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What Is a Birth Plan? Plus a Caveat…




Written by:

Barbara Mighdoll

What Is a Birth Plan?

A birth plan is like a blueprint for your labor and delivery journey. It's a practical guide that outlines your preferences, from how you want to manage pain to the atmosphere you want in the delivery room. Creating a birth plan not only helps your medical team understand your wishes but also empowers you during this special moment in your life. It's a process that encourages you to research and learn about your options, ensuring you're well-prepared for different scenarios. Although having a plan is important, it's also essential to stay flexible because birth is a dynamic process and unexpected things may happen.

For me, I thought about it more as a birth wish list, rather than a strict plan. It was less about meticulously planning my birth experience and more about equipping myself with the knowledge and understanding of various scenarios that could happen. As you consider your ideal birth experience, let your responses guide the development of your birth plan.

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Importance of a Birth Plan For Expecting Moms

Creating birth preferences for expecting moms couldn't be more important. It serves as a communication tool between you and your healthcare team, ensuring your wishes are known, respected, and followed as closely as possible. It provides you with the opportunity to express your hopes for your childbirth experience while also preparing you to make informed decisions.

The process of creating a birth plan encourages you to educate yourself about the many elements of labor, delivery, and postpartum care, which can alleviate anxiety and promote a sense of control. A birth plan is not set in stone – it's a living document that can be modified as your pregnancy progresses or as circumstances change during labor and delivery.

Do I Need To Have a Birth Plan?

Having a birth plan isn't strictly necessary, but I highly recommend it, even if you plan to have a doula guide you during your birth. Many expectant parents find it super helpful and it can increase confidence as you walk into the unknown. Having a birth plan comes with its advantages, but it's important to be aware of the potential drawbacks as well.

A too-rigid birth plan can create unrealistic expectations for how the birth will proceed. Childbirth is unpredictable and unexpected events may occur, leading to disappointment or anxiety if the actual birth experience deviates from the plan. Aim to keep your birth plan flexible and try to be open to changes.

When To Create Your Birth Plan

The best time to create a birth plan is in the second trimester of your pregnancy – specifically around the 20th week. This provides ample time for research, reflection, and discussions with your healthcare provider. During my first pregnancy, I made the mistake of waiting until two weeks before my due date to think about my birth plan. Trust me, it can get overwhelming trying to educate yourself on all the “what-ifs” at the last minute.

I recommend starting your birth plan with your partner at the beginning of the third trimester. It's a good balance between having enough information to make informed decisions and not leaving it to the last minute. You can tackle your birth plan along with other important items on your third-trimester checklist.

What To Include in Your Birth Plan

When crafting your birth plan, there are numerous elements to consider and here are some key items to consider:

Pain Management

Pain management is a crucial aspect to consider when drafting your birth plan. It's important to think about the different options available to you and what you feel most comfortable with. Some common pain management methods include:

  1. Epidural Anesthesia: This method is one of the most common forms of pain relief during labor. The anesthesiologist will administer medication into the lower back that numbs the lower half of the body. The epidural placement feels like a bee-sting, but after administered, you’ll feel like you’re laying in a cozy hot tub.
  2. Spinal Block: This is another type of regional anesthesia, used mainly for planned C-sections, which brings immediate but short-term relief.
  3. Narcotics: These are systemic drugs that can be administered through an IV or shot into the muscle to dull the pain. If you get induced, or appear in the L&D with painful contractions prior to being ready to be admitted, you may be offered a shot of “therapeutic rest.” This is a combination of morphine sulfate and promethazine, and allows you to have some pain relief while resting. I got this during the induction of my second baby, and it really helped me sleep through the night in the hospital as the foley balloon did its thing to start labor.
  4. Nitrous Oxide: Also known as laughing gas, it's used to take the edge off labor pain, allowing for a more relaxed experience. It’s a temporary relief that only lasts as long as its inhaled, so some woman enjoy that it is very short-lived.
  5. Natural methods: Techniques such as breathing exercises, hypnobirthing, yoga, the use of a birth ball, and water birth can also be effective for pain management.

In your birth plan, you can specify which pain management methods you prefer and under what circumstances.

Medical Intervention

Medical interventions during labor and delivery are procedures that healthcare professionals utilize to ensure the safety of both mother and baby. When crafting your birth plan, it's essential to note your medical history and consider possible interventions. These may include the use of forceps or vacuum extraction to assist with a difficult delivery, a cesarean (C-section) if a vaginal birth is deemed risky, or the administration of synthetic oxytocin (Pitocin) to stimulate contractions. You may also need to discuss the possibility of episiotomy, which is a surgical incision to enlarge the vaginal opening during childbirth.

Labor Preferences

You may also want to think about additional labor preferences such as:

  1. Ambience – dimmed lights, your own music, aromatherapy
  2. Mobility – do you want to be free to walk around or prefer to stay in one position?
  3. Sustenance – are you planning to eat or drink during labor?
  4. Support people – do you want the help of a doula?

Consider whether you'd like to use birthing aids such as a birthing ball, birthing tub, or squatting bar. The presence of a doula or a loved one to provide support might also be a part of your labor preferences.

Delivery Preferences

Delivery preferences refer to the specific choices made regarding the actual moment of birth and the immediate postpartum period. When deciding how to make a birth plan, consider aspects such as who you want present at the moment of delivery, whether you prefer immediate skin-to-skin contact with your newborn, and your preferences about umbilical cord clamping.

Some mothers prefer to delay cord clamping to increase the baby's iron stores, while others prefer immediate clamping. You may also wish to specify your preferences for newborn procedures such as vitamin K injection and eye ointment application.

Newborn Care Preferences 

Newborn care preferences encompass decisions you have regarding your baby's care immediately after birth. Considerations might include:

  1. Feeding preferences – breastfeeding or formula
  2. Location of the baby – rooming with the mother or time in the nursery
  3. Whether you want your baby to have a pacifier
  4. Your stance on routine newborn procedures such as bathing, hearing screening, and immunizations

Religious and Cultural Traditions 

Religious and cultural traditions can significantly influence one's birth plan. These traditions might dictate preferences regarding who is present during labor, methods of pain management, and postnatal customs. For instance, some cultures may prefer female-only support during childbirth, while others might have specific rituals or prayers to be performed immediately after birth. It's important to communicate these preferences with your care provider to ensure that your cultural and religious beliefs are respected during your birthing experience.

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Tips on Writing Your Birth Plan 

Creating a birth plan can seem daunting, but with a little guidance and careful consideration, it can be an empowering part of your journey to parenthood. Once you’ve decided on your preferences, feel free to write them down into my free birth plan template.

Involve Your Partner and Other Support People

I discussed EVERYTHING with my husband. It was great having him understand my wishes because it meant he could support and advocate for me when I felt overwhelmed. Here are a few other ways I involved him:

  1. We attended workshops together that were specifically designed for birth partners.
  2. We practiced pain-relief techniques as a team so that they would be familiar during labor.
  3. I shared books, articles, and videos about the birthing process so that he knew what to expect. You know those reels and TikToks we send each other throughout the day? Start including some birth partner support ones too!

Some other ways to involve your partner:

  1. Share Information: Make sure to talk to your partner about what a birth plan is and why it's important during the birthing process. Share some helpful resources and research to help them understand it better. It's all about being on the same page and supporting each other!
  2. Discuss your Preferences: Talk to your partner about your preferences for the birth process. This could include your desired birthing environment, pain relief options, and post-birth care decisions.
  3. Encourage Participation in Prenatal Appointments: Your partner's attendance at prenatal appointments can provide them with more insights into the birthing process and help them better understand what to expect.
  4. Create an Open Dialogue: Encourage your partner to voice their thoughts, fears, and expectations. This can foster a shared understanding and mutual support as you formulate the birth plan.
  5. Assign Responsibilities: Outline specific tasks your partner could take during labor and delivery. This might include managing communication with the medical team, ensuring that your birth plan is followed as closely as possible, repeating birth affirmations or leading certain comfort measures.
  6. Take a Birthing Class Together: This can not only educates your partner about the birth process but also equips them with practical skills to support you during labor.
  7. Review Drafts Together: After drafting the birth plan, review it together and make any necessary adjustments. Their inputs can provide a different perspective and help you create a comprehensive and balanced plan.

Ask Your Healthcare Provider Questions

Engaging your healthcare provider in discussions about your birth plan is an essential step toward ensuring your birthing experience aligns with your preferences. It's crucial to approach these conversations with clarity and confidence. Prepare a list of questions beforehand about what to include in your birth plan and any concerns you have. These could cover topics like pain relief options, procedural interventions, and post-birth care.

There's no such thing as a silly question; if it matters to you, it's worth asking. Make sure to note down the responses, as this information will be beneficial when finalizing your birth plan. This open dialogue will help establish a strong rapport with your healthcare provider and make you feel more prepared and at ease.

Advocate For Yourself and Your Baby

Developing your birth plan offers the incredible advantage of self-advocacy. You can practice self-advocacy by educating yourself thoroughly about different aspects of childbirth, asking your healthcare provider detailed questions, and not hesitating to express your thoughts and concerns. While it's important to respect medical expertise, remember that you are an active participant in the process and you know your body best.

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Know Things May Not Go as Planned

Despite meticulous planning, the safety of both mother and baby is paramount, and medical circumstances may necessitate deviation from your birth plan. For instance, labor may progress more quickly or slowly than expected, or complications may arise that require interventions such as a C-section or the use of forceps. Embracing flexibility and having an open dialogue with your healthcare provider will help you navigate any unexpected turns, ensuring the best possible outcome for you and your baby. The ultimate goal is a safe delivery and a healthy baby in your arms.

I hope that at least a few of the tips in this post can help you prepare for labor and the birthing experience. For additional resources, use this birth plan template to compile your birth wishes and this hospital bag checklist when you're packing your hospital bag.

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Feature image by Mirida


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