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Wednesday, March 1, 2023

Birth Plan Basics: Make Your Preferences Understood

By Dr. Robert Wool

Whether you are pregnant with your first child or have given birth before, every delivery is different—and women have diverse preferences when it comes to how they would like the experience to go. When you begin your third trimester, putting together a birth plan can help you think about your birthing options and communicate your wishes to your care team. Plus, making some decisions in advance may help you feel more prepared and less stressed when the big day comes.


Here are a few birth plan basics for you to consider.   


In the Room

You may be in labor for a short time or many hours, so make a list of the things you’d like to bring with you to provide comfort and distraction. Consider things like music and headphones; a favorite nightgown, pillow or blanket (but be warned, they may become soiled during the birth); a book; scented lotion or oil; your mobile device and charger; or a picture to focus on. You can also specify details related to ambiance, such as dim lighting or hushed voices.


Think about who you want in the room with you. Some women want just their partner, birth coach or doula, while others welcome family or friends. Perhaps you are willing to have company during your early labor but not during the birth. Even after baby is born, it’s your choice whether or not to allow visitors.


Keep in mind that hospitals may set limits on visitors due to factors like COVID or flu prevention. Otherwise, the choice is yours, and letting loved ones know your thoughts in advance can help stave off awkwardness in the moment. Make a list of the names of people who are allowed to visit, so the care team can run interference for you.


Pain Control

There is a wide range of options for pain control during labor and childbirth, so it’s worth doing some research and talking to your provider in advance about your preferences. Most women find relief through a combination of techniques at different points in their labor and delivery.


Medical options may include:

·         An epidural

·         Nitrous oxide (laughing gas)

·         Pain-relieving medications

·         Local anesthetics


Non-medical options include:

·         Hydrotherapy (labor tub or shower)

·         Massage or acupressure

·         Hypnotherapy

·         Walking/movement/birthing ball

·         Breathing techniques

·         Changing positions

·         Heat/cold packs


Medical Interventions

Talk to your health care provider about the different medical interventions that become necessary during labor and delivery, and note your preferences or concerns about them. These may include:

·         Intravenous (IV) line, while IV access is a necessary safety precaution, not every patient needs fluids given

·         Fetal monitoring, be it continuous or intermittent

·         Potential need for an episiotomy

·         The need for forceps or vacuum delivery

·         The possibility of needing a Cesarean section (C-section)

·         Placental delivery (active or physiological); do you want to see the placenta?

·         Delayed cord clamping


Other Items

There are a number of other items you can address in your birth plan, such as:

·         Are there any specific cultural or religious customs you want to include?

·         Do you want a drape so you can’t see the birth, or a mirror to help you see better?

·         Would you like immediate skin-to-skin contact with baby after delivery?

·         Who do you want to cut the umbilical cord?

·         How do you plan to feed the baby after birth?

·         If you have a boy, are you opting for circumcision before leaving the hospital?


Keep It Simple

There is no special form for a birth plan; it can be just a simple list. Writing a birth plan is not required, but knowing and stating your wishes in advance can help you feel more in control in the moment. At times, medical necessity may mean the care team can’t follow your plan exactly, and at these times it is important to talk to your provider and discuss how and why some changes need to be made. You are always free to change your mind about any of your choices at any point and discuss those changes with your provider.


If you do write a birth plan, we suggest you give us a copy in advance of your birth, so we can review it together and have it in your medical record. During your prenatal visits, we’ll talk to you about your birth plan options, but feel free to ask us any questions at any time. Our goal is to ensure a smooth, safe and healthy birth for every mom and baby.