Steer clear of prewritten birth plans that you may find. Using these for examples are great but you might find yourself writing down things you’re not even sure why it’s on there or why you would or wouldn’t want it. Instead, start with these topics and move on from there:
- Your Philosophy of Birth
This doesn’t have to be a three page treatise on why you chose which childbirth class or doula, but it should be a quick statement that allows anyone who comes in a 10 second understanding of how you’re processing all the requests. So if your goal is to avoid pain medications, state that up front in a friendly tone, asking for the help. If your goal is to get the epidural as quickly as possible, same thing…
- Surroundings in Labor
You will want to address how you feel about how you labor. This means what the room looks like in terms of light versus dark, calm versus hectic. You will also want to address some basics like what can you expect to eat and drink in labor given the other desires you have for your birth. You can talk about what coping skills you intend to use be it positioning, breathing, relaxation, water use, etc.
- Fetal Monitoring
Discussing what is common given where you have chosen to give birth and your level of intervention is a must. It is important for you to know what the official policies of your practitioner and place of birth are before you are in labor. Do you have to have fetal monitoring done electronically or can you use a stethoscope or fetoscope? Can you use intermittent monitoring assuming baby is tolerating labor and that you are not moved into a higher risk category by other interventions like Pitocin or pain medications?
- Pain Medications
This is where you will talk about what you would like in terms of pain medications. You can also acknowledge that you know the policies of your facility. But you could also use this space to talk about your support staying with you during the administration of an epidural or when you’d like to try an epidural versus some other medication like IV medications.
- Back Up Plan
Let’s face it, we all need a back up plan. You may not even want to think about it but you can’t bury your head in the sand. Use this space to discuss what you would like to have happen if you needed to throw out most of your birth plan or if you needed an emergency procedure, including a cesarean section. Who stays with you? Who communicates to your family? Does your doula go to the OR with you?
- Baby Care
Once your lovely baby is born, there are more things to think about in terms of your preferences. Do you want your baby immediately? Do you want skin to skin contact? Would you like to request any special testing after the initial hours after birth? My advice is to always arrange for rooming in, even if it is not the standard of care at your birth place. This way you can have your baby with you. If you change your mind, you can always send the baby to the nursery but trying to keep the baby, if it’s not standard, will be harder without the prep work.
- Infant Feeding
The vast majority of mothers begin breastfeeding at birth. Studies show us that moms who are able to go skin to skin and latch in that first hour have fewer breastfeeding challenges later. If you are planning to breastfeed you may also wish to avoid any supplements and anything given would best be given with finger feeding or something other than a baby bottle. Do you want your baby to have a pacifier? Do you want your baby to be brought to you to nurse on demand? If you are not planning on breastfeeding, do you have specifics in mind that you need met?
Remember that birth plans are ultimately communication tools and not scripts or legal documents. Having an idea of your preferences is always a good idea, but so is keeping flexibility in mind.
Ina May's Guide to Childbirth. Gaskin, IM. Bantam; 1st edition.
The Labor Progress Handbook. Simkin, P and Ancheta, R. Wiley-Blackwell; 2nd edition.
The Official Lamaze Guide. Lothian, J and DeVries, C. Meadowbrook; 1st edition.