|Photo courtesy of Birth Boot Camp|
I recently had my home visit in preparation for my home birth and one of the main things we covered was our birth plan. When our midwife brought this up I thought it seemed a little silly to have a birth plan for a home birth. It is my house, so won't everyone be following my rules anyway? Luckily, she provided us with a worksheet that helped me to see that there are many important things that need to be covered in a birth plan - even in the case of a home birth. Here are the basic pieces of a birth plan:
Format: Remember that you are not your care provider's ONLY patient - especially if you are in the hospital. Make sure it is short and to the point, but also gives your care providers a good idea of who you are and what you expect. A great way to do this is to write a short bio about yourself and your birth and follow it up with a list of "Yes, please" and "No, thank you" procedures and preferences below that. Try to keep it to one page so it can easily be added to your chart.
Content: Below are some things to think about when creating your birth plan. Remember, put emphasis on what matters to YOU.
Though you may not need to write all of this out, it is important to know what you want in terms of your prenatal care. This becomes even more important as your due date approaches. Which, if any, tests would you like to be performed on you during your pregnancy (GBS test, glucose tolerance, etc.)? How do you feel about vaginal exams late in pregnancy? What will happen as you approach and possibly pass your due date? If induction becomes necessary, what methods are you willing to use? Bring these issues up with your care provider at your next appointment to make sure that you are on the same page.
Think about where you imagine this portion of your labor happening. Do you want to be at home or in the hospital? What comfort measures would you like to have available? Who do you want for support at this stage? What kind of environment do you expect for this part of your labor? Would you like to be able to eat and drink freely during this time?
This portion of labor can be very demanding on you and your birth team. It is important that you have a birth plan for this time so that your care providers can easily cater to your wishes when you may be unable to articulate those wishes to them. Who do you need for support at this point in your labor? Where would you like to be for this portion of labor? Would you like to labor in water? Do you need anything special (music, dim lights, etc.) to help you relax? What kinds of relaxation techniques do you plan to use? How do you wish to be monitored? How often would you like vaginal exams, if at all?
At last, it will be time to meet your baby. Which positions would you like to try for pushing? Do you need to be directed to push or would you like to push instinctively? Who do you need for support? What kind of environment do you need to concentrate on delivering your baby? Do you prefer a natural tear or an episiotomy? How do you feel about instrumental delivery? Who should "catch" the baby? Is anyone taking pictures/video and what would you like them to capture/avoid?
After the Birth
Not only do you have to plan for your baby's care after birth, you should plan for your own care as well. Would you like to delay cord clamping until the cord stops pulsing? Do you want immediate skin-on-skin time with baby? Who should cut the cord? Would you like to deliver the placenta naturally? Are you planning to breastfeed? Which newborn tests and procedures do you consent to? Should baby be given a pacifier or bottle in any circumstances? Where would you like baby to sleep?
Just In Case
It is a good idea to talk over what may happen in an emergency with your partner and your care provider. You can choose to put this information in the same birth plan, make up a separate birth plan, or ensure that you have someone that will advocate for you in a time of emergency. If you must have a c-section, who should be with you in surgery? Would you like to remain conscious during the procedure? Would you like to have more children vaginally after a c-section and need a low transverse incision? Where should baby go after delivery (if it is healthy)?
If you are an over planner like me, it may be difficult for you to keep your plan concise. I highly recommend that it is as simple as possible so that your care team can give you what you want without spending the entire birth reviewing your chart and wishes. In order to decide what you feel is best for you and your birth, I recommend taking an awesome childbirth class like Birth Boot Camp so that you will be well prepared for your mission ahead. Check out my class schedule for my latest class offering.