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Maternity7 Minute Read

Crafting a Birth Plan While Preparing for Every Twist and Turn

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Reviewed By: Jamila Pleas, Labor and Delivery Nursing Manager
Published: Wednesday Aug. 30, 2023
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A birth plan is a document that outlines your preferences for labor, delivery, and postpartum care. It serves as a communication tool between you and your healthcare team, allowing you to express your wishes and expectations in advance. It can include details about pain management options, laboring positions, newborn care, and more. However, it's important to approach a birth plan with flexibility as childbirth can be unpredictable. While your healthcare team will strive to honor your birth plan, their primary concern will always be the well-being of you and your baby.

What goes into your birth plan?

The birth plan is generally divided into several key sections:

  • Location: This section addresses where you plan to give birth. Options may include a hospital, birthing center, or at home, each offering distinct amenities and services. Your choice might depend on your health, risk factors, and personal comfort.
  • As part of your preparation, it's recommended to tour potential birth locations. This will provide an opportunity to familiarize yourself with the environment, procedures, and practices of each facility. During the tour, inquire about the labor tools and resources available. Some locations may provide birthing balls, tubs for water labor, and birthing stools. Others might offer a range of pain management options, from epidurals to natural methods. Meeting the staff, exploring the delivery suites, and understanding the care strategies will empower you to make an informed decision. Remember, the environment in which you give birth can significantly impact your overall birthing experience.

  • Delivery Options: This section explains your preferred method of delivery - vaginal birth, vaginal birth after cesarean (VBAC), or cesarean section (C-section). It can also detail your wishes for managing labor pain, such as the use of epidurals, nitrous oxide, or natural techniques like massage and breathing exercises.
    Contingency Measures: This section outlines your preferences in case of complications or emergencies, such as a need for an emergency C-section or the use of forceps. It's essential to state your wishes, but also maintain a level of flexibility, as the health and safety of mother and baby are paramount.

Writing Your Birth Plan

Begin your birth plan with a short introduction to introduce yourself and any birthing partners. Include details about your overall health, any pre-existing conditions, allergies, previous pregnancies and births, and any complications you've experienced. Should you arrive at the Labor & Delivery ward and encounter a healthcare provider with whom you've never met, this section will provide them with a comprehensive understanding of your medical history. Remember, while your regular healthcare team may be familiar with your medical background, on-call doctors or labor and delivery nurses might not have immediate access to your complete medical records. Providing this information in your birth plan can ensure that all healthcare professionals involved in your care are well-informed, promoting safer and more personalized care.

Labor Pain Management

This section of your birth plan outlines your preferences for pain management during labor. Although labor pain is subjective and varies widely from woman to woman, it's important to be prepared with a plan to manage your discomfort:

  • Medicated Options: If you prefer medicated pain relief, there are several options available. Epidurals, the most common form of pain relief during labor, deliver continuous pain relief to the lower part of your body while allowing you to remain alert and active during labor. Spinal blocks offer a quicker, more complete pain relief but last only for a few hours. 
  • Non-Medicated Options: If you prefer to avoid medication, include natural pain management strategies in your plan. These can include specific breathing techniques, hydrotherapy, using a birthing ball, acupressure, and massage. Hypnobirthing, a technique involving self-hypnosis and relaxation, is another option you might consider.
  • Nitrous Oxide: Often known as 'laughing gas,' nitrous oxide provides an alternative pain relief method that doesn't involve an epidural or opioid medications.
  • Pain Management Support: If you're open to various options, you might want to state the kind of support you'd prefer during labor. This could range from the support of a doula, the use of a TENS machine, or any other specific methods you've researched.

Remember, it's crucial to discuss these options with your healthcare provider before deciding what to include in your birth plan. Their knowledge and experience can offer valuable insights into what might be the best options for you.

Delivery Room Preferences

This section of your birth plan outlines your preferences for the atmosphere in the delivery room. The delivery room experience significantly impacts your childbirth, and your comfort level is paramount.

  • The Presence of Others: Birth is an intimate experience, and who you choose to have in the room can profoundly affect your comfort and labor progression. You may want to have your partner, family members, a doula, or close friends present. Some people prefer a one-on-one environment with their healthcare provider, while others prefer a more communal experience.
  • Noise Level: Labor can be an intense process, and noise level preferences can vary greatly. Some women find comfort in a quiet room, while others prefer a lively environment. Make sure to communicate your preferences, whether that's a request for quiet or the freedom to vocalize without restraint during contractions.
  • Touch: Some people find touch comforting during labor, while others may prefer limited physical contact. Express your preferences for touch, massage, or other physical support in this section. 
  • Fetal Monitoring: Most hospitals will monitor the baby's heart rate during labor. If continuous monitoring is not medically necessary, you may request intermittent monitoring to allow more mobility during labor.
  • Music: Music can be a powerful tool for relaxation and distraction during labor. If you'd like to play specific songs or types of music, include this in your plan. Some birthing centers may provide music players, but consider bringing your own just in case.
  • Lighting: Many people overlook this aspect, but the ambiance of the room can impact your labor experience. If you prefer dimmed lights for a more serene environment, or bright lights to keep the atmosphere alert and cheerful, make sure to mention it.

As with all aspects of your birth plan, remember that these preferences are just that—preferences. Circumstances may require adjustments in the moment, so maintain an open mind and flexible attitude as you go into your childbirth experience.

In the Event of the Unexpected

No one wants to contemplate the potential complications that could arise during labor and delivery, but it's essential to be prepared for the unexpected. This section of your birth plan should thus address any exceptional circumstances or emergency procedures that you might encounter, stating your preferences where possible. 

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  • Emergency Cesarean Section: Despite your best-laid plans for a vaginal birth, certain complications may necessitate an emergency C-section. Discuss your preferences for this scenario with your healthcare provider beforehand, such as who you'd like to accompany you in the operating room.
  • Assisted Delivery: In some cases, vacuum extraction or forceps may be required to assist in the delivery of your baby. If this situation arises, specify your wishes regarding pain relief options and the presence of support people.
  • Neonatal Intensive Care Unit (NICU): If your baby needs immediate medical attention after birth, it's important to outline your preferences for NICU care. If possible, you may wish to express a preference for skin-to-skin contact before the baby is taken to the NICU or for your partner to accompany the baby at all times.
  • Birth Complications: Childbirth can sometimes involve unanticipated challenges, such as fetal distress or a prolonged labor. In these situations, your healthcare team might need to intervene with various treatments or procedures. Discuss these possibilities in advance with your provider and express your preferences in your birth plan, always bearing in mind that flexibility is key in these situations.

Planning for the unexpected doesn't mean expecting the worst. Rather, it's about having a plan in place to navigate potential challenges with as much confidence and control as possible. Regardless of how your labor and delivery unfold, remember that every birth is a unique and beautiful journey.

Newborn Procedures

The moments immediately following your baby's birth are filled with significant first experiences and procedures. Your birth plan should address your preferences for these newborn procedures to ensure that your healthcare team is aware of your wishes. Below are some key areas you might want to consider:

  • Immediate Skin-to-Skin Contact: Skin-to-skin contact immediately after birth can promote bonding, regulate the baby's temperature, heart rate, and stimulate breastfeeding. If you wish to have immediate skin-to-skin contact, specify this in your birth plan.
  • Delayed Cord Clamping: Delayed cord clamping allows more blood to transfer from the placenta to the baby, which can provide health benefits. If you prefer delayed cord clamping, mention this in your plan.
  • Newborn Screenings: Routine newborn screenings are performed to identify conditions that may impact your baby's long-term health. Discuss these tests with your healthcare provider in advance and state your preferences in your birth plan.
  • Vitamin K Injection: This shot is given to newborns to prevent Vitamin K deficiency bleeding. If you have any particular preferences about this injection, include them in your birth plan.
  • Eye Prophylaxis: A topical medication applied to the newborn's eyes to prevent bacterial infection is a standard hospital procedure. If you have concerns or preferences about this procedure, address them in your birth plan.
  • Feeding Preferences: If you plan on breastfeeding, specify your wish to start as soon as possible after birth. If you're planning to formula feed, mention this too.
  • Hepatitis B Vaccine: The first dose of this vaccine is usually given to the baby before discharge from the hospital. If you have any specific wishes regarding this, include them in your plan.

The health and safety of your baby is the top priorities. All decisions made will aim to ensure a healthy start for your little one.

Key Takeaways

Creating a birth plan is an empowering exercise that promotes active participation in your childbirth experience. While it's important to outline your preferences, remember to maintain flexibility. The ultimate goal is the health and safety of both mother and baby. However uncertain the journey might seem, know that each birthing experience is unique and beautiful in its way. With careful planning and open communication with your healthcare team, you are well-equipped to welcome your baby into the world.

Broward Health, providing service for more than 85 years, is a nationally recognized system in South Florida that offers world-class healthcare to all. The Broward Health system includes the statutory teaching hospital Broward Health Medical Center, Broward Health North, Broward Health Imperial Point, Broward Health Coral Springs, Salah Foundation Children’s Hospital, Broward Health Weston, Broward HealthPoint, Broward Health Physician Group, Broward Health Urgent Care, Broward Health International, and Broward Health Foundation. For more information, visit BrowardHealth.org.