What’s a birth plan?
A birth plan is a flexible written document communicating to your birth team what your delivery and postpartum preferences are, and what would make you the most comfortable during your birth experience. Why do you say flexible, Lauren? I have to say flexible. It’s the labor nurse in me. Birth plans, just like some of the best laid out plans we make for our lives do not always pan out the way we expect them to, and I think I’d be a foolish childbirth educator not to express that to you in advance of the big day. In light of this statement, you might be asking yourself, then why should I bother making one?
The answer- my strong, powerful, beautiful mamas - is for self-advocacy, laid out weeks or even a few months before your expected big day. Doing so gives you the time to reflect, visualize, and think about how you hope your birth experience will be, and outlines clearly for your birth partner, doula, nurses, ob/midwife and the rest of your birth team your expectations for your birth. Once created, share your birth plan with your partners, doula, nurses, and your providers at your prenatal visits, stash it in your labor bag to be easily accessed, and get ready to review it with the team when the big day occurs and it’s go time.
How and when should I begin creating a birth plan?
I strongly advise you to start the process by around 28-30 weeks in your pregnancy. If you’re a first time mom or even if this isn’t your first go around, my other piece of advice is to educate yourself on what all of your options are – with the help of a certified childbirth educator, labor doula, or by talking with your provider during your prenatal visits. This way you have assistance navigating the many options. If after discussions with those you trust you start feeling overwhelmed, your best bet may be using a free downloadable birth plan template that you find online and going from there. Two examples to start with are can be found on thebump.com and madeformums.com.
What will be included on my birth plan?
Birth plans come in all different lengths, vary in degree of detail, and even style (written out, template based, or even done with various icons for those visual learners out there). The content of your birth plan will also vary from person to person, but generally include some or all of the following elements:
What kind of positions you would like to use during your labor
What kind of environmental elements you would like in your labor room (i.e. dim/bright lights, music, aromatherapy or not, noise/music or no noise)
Positional tools you might like to use (i.e. yoga balls, peanut balls, birth stools)
Fetal monitoring options (intermittent vs. continuous electronic fetal monitoring, hand held doppler use intermittently)
Pain management options you would like offered or not offered (i.e. comfort measures only vs. IV sedation, Nitrous Oxide, epidural administration)
Your feeding preferences for your baby (breast vs. formula)
Baby care elements (i.e. cord blood collection, delayed cord clamping, bathing preferences for baby, med administration for baby, rooming in with baby, immediate skin to skin care with baby if both of you are medically stable).
Other considerations you may want to include might be religious or cultural preferences, a quick intro about yourself and your partner, allergies, any underlying medical problems complicating this pregnancy or your health in general, what number baby this is for you, and maybe a few fun facts about yourself!
Finally, for my cesarean birth mamas out there, do not think that all is lost and you can’t have a birth plan as well! Things to consider for your cesarean birth plan might include:
Whether or not you would like to have immediate skin to skin in the OR if mom and baby are medically stable
Who you would like to announce the baby’s gender
Whether or not you would like the surgical drape lowered so you can see baby being born
If you would like music playing or a quiet birth environment
If you would like the procedure explained to you as it is happening
Who you would like present with you in the OR
Whether you would like photos taken during the birth
For a template example check out kindredbraverly.com and for more options regarding cesarean birth check out Lamaze.org.
Things to keep in mind when it comes to creating a birth plan
One size does NOT fit all. Make the birth plan your own – and modify over time as needed.
Do discuss with your provider. Again, keep in mind that certain medical conditions during your pregnancy, such as high blood pressure or gestational diabetes, low lying placenta may bring about the need for greater medical interventions during your labor such as IV placement, continuous fetal monitoring, bedrest, or the need for cesarean birth. It’s frustrating as a nurse to see my patients come into the hospital for a labor induction, for example, and find out that some of the elements of their birth plan just got squashed on admission, and they had no idea in advance because they didn’t know to bring up their birth plan with their provider.
Try to keep it to a page or two. Make clear, concise statements that are easy to follow along with.
Realize that sometimes your birth team can frame your birth plan on the wall and everything goes according to preference, and other times the “ish” hits the fan and the entire plan goes out the window. It’s not common, but it does happen.
Final take away
This is YOUR big day. Educating yourself on labor, birth and baby care preferences can really help put you in the drivers seat for your birth experience and help you make the most informed decisions for you and your baby’s health. As always, even if it’s not laid out specifically in your birth plan, use your BRAIN and ask questions when medical interventions are being discussed. The BRAIN acronym is as follows:
B – Benefits – what are the benefits of this intervention?
R – Risks – what are the risks of this intervention?
A – Alternatives – Are there any alternatives to this intervention that could be considered?
I – Intuition – Trust your gut – if it doesn’t feel like the right decision, speak up and ask for clarification.
N – No, not now – Discuss what might happen if you wait it our or do nothing right now.
I hope you find this post to be empowering for you as an expecting mother, and as always…may you be strong as a mother today, and every day.