- Women's Health
How to Make a Birth Plan for Your Delivery
Know What a Birth Plan Is
As a doula, one of the things that I like to cover with the pregnant woman and her family is the birth plan. The birth plan is an idea and hope list that covers the things that you would like to experience and would not like to experience during labor and childbirth.
A birth plan can cover many things during the pregnancy as well. Having a birth plan can make everything go much smoother when all of the pregnant woman's support of friends and family know what to expect for the mother and themselves.
What You Can Include in a Birth Plan
Think of the ideal birth situation. Are you wearing certain clothes? Are there certain people present? Are there not certain people present? If you have children, where will they be when your labor begins?
A good birth plan will include your labor, your delivery, and your postpartum care. I once attended an adoption pregnancy where the adoptive family did not want to leave the labor room to let the birth mother have some time to rest after delivering the baby! This was unacceptable and I let them know.
Birth plans that involve other people are great, so long as those people are made aware of their role or lack of role in your plan.
Know What Your Birth Location Allows When Making Your Birth Plan
A client of mine wanted to have as natural of a birth as possible. She also wanted to give birth to her child in a hospital because she had elevated blood pressure.
Her original birth plan stated that she did not want to be hooked up to medicine, machinery, or monitoring devices. Luckily, I was reviewing her birth plan with her, and I explained that she needed to discuss her labor options with her physician and the hospital. Her doctor stated that as long as she was one of his patients, she would have monitoring devices for her blood pressure, no food or drink, save for ice chips and small amounts of water once she was admitted, and that as a precaution, she would have an IV started when she was admitted, in case there was a need to administer medicine quickly. He told her that if she was unwilling to do these things, she could not remain as a patient in his care group.
Knowing what your primary care person is going to do during your labor and delivery is your right to know. It allows you to create a birth plan that you understand. During active labor is not the time to learn that your doctor does or does not do things according to your birth plan.
Some questions to ask of your primary care person are:
- Tell me what happens during a standard procedure? What devices will be connected to me?
- How long will you allow a mother to labor if there is no distress of mother or child?
- What is and is not allowed during the labor and delivery process?
- Do you allow food or drink by the woman in active labor?
- What is your rate of C-Section births? (If a physician)
- How long will I be able to stay after I give birth before being discharged?
- Is a tour of the facilities available?
- How many people are allowed in my room?
- Is there an option to have the baby in the room for me as well as send the baby to the nursery if I need my rest?
- Are there visitor hours in the nursery as well as in my room? Are they enforced?
- What things to I need to have for the baby before I am discharged with the baby?
- If I am on medicines, should I bring them with me when I come to the hospital?
These are simply guidelines. A good dialogue is one where you ask the questions that are relevant to you.
When Emergencies Happen....What Happens to Your Birth Plan?
No matter how well we plan, things can happen that upset the best ideas. One of my closest friends had planned a water birth. She was very happy. Her partner, her midwife and her family all rallied around her idea. A birthing center was selected, and a backup plan of a nearby hospital was researched.
The morning of the birth, getting ready to go to the birthing center, her water broke in the shower. Literally, in the minute it took to grab her towel, step from the shower to the tiled floor, the baby crowned and she delivered the baby into her own hands while squatting on the floor. No one was hurt or harmed, but assuredly this was not the plan.
Another mother who was a client wanted to have a home birth. She phoned me to tell me that she was in labor. I drove out there, and the midwife started out as well. The client labored for several hours with no progress being made. A quick evaluation from the midwife revealed that her labor had stalled. We all slept at the house that evening, to be rousted a few hours later by the father, telling us that our client was now vomiting and had diarrhea. We all went to the hospital, where a beautiful boy was born to our client who was diagnosed as having the flu in combination with food poisoning.
If you are ever in doubt about the level of care that is available, do not be afraid to go to a hospital where there is a facility that can more closely monitor you. Not being apprehensive about needing more help allowed this client to have a great birth, although it was not the one that she imagined.
Make a "worst case scenario" section of your birth plan. Learn where things are located, and do pack an emergency bag to have with you just in case something unplanned happens.
Attach Your Medical History and Pertinent Information to Your Birth Plan
Your birth plan may only be a few paragraphs. Don't make it so long that people have to spend a good deal of time reading through it. Boil everything down to the simplest terms.
Make sure that you have your medical information attached to your birth plan. This should include:
- your medical history
- all of your physician info and their contact information
- medicines that you are currently on
- emergency contact information
- your home address
- your insurance information
- the name of the hospital or birthing center where you plan to give birth
- allergies and what happens when you are exposed to your allergen
- your due date
Having this information filled out before you are in labor can be a big time saver for you.
Including Personal Beliefs or Religious Statements
A client once had a very strong opinion about her religion, and rightfully so. She wanted it included in her birth plan her beliefs as well as religious guidelines for the care of her and her newborn. It was very helpful to be able to read a small paragraph that explained her belief system so that we could all be mindful of the way she wanted to parent and raise her child. Realize that emergency care for mother or child will cause this to be cast aside if the life of either is in question.
Things That Can Be Hard to Enforce
The longest birth plan that I ever saw personally was over 100 pages long. The pregnant mother wrote about what she wanted to happen from the earliest moments of labor to how she wanted to be treated the first month, and the care and treatment of her newborn for the same amount of time.
A birth plan is simply that. It is the plan of how you would like to experience your labor, your childbirth, and your postpartum care for the first few hours after birth. After that, you are writing your mother and child care plan, which is something separate from a birth plan. Be realistic about your birth plan. Don't demand that only certain music be played during certain phases of your labor or delivery. Request that certain music be played. Realize that the first goal of everyone is the safety of the mother and the child.
The pregnant mother who is already a mother to other children may want to have the other children present when she is laboring. When actually laboring, the children may become a distraction, or they may become scared of seeing their mother in the scenario of giving birth. Children may not be as fascinated by the birthing experience as the pregnant mother would like them to be. Have alternative plans in mind for children.
The pregnant mother who does not want to have an iv in her arm during labor may have to get an iv started for various reasons. Be prepared that labor and delivery is constantly changing, and accept that you are there giving birth to a child that you want to be able to deliver as safely as possible. It can be hard to enforce ideas of your birth plan when medical intervention is needed.
Express Your Needs and Fears
The old adage says that there is nothing to fear except fear itself. By writing down your fears and needs in your birth plan, it allows you to have some control over the big "What If?" that could be looming in your head. You don't have to include all of them in your birth plan, but addressing the fears you have in your first draft can allow you to create a birth plan that allows you to feel the power of having control over the type of birth that you will have.
An Example Birth Plan
This is an example birth plan. I have changed names and places to protect my client. It was so beautifully executed that I felt immense admiration for her for allowing me to share it.
Birth Plan for Miranda J. Doe
During the first part of my labor, I wish to have no intervention by anyone. I want to eat and drink freely when I want in order to have strength to deliver my baby into the world.
When my contractions become time-able and less than 5 minutes apart, I would like my husband to phone our midwife, our doula, and our sitter who will take our daughter for the next few days until we call her.
Attached to this birth plan is a checklist of things to place in the bag that goes with us to the birthing center as well as a copy of my medical and insurance information.
I do not want to be hooked up to monitors to check the status of me or the baby unless it seems that either of us are in distress. I want to be allowed to freely labor for a full 24 hours unless there are signs of distress or imminent need.
We do not want to know the gender of the baby until s/he is born, and we want to learn for ourselves, without intervention of any person at our childbirth.
Please do not offer me or mention to me pain medications. I want to have my child as natural as possible.
We will be using a birthing ball and a tub to bring our child into the world. We will be bringing the birthing ball with us. We will use the shower and a birthing stool if the tub is being used by another client.
In the event that movement to the hospital is needed, we would like to have myself, my husband, our midwife and our doula present. We do not want the baby removed from us for weigh and measure until we are done meeting and sharing time with our baby. In the event of a surgical intervention, we would like for my husband to cut the cord and be the first person to hold the baby. We do not want anyone else, save for essential medical personnel to hold the baby before both he and I do. Don't ask to see or hold the baby before both of us have seen and held him or her! We ask the hospital to not display our baby in the nursery on view to strangers.
If photos are taken during any labor or delivery moments, we ask to kindly and please be respectful and do not take photos of my breasts or genitalia. If a hospital birth is needed, we ask that the newborn baby photographer see us to have photos made of our baby and us together.
Please do not post any information about us or our baby onto any social networks without our permission. We would like to share our news with our closest friends and family before it is blasted across the internet. This is not a news story that you are getting a scoop on!
If anything happens during the birth that is medically unexpected, please do not share that information with others unless we ask you to.
Thank You for reading our birth plan. We look forward to meeting our baby when they decide the time is right!
Did You Use a Birth Plan?
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Do You Have a Birth Plan?
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