tips to prepare a birth plan

The birth of your baby should be one of the most memorable, life-changing and joyful experiences of your life. You will want to spend time thinking through the details of your hopes and desires for this special event. Starting with a journal, write down as many of thoughts and plans for the upcoming birth as you can. Your journal will help you establish priorities and provide a list of ideas to help you create a birth plan.

A birth plan is a simple, clear, one-page statement of your preferences for the birth of your child. Providing a copy of the plan for everyone directly involved in the birth will help them better understand what is happening and give them the opportunity to resolve issues before the big day. Because there are so many aspects of birth to consider, it is best not to wait until the last minute to put your plan together. The plan will provide an effective avenue for discussing important details with those responsible for supporting and caring for you.

Try to remain reasonably flexible in your desires because things don't always go according to plan. Remember that the important thing is the safe birth of your little bundle of joy. Keeping that goal in mind, the following points can serve as a guide for your plan.

1. Compile Considerations:

Find out ALL the routine policies and procedures for “mommy care” in your birth setting. If you do not agree with a policy or procedure, you should discuss it with your health care provider. As you learn more about what to expect, you will likely identify details that you want to include in your plan.

You may want to consider dedicating an entire page for an uncomplicated birth/postpartum and a second page about how to handle complications should they occur. The following list of questions might seem overwhelming, but now is the time to consider them one by one. If you find that a question does not pertain to you, just cross it off the list and continue to prioritize those that are relevant.

• Who do you want to be present?
• Do you want a doula?
• Will there be children/siblings present?
• Do you want mobility or do you wish to stay in bed?
• What activities or positions do you plan to use? (walking, standing, squatting, hands and knees)
• Do you prefer a certain position to give birth?
• What will you do for pain relief? (massage, hot and cold packs, positions, labor imagery, relaxation, breathing exercises, tub or Jacuzzi, medication)
• How do you feel about fetal monitoring?
• How do you plan to keep hydrated? (sips of drinks, ice chips, IV)
• Do you want pain medications, or not? Do you have a preference for certain pain medications?
• Would you be willing to have an episiotomy? Or, are there certain measures you want to use to avoid one?
• What are your preferences for your baby's care? (when to feed, where to sleep)
• Do you want a routine IV, a heparin/saline block, or neither?
• Do you want to wear your own clothing?
• Do you want to listen to music and have focal points?
• Do you want to use the tub or shower?
• For home and birth center births, what are your plans for hospital transport in case of emergency?
• If you need a cesarean, do you have any special requests?

2. Consult Health Care Provider:

Most of the time, health care providers have a set routine. They have been trained, and they also want what is best for the birth. They might or might not be receptive to some of your ideas. They might view your list as being too demanding or as increasing certain risks.

Keeping in mind that every birth is different and that the definition of a “normal” birth can vary, try to use terms and phrases like “birth preferences,” “our wishes for childbirth,” “as long as birth progresses normally,” or “unless there is an emergency.” Make an appointment with the labor and birth area of your hospital or birthing center to have the staff review your plan in order to make suggestions. You can request to spend time in an empty birthing or labor room to become more familiar with where you will be and what you might want to add to your packing list (extra pillows, pictures, music, etc). This should leave you feeling more confident about your birth plan and your choice of birth location.

3. Confidence & Control:

During childbirth, many women feel like they are losing control. A birth plan helps many women maintain their focus and regain a measure of control even if unexpected events occur.

Try to plan for the unexpected by using phrases like, “If a cesarean becomes necessary...” During birth, if you feel pressured to do something about which you are uncertain, you can ask if it is an emergency situation. You can also request more information on any aspect of the situation and time to think about it.

4. The Power of Positive Thinking:

Design your birth plan with a focus on the positive. Instead of making a list of what you don't want. Use words like, “We hope to” or “We plan to” or “We anticipate.” Try to avoid phrases like, “We don't want” or “We want to avoid.”

Here are some examples:

• “Regarding pain management, I have studied and understand the types of pain medications available. I will ask for them if I need them.”
• “Regarding an episiotomy, I am hoping to protect the perineum. I am practicing ahead of time by squatting, doing Kegel exercises, and perineal massage. I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch.”
• “Immediately following the birth, I plan to keep the baby near me. I would appreciate the evaluation of the baby be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.”