Pen your plan

Get the lowdown on crafting this important document for labor day.
By Rachel Reiff Ellis

Prebaby to-do lists can be mighty long. There are doctor visits to remember, prenatal vitamins to take, names to consider, gear to purchase, maternity leave to negotiate—oh, and one more tiny thing: There’s a birth plan to write. When I was pregnant with my firstborn, “write birth plan” was the item on my list that I avoided the longest. It seemed too overwhelming, like writing a paper for a class I had spent an entire semester skipping. Who was I to tell the pros what I wanted? Weren’t they the experts? Shouldn’t I just do what they said?

When I finally started to wade into the murky waters of planning my preferences for labor and delivery though, I discovered that preparing a birth plan is less about dictating every detail of the experience and more about taking the time to make important choices before you’re in the throes of second-stage contractions. A well-thought-out plan can serve as your voice when your vocal cords are otherwise occupied with pants and groans (and maybe the occasional four-letter word).

Here are the main points to consider when writing your birth plan.

writingbirthplan_0All about you
Discuss your personal needs. Do you have allergies the staff will need to know about? Do you have religious beliefs that should be considered during your stay at the hospital? Make sure you also outline any previous experiences that might shape your approach to L&D.

Laboring limitations
Consider all the possibilities associated with labor. Is mobility important to you, or are you content to stay in bed? (This will determine whether you are hooked up to an IV upon arrival or a heparin lock is attached to your arm instead.) And while you’re making a decision regarding an IV, think about whether you want continuous fetal monitoring, or intermittent checks of baby’s vitals as labor progresses, and what each choice would entail. Is water birth something you would like to try? Find out if your facility provides birthing tubs. Talk to your caregiver about positions as well to see if there are expectations for how you’ll be situated during the labor process. Also ask if you can eat and drink after you’re admitted so you know whether to add “get labor snacks” to your ever-growing list.

Pain management
Make a point to really research your options when it comes to pain medications. Learn what risks are involved with each narcotic or anesthetic available to you and then decide at what point you would consider using one. If you feel strongly about delivering without medication, you may ask that the staff not offer pain management options, but instead wait until you request them yourself, when and if you feel the need.

The crowning moment
Decide how you feel about the use of an episiotomy (a physician-directed incision of the perineum), and weigh the pros and cons between that and natural tearing. If you think that seeing the event as it’s happening will help you focus during pushes, you can request that a mirror be used so you can keep your eyes on the prize.

After birth
At the end of all this hard work comes the best part—a baby! But with the baby comes a whole host of other questions to consider. Find out from your doctor what the normal procedures are postdelivery. Will you want baby placed straight on your chest? Who do you want to cut the cord? Do you plan to collect cord blood? (If so, make sure you’ve made arrangements ahead of time for the retrieval and storage.) Also consider your nursing options: Do you plan to breastfeed? If so, how soon after birth do you want to attempt baby’s first latch? Will you be breastfeeding exclusively or can formula be used for supplementation? Talk to your baby’s pediatrician (don’t forget to get one of those!) to see what will go on with your baby during your stay in the hospital. Some newborn tests are optional, and you’ll want to know whether to give permission or decline. And if your new baby will be arriving with boy parts, you’ll need to make a decision regarding circumcision.

Thoughtfully considering and writing down your preferences for one of the most important days of your life is more than just a good thing to do. It’s an empowering practice that will help you go confidently into the unknown, so that you can bring your newest family member into the world with joy.

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