Wednesday, August 16, 2017

Creating A Birth Plan

Let's talk birth plans!

It is important to remember that birth can be unpredictable. You may find yourself and your baby in situations you didn't plan for or anticipate, but a birth plan will help communicate your wants and needs in a variety of situations to everyone involved in your baby's birth.

Customize it. There are a lot of options to print an already established and thought-out birth plan online. Although this is the easiest thing to do, it will most likely not cover all of your individual needs and wants.

Include the names and roles of everyone you wish to have in the room during your labor and delivery. Who are the people necessary for your baby's birth? Do you have a doula? A family member you want present? Make sure everyone knows what their role and other's roles are during the birth.

Make informed, educated choices and make them clear. Whether it is about your pain management, interventions, routine procedures etc. make sure you know what your options are and make your choice clear. If you have one, ask your doula for evidence based information and talk to your doctor about your options, remember you have the right to informed consent on any and all medical procedures regardless of how routine they may be to your birthing place. But also keep in mind that different hospitals have different policies, so it would also be a good idea to read up on the policies at your desired birth location and talk to your doctor about any concerns or questions you may have. As an example, some hospitals follow delayed cord clamping, and some do not. Is this something you wish to have

Talk about the atmosphere that makes you the most comfortable. Do you like quiet, dark spaces to relax? Or do you prefer an environment filled with conversation, laughter, etc.

Include any medical history you feel necessary. Are you allergic to anything used in a hospital, like latex or adhesive? This is something you would want your medical care providers to know. In addition it could be beneficial to add previous birth experiences or any medical concerns you may have.

Talk about newborn care. Knowing what you want to happen when your baby has arrived is just as important as what happens during labor and delivery. Do you prefer skin to skin? Even after a C-section it is still possible to have skin to skin. You can also talk about breastfeeding wishes, vitamin K shot, antibiotic eye ointment, hep B vaccine, baby's first bath, who you want to hold baby in the first minutes, hours after birth, etc.

Talk about your own care preferences after baby is born. After your baby is born a lot of focus will be on baby's care, but make sure you talk about what you prefer for your own care. What pain relievers would your prefer, if any? What about laxatives or stool softeners?

Remember that birth does not always go according to plan, have a back up plan just in case. You can talk about and prepare your birth plan to be as ideal as possible, but you also have to expect the unexpected. Sometimes there are medical emergency's that will change your plans. Including a detailed back up plan will save you some stress and panic if you are told something will not go as you have planned. If you have to have an emergency C-Section when you were planning for a vaginal birth, what are your preferences? It may not be ideal, but at least you will have a plan in place if needed.

There is certainly a lot to think about when creating a birth plan. In addition to the tips above here are a list of things you can research, think about and discuss with your doula and/or medical care provider to decide what option is best for you, your baby and your family.

During Labor and Delivery:

  • 6 Healthy Birth Practices
    • Let Labor Begin on it's own
    • Freedom of Movement
    • Continuous Support 
    • Avoid Interventions that are not medically necessary
    • Avoid giving birth on your back, follow your body's natural urge to push
    • Keep mom and baby together
  • Preferences for a C-Section if medically necessary
    • types of drugs used 
      • do you prefer to not use drugs that would alter your conscious state?
    • who do you prefer in the operating room with you?
  • Epidural
  • IV
  • Unmedicated Birth
  • Labor Props
    • shower/tub
    • birth ball
    • squatting bar
    • birth stool
  • Artificial breaking of water/sweeping membranes
  • Comfort Techniques
  • Birth Positions
  • Coached breathing/pushing preferences
  • Fetal monitoring
  • Vaginal exams/progression assessments 
  • Research your hospital's routine procedures and policies during labor and delivery and discuss any questions or concerns with your ob or midwife. 

After Baby is Born:
  • Skin-to-Skin
  • Delayed Cord Clamping
  • Breastfeeding 
  • Golden Hour
    • When to do routine procedures
      • weight
      • measurement
      • footprint
      • full assessment 
  • Antibiotic Eye Ointment
  • Vitamin K
  • Hep B Vaccine
  • Pacifier use 
  • Baby's First Bath
  • Visitor preferences
  • Rooming In
The most important part of your birth plan is that you feel confident in your decisions. Remember that these are YOUR decisions for you and your baby. There are a lot of opinions and information out there so it is important to do evidence based, non-biased research. Discuss your options, ideas, thoughts and opinions with your care provider, doula, birth partner, family or close friend. Here are two links that I have found very helpful and informational for evidence based information. 

Lamaze for Parents:

Happy Birth Planning!