Birth plans are written to put us at ease and think about how we want to bring a baby into the world. Just like we spend months planning a wedding, why wouldn't you plan out one of the most incredible days in your life?
They are also helpful to be prepared and know how to work through the process of labor and delivery.
Elizabeth Stein, a NYC-based certified nurse midwife shared her top tips for creating a birth plan -- these are the questions you should ask yourself and your partner so you have the answers and proper tools in place for baby's birth day. It can help everyone feel informed, ready, and ease the worries of what ifs and how tos.
- Remember, your baby is going to come when the baby wants to come. Your baby is in charge. Your baby does not read the due date on the prenatal chart or your sonogram report. Your due date is used to manage the pregnancy to schedule prenatal appointments, schedule tests, sonograms and an induction if necessary.
- Know exactly who will deliver you. Does your midwife or physician belong to a group? If that person is not on call the day you go into labor, who will actually deliver you? Clarify this so you are not disappointed.
- Rest up. Labor is like running a marathon. Save your energy spurt for when you are in labor. When you get that energy spurt that predates labor, save it inside of you. Don't waste your energy cleaning the kitchen or bathroom.
- Stay home as long as possible unless told by you midwife or physician to go the hospital. It is more comfortable to labor at home in familiar surroundings than the hospital. If you have no risk factors you may labor at home. Early labor can last many hours so don't become exhausted. Eat, drink, walk, rock, and take a shower.
- Know when you should go to the hospital. You should go to the hospital immediately if your water breaks or you are group B strep positive or have a medical or obstetrical reason and were told to go straight to the hospital. Talk to your midwife or physician to find out exactly when they want you to call them or go directly to the hospital.
- Eat and drink continuously at home. Know the hospital rules and follow them regarding eating and drinking in labor. Most hospitals don't allow eating solid foods in labor, but many will allow clear liquids. Other hospitals may only allows IVs and ice chips. Plan on respecting these rules. This emphasizes the importance of eating and drinking at home prior to admission. Even if you vomit labor (common in labor) some of the food will have been absorbed into your body.
- Decide how will you labor. Walking, on a birthing bed, sitting in a chair, rocking on a big ball, in the shower? A combination of all of them?
- Be open-minded about measures that promote a vaginal delivery. There are AROM (artificial rupture of membranes), pitocin, and epidural. Some women say they want natural . I define natural as vaginal and cesarean as surgical. Do everything you can to have that vaginal delivery.
- Know when to bail out and have a cesarean delivery. There are no gold stars for torture. Cesarean delivery is a not a failure, just another route of delivery. You just don't want to have a cesarean that isn't indicated (decided on too early). Discuss with your midwife or physician how and when they decide to perform a cesarean in labor. In other words, how do they manage labor? Realize that some conditions are delivered by cesareans: breech, multiples (usually), placenta previa. Understand how prolonged dilatation and descent (taking a long time for your cervix to open and your baby to descend) is managed.
- If you are planning to deliver in a birth center or at home, know the protocols for transfer. What are the reasons for transfer to the hospital, who decides-midwife or patient? Who has the final say if there is a disagreement about the need to transfer? How will you get to the hospital? What hospital will you be transferred to? Does the midwife have privileges there? Will a physician take over your care? Did you meet him/her during your pregnancy or is the physician a stranger? Will your midwife stay with you?
Stein recommends creating a birth plan and discussing it during a prenatal visit with your doctor or midwife toward the end of pregnancy (36 weeks on).
Did you put your birth plan together yet?
Image via -nico/Flickr
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Comments 9
Birth plans are really important and I hate the idea that so many people right now act as if women with them are bad or stupid.
EDUCATION about birth and having a goal is NOT stupid. Going into something major and life-changing without having a plan or education -- that's stupid.
Birth plans generally contain things such as "I refuse to be on my back unless it is entirely necessary." I think that demand should be normal hospital practice, but hey.
"DO NOT offer pain medication to me." It's totally within a woman's rights to tell people to offer massage and support without trying to throw the option of drugs in her face -- she's knows it's an option, she doesn't need people harassing her about it.
"Do not touch my water." This one is a huge one. AROM is done WITHOUT consent often, and it's a horrible thing to do. In fact, without medical need (which is rare) it should NEVER be done... and yet most women who go in with intact water get it broken. NOT okay.
Good post, Michele. I hope more women realize that like their wedding day (good analogy) this day is ABOUT THEM, and they should not only plan it, and plan for any hitches, but they have every right to demand that things go their way as well.
Hah!
Do more reading than what to expect when you expecting and for god sakes turn off the baby story shows. They are full of tense language and fear surrounding birth. Nonmember comment from Allboys
THIS! Yes!
That book is TERRIBLE and the shows make it look like every single woman is going to scream bloody murder and end up with a c-section or "need" to be induced.
I actually have a problem with some of this.
"Know the hospital rules and follow them regarding eating and drinking in labor. Most hospitals don't allow eating solid foods in labor, but many will allow clear liquids. Other hospitals may only allows IVs and ice chips. Plan on respecting these rules."
This is not an evidence based policy and you CAN eat or drink, regardless of what the hospital "rules" are. They are not going to kick you out for eating. It's mentioned that labor is like a marathon...it IS! If a woman feels compelled to eat, she should do so. The body needs fuel, especially during long labors.
"Be open-minded about measures that promote a vaginal delivery. There are AROM (artificial rupture of membranes), pitocin, and epidural"
What? Since when does artificial rupture of membranes promote a vaginal delivery?! It actually increases your chances of a cord prolapse (cord comes out before baby's head) which would mean an automatic section. It also puts you on a time limit as most doctors want baby deliver within 24 hours of your water breaking. If baby isn't out... chances are you will get sectioned. An epidural often slows labor and one of the main side effects is for mom's blood pressure to crash. If they can't get the blood pressure back to normal, mom gets sectioned. Pitocin is then often used to speed labor back up, but can cause baby's heart rate to decel because of the unnatural strength of the contractions. If baby goes in to distress....section.
Avoiding the cascade of interventions is a good way to promote vaginal delivery.
Gotta say I agree with the pretty lady there, on both points.
Just followed your advice and started my own birth plan. I totally wish this site had a "like" button. :D
I wish I was more into all of this stuff when I was pregnant but I really didn't know much. I will be much more educated on my next birth!
i had one but never gave it to the nurses or doctors at the hospital.