Birth Plans: How to Make The Best Use of Your Time

While labor and delivery don’t always go as planned, creating a birth plan gives you confidence and knowledge to get through the birthing process.
Every pregnancy is different. Your situation may change when you’re ready to give birth, and things may not go as you’d expect. A birth plan saves precious time during labor and delivery by providing the framework and opportunity to research childbirth and make informed decisions.

Why do I need a birth plan?

Collaborating with your medical team to create a birth plan is a great way to play an active role in your healthcare. If a patient is involved in their healthcare planning, it often improves their care and satisfaction. Healthcare workers should educate you on your choices and support your decisions.
A written birth plan prepares you for childbirth by outlining the processes of labor and delivery. Bring a birth plan template to prenatal visits with your healthcare provider to guide your questions and make informed decisions.
Keep in mind that your medical team knows the safest and best way to deliver a baby. Still, they will try to accommodate your plan as much as possible.

When should I create my birth plan?

Most women start thinking about their birth plan in their second trimester and finalize plans in their third trimester.
There’s a lot to think about, including what to do if your situation changes and you need to pivot your plans. Talk with your medical team throughout your pregnancy to learn as much as you can about labor and childbirth. Consider which options doctors may push on you that aren’t necessary, and be sure your most responsible physician (MRP) supports and advocates for your plan.
In addition to a birth plan, you should also complete important estate planning documents. The birth of a child is a major life event that impacts how you distribute your estate in your Last Will and Testament upon your death. Create or update your Will to reflect the new member of your family.
Further, if complications during your labor or delivery leave you incapacitated, you should create a Living Will to document your health care preferences.
Update my estate plans

What should I write in my birth plan?

Birth plans are as unique as the mothers that create them. Your birth plan should touch on the medical care you’d like to receive during labor, delivery, and postpartum.
Locations
Think about your ideal location for your child’s birth. You may wish to give birth at home, at a birthing center, or in a hospital.
Research the options available in your area, and consider what locations are appropriate for your particular pregnancy. For instance, if you’re a high-risk pregnancy, the safest option is often to deliver at a hospital. If you plan to give birth at home, consider where you might go if your situation changes and you need extra medical attention.
You should also weigh your financial situation. You may have a health benefits plan that covers a portion or all of the costs, or you may not have coverage at all. Find a location that provides the level of medical care you want and need that also works with your budget.
Medical teams and support people
List the names and contact information of your care providers and support people in your birth plan. Your medical team will help you design a birth plan that’s right for you; your support people will advocate for that plan.
Some pregnancies demand a level of care that only certain healthcare professionals (such as an obstetrician) can provide. But you may be able to choose a doctor or a nurse-midwife as your most responsible practitioner (MRP). Your MRP is mainly responsible for coordinating your healthcare and management.
Keep in mind that your MRP may be unavailable when your baby comes. During labor, you may not be in a state of mind to answer questions or make informed medical decisions. As such, you should choose a support person (or people) who can defend your birth plan. A doula, midwife, spouse, family member, or friend can work with medical teams to ensure your child’s birth is as close to your plan as possible.
Preferred delivery method
List your ideal delivery method in your birth plan but prepare for alternative procedures in case complications arise. Pre-existing health conditions and the status of your pregnancy may determine the safest delivery method for you and your baby.
Birth methods include a vaginal delivery or a cesarean section (c-section). Your medical team may assist a vaginal delivery in different ways. Discuss these options and others with your health practitioner to decide which procedures you prefer or wish to avoid if possible.
Pain management
Think about the pain medications or natural coping methods that you might use to deal with the labor pains. Discuss these options with your medical team ahead of time to understand each method’s pros and cons. Then, list your preferred options in your birth plan.
Postpartum support
Your care continues immediately after the baby is born and in the weeks that follow. Consider what postpartum procedures you want right after childbirth and the extra support you may need later.
Think about postpartum procedures such as:
  • Who should cut the umbilical cord
  • Whether to bank or donate cord blood
  • The delivery of the placenta
  • Whether you want to donate, save, or encapsulate the placenta
  • Treatments for avoiding a postpartum hemorrhage
  • Immediate skin-to-skin bonding
  • How soon after delivery caregivers may examine the baby
  • If caregivers can give your baby a pacifier, vitamins, or formula
  • If you wish to circumcise your male baby
Depending on your medical team, different people may play different roles in your postpartum support. For example, a nurse or a midwife may visit you at home to check on the baby’s growth and guide you through breastfeeding. You may also wish to request a lactation specialist.

How painful is labor, and how do I manage it?

One woman may tolerate pain differently than another, so it’s important to weigh your tolerance and consider the kinds of coping mechanisms that work best for you. Many women describe contractions as extremely painful menstrual cramps that can take away your ability to speak or focus on anything else but getting through labor.
Medicated pain relief
Epidural anesthesia is a common tactic many women take towards pain management during labor. An anesthesiologist inserts a needle into a space near your spinal cord and places a catheter into your back. The physician administers numbing medicine through the epidural catheter (sometimes periodically throughout labor as the medicine wears off).
Other pain medications include:
  • Opioids (such as fentanyl or diamorphine)
  • Local anesthetics
  • Nitrous oxide (also known as laughing gas)
Talk with your medical team in advance to learn the effectiveness and side effects of these drugs. You may not plan to use pain medications initially, but you may change your mind as your labor progresses. Also, consider which medications may not be available in the location of your childbirth.
Non-medicated pain relief
There are many different mental and physical coping mechanisms you can use during labor. For instance, your support person may guide you through mental relaxation and visualization techniques. They may alter your environment so that you’re comfortable by using aromatherapy, dimming the lights, playing soothing music, or massaging you. Walking around, using a birthing ball, and practicing deep breathing may also help.

What are my delivery options?

You’ll learn the safest possible delivery options for you during prenatal visits with your medical team.
Many women can plan to have a vaginal delivery, while others may need to schedule a c-section. A c-section is a surgical procedure that occurs in a hospital. Vaginal birth can occur at home, a birthing center, or a hospital. If you’re planning to deliver vaginally, you should also understand how c-sections work in case you require an emergency one.
Medical teams may assist vaginal deliveries in many ways:
  • Induction: To induce labor, a physician may administer hormones such as prostaglandin or oxytocin through gel insertion, oral tablet, or an IV. They might also strip the membrane around the amniotic sack during a vaginal exam, which causes the body to release hormones and prepares the cervix.
  • Amniotomy: A physician ruptures the amniotic sack (breaks your water) during a vaginal exam. This tactic also helps induce labor.
  • Episiotomy: A physician makes an incision to reduce the risk of tearing as the baby comes through the birth canal.
  • Tools: As you push during a contraction, a physician may use forceps or a vacuum (which looks and acts like a suction cup) on the baby’s head to guide the baby out of the birth canal.

How do I prepare for postpartum?

The postpartum period begins immediately after childbirth. There are different postpartum phases (that may vary in length for each woman) in which your body recovers from childbirth and adjusts to motherhood. To account for the postpartum period in your birth plan, consider the time immediately after your child’s birth and the days that follow.
Immediately after delivery, your support person may wish to cut the baby’s umbilical cord. If you’re interested in saving your baby’s cord blood, research cord blood banks and their procedures. Cord blood is rich in stem cells, and blood banks can store this special blood to treat blood and immune system disorders. Let your medical team know your plans in advance so they can collect and store the blood appropriately.
Most medical teams encourage immediate skin-to-skin contact once the baby’s born. If this is important to you, include instructions in your birth plan and ask your support person to advocate for the decision.
If you give birth in a hospital or birthing center, you may stay with your medical team for a few days of observation and medical support. If you give birth at home, your team will likely leave once you and the baby are stable and return the following day for a check-up.
In any case, consider what kind of support you’ll need in the first few postpartum days. Your medical team can answer any questions you might have about baby swaddling, soothing, and feeding. Your team can also provide you with certain hormones to help your uterus contract back to its pre-pregnancy size, or give the baby an initial dose of vitamins.
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