Your Birth Plan
Be Empowered Birth Series
Planning Your Birth
Though there are a few ways to give birth, there are seemingly limitless ways to customize it. This blog is about things to consider when making your birth plan. Hopefully you will become more aware of the choices you actually have in birth. It is good to consider the risks and benefits of each choice you have now before the contractions and excitement really set in. This post ends with encouraging a plan B or C in case your first plan is not possible.
The first parts of your birth plan to consider is what your preferences are when you get near your due date. Depending on your health care provider, you may be offered a cervical exam to check your dilation and maybe even a membrane strip. If it looks like you are going past your due date, something that is VERY common, then some providers may mention the possibility of an induction. If you would prefer to wait until 42 weeks to consider an induction then there are tests that you can take to make sure you and your baby are still doing well. Some providers tend to encourage inductions whereas others encourage non-stress tests and waiting on your body to go into labor on its own. Another thing that may come up around this time is breaking your water to get labor started. Recognize that ultimately you can choose, but if you are with a midwife practice that is outside of a hospital and you want an induction then they may try some other natural ways to induce you before sending you to a hospital.
Your choices before labor: cervical exams, membrane strip, and what to do if you go past your due date.
During labor, there are many more things you can consider. Do you want any medication? Surprisingly there are more options than an epidural. What kind of monitoring do you want (continual or intermittent)? Where and how do you want to labor? Really the only choice regarding labor positions that you need to make is do you want to labor entirely on your back in a bed or do you want to be able to move freely. Free movement is more feasible if you choose intermittent monitoring. If you water hasn’t broken (or been broken) yet then you may have the chance to have it broken for you. Sometimes your water never breaks, and other times it may be broken accidentally during a cervical exam. Your provider should ask you before intentionally breaking it. A few more things to consider is the lights in the room, laboring in the shower, and laboring or giving birth in a tub. Finally, consider whether you want to have an episiotomy.
Your choices during labor: medication, movement, water rupture, monitoring, lights, laboring in the shower, water birth, and episiotomy.
In most circumstances after delivery, the choices continue. Do you want delayed cord clamping (that is when you wait until the cord stops pulsing before it is cut)? Who do you prefer to cut the cord? Where will the baby immediately go after birth (skin-to-skin or not)? Are you saving your placenta for encapsulation? In the case of a C-section, do you want your partner to go with your baby after delivery? Do you want your partner to do immediate skin-to-skin as soon as possible? Do you prefer to try breastfeeding as soon as possible? Do you want your baby to have the vitamin K shot, eye antibiotic ointment, or have a bath? What about circumcision and the Hepatitis B vaccine? Finally, do you want to delay exams to give you more time for bonding?
Your choices after delivery: delayed cord clamping, cord cutting, immediate skin-to-skin, where the placenta will go, when to start breastfeeding, when to give first bath, eye ointment, vitamin K shot, Hepatitis B vaccine, examinations, and circumcision.
It seems like enough just to make all of the choices, especially if this is your first time going through it. It is ideal to start thinking about these choices before you go into labor, hopefully months before, so you can have your birth plan actually written out. There is so much information online that can help you, but it can also be information overload. Having a doula is a great resource during this time. She has seen many births, knows a plethora of information about the pros and cons of each choice, and can give you credible resources to get more information about each one. Your healthcare provider is definitely another great resource. Some providers will be very used to their patients making a birth plan, and some will actually decide at which appointment to go over your birth plan with you, but there are probably just as many providers that are not used to their patient having a birth plan and unfortunately some may actually scoff at it.
After doing your due diligence in deciding your birth plan, try to hold on to it with open hands. Decide which things are non-negotiables, but give yourself grace if things do not go to plan. Maybe you want to have a birth plan for if you go into labor naturally, one if you have to be induced, and one if you need or choose a C-section. There are different variables to consider with each situation. It can be really helpful to hear birth stories to help you decide what you prefer in your birth. Try to hear all kinds of birth stories: medicated vaginal births at the hospital, medicated and un-medicated inductions, completely un-medicated vaginal births in a birth center, at home, and at the hospital, planned and unplanned C-sections, and try to hear stories of births that went to plan and ones that did not. You can ask your family members and friends to tell you everything about their birth stories that they remember. Another great resource is to listen to The Birth Hour Podcast. There are new episodes weekly and hundreds of episodes already recorded. On the website you can also find the birth stories categorized by what type of birth it was or by a key event that took place in the birth.