Creating Your Birth Plan

The “perfect” birth plan is: a happy, healthy mom and a happy healthy baby.  But when thinking through how you want your child’s birth to go, try to remain reasonably flexible in your desires because things don’t always go according to plan. Remember, the important thing is the safe birth of your little bundle of joy. Use your birth plan as an effective tool for discussing important details with those responsible for supporting and caring for you, especially your doctor and partner.

Developing your birth plan:

1. Compile Considerations:

Find out ALL the routine policies and procedures for “mommy care” in your birth setting. If you do not agree with a policy or procedure, you should discuss it with your health-care provider. As you learn more about what to expect, you will likely identify the details that you want to include in your plan.

You may want to consider dedicating an entire page for an uncomplicated birth/postpartum and a second page about how to handle complications should they occur. The following list of questions might seem overwhelming, but now is the time to consider them one by one. If you find that a question does not pertain to you, just move on to those that are relevant.

  • Who do you want to be present?
  • Do you want a doula?
  • Will there be children/siblings present?
  • Are you wishing to delay the cord clamping for the baby?
  • Do you want immediate skin to skin contact?
  • Do you wish to breastfeed immediately after birth?
  • Do you want mobility, or do you wish to stay in bed?
  • What activities or positions do you plan to use? (walking, standing, squatting, hands and knees)
  • Do you prefer a certain position to give birth?
  • What will you do for pain relief? (massage, hot and cold packs, positions, labor imagery, relaxation, breathing exercises, tub or Jacuzzi, medication)
  • How do you feel about fetal monitoring?
  • How do you plan to stay hydrated? (sips of drinks, ice chips, IV)
  • Do you want to take pain medications, or not? Do you have a preference for certain pain medications?
  • Would you be willing to have an episiotomy? Or, are there certain measures you want to use to avoid one?
  • What are your preferences for your baby’s care? (when to feed, where to sleep)
  • Do you want a routine IV, a heparin/saline block, or neither?
  • Do you want to wear your own clothing?
  • Do you want to listen to music and have focal points?
  • Do you want to use the tub or shower?
  • For home and birth center births, what are your plans for hospital transport in case of emergency?
  • If you need a cesarean, do you have any special requests?

2. Consult Your Health Care Provider:

Most of the time, health care providers have a set routine. They have been trained, and they also want what is best for the birth. Your health care provider may or may not be receptive to some of your ideas. They might view your list as being too demanding or as increasing certain risks.

Keeping in mind that every birth is different and that the definition of a “normal” birth can vary, try to use terms and phrases like “birth preferences,” “our wishes for childbirth,” “as long as birth progresses normally,” or “unless there is an emergency.” Make an appointment with the labor and birth department of your hospital or birthing center to have the staff review your plan in order to make suggestions.

You can request to spend time in an empty birthing or labor room to become more familiar with where you will be and what you might want to add to your packing list (extra pillows, pictures, music, etc). This should leave you feeling more confident about your birth plan and your choice of a birth location.

3. Confidence & Control:

During childbirth, many women feel like they are losing control. A birth plan can help you maintain your focus and help you stay calm even if unexpected events occur.
Try to plan for the unexpected by using phrases like, “If a cesarean becomes necessary….” During birth, if you feel pressured to do something about which you are uncertain, you can ask if it is an emergency situation. You can also request more information on any aspect of the situation and time to think about it.

4. The Power of Positive Thinking:

Design your birth plan with a positive focus. Instead of making a list of what you don’t want, focus on what you do want. Use phrases like, “we hope to,” “we plan to,” or “we anticipate.” Try to avoid phrases like, “we don’t want” or “we want to avoid.”
Here are some examples:

  • “Regarding pain management, I have studied and fully understand the types of pain medications available. I will ask for them if I need them.”
  • “Regarding an episiotomy, I am hoping to protect the perineum. I am practicing ahead of time by squatting, doing Kegel exercises, and perineal massage. I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch.”
  • “Immediately following the birth, I plan to keep the baby near me. I would appreciate that the evaluation of the baby be done with the baby on my abdomen and with both of us covered by a warm blanket unless there is an unusual situation.”

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Compiled using information from the following sources:

Pregnancy, Childbirth, and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 7.