Creating Your Birth Plan

The birth of your baby is one of the most memorable, life-changing, exciting experiences of your life. You will want to spend some time thinking through your hopes and wishes for this special day. Starting with a journal, try to write down as many of your thoughts and plans for your birth as you can. Your journal will help you prioritize and articulate your ideas for creating your birth plan.

A birth plan is a simple, clear, one-page statement of your preferences for the birth of your baby. Having a copy for every person involved in the birth will help each person understand each other and work out communication 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 create your plan. You will want to discuss it with those who will support and care for you.

Try to remember to be flexible, because deviations may be necessary. You will also want to remember the goal: the safe birth of your little bundle of joy. Keeping the goal in mind, the following step-by-step guide will help you create your birth 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 something that is a routine part of birth at your particular setting, you may want to talk further with your health care provider. As you learn about the typical care provided, you will realize areas you want to mention in your plan.

You may want to consider one page for an uncomplicated birth/postpartum and a second page about how to handle complications should they occur. The following list of questions may seem overwhelming, but now is the time to think them through. If a question does not pertain to you, cross it off the list, then prioritize the ones that mean the most to you.

• Who do you want to be there?
• Do you want a doula?
• Will there be children/siblings present?
• Do you want mobility or do you wish to be confined to a bed?
• What activities or positions do you plan to use? (walking, standing, squatting, hands and knees)
• Would 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 do you want to avoid them? Do you have preferences for which pain medications you want?
• Would you like 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 nothing at all?
• 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 in case of hospital transport?
• If you need a cesarean, do you have any special requests?

2. Consult Your Health Care Provider:

Most of the time, your health care provider have a set routine of how things are done. They have been trained, and they want what is best for the birth as well. They may or may not be welcoming of your birth plan. They might feel it is a list of demands, or that you may be setting yourself up for failure and disappointment if everything doesn’t go precisely as planned.

Keeping in mind that every birth is different and that a “normal” birth may have a wide range of definitions; use wording 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 staff look over your plan and provide feedback and suggestions. Kindly request to spend time in an empty birthing or labor room to get a feel for where you will be and what you might want to add to your packing list, like extra pillows, pictures, music.

After this step, you will feel more confident about your birth plan and have greater confidence in your choice of birth location.

3. Confidence & Control:

During childbirth, many women feel like they are losing control. A birth plan helps you to feel confident and in control as much as possible and helps you feel part of the decision making 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 comply with something you are unsure of, ask if this is an emergency situation; ask if you can have more information on any alternatives and time to think about it. See if they can check back with you in a little while.

4. The Power of Positive Thinking:

Try to have your birth plan focus on the positive, instead of a list of what you don’t want. Use words like, “We hope to” or “We plan to” or “We anticipate.” Try not to use 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.”