How to Write a Birth Plan

A Birth Plan is a powerful tool to help you have the birth experience you want, by clearly outlining your wishes to your birth attendants and caregivers, and avoiding confusion.

Difficulty: Moderately Easy

Instructions

1. 
    

   Research your options. I highly recommend "Gentle Birth Choices" by Barbara Harper, "The Thinking Woman's Guide to a Better Birth" by Henci Goer, and "Ina May's Guide to Childbirth" by Ina May Gaskin.

2. 
    

   Choose your venue and care provider. Your options available vary greatly, depending on where you choose to give birth (hospital, birth center, home). Hospitals, for instance, often require constant fetal monitoring and IV, and may not offer water birth.

3. 
    

   Write your name clearly at the top. Try to keep your Birth Plan short, succinct, and to the point. One page only. If you go into lengthy paragraph-long explanations, it's very unlikely that anyone will read it, especially a hurried doctor or nurse.

4. 
    

   To prevent putting care providers on the defensive, try to begin by making it clear that these are your preferences, but you are willing to negotiate in case of emergency or unforeseen complication. For instance:
   "We appreciate all your help at this special event. Mother and baby's health and safety are our top priority. Please understand our preferences are flexible in the face of unexpected complications. Thank you for supporting us in our goals for a natural childbirth."

5. 
    

   Make a list of your preferences during Labor:
   - Attendants: Who would you like in the room with you? Husband? Mother? Doula? Write down their names, and give them roles, if possible. In case of emergency, who should remain in the room with you?
   - Atmosphere: Dimmed lighting, aromatheraphy, soothing music (you provide)?
   - IV: None, Heparin Lock only, or constant IV?
   - Fetal Monitoring: Constant or Intermittent? Internal or External?
   - Freedom of Movement: Walking? Birth Ball? Shower/Tub?
   - Labor Progress: Pitocin? Natural Methods such as nipple stimulation?
   - Medication: Epidural? Narcotics? If you plan to deliver naturally, try "At Mother's Request Only. Please Do Not Offer." (If you are allergic to any medications, be sure to mention them here).
   - Nutrition and Energy: Food and drink? Clear liquids only?
   - Cervical Checks: limited?

6. 
    

   Make a list of your preferences during Delivery (keep in mind your options can depend on whether you are using an intervention such as epidural):
   - Pushing Position: On your back? Mother's Choice? (squat, side-lying, etc.)
   - Technique: Being told when to push, while someone counts to 10? Bearing down with urges, changing positions as needed, using controlled breathing?
   - Perineum: Episiotomy, or only in case of emergency? Hot compresses, lubrication, massage?
   - BABY: placed immediately at mother's breast? Cleaned up first?
   - Cord: Cut after pulsation stops? Collecting cord blood?
   - Placenta Delivery: Natural method such as nursing baby, or nipple stimulation? Pitocin for emergency only?
   - Feeding: Breastfeeding only? Supplement with formula?
   - Accommodations: Rooming in with baby?
   - Abstentions: Are you abstaining from any routine newborn tests or treatments, such as Hepatitis B vaccine or eye prophylaxis medication? (If so, you may be required to sign releases).

7. 
    

   Make a list of your preferences in case of Cesarean Section:
   - Who should be in the room with you?
   - Medication: Epidural or Spinal, if possible?
   - Baby: held by mother or father as soon as possible? Person to stay with baby at all times (Father or Grandma)?
   - Feeding: Breastfeed as soon as possible? Supplement with formula?
   - Person to stay with mother at all times?

8. 
    

   Go over your Birth Plan with your care provider early in your pregnancy, to make sure you're on the same page. If they do not agree with any part of it, you are entitled to switch to another provider who will support and respect your wishes (remember: it is your body and your birth, and you are paying them to provide a service, not take over your birth). Ask them to sign it and put a copy in your file. Make sure your husband, partner, or birth coach is in full agreement with your birth preferences (their support is essential). Give a copy to everyone who will attend the birth, and bring a few copies to the hospital with you (post on the door or distribute to nurses). Communication is key to having the birth experience you want!

Tips & Warnings

• Although many complications are preventable by avoiding unnecessary interventions, unexpected complications can occur. Educate yourself on the risks, benefits, and alternatives to common treatments and interventions so if the need arises, you can make an educated decision and alter your birth plan accordingly. Childbirth classes such as Bradley can be extremely informative and helpful in this area.

Resources

• The Business Of Being Born
• The Thinking Woman's Guide To A Better Birth
• Ina May's Guide To Childbirth
• Pushed: The Painful Truth About Childbirth And Modern Maternity Care
• Gentle Birth Choices
• Childbirth.org
• Empowering Women To Give Birth Naturally
• History of American Birth Practices
• How to Have A Natural Birth In A Hospital
• How to Decide If An Epidural Is The Right Choice For You
• How to Avoid An Unnecessary Induction
• How to Prepare For Pospartum Recovery

[krazigirl79]

on 8/19/2008 I have a friend who is pregnant right now, I'll pass this on to her- thanks for the great article!

[Limowreck]

on 7/18/2008 Excellent information! Wonderful article. Wish I could give 6 stars.

[amylaine]

on 6/13/2008 Good tips!

[akchrist]

on 6/13/2008 Wonderful ideas!

[madams1982]

on 6/13/2008 This is fantastic information! I did something very similar to this with my youngest son...after having two births where I felt I had NO input in or control over. Thank you for sharing this!