What’s in a birth plan and do you need one?

The birth of a child is an amazing and wondrous event. It can also be scary, especially if it’s your first. The fear of the unknown can be crippling and terrifying. A birth plan is a way to communicate your wishes to those caring for you during your labor and after the birth of your baby. It is a tool to let the team caring for you know about your preferences.

When you pick your obstetrician, you are choosing the person who will play a huge part in the most amazing, wonderful and scary event in your life. Your obstetrician should be a partner – someone you trust with your new bundle of joy. As obstetricians, we are there to inform, guide and assist in this most intimate moment.

But in order to give you the very best birth experience, we need to have a detailed understanding of your preferences. That’s where the birth plan comes in.

Birth plan worksheets and templates can be found in pregnancy books and of course, online. No matter where you find the template, the birth plan should be a simple, clear, one- or two-page statement of your preferences. Many women, especially first time moms, may need to talk with their doctor to help them decide what their preferences are.

Typical birth plans will include preferences for:

• Pain medication (none, IV, epidural or nitrous oxide)
• Movement/position during labor and delivery
• Labor props (tub, birthing ball, squatting bar, stool, etc.)
• Induction/intervention/augmentation (breaking of water, pitocin)
• Support people (spouse, parents, Doula, extended family)
• Fetal monitoring (intermittent vs. continuous)
• Position and timing of pushing
• Episiotomy
• Delivery assistance (vacuum, forceps)
• Fluid management (to have an intravenous line (IV) or not) and food/liquid intake
• Ability to photograph or video (this will differ at each facility and with each health care provider)
• Environmental preferences (lights, music, scents, etc.)

After delivery preferences

• Cord clamping
• Skin to skin (putting baby on your bare skin immediately following delivery)
• Medication/bathing
• Breastfeeding vs. bottle feeding
• Pacifier use
• If male child – circumcision

Keep in mind you can’t control every aspect of labor and delivery. During childbirth many women feel like they are losing control. A birth plan can help maintain focus and it also serves as a refresher for your healthcare provider and serves to inform new members of your medical team about your preferences when you are in active labor.

A birth plan can be a way to ‘marry’ your idea of the birth experience with the obstetrician’s idea of a safe and ‘normal’ labor and delivery. It is important to ensure that everyone is on the same page and is comfortable with the plan of care. Also, each hospital and obstetrical department has its own policies and procedures. Discussing the birth plan gives an opportunity to gain information about those policies and procedures.

It is important to stay flexible in case something comes up that requires your birth team to depart from your plan. Remember, the important thing is having a safe birth.

Our goal with every new mom (and dad) is to have a happy healthy mom and a healthy baby.

By Whitney Dunham, MD

Whitney Dunham, M.D.
Dr. Dunham is the Medical Director of the OB Hospitalist Program at Huntsville Hospital for Women & Children. She also cares for patients at Huntsville Hospital Obstetrics & Gynecology.