Developing your personal birth plan gives you a chance to think about and discuss with your primary support person and your caregiver, how you’d like your baby’s birth to be handled. It’s not possible to control every aspect of labor
and delivery, but if you develop a plan and have a printed document available for those supporting and caring for you, it’s easier for them to follow your wishes if possible. Remember that the birth plan is just a guideline.
It is beneficial to begin the discussion of your birth plan with your OB Provider during your prenatal visits to build a partnership and begin the process of shared decision making. Shared decision making is a key component of patient centered health
care. It is a process in which clinicians and patients work together to make decisions and select tests, treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values.
Shared decision making is important as: It can create a new relationship between individuals and professionals based on partnership. People want to be more involved than they currently are in making decisions about their own health and health care.
Some of your decisions before and during childbirth may affect your risk of cesarean. These decisions are best made in collaboration with your provider during your prenatal visits, well in advance of labor beginning. Here are some common decision points:
- Whether to wait for labor to begin on its own (induction of labor may increase your risk of cesarean)
- Whether to be admitted to the hospital in early labor or to wait until active labor (being admitted in active labor improves your chances of having a vaginal birth)
- How to monitor your baby’s heart rate during labor (low-risk women who are continuously monitored may be more likely to have a cesarean)
- Whether to have continuous labor support by a trained caregiver like a doula (continuous labor support improves your chance of having a vaginal birth)
- How to help manage labor pain and labor progress
- How to stay hydrated and maintain strength during labor
- Whether to remain mobile and upright during labor
- How to push around the time of birth
- What practices to engage in shortly after your baby is born and before you go home
Below are some common birth plan options to help you customize your own plan.
Labor and Delivery
Preparation
- Mobility – I would prefer to walk around
- Fetal monitoring
- I would prefer continuous fetal monitoring
- I would prefer intermittent fetal monitoring if I meet the criteria
- Nurse presence – I would like the nurse present at bedside during labor
- Water
- I would like the option of laboring in the tub if I meet the criteria
- I would like to use the massaging shower for comfort during labor
- Placenta – I would like the option of taking my placenta home after delivery unless it is needed for medical testing
Anesthesia/pain medication
- I would prefer to labor without pain medication – I will ask if I would like something for pain (please do not ask me)
- I would like to try IV pain relief medications before trying an epidural
- I would like an epidural
Environment/comfort and relaxation aids
- Visitors
- I would like help with limiting my visitors
- I would like my children to be present; I understand that another adult must supervise children under 16
- Lighting – I would prefer dim lighting
- Music – I would like music therapy using my own music choice
- Aromatherapy – I would like to use essential oils
- Massage – I would like a massage by a massage therapist; I understand this should be scheduled in advance, and I will be responsible for payment to the therapist
Equipment
I would like the following equipment available to me:
- birthing ball or peanut ball
- hydrotherapy tub (based on availability)
- massaging shower
- squat bar/kneeler
During labor and birth
- Labor
- I do not want to be separated from my primary support person during labor or birth.
- I would prefer to labor naturally unless interventions are medically necessary.
- Pushing
- I would like for my support person to support my legs when I push.
- I would like to use the squat bar during pushing.
- I would like to try different positions during pushing.
- I would like to wait to push until I feel the urge.
- Birthing
- I would like a mirror available so I can view the birth.
- I would like to be able to touch my baby’s head when it crowns.
- Umbilical cord
- My partner would like to cut the cord.
- I would like cord clamping delayed if it meets medical criteria.
- Mother-child bonding
- I would like to enhance bonding with my baby by having the baby placed skin-to-skin with me immediately after birth, providing my baby is stable.
- I would like to breastfeed immediately after delivery.
- Medical assessment – I would like for my baby’s first assessment to be done in my presence or that ofmy support person.
Postpartum
After birth
- Discharge – I would like to be discharged at 24 hours post-delivery as long as my baby’s doctor can see my baby on the following day and my baby is healthy enough to go home.
- Pain medication – Please offer my pain medication when it is due; I prefer not to have to ask for it.
- Comfort – I would like to shower before I move to the postpartum room.
- Nursing – I would like a nurse to check on me every hour while I’m awake.
- Circumcision
- I plan on having my child circumcised.
- I do not plan on having my child circumcised.
- Visitors – I would like help to limit my visitors during my stay.
Feeding and comfort methods
- Feeding options
- I plan on breastfeeding.
- I do not want my baby given any formula unless medically necessary and with my consent.
- If my baby requires supplementation, I am interested in an alternative feeding method other than a bottle.
- I plan on bottle-feeding.
- I would like to see a lactation specialist.
- I prefer my baby not have a pacifier.
Night-time plan
- Pain medication – If I’m sleeping, please do not wake me to offer pain medication.
- Visitors – I would like my support person to stay with me during the night.
- Nursing – I would like to participate in the discussion of my plan of care; please wake me if I am sleeping at shift change.
Your birth plan can be as extensive or short as you would like it to be, but it’s important that you share it with your support person and your doctor, nurse or midwife so everyone understands what you want and can help you have the best possible birthing experience. If you have any questions about developing a birth plan, talk with your provider.