Making a Birth Plan

Making Choices for You and Your Baby

Throughout your pregnancy you may have thought about what your birth will be like or the things that you would like to have happen during labour. Birth plans are a way of organizing these thoughts and sharing them with others. Birth Plans can be formally written or simply discussed with those who will be involved in your birth experience. If you are giving birth in a hospital setting that has a group practice we suggest you use a written form in the event that your caregiver doesn't attend your birth. The important thing about Birth Plans is that they describe the preference of the family in relation to different situations that you might encounter in childbirth. Because no one cares more about you or your baby than yourselves, it is important for you to gather the information that you need to make informed choices and communicate them effectively to those who will be helping you make decisions in birth.

The purpose of a Birth Plan is to improve the cooperative relationship and communication between the pregnant woman, her support persons and her health care providers (i.e. Physician, nurse, midwife). It should be written with an attitude of cooperation and flexibility in a non-judgmental and undemanding tone. Think about your own attitude towards childbirth and any priorities you may have regarding your care. It is helpful to educate yourself so that you understand the advantages, disadvantages and alternatives to the various options that you may be considering. You may want to look into hospital routines and medical procedures to find out which are standard; some options may be more available in different settings and with different caregivers than with others. Even though you are probably anticipating a normal birth, your Birth Plan is simply a tool to help you communicate your preferred choices. The information below should help you in developing your own personal Birth Plan.

Steps to Developing a Birth Plan

1. Early in Pregnancy:
• Choose a place of birth. Tour hospitals/birth centers or consider a home birth.
• Choose a caregiver. Interview physicians and midwives to find someone who will support you in the kind of birth experience you want.

2. Educate Yourself:
• Read books related to childbirth.
• Take Childbirth Education classes that support choices for childbirth.
• Speak with others who have developed Birth Plans.

3. Review the DRAFT Birth Plan with your caregiver(s).

4. Modify and finalize your Birth Plan.

5. Make at least 3 copies of your Birth Plan: One for you in labour, one for your caregiver and one for your hospital records.

6 In labour, ensure all caregivers are familiar with your Birth Plan.

7. Be flexible and respond to your labour and have a safe, positive and satisfying birth experience.

It is crucial to understand that not all items below will be a concern for everyone. You should pick the concerns that are most important to you.

LABOUR

• Having only one person or having no limit on the number of support people in labour.
• Freedom to walk and change position.
• Induction of labour: stretch & sweep, amniotomy, artificial prostaglandin or oxytocin, OR Spontaneous labour and the use of natural stimulants: making love, breast stimulation, castor oil and brisk walking
• Electronic fetal heart monitor (continuous vs intermittent)
• Pain management with the use of medication OR pain management with the use of relaxation, massage, breathing, shower/bath, changing positions, etc..

BIRTH

• Lithotomy position or one position for pushing OR choice of position and freedom to move
• Directed or purple pushing with prolonged breath-holding OR self-directed (gentle) pushing with the urge to push
• Limit of two hours for the second stage (pushing) OR no arbitrary time limit.
• Delivery table and stirrups for birth OR mother's choice for position/location of birth.
• Episiotomy OR natural stretching of the perineum with the use of massage, warm compresses, slow delivery, and perineal support.
• Forceps or vacuum extraction OR spontaneous delivery

AFTER BIRTH .

• Umbilical cord clamped and cut immediately by caregiver OR delay clamping and cutting until the cord is no longer pulsing
• Suctioning/intubation OR suctioning only as required with a bulb syringe
• Baby placed under electric warmer OR baby and mother skin to skin
• Baby care done out of sight of parents OR newborn care delayed for one hour to help with bonding
• Limit of 15-30 minutes for the third stage (delivery of the placenta) OR no arbitrary time limit for the third stage
• routine use of oxytocin OR Breastfeeding: oxytocin only as required

BABY

• Baby observed in nursery OR baby and mother not separated
• First feeding: sterile water or formula given by nurse OR exclusive breastfeeding
• Baby fed on 4 hour schedule OR feeding on demand
• Baby in nursery OR 24-hour rooming-in
• Male: circumcision OR no circumcision

CESAREAN BIRTH

• Scheduled cesarean birth OR vaginal birth after previous cesarean or surgery after labour begins (if required)
• Support persons not included OR support persons present
• General anesthesia OR epidural
• Mother not allowed to wear contacts or glasses OR mother wears contacts or glasses
• Baby cared for in nursery OR father holds baby, mother assisted to breastfeed




		Making Choices for You and Your Baby Throughout your pregnancy you may have thought about what your birth will be like or the things that you would like to have happen during labour. Birth plans are a way of organizing these thoughts and sharing them with others. Birth Plans can be formally written or simply discussed with those who will be involved in your birth experience. If you are giving birth in a hospital setting that has a group practice we suggest you use a written form in the event that your caregiver doesn't attend your birth. The important thing about Birth Plans is that they describe the preference of the family in relation to different situations that you might encounter in childbirth. Because no one cares more about you or your baby than yourselves, it is important for you to gather the information that you need to make informed choices and communicate them effectively to those who will be helping you make decisions in birth. The purpose of a Birth Plan is to improve the cooperative relationship and communication between the pregnant woman, her support persons and her health care providers (i.e. Physician, nurse, midwife). It should be written with an attitude of cooperation and flexibility in a non-judgmental and undemanding tone. Think about your own attitude towards childbirth and any priorities you may have regarding your care. It is helpful to educate yourself so that you understand the advantages, disadvantages and alternatives to the various options that you may be considering. You may want to look into hospital routines and medical procedures to find out which are standard; some options may be more available in different settings and with different caregivers than with others. Even though you are probably anticipating a normal birth, your Birth Plan is simply a tool to help you communicate your preferred choices. The information below should help you in developing your own personal Birth Plan. Steps to Developing a Birth Plan 1. Early in Pregnancy: • Choose a place of birth. Tour hospitals/birth centers or consider a home birth. • Choose a caregiver. Interview physicians and midwives to find someone who will support you in the kind of birth experience you want. 2. Educate Yourself: • Read books related to childbirth. • Take Childbirth Education classes that support choices for childbirth. • Speak with others who have developed Birth Plans. 3. Review the DRAFT Birth Plan with your caregiver(s). 4. Modify and finalize your Birth Plan. 5. Make at least 3 copies of your Birth Plan: One for you in labour, one for your caregiver and one for your hospital records. 6 In labour, ensure all caregivers are familiar with your Birth Plan. 7. Be flexible and respond to your labour and have a safe, positive and satisfying birth experience. It is crucial to understand that not all items below will be a concern for everyone. You should pick the concerns that are most important to you. LABOUR • Having only one person or having no limit on the number of support people in labour. • Freedom to walk and change position. • Induction of labour: stretch & sweep, amniotomy, artificial prostaglandin or oxytocin, OR Spontaneous labour and the use of natural stimulants: making love, breast stimulation, castor oil and brisk walking • Electronic fetal heart monitor (continuous vs intermittent) • Pain management with the use of medication OR pain management with the use of relaxation, massage, breathing, shower/bath, changing positions, etc.. BIRTH • Lithotomy position or one position for pushing OR choice of position and freedom to move • Directed or purple pushing with prolonged breath-holding OR self-directed (gentle) pushing with the urge to push • Limit of two hours for the second stage (pushing) OR no arbitrary time limit. • Delivery table and stirrups for birth OR mother's choice for position/location of birth. • Episiotomy OR natural stretching of the perineum with the use of massage, warm compresses, slow delivery, and perineal support. • Forceps or vacuum extraction OR spontaneous delivery AFTER BIRTH . • Umbilical cord clamped and cut immediately by caregiver OR delay clamping and cutting until the cord is no longer pulsing • Suctioning/intubation OR suctioning only as required with a bulb syringe • Baby placed under electric warmer OR baby and mother skin to skin • Baby care done out of sight of parents OR newborn care delayed for one hour to help with bonding • Limit of 15-30 minutes for the third stage (delivery of the placenta) OR no arbitrary time limit for the third stage • routine use of oxytocin OR Breastfeeding: oxytocin only as required BABY • Baby observed in nursery OR baby and mother not separated • First feeding: sterile water or formula given by nurse OR exclusive breastfeeding • Baby fed on 4 hour schedule OR feeding on demand • Baby in nursery OR 24-hour rooming-in • Male: circumcision OR no circumcision CESAREAN BIRTH • Scheduled cesarean birth OR vaginal birth after previous cesarean or surgery after labour begins (if required) • Support persons not included OR support persons present • General anesthesia OR epidural • Mother not allowed to wear contacts or glasses OR mother wears contacts or glasses • Baby cared for in nursery OR father holds baby, mother assisted to breastfeed
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