent. With continuous fetal monitoring, you are pretty much strapped to a bed and aren’t able to move much because they are constantly monitoring the baby. With intermittent monitoring, you can still move around and they will check it every so often. Studies have shown that intermittent fetal monitoring is just as safe.
If you have an epidural and are strapped to a bed, there isn’t much choice you have when it comes to these particular labor and delivery preferences. There are many different positions you can be in during labor and delivery. When I was choosing a hospital, one of the important things I checked was that I would have my own tub in my room. I wanted to labor in the tub as it made me more comfortable. Some hospitals have different rules when it comes to delivery positions, so this is one thing you want to check with your doctor before picking a hospital or birthing center. Do you want to deliver in a birthing pool? Would you like to deliver with a birthing stool or chair? Do you want to deliver in the bed? These are all choices you need to think about, and choices you need to discuss before hand.
Labor and delivery are probably not going to go as smoothly as you hope, so it’s important to be prepared. In the case of labor stalling or not even going into labor, you need to know answers to the staff's questions so you don’t have to make spur of the moment decisions when you are in a vulnerable position. If you don’t go into labor naturally, you need to decide how you are going to handle that. Do you want them to strip your membranes or induce you? If you do start labor naturally but you stop progressing, what type of interventions do you want them to take. One of the options is to rupture the membranes, which is known as breaking your water. The other option is to give you pitocin. Pitocin is a synthetic hormone that will help stimulate contractions. Be prepared with answers before you go into labor, just in case one of those situations should arise.
You have a higher likelihood of delivering vaginally, but it’s also good to be prepared in case everything doesn’t go as planned. You will need to discuss with your doctor when or why they will decide it’s time for a c-section. My thought is that if it’s the best way to keep mom and baby safe, then let’s do it. But there are different things to decide during your c-section. It’s common practice to let your partner be there with you, but if you want more than one person you will have to ask your doctor. You want to check if they will let your partner hold the baby as soon as possible after delivery. Some women like to view the birth, so if that’s something you want to do, definitely talk to your doctor. I don’t think all doctors allow this option so make sure you communicate your needs.
What other preferences do you have that maybe aren’t super common in a birth plan? If you find music super relaxing, you might request that you have certain music playing at all times. Maybe you want your partner or whoever is with you to stay by your head at all times. Some women want to eat or drink during labor. Although when I remember labor and delivery I remember vomiting a lot, so food and drink would not have been appealing to me. Some pregnant women prefer to wear their own clothing instead of wearing a hospital gown. Whatever it is that you would prefer to do, don’t be afraid to bring it up to your doctor. They might say no, but they might say yes. Jus make sure you decide which items are necessary and which items you can live without in case your hospital or birthing center doesn’t allow something.
Now this is the fun stuff! You get to decide what you want to happen during delivery. An episiotomy is not as common as it used to be, but there are many places that still perform episiotomies. This is something you will want to check with your doctor about. Some women like to watch the delivery with a mirror and they find it super empowering to watch. This shouldn’t be an issue at most hospitals or birthing centers. When the baby is coming out, do you want to actually pull your baby out or do you want your partner to catch the baby? A lot of moms find joy in being able to pull their own baby out and embracing them immediately. You will definitely want to discuss any delivery preference you may have with your doctor before hand. Make sure to check that they will allow you to do what you want to do.
Most hospitals are moving to immediate skin to skin contact after delivery which I think is an amazing policy. There’s nothing more exciting than delivering your baby and getting to hold them immediately. I used to joke that I would want the doctor to wipe my baby off before giving him to me, but at the moment you really don’t care how messy they are! Do you want dad to do skin to skin contact after you? Most importantly, where do you want baby to sleep? The hospital that I delivered at has done away with nurseries because they believe that baby needs to be with mom, and I love that. But there are hospitals that still have nurseries and will still allow you to send your baby to the nursery if you need time to recover. Just decide what is best for you and your family, and make sure your nurses and doctors know what you want.
There are a lot of options when it comes to the baby’s umbilical cord, and I honestly wasn’t as prepared with this subject as I should have been the first time around. The first thing to discuss is cord clamping. Some couples prefer to delay the cord clamping until after it is done pulsing to allow your baby to get all the nutrients possible. There are many risks and benefits so it’s important to do your research. Another thing to discuss is if you want to do umbilical cord blood banking. This means that they will take the umbilical cord blood stem cells and store them for future use in medical emergencies. And the most common option to discuss is who you want to cut the cord. Do you want your partner to cut the cord or do you not have a preference. Make sure to get educated on all your choices.
Your decision to breast feed or formula feed is an important one. While there are many benefits, you will want to weigh the benefits and decide what is the best choice for your family. Also, you will want to decide before you deliver because if you decide to breastfeed, it’s best to try and breastfeed immediately. Your baby will be hungry and you will have a higher success rate. If you decide to formula feed, you will need to talk to your doctor and figure out whether you will need to bring formula or if that is something they provide. If your baby will be spending time in the nursery, your nurse will make sure to document whether or not your baby is breast fed or formula fed. If your baby is breastfed, the nurses will need to bring your baby back to you so you will be able to breast feed.
There are a ton of decisions that you will need to make when it comes to baby care. If your child is a boy, the first decision you need to make is if you are going to circumcise him or not. There are both benefits and risks, so make sure you are educated and know what you want to do. And of course there is the vaccination subject that you will need to discuss with your pediatrician ahead of time. Whether you plan to vaccinate or not, it’s always a good idea to talk to your doctor so you know exactly what will be taking place. There are also many other routine procedures like antibiotic ointment on the baby’s eyes that you will need to decide on and document in your birth plan. The best thing to do is talk to your doctor and to get educated about the decisions you need to make.
Visitors will want to come and visit all day and night. They will want to come before the birth. They will want to come after the birth. They will want to come when you go home. It’s a good idea to discuss what your preference is with your partner so you are both on the same page. Do you want anyone to come and visit before hand, or do you just want to focus on labor? Are you going to allow anyone to come and visit after the baby is born or are you going to limit it to just family. I didn’t want anyone to come visit me before hand and we only wanted a select number of people to visit after. We made sure that we didn’t put anything on social media about me being at the hospital which helped keep visitors at bay. Do what’s best for your family.
Finally we get to talk about going home! Going home can be scary, especially if you’re a first time parent. I remember thinking that I couldn’t believe that this hospital was just letting me take this tiny human home with me. Different hospitals and birthing centers have different policies on when they will let mom and baby go home, so many sure you know what the rules are wherever you are delivering. Birthing centers can let you go after a couple of hours, while some hospitals like to keep you over 48 hours. I was lucky to know my doctor and have a relationship with her. When I had my second child, I was having a hard time being away from my first born and I was really tired of being at the hospital. I told my doctor how I felt and she gave us the okay to go home before 24 hours.