Write a Birth Plan

Creating a birth plan is a great way to make your wishes known as you go through labor and delivery of your baby. If a birth plan is important to you, you should review the plan with your physician. There are some birth plans on the internet that have unsafe recommendations, and are incompatible with most hospitals. Knowing that some parts of your plan might change during the actual event, it is still well worth your time and effort to create a birth plan that describes the details of your hopes and desires for the birth of your new baby.

Steps

Creating Your Birth Plan

1. Start with a journal. Begin your journal early in your pregnancy. Think about the big day long before it arrives.
   • Write down everything that comes to mind about labor and delivery even if you do not yet know all the details involved.
   • Periodically reviewing your journal entries will lead you to a list of priorities which will help you to know what to ask your doctor and how to proceed with your birth plan.
   • Use your finalized list of priorities, along with input from your partner and your doctor, to create your final birth plan.
   • Learn more about your doctor’s routine practices and the procedures for the care of both the new baby and the new mom at the place you have chosen for your birth.
   • If you find something about the procedures that troubles you, talk with your doctor to be sure you understand and to consider possible options if needed.
   • Include journal entries about the things that matter most to you. Do not overlook important family and religious matters.
   • Think about your wishes for as many things as you can think of. Many areas may be routine or standardized procedures and can best be decided by talking with your doctor. Not every item needs to be included in your birth plan.
2. Consider these areas in your birth plan. There are many areas that can be covered in creating a birth plan. Common issues to think about include the following:
   • Who you want with you during your early stages of labor, including children, and during your active labor.
   • Decide if you and your partner wish to work with a doula, which is a woman that supports the mother during and after the delivery, but is not a trained healthcare professional.
   • Think about your desire to have the opportunity to be mobile, up and walking around, during your labor.
   • Decide what is your position of choice for delivering the baby, giving consideration to standing, squatting, using foot stirrups, or on hands and knees.
   • Consider any preferences you have regarding fetal monitoring.
   • Consider your wishes for pain management, realizing that you may need to have a back-up plan depending on how the labor proceeds.
   • Review the pros and cons of having an episiotomy and decide if this is an acceptable procedure or are there specific measures you prefer to avoid one. Ask your physician if they routinely perform episiotomies. Most do not, unless there is a compelling reason to do so.
   • If you are having the baby at a location other than a hospital, clearly detail your plans for medical transport should that become necessary.
   • Describe your wishes for the environment in the room such as dimmed lighting, television on or off, music to be played, few interruptions, or frequent nurse presence.
   • If music is an important factor, discuss if you would you like to provide your own.
   • Describe methods you may want used to record the event including everything from a frequent journal entry by your partner to a video.
   • Include your wishes regarding immediate skin-to-skin contact with your newborn following birth.
   • Describe your plan for feeding your baby, either by breastfeeding or formula.
   • If it is a boy, describe your wishes for circumcision. Keep in mind that no one will circumcise your baby without your written consent. Doing so is illegal and can be prosecuted as child abuse.
   • Discuss your preference for your partner to have extended visitation or to stay with you overnight.
3. Include possible complications in your plan. Most deliveries follow the predictable pattern of labor followed by natural delivery.
   • Think about your wishes regarding potential problems during your delivery and include them in your birth plan. The most common complication is the unplanned need to have a cesarean section.
   • A cesarean is considered a surgical procedure and is done in the sterile environment of an operating room. Therefore, most of what happens would be beyond your control.
   • Talk to your doctor so you will know what to expect if this becomes your method of delivering your healthy baby. Find out the areas that may be receptive to your input.
   • You will be given a form of anesthesia that allows you to stay awake during a cesarean section.
   • Examples of things you may be able to influence during a cesarean include the presence of your partner in the room with you during the procedure, and possibly having your partner cut the cord once the baby is delivered.
4. Try to word things in a positive light. The power of positive thinking and positive wording can be reassuring to you, your partner, and help your caregivers feel more at ease.
   • Focus on listing your wishes by describing what you do want, avoid writing in a demanding tone, and avoid listing things you do not want.
   • For example, instead of saying I do not want pain medications, consider wording that issue to say that you understand the pain management options and will ask for them if you need them.
   • By wording things in a positive manner, you are creating a feeling of confidence within yourself that you are prepared to handle the labor and delivery of your child. This can help you to avoid the feeling that you are losing control of the situation.
5. Consider any special needs. Either you or your partner may have certain needs that warrant attention.
   • For example, you may need an interpreter in the room if your partner does not speak English or is deaf.
   • You may also need to work with the facility regarding special equipment. If you or your partner are wheelchair-bound or need assistance with mobility, make that known in your birth plan.
6. Include your previous experience. If this is not your first delivery, include any wishes you may have from any previous experience in your new plan.
   • Think about your past labor and delivery situations. Focus on things you remember about your previous labor and delivery that made you feel comfortable and at ease.
   • Also think about any aspects of that experience that made you feel more anxious or uncomfortable.
   • Include any additional wishes based on your previous experience in your birth plan.
   • Talk with your partner about his or her previous experiences and include the areas you both agree are important for this delivery.

Including Your Partner’s Preferences

1. Ask your partner to talk openly. Your partner will be an important part of your labor and delivery so consider that person’s wishes as you create your plan.
   • For your first experience delivering a baby, both you and your partner are facing several unknown variables. Take some time to address any concerns that your partner may have well before the labor starts.
   • Talk about what happens during most labor and delivery situations and encourage your partner to speak freely about the areas that create some anxiety or fear.
2. Address your partner’s fears. Once you better understand the anxieties and fears of your partner, take steps to address them.
   • Take your partner with you to an appointment with your doctor. After having discussed your wishes with your partner and are more aware of any fears or concerns, allow your partner an opportunity to speak directly with your doctor to address questions, calm anxieties, and quiet any fears.
   • Visit the hospital or facility together where you are planning your delivery. This is an excellent way to address anxieties of both you and your partner as you spend a few minutes in an actual birthing room, and the new-born nursery area, if the facility permits that type of visit.
   • Your visit to the birthing center will help you and your partner to answer questions about the unknown, reassure one another about certain aspects of the delivery, and help both of you to add or remove some items on your birth plan.
3. Be sure your partner is comfortable with the final plan. Do not force your partner into a situation.
   • Use positive language in your final plan that may help provide comfort for your partner. This may include opportunities for your partner to participate in certain steps provided they are comfortable.
   • For example, your partner may be fearful of cutting the umbilical cord. If it is your wish that your partner cut the cord, try wording your birth plan in such a manner that addresses both your wish and your partner’s fear. For example, state that your partner will cut the cord provided he or she is comfortable doing so when that moment arrives.

Simplifying Your Final Plan

1. Review your plan with your doctor. Talk with your doctor about your final birth plan to be sure your wishes are reasonable.
   • Sometimes physician practices, and hospital or facility policies, dictate some procedures. Be sure your doctor understands what your wishes are, but also understand that you may need to make some adjustments in your birth plan based on the final input from your doctor.
   • Review any comments or concerns your doctor may have discussed, that you had not previously considered, with your partner. Your partner’s opinion is important as you work through any final matters.
   • Nobody wants last minute surprises. Include your partner’s input in the final decisions.
   • After taking the time to think about any issues your doctor brought to your attention, and discussing them with your partner, create your final plan.
   • Avoid waiting until the last minute to finalize your plan. There are many factors involved with delivering a baby, and sometimes the baby’s schedule to arrive may be earlier than what you had planned for.
2. Keep it simple. Once you have compiled the final list of your most important details, make sure it is simple and easy to understand.
   • Birth plans should be about one page in length and follow a format that is logical, briefly worded, yet makes your wishes clear.
   • One format that can be used is to provide your personal and relevant medical information at the top, then insert bolded headers that address the categories you wish to cover. For example, provide a bolded section header titled Pain Management, and include a brief statement beneath that describes your wishes.
   • Templates are available that you can use if you prefer, or your doctor’s office may have a template they can provide. Many available templates appear lengthy so it is up to you to choose only the most important issues.
   • Remember to keep the information to about one page and only include headings that are relevant to your situation and the wishes of both you and your partner.
   • You want to communicate your wishes, but your doctors and nurses may be limited by time and other delivery matters that could prevent them from fully comprehending a lengthy and detailed list.
3. Talk it over with your family. Your birth plan is an important tool for those closest to you to understand.
   • Some of the people that you share your plan with may be responsible for part of your care and the care of your newborn baby.
   • Discuss your wishes with your family and close friends so everyone understands and agrees to honor your wishes before the big day arrives.
4. Remember to include basic information. In creating your birth plan, do not overlook important details.
   • Include your name, your partner’s name, your doctor’s name, and your due date.
   • Include any information about your medical health that may be relevant such as if you have gestational diabetes, a recent strep infection, if you are wearing contacts, and your blood type. Women that are Rh negative need certain injections following birth.
   • Include any relevant medical information about your partner as well. Your doctor can advise you of any health-related information that is important to note about your partner.
5. Take your birth plan with you. Don’t forget to pack several copies of your birth plan in your bag that will go with you to the hospital.
   • In most cases, you will have at least one doctor with you, several nurses, possibly a nursing aid, and possibly an anesthesiologist depending on your pain management wishes or if a cesarean section should become necessary.
   • Plus, your new baby’s pediatrician will be present during your delivery to take care of the health needs of the baby.
   • The new pediatrician’s role is well outlined, but you may have some wishes that need to be communicated to that physician as well.
   • Bring enough copies of your plan so that everyone involved in your labor and delivery are aware of your wishes.
   • Beyond your family and friends, consider providing copies of your birth plan to your doctor, any partners in the doctor’s practice that may be part of your delivery, your delivery nurse(s), nurses in the new baby nursery, and any other medical professionals that may have a role in the delivery process and post-delivery care of yourself, and your new baby.

Tips

• Just like a wedding, don’t get so hung up on trying to plan the perfect day that you overlook that the marriage is the important part. At the end of the day, the most important thing is that you and your baby are safe. Everything else is secondary.

Related Articles

• Choose the Hospital for Delivery
• Plan a Home Birth

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