Reasons to write a birth plan and how to write one.
What is a birth plan?
A birth plan is written as a communication tool between you and your care providers. Writing a birth plan will help you get to know your medical care providers and their philosophies or routines. The medical staff can become more familiar with any special needs or concerns you have during your stay if you write a birth plan.
Why write a birth plan?
Critics of birth planning say that you should never plan your own birth since it is too hard to predict. There are two problems if parents do not have a birth plan. One is that there are many details to think through and discuss with your birth team. It is very difficult to go through every issue, the pros and cons as well as alternatives in birth, while in the throes of labor.
The other is the problem of simply letting things happen without any planning. Would you simply “wing it” on your wedding day with no preparation? Not likely. Our wedding day is no less important and equally as stressful as birth. Not to mention there are unpredictable events at nearly every wedding. Planning your wedding well in advance can ease some of the stress for a new couple, just as writing a birth plan can make a birth experience a bit easier for everyone.
How to write a birth plan
The following is a list of topics often covered in birth plans as well as the options you may have.
1. Names of support people present for birth and their roles (Partner, Doula, Family)
2. Pertinent background information about you (Include health history, allergies, special needs, diets as well as cultural or religious preferences.)
3. Previous birth history (Describe previous birth(s) and relevant preferences as they relate to this birth.)
4. Preferences regarding labor environment (Things to include would be how you feel regarding visitors or students, lights, noise, etc.. Would you prefer dim lights, monitors turned down, etc?)
5. Preferred positions used during labor (List options you are interested in including walking, standing, side-lying, sitting on a birth ball, leaning over the top of the bed, all fours, etc.)
6. Preferences regarding positions for pushing and birth (List positions you would like to use during 2nd stage labor, including position for the birth of the baby. These include side-lying, all-fours, squatting, etc.)
7. Type of non-pharmacologic pain relief methods requested (These could include massage, relaxation, breathing techniques, music, hot/cold packs, tub or shower, acupressure, aromatherapy, etc. See Pain Relief Techniques for Labor.)
8. Hydration and/or food requests (Would you like to eat and/or drink? See Eating during Labor. How do you feel about receiving IV fluids? Would you be open to a heparin lock?)
9. Type of pain medications interested in using (Includes epidural anesthesia and IV narcotics such as Stadol and Nubain. Read Natural Birth versus Medicated Birth.)
10. Preferences regarding fetal monitoring (Do you prefer dopplar, intermittent or continuous monitoring? Is a portable monitor (called telemetry) available?)
11. Preferences regarding use of pitocin (Under what circumstances would you agree to use pitocin and/or what natural methods would you like to try first if contractions/labor slows down (position changes, walking, showers, nipple stimulation, castor oil, herbs, pressure points)? Under what circumstances would you agree to an induction?)
12. Requests regarding episiotomy (Are you interested in avoiding an episiotomy and using perineal massage, warm compresses, giving birth in a non-supine position (off your back) with a slow birthing of the head?)
13. Type of anesthesia used during and after a cesarean (Request options for anesthesia such as epidurals, spinal and for post-operative pain medications.)
14. Requests with regard to timing or refusal of newborn procedures (These include such as eye ointment, bath, Vitamin K, Pku, circumcision, etc.)
15. Requests for timing of initiation of breastfeeding (Are you interested in nursing as soon as the baby shows signs of readiness?)
16. Preferences regarding use of formula, bottles or pacifiers while in the hospital (Most women who are interested in breastfeeding will not want the baby to to be exposed to nipples or breastmilk substitutes since they can cause nipple confusion and reduce the baby’s desire to nurse.)
17. Indicate your preference for length of stay in hospital/birth center (Some mothers will want to stay longer for help with nursing and care for baby while others will want to get home sooner to rest.)
18. Preference in the event of an unexpected outcome (Many parents include information about contingency plans should the baby require a longer stay or have special needs.)
Birth plans should be kept to one page if possible, shared with your Ob or midwife during prenatal visits and presented to the nurse upon admission to the hospital or birth center.
Remember to keep your birth plan positive, concise and flexible. When writing your birth plan, be sure to ask relevant questions of your primary provider as early in pregnancy as possible. A list of these questions can be found at Questions to ask your Provider.
Did you write a birth plan? Why or why not? Share your thoughts.
If you are struggling with how to write one, see this Sample Birth Plan.
See more ideas in Preparing for Birth.