Labor and delivery can involve way more decisions than you anticipate. Or not. It all depends on what happens from one contraction to the next. While birth plans aren’t set in stone – and safety is always the priority – a birth plan can certainly help you and your doctor create a unified vision for the type of labor and delivery you want.

Topics to Consider When Creating the Perfect Birth Plan

The following topics will help you write birth plan that resonates with you and your partner, and that you can share with your OB or midwives. Make multiple copies so they can be posted on your door, near your bed and at the nurses’ station – ensuring your plan is always visible, if/when shift changes occur.

Who will be there?

Make a list of names and contact numbers for anyone who you want to be present at your birth, or who should be allowed in your delivery room.

When do you want to go to the hospital or birthing center?

When you’re in labor, of course – right?? Actually, things can be trickier than you think. What if you are 10 days overdue? 14 days overdue? Many OBs start to get antsy about overdue mamas, even if there is no sign of fetal distress. This will often result in an induced labor, and induced labors have higher rates of C-Sections. For this reason, it’s worth discussing your doctor’s protocol when it comes to overdue babies or a labor that hasn’t progressed after the water breaks.

What type of environment do you want?

Think about the type of environment you want. Some women prefer to have it quiet, dimly lit and with minimal interruptions. Others don’t seem to mind the chaos and distraction of conversation, a television or chit-chat amongst the labor and delivery team.

Make a list of music you want to be played or personal items you want around the room. Will you want a mirror to see the birth for yourself? Do you want pictures or a video taken?

Making your birth plan will also help you to create your list of what needs to be packed at home and brought in your Birth Bag.

Interventions? No interventions? Somewhere in the middle?

This is one of the most critical part of your birth plan, and one of the reasons why it’s so important you have a labor and delivery team that you trust. Labor interventions are a very controversial issue in the natural vs. medially assisted birthing worlds.

Some of the most common interventions include:

• The use of Pitocin to induce labor
• Breaking the water (most women’s healthcare providers agree that labor must be induced or helped along if a woman does not go into labor within 24-hours of her water being broken to minimize the chance of infection).
• Pain relievers – both oral or intravenous
• An anesthetic that is administered directly into the spine.
• Cesarean Section (currently the World Health Organization considers the ideal C-section rate to be between 10% and 15%.)
• Episiotomy. This is a procedure where the doctor cuts the perineal tissue to make more room for the baby.
• Forceps or suctioning. These procedures are used to assist in the baby’s delivery when maternal pushing isn’t doing the job.

Your labor and delivery team should provide you with a list of interventions as well as their risks and benefits. Read through these carefully and do a bit of research yourself. For example, most women who receive epidurals during active labor are fine but research shows that if administered too early in labor, epidurals increase a woman’s risk of getting a C-section. Also, women who get C-sections are at higher risk for post-surgical infections and breastfeeding difficulties.

Knowing the risks means you can have a plan in place in case you require any of them, despite your best-laid plans.

Post-Delivery Plan

Think about how you want things to go after the delivery. Things to consider include:

• Immediate skin-to-skin contact with baby before APGAR, weighing and measuring take place (assuming the baby seems healthy).
• Breastfeeding before the baby is taken for weighing, measuring and an APGAR (assuming the baby seems healthy).
• How long do you want to wait before the cord is cut (assuming the baby seems healthy)?
• Do you want the father to cut the cord?
• Are you interested in banking the cord blood?
• If there is a concern regarding baby, will dad be allowed to accompany baby every step of the way?

What if Things Don’t Go as Planned?

Sometimes, the inevitable happens. The most dedicated of natural birthers can end up requiring a C-sections and this can throw your birth plan all out of whack if you aren’t prepared.

Have a back-up plan ‘just in case’. This should encompass topics such as:

• Allowing you and your birth partner a minute together before signing any surgical consent forms.
• Maintaining a respectful and quiet atmosphere during the operation.
• Using a “family-viewing” C-section drape so you can see the baby as it is pulled out. Better yet, campaign for a skin-to-skin drape which allows the baby to be passed immediately to you while the surgical team finishes up.
• Having contact with the baby as soon as possible after a C-Section.
• Having the father stay with the baby no matter what.
• Having the father hold the baby if at all possible for any testing, vitals or other diagnostics that need to be performed if the mother is unavailable.

Again, having the right labor and delivery team is key to creating a birth plan that will be respected and that correlates with the hospital or birthing center’s policies as well.

Looking for an Obstetrician who will respect your birth plan? Schedule a prenatal appointment and Women’s Health Associates and work who thrives on providing empowering birth experiences to our mothers and babies.