Yes absolutely every pregnant mom should write a birth plan! Just like anything in life, it really benefits you to have a plan. Setting your intentions and writing them down will help you manifest what you intend to achieve.

What exactly is a birth plan?

Your birth plan should represent your set of goals for your birth. Remember that the choices you make during your pregnancy, labor, and birth are the choices that you will live with for the rest of your life. Your doctor or your midwife, or your nurses do not have to live with the consequences or outcomes of your choices. You and your family do!  So make sure you are actively participating in those choices.

How do I actively participate in the choices made during childbirth?

First you need to get educated. It is the one thing you can do to help your baby into the world as safely as possible. Learn the risks and benefits of all of the interventions.  Don’t let others make decisions for you in pregnancy, labor, and birth, except in a true emergency. Make your healthy decision WITH your care providers. It is their legal obligation to fully inform you so that you can give consent.  But it is your responsibility to ASK QUESTIONS! To know which questions to ask, you should learn about informed consent questions. Hopefully your childbirth educator will drill these questions into your brain in your childbirth classes.

Let’s Get Started Writing Your Birth Plan!

Once you are finished creating your birth plan, you will have your care provider sign it. You’ll make at least 4 copies of your birth plan: one goes in your file at the office; one goes in your file when you pre-register at the hospital or birth center; one or two go with you to give to the nurses when you arrive at your birth place.  It’s important to be flexible because the one thing you can count on in labor and birth is the unexpected.

GUIDE FOR

THE BIRTH PLAN/GOALS/WISHES OF ___________ 

Example: We understand this plan consists of our goals for our labor and baby’s birth.  We intend to be flexible.  We consider mother’s and baby’s health and safety our top priority.  We hope you will work with us as a team to achieve the birth we envision.  We would appreciate all your help in achieving a natural birth.

FIRST STAGE LABOR

I.V.
__No I.V.

         __Heparin or Saline lock

         __Mobile I.V.

         __Placement (forearm, hand, etc.)

Monitoring

         __Manual auscultation (fetoscope,stethoscope)

         __Doptone

         __One 20 minute external electronic strip

         __Intermittent external fetal monitoring once every 1 or 2 hours

         __Continuous external fetal monitoring

         __Continuous internal monitoring

         __Some mobility

Positions for labor

         __Freedom to change positions/walk around

         __Confined to bed in various positions

         __Confined to bed in one position

Dealing with pain

         __Natural methods

         __Medication at mother’s request

         __DO NOT offer medication

Enhance or speed labor

__Natural methods (visualization, walk, change  positions, nipple stimulation…)

__Enema, castor oil

__Artificial rupture of membranes

__Pitocin

__Herbal remedies

Empty bladder

         __Walk to toilet

         __Catheterization

         __Bedpan in bed

         __Other

Fluids

         __Juice, water, Popsicles

         __Water only

         __Ice chips only

         __I.V. fluids only

Food

         __Mother’s choice

         __Limited

         __No food

Cervical checks

         __Few at mother’s request

         __Staff prerogative

SECOND STAGE AND BIRTH

 Position for pushing:

The mother has been encouraged to take whatever position is most comfortable to her and to vary positions during second stage until delivery (semi-sitting, sitting, side-lying, hands and knees, standing, squatting, etc. she has been discourages from using the lithotomy or any supine position during descent of the baby, and for a delivery unless forceps, vacuum extractor, or episiotomy become necessary.

__Mother’s choice (vertical, hands/knees, squat, side lying

         __Lithotomy

         __Stirrups

         __Other

Bed for Birth

         __Birth chair, beanbag, floor, bed, toilet

         __Hospital bed/labor bed

         __Delivery table

Pushing techniques:                                       

Rather than prolonged breath holding and bearing down throughout contractions, her bearing down and breath holding efforts will be spontaneous and in response to the strength and duration of her urge to push. Bearing down will be for a shorter period (5-6 seconds) than is usually encouraged.  There will be several moments between these bearing down efforts during which she will breathe without pushing.

         __Spontaneous bearing down

         __Directed pushing (counting by birth attendants)

         __Other

Speed actual birth:

Pelvic floor relaxation

1 suggest that she change position if progress is slow

2 remind her to bear down with the urge, and not to push unless she has the urge

3 remind her to let go-thereby relaxing the pelvic floor

4 if spontaneous bearing down and changing position do not result in progress, ask her to bear down longer and more forcefully.

         __Prolonged pushing on command

         __Episiotomy

         __Forceps

         __Vacuum extractor

         __Patience for natural methods (position changes, visualization, intense coaching)

 Slow actual birth

         __Panting

         __Side-lying

__Other 

Care of Perineum

__Try for intact perineum (massage, positions, support, hot/cold compresses)

         __Pressure episiotomy without pain medication

         __ Other

 Baby Catcher

         __Parent’s choice (father, coach, family member)

         __Nurse

         __Doctor/midwife

Cord cutting

         __Clamp & cut after pulsating stops

         __Clamp & cut immediately

         __Parent’s choice who cuts cord (i.e. father/coach)

         __Doctor or nurse

         __Other

Placenta birth

__Spontaneous/natural (breast stimulation, baby suckling,)

         __Fundal massage

         __Pitocin

         __Other

In case of Cesarean Section:

Timing (if planned)

         _After labor begins

         _Scheduled before labor begins

         _Other

 Precaution (if not planned)

         _Fetal scalp sample

         _No fetal scalp sample

         _Other

 Others present

         _No separation of mother and coach

         _Medical staff only

         _Doula only

         _Other

 Pain medication

         _Regional with little or no premedication

         _Regional with premedication

         _General

         _Other

Participation

         _Screen lowered at birth

         _Events explained as proceeding

         _No participation by parents

 Contact with baby

         _Held by mother or father soon after birth

         _Breastfeeding soon after birth

         _Sent immediately to nursery with father in attendance

         _Other

Don’t forget to discuss pain management options for post surgery.  Remember to ask about meds: effects on breast milk and baby. Ask your pediatrician and lactation consultant the same questions.  You may get a different perspective or answer.