What is a Birth Plan?
A birth plan is a document that tells your medical team your preferences for such things as how to manage labor pain. Of course, you can’t control every aspect of labor and delivery, and you’ll need to stay flexible in case something comes up that requires your birth team to depart from your plan. But a printed document gives you a place to make your wishes clear when you have a choice. A written birth plan also helps refresh your provider’s memory when you’re in labor. And it informs new members of your medical team — such as your labor and delivery nurse — about your preferences when you’re in active labor. Most hospitals (and birth centers) provide a birth plan worksheet or brochure that explains the hospital’s policies and philosophy of childbirth, and lets you know what your options might be when you give birth. That information can help guide you in a discussion with your healthcare provider about your preferences when you face choices along the way. That discussion can be the basis for a birth plan if you decide to create one.
Writing Your Birth Plan
Educate yourself
Know how the typical birth goes in the United States and know what evidence-based practices are. Write your birth plan based on that research. Before writing your birth plan, enroll in a childbirth education class. If you are short on time before delivery, consider reading a book or taking a video course. Take a tour of your birthing facility before you deliver to learn about pain relief, birthing positions, and baby care options.
Keep it short and simple
Stick to one page. Ensure key
Know the policies of where you are delivering
Depending on where you are delivering, some things are not up for negotiation and some things go without saying. Know what your options are before you write your birth plan.
Include only the most important things
There is no need to have ten bullet points on the type of lighting, music and comfort measure you want to use. Bullet what’s important; example: unmedicated birth, immediate skin-to-skin, delayed cord clamping, exclusive breastfeeding, rooming in…
You should include your name, your baby’s name (if you know it! ), your obstetrician or midwife, your pediatrician/doctor, baby’s the names of everyone you don’t want during your birth.
Know why you’re choosing the things you include on your birth plan
Know the importance of skin-to-skin, exclusive breastfeeding, rooming in and any other things that you may include on your birth plan – don’t just include them because you saw them on a sample birth plan online. Unfortunately, you may find yourself defending your birth plan. By being informed you’ll be educating the staff that attends your birth and your knowledge of evidence-based birth practices will help you navigate your stay.
What Should be in a Birth Plan?
Start with labor, birth, immediate postpartum and end with newborn care.
Background Information and Contact Details
In the first section have all the contact details of everyone who should be there.
Then have a section on your medical history. Include your household medications, allergies, chronic medical issues, and prior pregnancies and deliveries in this box. Indicate your status for Group B Strep and gestational diabetes. Include any history of herpes, HIV, hepatitis, or other STDs.
Labour Plans
If you plan on having a natural birth without an epidural, discuss your pain management plan. Pitocin-assisted labor will likely necessitate an epidural for pain relief. If you’ve had bad experiences with pain control during birth before, talk about what happened and how you’d like to avoid it.
Please include certain birthing positions or props in your birth plan and inform your healthcare providers as soon as possible. Make sure you know how to use these positions/props and that your facility supports them. If you want to have an epidural, make sure you have a backup plan for your birthing position in case you lose leg control or strength.
Delivery Plans
Few women desire a C-section, but you should be ready for one. You should put in your birth plan your preferences for c-sections, such as not having your hands bound and not using sedatives.
Nobody wants an episiotomy, yet they can save a major tear. If you are refusing episiotomy, arrange ahead of time with your doctor to avoid a serious tear.
Do you want delayed cord clamping? Include this in this section if you do.
Postpartum Care Plans
What pain meds do you use? Which laxatives do you prefer? Do narcotics cause nausea? Inform your doctors.
Newborn Care Plans
Do you want to hold your kid immediately after birth, even if it’s a c-section? You must be clear. Provide details about nursing, antibiotic eye ointment, vitamin K, baby’s first bath, and hepatitis vaccine.
Be flexible
Your birth plan is a wish list; have a back-up plan if things don’t necessarily go how you envision.
Be kind
You can go far with kindness for the people who are attending your birth. You catch more flies with honey than with vinegar
Know you can ask for a different nurse.
The best birth plan and nicest attitude can’t change your nurse if she’s having an ‘off day’. If you’re not meshing well with your nurse, ask to speak to the charge nurse and request someone else.
How Many Copies of Birth Plan Do I Need?
You may experience several shift changes during your stay at the hospital, so have enough birth plans for everyone, even postpartum.
What a Birth Plan Looks Like
Birth plan for: YOUR NAME
Husband: [name and phone]
Baby: [name and gender, if known]
Obstetrician: [name and phone]
Pediatrician: [name and phone]
Patient History:
Details here on your history. Include details of previous pregancies and any history.
Labour Plans:
- I’m planning a VBAC. I will perform a c-section if needed.
- My spouse, XXX, will be there. Visitors are not restricted.
- Only use IV fluids when medically required.
- Don’t use Pitocin to speed up labor.
- Do not break my waters.
- After labor agony gets unbearable, I’d like a walking epidural (not a spinal). Episiotomy with lidocaine or local anesthesia. I like to walk, use an exercise/birthing ball, and grasp onto the wall’s handrail.
- I request 5 minutes following delivery for delayed cord claimping or until the chord stops pulsing.
If C-section Required:
- Please include my spouse in the OR.
- Don’t bind my hands.
- Please do not give me any drugs without my approval. Unless I need general anesthesia for a medical emergency, no medicines that affect my consciousness.
- If I am not hemorrhaging, I request 5 minutes following birth or until the cord stops pulsing.
- I want skin-to-skin with my newborn in the OR right after delivery
Post Partum Care Plans:
- I want ibuprofen every 4 hours for pain/cramping if vaginal delivery.
- I want visitors after 6 hours.
Newborn Care Plans:
- Wait till the baby is breastfed, my husband has held the baby and I am ready to rest before doing any tests.
- Please complete a pulse-ox CHD screen.
- Our infant will sleep in our room. Please assess her in our room.
- Please provide me the baby’s hearing screen, blood work, and other test findings.
When to Discuss Birth Plan with Doctor
When you are 28 weeks pregnant, or at the beginning of your third trimester of pregnancy, it is a good idea to sit down and write up your birth plan, and then discuss it with your doctor or midwife so that he or she is aware of your decisions.
Importance of Individual Birth Plan
It is possible to communicate your wishes to those who will be caring for you during your pregnancy and following the birth of your child through a birth plan. Every child’s birth is a one-of-a-kind experience. Making a birth plan gives you the ability to become informed of all of your alternatives when you are in labor. At the same time, it serves as a tool to communicate your choices to the team responsible for your care.
