A birth plan is a document created by you that outlines your desires for what kind of childbirth you would like and how you would like your baby cared for after birth. Many women write a birth plan after they have talked with their care provider and have researched what their hospital or birth center offers for birth routines and care (this is definitely a more modern practice.)
Write Your Own Plan (Don’t use a Generic Template)
I recommend writing out your own plan rather than checking off a generic template. Use a bullet point format to make it easy to read, and your plan will have more credibility behind it if you write it yourself.
Also, keep the tone friendly and flexible. If you use forceful language or present your plan in a confrontational manner, don’t expect to make too many friends on the hospital or birth center staff. Childbirth is a dynamic process, and your health and baby’s health are the most important considerations for any birth plan.77, 78
Keep it simple. The key to an effective birth plan is to keep it short and sweet—less than one page, if possible.
The following is provided to help you think through your plan and some of your childbirth decisions.
Name/Healthcare Providers/Other Critical Information
- Name
- Due date
- OB/GYN, midwife (and phone number)
- Pediatrician/baby’s doctor
- Anyone expected to be present at the birth
- Names of anyone you do not want attending the delivery
Medical History/Important health issues, fears, or concerns
- Medications, allergies, chronic conditions
- Group B strep (state + or -),
- Gestational diabetes
- OB/GYN history, previous deliveries, etc.
Special considerations or religious requests
Before labor begins, I prefer:
- To go into labor naturally and not be induced, as long as baby and I are healthy
- At least 10 to 14 days to pass after my due date before inducement
- To use natural induction methods first
- To use natural induction methods only
During the first stage of labor, I prefer:
Support
- Partner present during labor and birth
- Support from a doula
- Other family members present
Vaginal Exams
- No vaginal exams until I go into labor
- Limited vaginal exams
- No membranes to be broken, unless there is an emergency
Environment
- Wear my own clothes
- Lights dimmed
- Music playing (of my choice)
- Silence
- Medical students and residents may/may not perform medical procedures
- Medical students and residents may/may not attend my birth
- To stay hydrated with fluids and ice chips
- To eat and drink, as approved by my doctor
- A saline/Heparin lock (a type of vein access used for a low risk mother)
Labor augmentation
- Prefer natural methods
- Pitocin is okay
- Prostaglandin gel is okay
- No amniotomy (artificial rupture of membranes), unless necessary
Pain Relief, Natural Methods
- Support from a partner or doula
- Relaxation, breathing, and visualization
- Hypnotherapy
- Shower, bath, or jacuzzi
- Distraction techniques
- Birth ball
- Massage
- Acupressure
- Focal point
- Hot/cold therapy
- Pelvic rocking
Pain Relief, Drugs
- Do not offer medication during labor
- Classic epidural
- Walking epidural (not available at all hospitals)
- Analgesics or narcotics
During the Second Stage of Labor or pushing, I prefer:
Positions
- No stirrups or footrests
- To avoid supine positioning (on my back)
- To use a squatting bar, birthing chair, or birthing stool
- To use people for support of my legs
- To deliver in a birthing tub
Pushing technique
- Push spontaneously (I do not want to be told when to push)
- Push, as directed by a doula or staff
- Prolonged breath-holding, as directed by a doula or staff
- Push without time limits, as long as baby and I are healthy
Delivery
- To avoid forceps
- To avoid vacuum extraction
- Use a mirror to see head
- Touch the baby’s head as it crowns
- Who will catch the baby (doctor, partner, or mom assisting and pulling on to chest)
Perineum
- No episiotomy
- Use of warm compresses, oil, and massage
- Natural tearing okay
- Episiotomy with local anesthesia okay
If a C-section is deemed necessary, I prefer:
- To make sure all other options are exhausted
- To have my partner with me
- To have the screen lowered to see the baby come out
- To have baby stay with my partner at my side after initial checks
Once the baby is born, I prefer:
Birth
- To wait two to three minutes until the cord stops pulsating
- To have my partner cut the cord
- To bank the cord blood
- Baby placed on mom right away
Placenta
- For the placenta to be born spontaneously without Pitocin/oxytocin
- To be given/not given routine Pitocin after the placenta is born
- Retain my placenta
Breastfeeding
- No supplementation is to be offered.
- I will request a lactation specialist.
Newborn Care
- Baby rooming-in with me, unless there is an emergency
- Partial rooming-in, with baby sent to the nursery at night for mom’s rest
- Delay routine procedures, such as cleaning, ointment in eyes, etc., for bonding and breastfeeding
- Circumcision will/will not be performed, if we have a boy
Practical Tips from Real Parents: Birth Plan
- Make sure that you run a rough draft of your birth plan by your doctor. He or she may need to modify your requests for clarity and safety.
- Think about your birth plan in two parts: Plan A for what you would like to happen for a normal labor and delivery and Plan B for what you desire should complications arise.
- Print your birth plan on brightly colored paper so that everyone can find it. Put a nice thank you post-it on the paper, so that nurses and staff might actually read it. Note: Attach a bag of candy or cookies to your birth plan and the nurses will definitely read it, especially the night shift.
- Print several copies of your birth plan for your partner, doula, nurses, and others.
- My midwife told me to steer clear from stating that certain procedures were “unacceptable” or “forbidden.” You can write “unless medically necessary” to show that you understand that deviations from your plan can happen.
- Birth plans are not just for women wanting to give birth naturally. If you want an epidural, remember to voice any other concerns, such as the desire to avoid an episiotomy, use of forceps, a vacuum extraction, etc.
- Educate yourself on choices before writing them in your plan. Take a childbirth class, take a tour of your delivery facility, read a book on childbirth, and watch childbirth videos.
- The process of writing the birth plan and learning about what might happen during labor and delivery can be more useful than the plan itself.
Example Birth Plan
Birth plan for: Your name
Husband/Partner: [name and phone]
Obstetrician/Midwife: [name and phone]
Baby: [name and gender, if known]
Pediatrician: [name and phone]
Patient History:
- I am a X year-old mother who has been pregnant X times and delivered Y prior children. I am otherwise healthy and have no history of STDs or blood born diseases.
- My other child was delivered in 20XX and is healthy:
- Baby #1: Normal vaginal delivery of [insert weight]
- I have had a healthy pregnancy without gestational diabetes, hypertension or other complications. Prenatal testing was all normal.
- Medications:
- Allergies:
Requests for labor and delivery:
- I am planning a natural delivery. I will transition to c-section as necessary.
- My husband/partner, _____, will be present during delivery. I would prefer that only my spouse attend the birth of our child.
- Please use IV fluids only if medically necessary. I am fine with a saline-locked IV.
- Please do not augment labor with Pitocin, if possible.
- Please do not strip or artificially rupture membranes.
- For pain I would like a walking epidural (ie: a true epidural and not a spinal) after labor pain becomes too intense. Lidocaine or local anesthetic for episiotomy if needed.
- I am requesting delayed cord clamping for about 2 minutes after delivery or until cord has stopped pulsating.
- We are planning private cord blood and cord tissue banking. A cord banking kit will be provided.
If I have a C-section:
- I only desire a C-section if all other options are exhausted.
- My husband will be in the operating room with me.
- For the anesthesiologist: Please do not give me any medications without my consent.
- I am requesting delayed cord clamping for about 2 minutes after delivery or until cord has stopped pulsating.
- We are planning private cord blood and cord tissue banking. Please see the kit that I will provide.
- I’d like to do skin-to-skin with my newborn in the OR immediately after delivery and any necessary resuscitation.
- I would like to have baby stay with my partner at my side after initial checks.
Requests for newborn care:
- After any necessary procedures or resuscitation, please delay routine care (including antibiotic eye ointment, vitamin K, weight, measurements, footprints, bath and full assessment) until after infant is breastfed, my husband has held the baby, and I am ready to rest.
- Our baby will stay in our room with us at night. unless there is an emergency.
- Circumcision will be performed, if we have a boy.
- Please provide a copy of results of baby’s hearing screen, blood work, and any other tests/studies.
- I will be requesting a visit from a lactation specialist.
Sources
77. Writing a birth plan. J Midwifery Womens Health, 2014. 59(2).
78. Hadar, E., et al., Obstetrical outcome in women with self-prepared birth plan. J Matern Fetal Neonatal Med, 2012. 25(10).