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Birth Plan Writing Guide

More and more women are writing down their birth preferences and sharing them with their doctors and midwives. This guide will give you an inside look at the options you have for the birthing process and common newborn procedures. Women typically create their birth plans and share them with their care providers during the third trimester.

Induction

Women who bypass their due date may require induction to start the labor process. Most doctors will not let pregnant women go beyond the 42-week mark because of increased health risks to the baby and the mother. If an induction is scheduled, consider asking your doctor about the types of medication that will be used during the process. You may want to do some research on the types of drugs your doctor is considering to ensure that you are comfortable with the choices. Or you can request in your birth plan that natural choices, such as essential oils, nipple stimulation or membrane sweeping, be tried before you consent to medications.

Early Labor

When you are admitted into the hospital for delivery, you are typically given an intravenous therapy (IV) to prevent dehydration. Some women consent to an IV placement but prefer to delay fluids until they are in active labor. This allows you to move around easily and eat and drink as needed during the very early stages. You can also choose between continuous fetal monitoring or intermittent monitoring. Monitoring the baby for 15 minutes every hour will allow you to move around more. You can also request no vaginal exams until active labor or you can allow the medical staff to check you as frequently as needed. Additionally, consider your options for pain management. You can choose to use drugs or ask the hospital staff not to offer you any pain medications until you ask for them.

Active Labor and Delivery

During the active phase of labor, you may find certain positions more comfortable. If you prefer to stand, squat or lie down, let the medical staff know. You can also voice whether or not you consent to the use of forceps or a vacuum. If you prefer to not have an episiotomy, be aware that you may risk tearing, but either way, let your medical staff know your desires. If there are no delivery complications, you can ask to have your baby placed on your chest immediately for skin-to-skin bonding. The medical staff can suction and clean the baby on your chest.

Caesarean Section

If you have a scheduled C-section, ask your doctor about the anesthesia options beforehand. Doctors can use spinal or epidural anesthesia. Many women request to have their partner and doula in the room during surgery. You can also ask the doctor to explain what is happening at each step, since a screen will separate your upper body from the sterile equipment. Some women request to have their partner cut the cord and to have immediate skin-to-skin contact with their baby in the operating room.

Newborn Procedures

When it comes to newborn procedures, there are several things to consider and spell out in your birth plan. Most babies receive a Hepatitis B vaccine within 12 hours of birth. They are given eye ointment to prevent infection; vitamin K shots to help with blood clotting; and a screening test called the PKU or Phenylketonuria to detect genetic disorders. You can decide to delay all of these procedures, allow a few or consent to all.

After Birth

Whether you decide to breastfeed or formula-feed your newborn, you should let the nursing staff and doctors know your decision. Some breastfeeding mothers do not want their babies to be offered pacifiers, sugar water or formula. You may also choose to have your baby remain in your room all the time or send him or her to the nursery while you sleep.

After you think through each step, make your decisions and write down your preferences, talk to your doctor or midwife. Each hospital and birthing center has different options and guidelines. Communicate your desires and don't be shy about asking questions. Lastly, remember these are preferences and unexpected things may happen during the birthing process. Doctors and midwives are trained medical professionals and may need to make quick decisions for the safety of your baby and you. In the end, it is a miracle to welcome your child into this world whether you followed your birth plan or not.

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