As my pregnant patients prepare for their exciting new arrival, I encourage them to discuss their options for labor and delivery and to create a birth plan. Birth plans are one of the best ways to explore and communicate your preferences on important topics, such as the use of pain medication, medical interventions, how your baby will be fed and cared for once they arrive, and more.
Every birth is unique, and there's no way to predict with certainty how yours will go. But creating a plan can help you steer your birth in the direction you want — and gain a sense of control, which can be a satisfying and empowering experience. In fact, research shows that women who create birth plans with their healthcare team are more satisfied with their birth experience compared to those who don't make birth plans.
How to make a birth plan
It's often helpful to use a sample plan or template from a book or website, or you can write your own.
Your plan should be concise — think one to two pages. I tell my patients that a good goal is to cover the five to seven most important things you want your care team to know. List them out in bullet points that are short and easy to read.
What should be included in the plan? I often recommend that patients cover the following categories:
Basics
Include your name, medications, and conditions being treated (including allergies).
Atmosphere
Briefly note the things that will help you feel comfortable. You might request that the lights be dimmed, that your room be kept as quiet as possible, and that the room temperature be regulated. It is also important to consider who you would like in the room, including a partner, doula, or family member. Lastly, consider if you would like your support person to take photos or videos of your labor as permitted per hospital policy.
Labor preferences
Would you like to be able to move freely, use birthing tools (like a ball or chair), or take a warm shower or bath? Are you okay with being monitored continuously, or would you prefer remote monitoring so you can be more mobile?
Pain medications
Do you definitely want an epidural? Speaking with your provider can help inform your decisions for pain management.
Delivery preferences
If you're planning on having a vaginal birth, you may wish to ask your provider to avoid an episiotomy (an incision of the perineum and vaginal wall to allow the baby to pass through more easily) unless it's medically necessary. You can also include your preferences about treatments that could speed up your labor or tools for assisted delivery (like using forceps or vacuum extraction). Finally, note if you'd like to have immediate skin-to-skin contact with your baby and delayed cord clamping.
Cesarean section preferences
It's good to mention these, whether you're planning for a C-section or not since they're sometimes needed unexpectedly. List who you'd like in the delivery room, for instance, and ask if the hospital allows for a gentle cesarean, which includes having clear drapes and skin-to-skin contact after delivery.
Feeding and hospital care
Mention whether you want to breastfeed after delivery and if you want your baby in your room with you at all times (versus spending some time in the nursery). List your preferences about whether the nurses can give your baby a pacifier. If your baby is a boy, include whether you'd like him circumcised at the hospital. Keep in mind that if you're giving birth at a Baby-Friendly Hospital like Temple, many of your preferences around breastfeeding, skin-to-skin contact, and rooming in may be automatic.
Sharing your birth plan
After your birth plan is drawn up, share it with your doctor, nurse practitioner, or midwife. I suggest going over the plan with your provider together to ensure everyone is on the same page and address any potential questions or concerns. Keep in mind that you may need to make some adjustments, particularly if your pregnancy is considered high-risk.
Once it’s finalized, print out several more copies of your birth plan. Share one with the hospital when you arrive, keep one by your hospital bed or nightstand, and have a few more in your hospital bag, just in case.
I try to honor my patients' birth plan preferences whenever possible. At the same time, I encourage my patients to think about their birth plan as a set of flexible guidelines rather than hard rules. Some people change their minds about elements of their plan (like pain medication) when they're in labor. In some cases, certain steps may be medically necessary to ensure the safest possible delivery for you and your baby.
Pregnancy care you can count on
At Temple Health, we're here for you during your pregnancy, labor, and beyond. To learn more about maternity and newborn care at Temple or to find an experienced provider, call 800-TEMPLE-MED (800-836-7536) or request an appointment online.
Helpful Resources
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