Writing your birth plan can be one of the highlights of the final months of your pregnancy. It can give to time to dream, work through fears, and discuss your hopes with your maternity care provider. It is important to remember that the birth plan is a tool for communicating your wishes to your caregivers, and should not be written as an attempt to “protect” yourself from an otherwise unsupportive care provider or birthing environment. If you have not already read, The Birth Plan, I suggest you do before continuing on with this reading. In that post, I wrote about what a birth plan is and what one is not.
The beginning to writing any birth plan is to clarify for yourself how you would like to experience your birth, and how you have prepared yourself for that experience. There are so many options within childbirth, that I firmly believe the best place to learn about what options are available is in a complete series of childbirth preparation classes given either through the hospital or by an independent childbirth educator. If both types of classes are available to you, I suggest you take both to familiarize yourself with the variety of options as well as the policies and procedures common to the facility where you will give birth. If you have chosen homebirth, classes with an independent educator will be a great asset to your birth preparations.
Before making the important decision on how you would like to give birth, inform yourself on the most common medical interventions, why they might be necessary, and the risks, benefits, and alternatives to each of them.
- Continuous Electronic Fetal Heart Rate Monitoring
- IV Fluids
- Artificial Rupture of Membranes (Bag of Waters) – Amniotomy
- Cervical Ripening/Dilating Agents/Procedures – (ex. Cervidil, Cytotec, and Foley Catheter)
- Pitocin – (for induction of labor or labor augmentation)
- Pain Medications (Narcotics, Sedatives, or Anesthesia)
- Use of Forceps/Vaccum Extractor
- Cesarean Section
There is another similar list of medical procedures to consider for your newborn immediately following birth, many of which are parent choice. Include those decisions in your birth plan as well. (ex. breastfeeding, delayed cord clamping, vaccinations, Vit. K, circumcision, etc…)
If none of these interventions are medically necessary in your situation, begin by considering how you will cope with the hard work or “pain” of labor. Would you like to do this through natural comfort techniques or do you feel like you will be too fearful without some form of pain medication? Again, a good childbirth class can help you with information on either option. If you would like to give birth naturally (vaginally with no pain medications), how have you prepared yourself to cope with labor? Is your birthing facility supportive of the naturally laboring mother, and do they offer natural alternatives to pain medications (ex. freedom of movement, showers/tubs, birthing balls)? If you are thinking of pain medications, what form do you prefer? Do you know the side effects of that medication and when it would be available to you during your labor process?
Once you have decided upon how you would like to experience the birth of your baby, making decisions about the other options comes a bit easier. Certain choices in birth go hand in hand – for example if a labor is induced with pitocin, continuous electronic fetal monitoring is necessary to monitor mother’s and baby’s tolerance for the medication. To learn more about all the interventions and options of childbirth, I suggest (aside from childbirth classes) looking at About.com and Childbirth Connection for reliable information. Also, Penny Simkin’s book The Birth Partner is a wonderful book to read and have on hand during the birth. Simkin discusses most every possibility of birth, solutions, alternatives, and procedures for each. For more information on birthing naturally, I suggest beginning by looking at this free download pdf of Penny Simkin’s Comfort in Labor. Ina May’s Guide to Childbirth by world-renown midwife and birth advocate Ina May Gaskin is another excellent book on natural childbirth.
Other special health/medical situations may be strong determining factors in how you experience giving birth. If you know ahead of time that you will need induction or cesarean section because of medical issues for the safety of yourself and your baby, you still need a birth plan. Because you have to use one procedure or medication, does not mean that there still aren’t other choices that are yours to make. For more information of planning cesarean birth, visit the white pages of ICAN (International Cesarean Awareness Network) to read Family Centered Cesarean.
Lamaze International has used the most scientifically sound research to develop 6 Healthy Birth Practices. As many of these choices as can be adhered to during your experience, the less likely you will be to experience complications. (Nothing we do can guarantee a perfect birth experience. Life happens, but we can rest knowing we have done everything within our ability to be safe and healthy for ourselves and our babies.) Read more about these practices and view free videos on each of them at Mother’s Advocate.
- Let Labor Begin on its Own
- Walk, Move Around, and Change Positions During Labor
- Have the Continuous Support of Family, Friend, Loved One, or Doula
- Avoid Using Medical Interventions that are not Necessary
- Push in an Upright Position – Avoid Giving Birth on Your Back
- Keep Baby with You – It is Best for You, Your Baby, and Breastfeeding
After looking into all available options/possibilities, it is time to put something into writing. This can take many forms from extremely detailed to very simple. All it takes is a quick internet search to come up with as many templates as you could imagine. When choosing the format of your birth plan, remember that not all options will apply to the facility where you birth, and you should be aware of what is and isn’t an option there. It also isn’t necessary to state the obvious. If you have chosen a care provider and facility that is supportive of your choices, it is only necessary to state the options you have chosen and would consider if necessary.
After considering many different types of birth plans, my favorites are short and sweet. They are respectful of the professionals overseeing the care of the laboring mother, and there is plenty of room for changes if the situation requires it. The following is an example of a simple “reminder” style birth plan that I first saw in my Passion for Birth training workshop.
Healthy Birth in Progress!!
- Labor has started on its own.
- We want continuous support. Please share tips and tricks to facilitate this birth!
- Please no routine interventions. Please explain the B.R.A.I.N. (benefits, risks, alternatives, inuition, not now/nothing) for each one when needed.
- Help us move and change positions.
- We want to be upright or on all fours for pushing. We want to use physiological pushing and will need your support.
- Mother and baby will stay together, skin to skin. Give us plenty of opportunity and support to breastfeed.
For those who would like a little more detail to a more simple birth plan, I recommend the birth plan template on Mother’s Advocate.
Share your thoughts about birth plans and birth planning with us! Leave a comment to this post to start a discussion. If I can help you with further information on birth planning, feel free to email or visit the Facebook page for Birth True to ask.
Happy birth planning!