Thursday, April 24, 2014

A Birth Plan (How to)


A birth plan is a document that tells your medical team your preferences for such things as how to manage labor pain. Of course, you can't control every aspect of labor and delivery, and you'll need to stay flexible in case something comes up that requires your birth team to depart from your plan. But a printed document gives you a place to make your wishes clear when you have a choice.

A written birth plan also helps refresh your provider's memory when you're in labor. And it informs new members of your medical team — such as your labor-and-delivery nurse — about your preferences when you're in active labor.


I supply all my clients with a mock birth plan template so that we can easily talk about all the things you can expect at birth. Often times (especially for new moms) we have no idea what to expect in birth until we're there, in the moment. And though we can talk with our physician or mid-wife what to expect, its often impossible to talk through all the scenarios and choices there are in birth without having done it yet. There are so many variables that contribute to the birth experience and having a birth plan helps us prepare psychologically for birth. A birth plan can really empower a woman to have a voice during birth. I recommend giving everyone a copy of your birth plan that is expected to be in the room during your labor (doctor, hospital staff, doula, friend or relative, etc.) This is because you want those who plan to be there with you know how to best support you. It simply is not best to only inform your doctor/mid-wife what you desire in labor and birth. Every support person you choose to be in the room with you during labor and birth will effect your experience - it's important every person present are on the same page - and thats it's all about the mother who is laboring. 

A birth plan also helps us talk about the possibilities and alternatives to things not going according to The Plan. So much of birth prep is mental, that evaluating all your options and alternatives can prepare you for processing your birth experience in a healthy way if things don't go according to plan. 

Here is my template I use, with options listed so moms have a good understanding of what is available to them. This plan has worked really well with both home, birth centers, and hospital births. 



www.sacred-birth.blogspot.com  
Birth Plan Worksheet  
  
Basic Information  
Name: __________________________________________  
Partner’s Name: ___________________________________  
Doctor/Midwife’s Name(s):  __________________________  
Other Birth Attendants (doula, friends, etc.): 
_________________________________________________________________________________
Children and Helpers, if attending: _________________________________________________________________________________
Baby’s pediatrician, if known: _________________________________  
Delivery location: ______________________________________  
Estimated Due Date: ___________________________________  
  
Pre‐Birth Preferences  
Do have any religious practices that will be contributing to your birth environment/experience?
_________________________________________________________________________________

Induction:  
___ I prefer to be induced on _____________ (date)  
___ I will discuss induction after _____________ (date)  
___ I prefer not to be induced unless it becomes medically necessary  
___I am having a scheduled c‐section on _____________ (date)  
  
Arriving at the Birth Location  
___ I will be birthing at home  
___ I prefer to arrive as soon as contractions begin or my water breaks  
___ I prefer to arrive once my labor is well established  
___ I prefer to arrive only once I am advanced in labor; I want to labor at home as long as possible  
  
Paperwork  
___ We will pre‐register  
___ We will do the paperwork at our earliest convenience; please do not separate me from my support  
person  
___ We will do the paperwork immediately; please make an y separation as brief as possible  
  
Comfort Measures  
I would like to use the following comfort measures:  
___Pain medication (see below)  
___Massage  
___Birthing ball  
___Birthing tub  
___Music  
___Essential oils 

___Other: _____________________________  
  
Pain Medication  
___Please don’t offer it; I will ask if I want it  
___Please offer me pain medication immediately upon arrival (explain my options)  
___Please offer me pain medication only if I seem to need it  
  
IV  
___I do not want an IV or Hep lock at all  
___I am okay with a Hep lock, but do not want an IV  
___I would like an IV  
  
Water  
___I would like my water broken upon arriving at the hospital, to speed things along  
___I would like my water broken only if my labor is slow and I am exhausted  
___I would like my water broken only if my baby’s arrival is imminent and it hasn’t broken on its own  
___I would not like my water broken under any circumstances  
  
Food/Drink  
___Please offer me ice chips or popsicles and nothing else  
___Please offer me drinks but not food  
___Please offer me food and drink as I need it  
___Please do not offer me anything; I will ask or have an IV  
  
Labor Augmentation  
___If it becomes necessary, I would like to try natural methods first, including:
___Nipple stimulation  
___Walking  
___Herbs  
___Other  
___Please offer me Pitocin  
___I would like to try to avoid augmentation if at all possible; my baby will come when s/he is ready  
  
Fetal Monitoring  
___I prefer an external continuous monitor  
___I prefer a continuous internal monitor  
___Please use an external monitor for a few minutes per hour to check on my baby  
___Please use a Doppler to check on my baby occasionally  
___Please do not use any devices to monitor my baby; use a fetoscope or palpations only  
  
Labor Positions  
I would like to labor: 
___While walking  
___Lying down  
___Sitting on a birthing ball  
___In the tub/shower  
___Let me decide at the time  
  
Environment  
___Please keep the lights dimmed  
___Please keep noise levels low  
___Please play music.  I would like a particular collection: _________________  
___Please do this: _______________________________________  
  
Internal Exams  
___Please examine me as soon as I arrive and hourly after to check my progress  
___Please examine me only if I ask  
___Please keep examinations to a minimum  
  
Pushing Preferences  
___I would like to push on my back  
___I would like to push on my hands and knees  
___I would like to push on my side  
___I would like to push on a birthing stool  
___I would like to push _____________________  
___Let me the decide at the time  
  
Episiotomy  
___Please cut an episiotomy if my baby is large and having difficulty  
___Please do not cut an episiotomy; I would rather risk a tear  
___Please allow me to try different pushing positions to avoid a tear  
___Please use perineal support, massage and hot compresses to help avoid a tear  
  
Vacuum/Forceps  
If I need an assisted delivery, I would prefer:  
___Vacuum  
___Forceps  
___I trust my doctor to decide what’s best  
  
C‐section  
___Please help me to avoid a c‐section unless an emergency arises  
___Please offer me a c‐section in my labor is not progressing after ___ hours  
___I would prefer a c‐section  
___Other: ___________________________ 

  
Emergency Procedures  
___Please explain to me what my options are so I can choose  
___Please use your own discretion and choose what is best for me   
  
Moment of Birth  
___Please place my baby immediately onto my chest and leave him/her there  
___Please allow me to hold my baby briefly before taking him/her to be cleaned and weighed  
___Please take my baby to be cleaned/weighed immediately



Please explain:
_______________________________________________________________________________

  
Cord Cutting  
___Please cut my baby’s cord immediately  
  ___Please allow my husband/partner to cut the cord  
  ___Please have a doctor cut the cord  
___Please wait until the cord stops pulsing before cutting  
___Please wait at least an hour to cut my baby’s cord  
___Please do not cut my baby’s cord (lotus birth)  
  
Initial Bonding  
___Please leave us alone for an hour after birth to bond  
___Please clean and dress my baby, complete our medical exams, and then allow us bonding time  
___Please do this: _______________________________________________  
  
Newborn procedures:  
We give consent for:  
___Eye ointment  
___Hep B vaccine  
___Vitamin K shot  
___PKU test  
___Hearing test  
  
We do NOT give consent for (please bring us any waivers we need to sign):  
___Eye ointment  
___Hep B vaccine  
___Vitamin K shot  
___PKU test  
___Hearing test  
  
Feeding  
___My baby is exclusively breastfed, please do not offer:  
___Formula  
___Sugar water  
___Pacifiers  
___My baby is formula fed, please help us choose a formula  
  
Rooming In  
___I wish for my baby to remain in my room 24/7  
___Please take my baby to the nursery only at my request  
___Please take my baby to the nursery at night so I can sleep (bringing him/her for feedings)  
___Please take my baby to the nursery except when s/he needs fed  
  
Visitors:  
___I am open to any visitors during visiting hours  
___Please allow only the following people: __________________________________________  
___Please do NOT allow the following people: _______________________________________  
___Please, no visitors during these times: ___________________________________________  
  
Medications Post‐Birth  
___Please offer me OTC‐strength medications to cope with pain (acetaminophen, ibuprofen)  
___Please offer me stronger medications to cope with pain (as prescribed)  
___Please offer me arnica or another natural pain reliever  
___Please do not offer me pain medication  
___Please offer me a stool softener  
___Please do NOT offer me a stool softener  
  
Baby’s Exam  
___Please perform my baby’s exam in my room  
___Please perform my baby’s exam in the nursery with myself or my partner present  
___Please perform my baby’s exam in the nursery, we do not need to be present  
  
Hospital/Birthing Center Stay:  
___We prefer to leave 6 hours after birth  
___We prefer to leave 24 hours after birth  
___We prefer to stay 48 hours after birth  
___Please give your recommendation on our length of stay  
  
Complications   
___If my baby requires a hospital transfer, please allow my partner to accompany him/her  
___If my baby requires a hospital transfer, please allow us to go together once I am released  
___Please allow another family member to accompany my baby: ________________________   
  
Other:  
_________________________________________________________________________________
_________________________________________________________________________________

www.sacred-birth.blogspot.com

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