It is important for expecting mother's to have a birthing plan so that their labor and delivery can go as they would like it to. Of course, mother's need to be aware that their labor and delivery probably won't go exactly as they wish, but it helps to have a birthing plan so the doctor or midwife has some direction from the mother. "The birth plan is an ideal way to
communicate her preferences, so the mother-to-be can fully focus on the
amazing process of birthing a baby," says Dr. Coral Slavin, doula and
owner/director of Well-Rounded Maternity Center in Menomonee Falls,
Wisconsin. Photo
Some things to consider while creating a birth plan:
This step includes choosing where to give birth, hospital, birthing center, or home, and who delivers the baby, an OB-GYN
, family practitioner, or midwife.
Mother's should also consider if they would like to be able to move around, use a rocking chair, birthing ball, or other means of movement while in labor. Mother's should also consider how the want the lighting, if there is any music playing, aromatherapy, preferences for television, being able to eat or drink, and who to have present in the delivery room. Photography and video preferences can also be addressed, whether the mother is comfortable with it and if the hospital will allow it.
"Some women worry about their baby's heart rate, especially through contractions, and would prefer to have continual monitoring despite the fact they are bedridden," says Jennifer Hunt. "Others prefer to have the freedom to move around."
Induction choices include: stripping membranes, artificially rupturing membranes (breaking the water), medications like Pitocin or Cytotec, and natural methods like walking. "There may be restrictions to your requests, such as no food or drink,
continuous monitoring, or confinement to bed, once you have pain
medication or labor augmentation," says Dr. Slavin, who advises women to
consider delaying these choices as long as possible.
- Pain Medication/Anesthesia:
"There are three main choices in pain management during labor—natural
pain management, narcotics, and epidurals," Hunt says. "Most women will
go into labor with a strong sense of what kind of pain management they
plan to use."
Narcotics lessen pain but may have side effects. Epidurals
eliminate pain but confine the mother to bed. Mother's need to consider this when making choices and remember, she doesn't have to choose now. Mention on the birth
plan that she'll ask for pain relief when/if she desires some.
"With one in three women currently giving birth by Cesarean section,
it is important for parents to consider what would make their birth
experience more meaningful if they should have a C-section," Dr. Slavin
says. Mother's can choose if they would like to be awake during the C-section, if they would like a mirror to watch the delivery, having the baby placed directly in their arms after the deliver and if they would like their partner or family in the operating room.
Mother's need to discuss episiotomies
in advance so they know their physician's practices. "It would be
unfortunate for a couple to feel strongly that they would like to avoid
an episiotomy only to learn in month nine that their provider does them
routinely," says Shelly Holbrook.
Remember, an episiotomy can become necessary if quick delivery is
needed. "I had a really empowering birth that was exactly as I had
envisioned it," says Sarah Rose Evans. "The only
thing that didn't go according to plan was that I had an episiotomy, but
after 40 minutes of my baby being stuck in the same place, I told them,
'Just cut me already!' I was glad I'd made the decision, and that I
wasn't pressured into anything."
This step involves delivery positioning and support. "The so-called 'normal' way to deliver—lying on your back—works against gravity, so many women prefer to deliver squatting, in the hands-and-knees position, or in a birthing pool," Hunt says. "Mom can also choose who she wants to help during delivery and what type of help she wants, for example, holding her legs, supporting her while squatting, sitting behind her while in the pool, etc."
- Immediately after delivery:
Mother's can choose who is to cut the umblical cord, where the baby is to be placed (on the mother's chest), whether to keep the placenta, and when to breastfeed.
Mother's can choose if they want the baby in their room with them or in the nursery full time or part time.
If the mother's plan is to breastfeed exclusively, make sure to be very specific about it in the birth plan. "If you would like to make sure that the nurses do not supplement the baby with anything other than your breast milk if you are unable to nurse right away, you should make sure that you include that on the plan," Holbrook says.
Other choices related to breastfeeding are whether or not to allow the baby a pacifier and whether the mother would like a lactation consultant to help out.
- Circumcision Preferences:
Discuss circumcision options with the baby's pediatrician prior to the baby's delivery. Mother's may also want to confirm who will be doing the circumcision—the baby's pediatrician or the mother's OB. Aside from the decision for or against circumcision, there is also the option to have it performed while in hospital (if available) or having it performed as an outpatient at a later date. Whether the baby receives a local anesthetic for the procedure may also be an option.
This can include who the mother wishes to be in the room before and after delivery (friends, family, other children, etc.) and anything else important to the mother's plan. Remember, birth plans should be thought of as a request list. "Chances are, there will be a few twists and turns in there that you don't expect," Holbrook says. "As long as you can keep an open mind with those expectations, you will have a more satisfying experience."
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