A birth plan not only helps you to cope during labor and delivery; it also helps you think clearly and logically about the kind of birth you want and what that requires. Maybe you're wondering what your birth-plan options actually are. Here's a list of the basics:
- Where do you want to give birth? You may give birth at home, in a hospital, or at a birth center. You also should consider which hospital or birth center to choose. Finding out whether delivering at home is legal in your state is also important.
- What kind of practitioner do you envision? You may decide on an obstetrician or a midwife. You may or may not want to stick with your current gynecologist or midwife.
- Who will support and advocate for you during labor and delivery? Your significant other is not the only option for labor support. You may consider hiring a doula to work with your partner or as your sole support. You may also choose a friend or family member for this role.
- Whom do you want to invite to the birth? You can invite friends and family members to the birth, either to wait down the hall or be by your side in the delivery room. You may even consider including your older children at the birth. Or you and your partner can be alone, inviting family after the baby arrives. Rules for how many visitors can be present during the delivery vary from facility to facility and can change based on emergent situations.
- Do you want a natural childbirth? Women choose natural childbirth for a number of reasons, from concerns about epidural risks to wanting a "natural experience." If you decide to use pain medications, you have a number of pain-relief options, from epidurals to walking epidurals to IV narcotics.
- What comfort techniques will you try? Pain drugs are only one way to get relief from labor pains. To name just a few other options, you can use massage, hydrotherapy, or hypnosis. Even if you plan an epidural, you probably won't be able to get one right away, so having an arsenal of comfort techniques is important.
- What birthing tools or props do you want to use? Birthing props and comfort tools are not only fun but also extremely helpful! You may decide to use a birthing pool, a squat bar, a birth ball, or massage tools. Even your music choices can be important for the birth. Checking with each facility to see what's available and what you can bring to the hospital is also a good idea.
- How do you expect to stay active during labor? If you assumed you'd be lying in bed for the entire labor, think again! Many positions and movements can be helpful during labor, and remaining active has lots of benefits.
- Will you accept an IV for hydration, or do you hope to drink fluids on your own? IVs are routine in many hospitals but not all, and you have options. You may even be able to eat and drink lightly.
- What kind of environment do you hope for during delivery? Perhaps you'd like a meditative environment, with ocean waves playing in the background. Or perhaps you want upbeat music to energize you.
- What kind of monitoring do you want? If you're getting an epidural, continuous monitoring is required, but if you're hoping for a natural birth, you may be able to have intermittent monitoring.
- How do you feel about induction and speeding up labor? Induction is a controversial topic, especially when done for convenience or when scheduled before your due date. Labor augmentation (speeding up labor) is another touchy topic, and your medical practitioner plays a big role in your options.
- How do you want to push? Surprise: You don't have to push while lying on your back! In fact, you'll probably have an easier time if you don't. You may even choose to have a water birth.
- How do you envision the delivery of the baby? Are you hoping to help guide the baby out (with the help of your practitioner)? Do you hope to watch the delivery in a mirror? If you don't know the sex, do you want your medical practitioner to announce it, or do you want your partner to tell you?
- Do you prefer to receive an episiotomy (surgical incision) or to tear naturally? Some (but not all) women prefer to tear rather than be cut, and in an emergency, an episiotomy isn't always an option.
- What are your feelings about cesarean section (C-section)? Some women are fearful of C-section, whereas others actually opt for one (sometimes without medical reason). In the past, after you had a cesarean, you always had to have a cesarean with subsequent babies, but now many women can try for a vaginal birth after cesarean (VBAC). If you do need a C-section, you have options — yes, even for a cesarean! — like lowering the drape to watch the delivery or breastfeeding on the surgical table.
- Who will cut the cord and when? Do you want the baby placed directly on your chest after birth or cleaned up and weighed first? A number of birth-plan choices are relevant to the moment your baby is born.
- What do you want to do with the placenta? You even have options regarding the placenta! For the delivery of the placenta, you may request that the medical practitioner not use controlled traction and allow a natural delivery of the placenta. You also may request that the birth team save the placenta for you so you can make a "placenta print" or bury your placenta in the back yard.
- Do you plan to take pictures or video of the birth? Some parents want pictures only after the baby is delivered, but others want photos of the entire birth experience.
- How do you plan to feed your baby? Will you breastfeed, bottle-feed, or do a little of both? Some bottle-feeding moms face bottle guilt, but breastfeeding isn't always possible or desired. Some hospital routines unintentionally sabotage breastfeeding mothers, but your birth plan can include requests to avoid some potential problems.
- Where do you want your baby to sleep? Full rooming-in means your baby stays with you around the clock, while partial rooming-in means your baby sleeps in the nursery.
- What drops, shots, and tests do you want for your baby? If you have a baby boy, do you want the hospital to do a circumcision? Vaccinations are a hot topic in the United States. Some parents decide to forgo all shots, while others accept them all, choose selectively, or delay them. Circumcision is also a hot topic, and parents who decide to snip may or may not want to do so right after the birth or at the hospital.
