Creating a Birth Plan
Exercising Control Over Your Birth Experience
In today's culturally-diverse society, hospitals are realizing that care needs to be customized to a patient's needs in a manner that is aligned with her culture and values. This model of care is known as "Patient-Centered Care" and is being adopted by progressive hospitals throughout the United States.
In a "Patient-Centered Care" hospital, patients are empowered to have a say in their own care. If a pregnant patient comes to the hospital ready to deliver and has developed a Birth Plan, the hospital is compelled to follow that Birth Plan to the best of their ability.
If you've never had so much say in your care, you might not be sure what you want included in your Birth Plan. No one can predict how every aspect of your delivery might unfold, but a Birth Plan tells the care team what your preferences are and in what priority you hold them.
When you deliver, there are numerous options to consider about your labor and birth experience. The Birth Plan will not only help you communicate your preferences, it will educate you on what to anticipate so you can give consideration to things you might not have thought about before.
What to include in your Birth Plan
A Birth Plan should be clear, simple, and no longer than two pages. It should cover the following three major areas:
Considerations for a Normal Labor and Delivery
- What type of atmosphere do you want? - Music and low lighting? DVDs to watch while laboring? Freedom to walk around? Do you want a mirror so you can see the baby's head when it crowns?
- Who do you want in the room? - Is this a private event for you and your partner or do you want family or other children present? Do you want a doula, someone who assists you during labor and delivery, present?
- Procedures during labor - Do you want an enema to clean out your bowels before you start pushing? How do you feel about labor being induced? Typically, shaving the pubic area is no longer done unless requested.
- Anesthesia/Pain management - In addition to an epidural, other options include massage, relaxation, breathing, sedatives, and tranquilizers; consider that you may change your mind during the birthing process but it could be too late to administer narcotics or anesthesia.
- Positions during delivery - Classic semi-recline with feet in stirrups; lying on your side; squatting; standing are all options.
Considerations for After the Birth
- Do you want the baby placed on your stomach immediately after birth?
- Do you want your partner to cut the cord?
- Do you wish to donate cord blood?
- Will you breastfeed or bottle-feed?
- Do you want the baby to sleep in your room or in the nursery?
- Do you wish to have your baby boy circumcised?
- Do you want to have someone take photos or videotape the birth?
Considerations for the Unexpected
- Episiotomies - When necessary, doctors cut the area between the vagina and the anus to ease the delivery; you may have one if you risk tearing or in the case of a medical emergency.
- Assisted birth - If the baby becomes stuck in the birth canal, your doctor may find it necessary to use forceps or vacuum extraction. Find out what your doctor prefers and has the most experience with as that's probably your best choice.
- C-section - Do you want your partner present, if possible? Do you want to be conscious or unconscious? Do you want to be able to see the baby coming out?
A Birth Plan can facilitate communication between you, your physician, and the hospital care team. If everyone knows your preferences, and the priority of those preferences, you are more likely to be satisfied with your birthing experience. While you can't always control what happens during labor and delivery, you can play a significant role in making key decisions that impact both you and your baby.