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Creating a Birth Plan

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Rochester Area Birth Network

www.rabn.org

Creating Your Birth Plan

 Why write a birth plan?

As you go through your pregnancy, you may begin to form some ideas about how you would like things to be at your baby’s birth. Care providers and medical personnel deal with many different people, all with different wants and needs. When you write a personalized birth plan outlining what is most important to you, you have created an effective tool for communicating your wishes to your birth attendants so they can help you achieve the kind of birth experience you desire.

Creating your birth plan:

Before writing a birth plan, educate yourself about the options available, and also about the advantages and disadvantages of different interventions and routine procedures (see below for recommended reading). The more you learn, the more likely you are to form a “birth philosophy” that will guide you in writing your birth plan. Find out what the routines and protocols are at your birthplace.

Your birth plan can be short or long, general or specific, but keep it personal. It should be as individual as you are. You may want to use some or all of the suggestions in the attached “Birth Plan Guide “. Keep in mind that a very long and detailed birth plan may be seen as inflexible and demanding. To avoid this while still getting what you want, use a friendly tone, positive language (say “I want…”, not “I don’t want…”), and express your willingness to be flexible should complications arise so long as you are fully informed of risks, benefits and alternatives and allowed to participate in decision making regarding your care. This sends the message that you are a concerned well-informed parent seeking to ensure the safest and most satisfying birth experience possible.

Presenting your birth plan:

Prepare a rough draft of your birth plan and let your midwife or doctor know when you schedule your next visit that you will bringing it in so the two of you can go over it together. You may want to request a longer visit to allow time for discussion without either of you feeling rushed, especially if some of your requests involve foregoing hospital policy regarding certain protocols and procedures. (Your care provider can give permission for you to forego many of these, if she or he is willing, but get it in writing!)

If your care provider is comfortable with your birth plan, terrific! Congratulate yourself on having picked a compatible provider, and make final copies of the plan. Have your doctor or midwife sign it and present it to all backup colleagues for their approval and signature. Make copies and have one put in your office records, one in the pre-registration file at the hospital or birth center, and give one to each of your labor support persons. Bring a few to the hospital or birth center (or have one at home for a home birth) and make sure that they get handed to nurses as needed

If your care provider seems uncomfortable with some of your requests. this is the time to have an honest discussion. Remember this is your baby’s birth, and you deserve to have it your way. If your care provider is not comfortable meeting your needs, and you are not comfortable changing your plans. you have the right to change care providers. As stressful as this may seem, it may be better than finding out during labor that your care provider can’t meet your needs. (It may help to remember that they attend perhaps hundreds of births a year, but this baby will only be born into your family once!)

 

The following books are excellent for anyone desiring informed options for birth, and contain wonderful birth plan ideas, as well as sample birth plans:

Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth
by Marsden Wagner & Stephanie Gunning 2006

 

The Birth Book by William and Martha Sears, 1994

Your Baby. Your Way: Making Pregnancy Decisions and Birth Plans by Sheila Kitzinger, 1987

Birth Plan Guide

In The Birth Book by William and Martha Sears, the authors recommend that you keep your birth plan friendly and personal, and include the following:

Opening paragraph. Introduce you and your partner, your birth philosophy, childbirth preparation.. and any fears, concerns or special help you require.

A list of everyone who will be at your birth. If using a professional labor assistant, list her name and credentials. State your preference that they remain with you at all times.

    Your preferences at time of check-in. Sears and Sears recommend asking for the option to go home if less than 5 centimeters dilated

–   Specify your room preference. State that you want a birthing suite or LDRP room.

–     description of the birth environment you desire. Mention lighting; your own music; no extraneous staff; privacy when desired and attention when needed freedom to vocalize feelings in whatever way helps. Mention comfort measures you plan to use.

Use Positive phrases – rather than saying NO to things, try to phase preferences in the form of a request. (e.g. “We Prefer to avoid…”) This avoids an adversarial atmosphere.

–  No time limits, please. State your preference that you not be hurried or given anxiety-producing time constraint as long as you and the baby are tolerating labor well.

–  State your nutritional needs. Ask for clear juices, water, and light snacks.

–  State your preferences regarding pain relief. If you do not want pain medication at all, request the freedom to use any self-help alternatives you find helpful, and ask that you not be offered medication, that any request should come from you if you change your mind. If you may want to use medication, state your preferences regarding type, and your desire to be informed of risks and benefits of the types available.

–  List your concerns about interventions. Mention electronic fetal monitoring; alternatives to pitocin augmentation; rupturing of membranes; I.V.; vaginal exams. Stress your desire to move freely during labor and use whatever positions you feel comfortable with.

–  List you delivery preferences. Request the freedom to choose whatever position you are comfortable in to deliver (squatting or side lying, for example). Ask for spontaneous pushing when you get the urge. rather than directed pushing. Ask to take the crowning stage slowly and have perineal support to prevent tearing rather than have an episiotomy. Ask that if an episiotomy appears necessary, that you be consulted Request that you or your partner cut the cord, if desired.

–  State preferences for first contact with baby. Ask that the baby be given immediately to the mother if medically stable. State desire to initiate breastfeeding immediately during private time for family bonding, and request that birth attendants and staff leave family alone as long as mother and baby are doing well.

–  State your preferences regarding care of your newborn. Request that routine procedures and exams be delayed until after bonding time, and then to be done in the presence of the mother, in the room if possible. Request rooming in, and keep baby with you skin-to skin. This encourages bonding, breastfeeding, and allows the mother the natural stimulation to help expel the placenta and cut down on bleeding.  State feeding preferences, circumcision or no circumcision, visits with siblings. etc.

For additional information speak to your local childbirth educator. A list of Independent Childbirth Educators can be obtained from Rochester Area Birth Network  ahaas@rabn.org

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