What?? I can plan my baby’s birth?? No. You can’t. Unfortunately, birthing just isn’t plannable. However, you can have preferences about how you’d like your birthing to proceed that you can write down for your suppor team/nurses/OB/Midwife.
“We cannot know the day or week labor will begin, how long it will last, exactly how it will feel, how we will react, or the health and sizes of our babies. What we can do, however, is educate ourselves about the vast array of possibilities and learn which are more likely to occur. We can decide what is ideal and what we will strive for, what are the means to creating the most conducive environment for such a birth, and which people can best help us to attain those birth arrangements. Finally, we can prepare our own bodies and hearts for the process.”
Eyes-Open Childbirth: Writing a Meaningful Plan for a Gentle Birth
by Amy Scott
Here’s an excellent list of do’s and don’ts taken from Nursing Birth…
#1 DO keep your birth plan short, simple, and easy to understand (1-2 pages max).
“Keep [your birth plan] short. If you need to spell out a long list of points, you may not be with the right caregiver. If most of the things you want aren’t things your caregiver is used to doing (in which case you don’t need to put them in a birth plan!), you are unlikely to get them. For maximum effectiveness, keep your birth plan to a single page.”
Writing a Birth Plan by findadoula.com
#2 DO keep the language of your birth plan assertive and clear.
“Remember to keep your language assertive – polite but clearly stating what you want. Use phrases like “I am planning” and “I would like” rather than “if it is ok” or “I would prefer.”
Be specific. Avoid words and phrases such as “not unless necessary” or “keep to a minimum.” What one person thinks is “necessary” is not what another does. What one person defines as the minimum is not what the next person does. Instead, use numbers or specific situations, for example: “I am happy to have 20 minutes of electronic monitoring and if all is well then intermittent monitoring every hour for five minutes after that” or “I am happy to have a vaginal examination on arrival in hospital and after that every four hours or on my request.”
Writing a Birth Plan by findadoula.com
“Be sure to be assertive, but not aggressive when discussing your options. Do not allow your caregiver to brush off your decisions or suggest that this is unimportant. At the same time, don’t assume your caregiver [or nurses] will be hostile or uninterested in hearing what you have to say.”
How to write a Birth Plan by birthingnaturally.net
#3 DO use your birth plan as an impetus for doing your own personal research about your preferences for childbirth.
One great place to start is at MothersAdvocate.com who, in partnership with Lamaze International and Lamaze’s Six Steps to A Healthy Birth, have created a website that offers FREE, evidenced-based, educational video clips and print materials to educate and inform childbearing families on how to have a safe and healthy birth for both you and your baby. These extremely well researched and produced materials are a MUST READ for all expecting moms!!!
The introduction handout for these video clips and print-outs entitled Introduction: Birth–As Safe and Healthy As It Can Be reads:
“While no one can promise you what kind of birth experience you will have, common sense tells us and research confirms that there are two tried-and-true ways to make birth as safe and healthy as possible:
• First, make choices that support and assist your natural ability to give birth.
• Second, avoid practices that work against your body’s natural ability, unless there is a good medical reason for them.
Lamaze International, the leading childbirth education and advocacy organization, has used recommendations from the World Health Organization to develop the Six Lamaze Healthy Birth Practices that support and assist a woman’s ability to give birth. Years of research have proven that each of these practices increases safety for mothers and babies.
The Six Lamaze Healthy Birth Practices are:
1. Let labor begin on its own.
2. Walk, move around, and change positions throughout labor.
3. Bring a loved one, friend, or doula for continuous support.
4. Avoid interventions that are not medically necessary.
5. Avoid giving birth on your back, and follow your body’s urges to push.
6. Keep your baby with you—it’s best for you, your baby, and breastfeeding.”
#4 DO include your fears, concerns, and helpful things for the nurse to know.
If appropriate, a birth plan can also include a few sentences regarding things you just want the nurse to know about and are important enough to make sure that every shift is aware of. For example:
“My husband is a type I diabetic and at times suffers from episodes of hypoglycemia where he does not have any warning signs or symptoms. So if my husband starts to act inappropriate or seems ‘out of it’ or ‘drunk’ please offer him some juice!! I am afraid that if I am in the throws of labor that I will not notice and this is something that I am very concerned about!”
Although this information wasn’t necessarily birth related, a nurse taking care of this family would find this information EXTREMELY helpful to have in the birth plan!!
#5 DO review your birth plan with your birth attendant and ask him/her to sign off that he/she read and understands it.
“Add a line at the bottom of your birth plan for your doctor or midwife, and other caregivers, to sign your plan under the statement ‘I have read this plan and understand it.’ When caregivers sign your plan, they are only acknowledging to you—on the record- that they have read and understood it. They do not have to sign and say: ‘I agree.’ No matter what you tell them, they are always responsible for offering you their best judgment and skills as different circumstances arise, and then together you and your caregivers can agree on your care. This benefits you. Your birth plan will help you take responsibility for your decisions and ask to be fully informed.”
Creating Your Birth Plan, page 219
By Marsden Wagner & Stephanie Gunning
#6 DO make your birth plan personal (don’t just copy paste) and DO make sure that you understand and can elaborate on everything in the birth plan if asked.
In my humble opinion (regarding birth plans), there is nothing more frustrating for a nurse (and nothing more detrimental to a nurse’s overall attitude and view of birth plans) than to have a patient just copy and paste a general, “all-purpose” birth plan off the internet, check the boxes that “sound good”, and pass it in to a nurse with her name typed in at the top. Why? Because when a nurse sits down to review the birth plan with the mother and her labor companions in order to start a dialogue about how the nursing staff can assist in adhering to the birth plan, it will most certainly become obvious to the nurse that the patient has done little to no research on any of her choices making it almost impossible to help the patient follow her birth plan when the birth attendant comes in and wants to do things differently.
It is really hard for a nurse to advocate for you if you don’t even understand what you are asking for!
It’s important for a woman to understand and agree with everything she herself puts in her birth plan! Remember, mothers, labor companions, and nurses work best when they are all on the same page and work as a team to facilitate a positive and empowering birth experience!!
#7 DO look at examples of great birth plans online to get some ideas.
The following is a list of some good places to start. Remember, while these websites provide a wealth of ideas, they should not be simply copied and pasted! The best and most effective birth plans are personal, NOT just a list of things with check marks next to them!!
a) BirthingNaturally.net
b) Sample Birth Plans from BirthingNaturally.net
c) ChoicesinChildbirth.com
d) American Pregnancy Association
e) BabyCenter.com
f) MothersAdvocate.com
#8 DO run through scenarios in your mind about how labor could unfold and actually talk these scenarios out with your labor companions and doula (or perhaps even your childbirth educator or birth attendant too!)
Think about all the different ways labor could unfold and how you might react if labor was faster or slower than expected; harder or easier than expected. What would you need for comfort, support and information in each of these variations? Thinking about “worst case scenario” doesn’t mean it’s going to happen. But if it does, or if any variation does, it will make you more at ease to know that your team has already talked about it and knows your wishes.
“If you knew that something would go wrong or would pose a difficult challenge during a portion of the labor and birth, what would your ideal strategy and scenario for handling that problem be? How would you want your midwife or doctor to speak with you? How would you like your spouse or another support system to help? What alternatives would you like to try, and in what order? Again, in your mind’s eye permit yourself to have the best. What would help you relax and be able to continue labor under difficult conditions?”
Creating Your Birth Plan, page 219
By Marsden Wagner & Stephanie Gunning
#9 DO try to treat researching and birth plan writing as a fun and exciting experience, not a chore!
It is never too early to start so don’t put it off till the last minute!
And finally…
#10 DO remember to bring your birth plan to the hospital!!
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SAMPLE BIRTH PLAN
This birth plan was by a reader of Nursing Birth who goes by the name “ContortingMom”. I really like her birth plan for a variety of reasons.
#1 She was inspired to add some stuff to her birth plan after reading a couple posts of mine (which I think is pretty cool 
and #2 I think it is a perfect example of a personalized birth plan!! No check boxes here! Thanks again to ContortingMom for allowing me to post her birth preferences for other moms to read and learn from!!
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Birth Preferences:
I understand that labor and birth are unpredictable and ultimately want the health and safety of both the baby and I to take precedence. In all non-emergency situations, all proposed procedures are to be discussed (benefits and risks) so I can direct the decision making with informed consent.
Your help with these preferences is very much appreciated.
Labor:
• I intend to have as natural a labor as possible – including freedom of movement, intermittent monitoring, a saline lock instead of an on-going IV, and clear liquids as tolerated.
• Due to my GBS+ status, I request only very limited vaginal exams and do not want an amniotomy.
• Please accept my request that pain medication not be offered to me. For many reasons – personal and medical, I’m striving for an unmedicated labor and delivery. If I eventually want drugs or an epidural, I’ll be the first to ask for it and understand that options change as labor progresses.
• If augmentation is necessary, I would like to try non-pharmacological methods before resorting to meds. However, if my OB and I agree that pitocin is required, I request that the it be administered following the low dose protocol and increased in intervals no closer than every 30 minutes, allowing my body an appropriate amount of time to adjust and react to each dose increase.
Birth:
• Please do not direct my pushing with counting or yelling. I will ask for help if needed.
• I strongly prefer a tear to an episiotomy and do not want a local anesthetic administered to the perineum.
• I plan to be as active during pushing & delivery as possible, including choosing productive positions. They will be probably anything except supine, lithotomy or “sitting squats” that put pressure on my tailbone. It’s been broken several times & currently inflamed. I also have restrictive pain from spinal injury & surgery, so please allow a position suited to my medical needs. I’ll make sure the OB has comfortable access.
• I would like to have the baby brought to my chest immediately for skin-to-skin contact & initial procedures – and to try nursing to see if it works to contract my uterus, delaying pitocin until we know.
If Cesarean Is Required:
• Please use double-layer sutures when repairing my uterus. If I have a second child, I hope to attempt a VBAC and understand this is a requirement for many doctors.
• As health permits, I would like to skin-to-skin contact with the baby, to stay together during repair and recovery, and to breastfeed during the initial recovery period.
• If my husband has to leave the operating room with the baby, I would like my doula to take his place.
Baby Care:
• We would like to spend as much time as possible with our baby after birth before being taken off for procedures and will be breastfeeding, so please refrain from giving bottles/pacifiers.
We Appreciate Your Support. Thank You!