Planning for a birth can seem daunting, but it doesn’t have to be! Think of your birth plan as more of a wish list than anything else: a layout of how you’d like things to go, with plenty of room for flexibility if necessary. Here’s what to include …
1. The basics
- Your name
- Your doctor’s, midwife’s and/or doula’s names
- Any red flags your team should be aware of (group B strep, Rh incompatibility, gestational diabetes, etc.)
- Who will be joining you in the delivery room (your partner, mom, birth photographer, etc.)
2. Laboring desires
- Ambiance. Do you want low lighting, minimal conversation and soft music? Or a pumped-up playlist and a celebratory vibe?
- Comfort. Would you prefer to labor in your own clothes or a hospital gown? Do you plan to move around frequently in early labor, or will you most likely rest in the bed?
- Exams. Should your medical team limit vaginal examinations as much as possible, or would you like regular progress reports?
- Medical staff. Are you open to “guest” staff members (students, residents, etc.), or would you prefer to stick to only your hands-on team?
- IVs. Are you OK with an automatic IV, or would you rather go that route only if you’re dehydrated? How do you feel about a heparin or saline lock?
- Fetal monitoring. Does your plan include continuous or intermittent fetal monitoring or monitoring only if baby is in distress? Internal or external?
- Are you open to the following medical interventions?
- manual rupturing of membranes
- oxytocin (Pitocin) to start or augment labor
4. Pain management
- How do you feel about an epidural? Do you want one as soon as possible, only when absolutely necessary or not at all no matter what? Is a walking epidural a possibility?
- If you choose to have an epidural, would you like it to wear off before it is time to push?
- Consider whether any of the following might be an option for you:
- acupressure or acupuncture
- breathing techniques
- other natural pain relief methods
- Are you hoping to labor in the tub or shower to ease pains? Do you want to deliver in the water or move back to your bed before pushing?
- Are you interested in non-epidural medication (such as Demerol)?
- Will you be bringing along any of the following, or would you like to see if they are available at your place of delivery?
- birthing ball
- birthing stool
- squatting bar
- Would you like direction from your medical team in pushing, or would you prefer to follow your body’s cues?
- Do you want to use a mirror to see baby’s head emerge?
- Do you want to reach down and touch baby as he crowns?
- Do you or your partner want to catch the baby?
- How do you feel about using the following to assist delivery:
- perineal massage
- Even if a C-section isn’t in your plans, what conditions would constitute you approving a move to the OR?
- Do you want to ensure all other options have been exhausted before taking the surgical delivery route?
- Would you choose to stay conscious, if possible?
- Would you like your hands to remain free, so you can touch baby?
- Should your partner remain with you during the procedure and hold baby as soon as possible?
- Would you like the screen lowered, so you can watch baby come out?
8. Cord care
- Will your partner be cutting the cord?
- Are you delaying cord cutting?
- Are you banking or donating baby’s cord blood?
- Would you like to see or keep the placenta?
- Would you like to hold baby as soon as possible?
- Would you like to breastfeed baby as soon as possible?
- Would you prefer baby to be suctioned, weighed, cleaned off and administered eye drops/ointment before you hold him?
10. Newborn care
- Should baby’s medical exam and procedures be performed only in the presence of you or your partner?
- If baby is healthy, would you like to delay these procedures until you’ve had a chance to bond?
- Which of the following newborn screening tests/medical procedures would you like your baby to have?
- advanced heel stick
- hearing screening
- hepatitis B vaccine
- vitamin K
- antibiotic eye treatment
- Can a nurse give baby his first bath, or do you want a family member to do it?
- Will you be exclusively breastfeeding baby? Do you want to supplement with formula?
- Do the nurses have your permission to give baby a pacifier in the nursery?
- If you have a boy, would you like to have him circumcised? If so, would you like to use anesthesia?
- In the event that baby needs to be transported to the NICU or another hospital, who will accompany him? Do you have any special requests for the staff?
By Sarah Granger