Part of my doula services is to sit down and help the expecting parents come up with a birth plan if they haven't already. I highly recommend it. Not only do I recommend it, but its almost sort of required for me to support you. I can't do my job unless you tell me what you want me to do and what you expect out of the labor and birth process. I personally do not give birth without one. It's as essential to me as having my own doula present at my births.
Now before I continue let me tell you what a birth plan is NOT. A birth plan is not:
- A list or rules
- Demands
- Requests are not set in stone
- A legally binding contract
Think of a birth plan as more of a set of wishes and not something that has to be followed point by point. Labor and delivery sometimes has a way of not going to "plan". For example, on my birth plan I have always wanted to avoid internal monitoring. The fetal monitor looks like it has a little coil or spring at the end and what they do is actually puncture the top of the babies head and place that just under the scalp to get a better reading of the baby's heart rate. I have always disliked the thought of that piercing my child's skin. For my first 3 deliveries I was able to avoid that, however with my last child, a combination of things did not allow us to keep the external monitor on. It was not giving proper readings so I finally agreed on it. It was a good thing too. Not too long after I agreed to it, my baby's heart rate dropped dangerously low into the 30's and I had to deliver ASAP. So you never know what could happen and you may need to deviate from the birth plan at times.
What do you include in a birth plan?
You can find lots of birth plan examples online to get some ideas but here are some categories I always list on my birth plans and things to consider
Labor
- Is eating and drinking an option during labor? Is that something you want?
- Do you want to be connected to an IV machine upon arrival? This means you won't be able to walk around as freely.
- Do you want to keep the number of vaginal exams to a minimum?
- Does it matter to you who checks you? Nurses? Nurses in training? Students?
- Who do you want to have present? Your partner? Your mother? Your doula?
- Do you want to be coached when its time to push?
- Does the use of forecast or a vacuum matter to you?
Monitoring
- Do you have a preference with internal and external fetal monitoring?
- Do you want to have all procedures explained to you prior to it being done?
Pain Relief
- What kind of birth are you going for? Natural? Medicated?
- Will you have a labor coach or doula present? (if yes its important to name them)
Cesarean
- Would you like to avoid a cesarean unless absolutely necessary?
- If you end up getting a c-section who do you want in the operating room with you?
- Do you want everything to be explained to you? Your partner? Both?
- If your baby is not in distress, would you like to see your baby?
- If you are not able to hold your baby, do you want your partner to hold your baby?
- Do you want to breastfeed in the recovery room?
Episiotomy
- Are you against getting one? Are you ok with getting one?
- Do you want guidance in when to push and when to stop pushing so the perineum can stretch?
- Do you want local anesthetic to repair any tears?
- Would you rather tear naturally than have an episiotomy?
Immediately After Delivery
- Do you want your partner to cut the cord?
- Do you want to hold your baby while you deliver the placenta and any tissue repairs are made?
- Do you want to keep your placenta?
- Do you want immediate skin to skin contact?
- Do you want to delay newborn procedures so that you can attempt to breastfeed?
- If your baby must be taken from you to receive medical treatment, do you want your partner to go with the baby?
- Do you want to avoid using a catheter?
- Do you want your baby to room with you? Or taken to the nursery?
- Do you want your baby to receive any vaccinations? if so, which ones?
- Will you accept eye drops and the vitamin K shot for your baby?
Postpartum
- If you are having a boy, do you want him circumcised?
- If you were told you were having a girl, but end up having a boy, do you want him circumcised?
- Do you want to avoid giving your baby bottles? Artificial nipples?
- Do you want to avoid supplementing feedings with formula?
You will also want to include any special instructions like people who are NOT allowed at your birth. Or perhaps any religious views on medical procedures like avoiding blood transfusions and whatnot.
As you can see, there is A LOT to consider. I suggest you research all these topics and see what is best for you and your child. Your doula or midwife can also assist you in providing information and going over topics. Once you have come up with a birth plan, you will want to go over it with your OB and make sure you are both on the same page and that all requests can be met... or at least to the best of their ability.
My Tip To You:
When the big day arrives and you are heading to labor and delivery, take at very least 10 copies of your birth plan with you. This is why:
- You will want to take a copy for you OB even if you gave them one previously
- Your labor coach/ doula will need a copy
- Have a copy for your partner
- Have copies for the nurses who will be assisting you
- Keep in mind there may be one or more shift changes so bring enough for them too
- Have copies for when you get moved to recovery/ postpartum care, those will be new nurses as well and you will definitely have a few shift changes
Side note: If you want to avoid artificial nipples you may want to print and bring with you a sign that states baby is breastfed or no artificial nipples please. I take the second sign with me always and always bring extras. I have seen nurses throw them away after I have taped it up in the baby's basinet. You can find those signs here and here.
Now, sometimes not always, but sometimes the nurses have a mama who comes in waving their birth plan acting like its a list of demands. And is unwilling to steer from it even in the least. And come on, lets be honest, who likes a difficult patient? Its not someone they take seriously, not someone they want to help, and definitely not someone that they will really listen to to honor wishes. So depending on the experiences your specific birthing location has dealt with, they may see mom arrive with a birth plan in hand and think "oh no... one of those". Because of that I have a very important trick to share with you. One that has worked every single time for me.
While I am in early labor and still at home, I like to bake chocolate chip cookies for the nurses and hospital staff. And I bake a few dozen to make sure I have enough for all nurses (delivery and postpartum) and for all shift changes. I usually fill a few baskets full of baggies filled with individual servings for each nurse. I attache a little note to each thanking them for being there for us on this exciting day. Now here is the kicker. It also states to "Grab some cookies and feel free to get a copy of our birth plan." And I conveniently have a stack of birth plans right in the basket with the cookies. Im telling you, works like a charm! And the plus side is you usually have extras so mama can have some late on too!
So all in all, there really are no cons to having a birth plan as long as you know you may have to compromise on some things during delivery. If you can deal with that, then you won't be disappointed.
