Childbirth inspires many emotions: excitement, anxiety, hope, fear and more. These feelings are normal! Imagine what your ideal birth experience would look like. Share that vision with your pregnancy care team! Let them know your priorities and ask them what can be done to achieve them.
Some women find it helpful to write out their preferences in a “birth plan”. Posting your birth plan in your delivery room can spark conversations and ensure your birth team is on the same page. As your pregnancy approaches the grand finale, here are the 12 important aspects to consider when making your birth plan.
1. Labor Environment
What do you want your labor environment to look like? Each woman has a different view of childbirth which will influence her goals. Some women feel most comfortable at home and want to labor there as long as possible before delivering at the hospital. Others want to stay out of the hospital all together and have a home birth. Whereas, other women want to be at the hospital the entire time.
Some women may prefer to have a home birth but are not a good candidate due to pregnancy complications. For moms who want or need to deliver in the hospital, ask if you can bring an electric candle for some mood lighting. Dim the room lights, play relaxing music, bring an essential oil diffuser. Make the experience what you want it to be! Whatever your vision may be, talk about your goals with your provider.
2. Pain relief
Whether you want an unmedicated childbirth experience or plan on using medications, there are many options for pain relief during labor. If you are considering an unmedicated birth, consider researching your chosen method of pain relief and practicing the meditations, breathing or movement techniques throughout your pregnancy. Trying to learn meditation during the throes of labor pain is unlikely to be very effective.
Remember, you can change your mind at any point in your pregnancy journey. If you’re determined to have an unmedicated birth and persevere, that’s great! If you change your mind during pregnancy, or unexpected events happen in labor and you end up using medications, that’s great too. Ask your physician or midwife what pain relief methods are available where you plan to deliver.
Non-Medication Options
- Breathing techniques
- Movement
- Aquatic therapy
- Massage
- Meditation
- Hypnobirthing
Medication Options
- Laughing Gas
- Pill medications
- Intravenous medications
- Epidural/Spinal Anesthesia
3. Hydration & Nutrition
One reason women may want to stay home during early labor is to eat! It is very common for moms to be made “NPO” on admission to the hospital, meaning you cannot take in any food by mouth! This is because of the theoretical risk of food particles backing up into the lungs if a woman were to have a labor complication that required complete anesthesia with breathing tube placement. More recent studies have shown the actual risk to be very low, with the recommendation that women with low risk pregnancies be allowed to snack some, depending on provider comfortability.
Once a pregnant mama is admitted, it is also common to insert an intravenous line (IV). This IV can be used to give medications during labor or fluids to keep mom hydrated, especially if she’s NPO. Even if you don’t need any antibiotics, pain medicine or fluids, the hospital will want an IV inserted just in case of an emergency. One of the most common and feared complications of childbirth is postpartum hemorrhage (PPH). There are many ways to manage excessive bleeding in PPH including medications and if needed blood transfusions.
In medicine, we hope for the best but prepare for the worst. Talk with your provider for their recommendations on eating and drinking during your labor. If you want to be able to move about during labor without the IV pole, ask if they can saline lock your IV when it’s not being used.
4. Movement during labor
Do you want to be able to walk around during labor? Are you planning to bounce on a birth ball or do the labor dance? Let your team know if you would like to walk around the labor unit or if you plan on bringing your own birth ball. Keep in mind that your movements will be limited if you choose to have an epidural. You won’t have the strength in your legs to move on your own. Instead, your nurses will frequently turn you, alternating sides to help position baby for delivery.
5. Interventions
Most deliveries are normal and uncomplicated. But, every birth is different and not everything goes according to plan. It’s difficult to make decisions when you’re in pain or scared, especially potentially life altering decisions. Take some time to discuss possible problem scenarios with your provider and what the solutions could be. Every medical intervention has risks and benefits. Talking about them ahead of time allows you to ask questions and do some research so you can make decisions that align with your values. Knowledge is power! You may want to ask your provider about:
- Labor augmentation
- Episiotomies
- Instrument assisted deliveries
6. Support People
Childbirth is a very vulnerable experience with high emotional tension. There’s excitement, fear, pain, determination, triumph etc. You’ll be in various states of undress and there will be blood, urine and other body fluids. Wherever you choose to deliver your baby, you’re going to want supportive people by your side who you trust to see you at your most vulnerable and be your strong advocate.
Make sure you discuss your birth plan with your support people! If you’re goal is to have an unmedicated birth, let them know so they can encourage you in your goals. It may be difficult for certain people to see you in pain, and they may ask you to get pain relief to spare you the pain. If you’re planning on using medication for pain relief that may not be an issue. But, if you are planning on an unmedicated birth, it can lead to tension during your labor. You may be able to say “no” when your pain is only a 4 out of 10. But when your pain is a 10 out of 10, you may give in and later feel robbed of your ideal birth experience.
7. Delayed Cord Clamping
Baby is attached to mom’s womb by his umbilical cord to the placenta. Baby’s blood travels through his body to the placenta where it is loaded with oxygen before going back to baby. At delivery, baby’s umbilical cord is cut and some of baby’s blood in the placenta is lost. Delaying cutting the cord by at least a minute gives baby’s blood time to travel back to his body. More blood in baby’s body means baby is less likely to have low blood counts (called anemia). Because of this benefit, many hospitals delay clamping the baby’s umbilical cord until after a minute. On the other hand, delaying cord clamping for too long can increase baby’s risk for complications like jaundice (more detail about this in a later post). Ask your provider whether they do delayed cord clamping at delivery.
8. Cord Cutting
The birth of your baby is an exciting time! Have you thought about who you want to cut baby’s cord? It can be the doctor, dad, grandma, grandpa, or even mom! Involving family in the delivery experience can be a great memory.
9. Visitors
Welcoming a new baby is an exciting time for any family! A few mommas may want the whole extended family to meet baby right after birth. Most mommas may want to wait until after bonding with baby skin to skin and a first breastfeeding. Some mothers may not want to have visitors until after they’ve settled back in at home. Others may not want visitors until baby’s had his first round of vaccines and has a more robust immune system.
I want you mamas to know it is your choice of who is allowed to visit and when.
You’ve accomplished an amazing feat! You’ve carried your baby within your womb for the last 9 months, imitating Christ in a special way. Sacrificing your desires, comfort, and very body for your baby’s welfare. You will be tired, in pain, and in various states of undress if you’re breastfeeding. It is perfectly reasonable if you do not want any visitors. The birth staff in the hospital will support you and respect your decision.
Whether or not you desire visits, keep in mind that the first three months of baby’s life outside the womb is called “the fourth trimester” for a reason. Baby may be outside your body, but he still needs his momma. You are baby’s safe place. Baby knows your voice, your touch, your smell. Everyone else is a stranger. Bonding time with mom and dad is a priority. Extended family will have plenty of time to meet and play with baby later.
10. Baby Procedures
There’s a lot of exciting things that will be going on during baby’s first 24 to 48 hours of life! Labor and delivery is physically and emotionally exhausting. It can be confusing when nurses ask you to make decisions when you’re sleep deprived. Common components of newborn care to think about as you approach your due date are:
- What is the “golden hour” or “skin to skin”?
- Do you want to breastfeed or bottle feed baby?
- Will baby use a pacifier?
- When do you want baby to have the first bath?
- Why do they give vitamin K injections?
- What is erythromycin eye ointment for?
- Do you want baby to get the Hepatitis B vaccine in the hospital?
- Are you going to have baby boy circumcised?
- What is the Newborn Screening test (PKU)?
- When do they do the hearing screen?
- What is a “Congenital Heart screen”?
- Do you want to be present during any procedures?
11. Important Health Conditions
Your medical team should already have all of your information from your doctor. But, some people may want to include important information like medication allergies or their blood type on their birth plan too.
12. Emergency Contact Information
Your emergency contact information is included in your electronic chart. But having your contacts names and phone numbers readily accessible in the room can come in handy.
Having a plan and knowing your preferences can ease your mind going into labor. Remember that the most important thing is for a safe delivery for mom and baby! As someone who has delivered babies, I can assure you that sometimes things don’t go according to “the plan” and it’s important to be flexible to achieve the ultimate goal: a healthy mom and healthy baby. If things don’t go according to plan, it’s normal to feel some disappointment. But, having a safe childbirth is the outcome we pray for.