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.
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
__Heparin or Saline lock
__Placement (forearm, hand, etc.)
__Manual auscultation (fetoscope,stethoscope)
__One 20 minute external electronic strip
__Intermittent external fetal monitoring once every 1 or 2 hours
__Continuous external fetal monitoring
__Continuous internal monitoring
Positions for labor
__Freedom to change positions/walk around
__Confined to bed in various positions
__Confined to bed in one position
Dealing with pain
__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
__Walk to toilet
__Bedpan in bed
__Juice, water, Popsicles
__Ice chips only
__I.V. fluids only
__Few at mother’s request
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
Bed for Birth
__Birth chair, beanbag, floor, bed, toilet
__Hospital bed/labor bed
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)
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
__Patience for natural methods (position changes, visualization, intense coaching)
Slow actual birth
Care of Perineum
__Try for intact perineum (massage, positions, support, hot/cold compresses)
__Pressure episiotomy without pain medication
__Parent’s choice (father, coach, family member)
__Clamp & cut after pulsating stops
__Clamp & cut immediately
__Parent’s choice who cuts cord (i.e. father/coach)
__Doctor or nurse
__Spontaneous/natural (breast stimulation, baby suckling,)
In case of Cesarean Section:
Timing (if planned)
_After labor begins
_Scheduled before labor begins
Precaution (if not planned)
_Fetal scalp sample
_No fetal scalp sample
_No separation of mother and coach
_Medical staff only
_Regional with little or no premedication
_Regional with premedication
_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
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.