You know what they say about “best-laid plans…”. That being said, plans are still a good idea. You might not stick to one – nature or other forces may have their way with your plan – but creating the plan is often the most important of the process because they produce a clarity of purpose, intention, and vision.
Creating a birth plan and keeping it flexible
The same is true for birth plans. Your labor and delivery may go as planned or veer off course occasionally, depending on what Mother Nature has in store. Regardless, birth plans are a good way for you and your delivery partner to “practice” what might be needed when, to come up with strategies to stall interventions if a natural birth is important to you, to create a “tool kit” of relaxation, breathing and pain relief techniques, and so on.
Step One: Speak with your healthcare provider
Some care providers are more dedicated to a birth plan than others. It’s worth asking about this when searching for the right OB for your labor and delivery. This is why we’re so supportive of midwives and doulas in the delivery room – they serve as the mother’s advocate throughout the childbirth experience and can keep the birth plan and intentions on track when mama is in the most challenging stages of labor.
Step Two: Start talking to the mothers in your life
Have conversations with various women in your life about their birth plans. Were they successful? Did it help? What do they wish they’d done differently or accounted for? The thing is, you never really know what you’ll want in labor. First-time mothers think they know what they want – but envisioning labor and being in labor are two very different things. Second and third-time moms are often surprised to find that each labor/delivery is different, and what worked with one doesn’t work with the other.
For this reason, create a specific plan that is open to the fact that things might change when you’re in labor.
Step Three: Create a birth plan with a Plan A and Plan B
Of course, Step 3 has multiple parts – so here’s how to get started:
Keep it all on one page – but create two pages.
One page is all any care provider will be able to review in the heat of the moment, but your birth partner will know every step in detail, so the plan will serve as a guide. It’s best to create two separate pages:
Page 1 – The uncomplicated birth plan(vaginal birth) version.
Page 2 – The birth plan that accommodates for complications (cesarean section or complications with baby).
Start from the beginning
Consider everything about the space you labor in, who should be there, who shouldn’t, what’s your code word or signal if you need a break from people in the room, and so on. What kind of lighting do you want? Do you plan to have some sort of sound in the background, etc.?
What interventions, if any, do you want for pain? Or to speed your labor along? If you want a natural birth – it’s best to ask the staff not to ask about induction, epidural, or pain meds AT ALL. Period. That way, you aren’t fielding unnecessary questions. Then, your birth partner, doula, and/or midwife can make a request if you change your mind midstream. Sometimes we hear that women were asked so repeatedly about a specific intervention they finally said, “alright, already…” and then wished they had stuck to their guns. The less you have to defend or deliberate during labor, the better.
While medication is an option, plenty of women can weather the discomfort associated with labor because they know it’s temporary. Things like massage, pressure, ice/hot packs, showers, soak or Jacuzzi tubs, position changes, mobility, visualization, and breathing techniques – all are available to you, and your labor coach can help you run through the gamut of options since what you want may shift from moment to moment.
What positions are available to me?
Freedom to move and change positions can make a tremendous difference in how your labor progresses – and how you and your baby feel through it all. It’s always best to work with providers who are flexible and supportive of you changing positions, getting up to walk around or sit on a yoga ball, and who don’t consider detaching and reattaching the fetal monitor a major inconvenience. Do you really need the fetal monitor, or will they agree to use a Doppler? That’s another potential adaptation/plan.
How do you feel about episiotomy?
While it’s still a mainstay in some hospitals, studies have shown that proper perennial support, massage, position changes, and mother-led pushing can eliminate the need for episiotomies. Similarly, ample evidence shows that a mother’s natural tearing heals better than episiotomies when all is said and done.
What’s your immediate post-partum plan?
Do you want to delay the cord-cutting? Do you want immediate vital signs taken while the baby is skin-to-skin on your chest? Excluding a complicated labor or dramatic signs that something is amiss with the baby, almost everything we do to check on the baby’s well-being can be done while the baby rests in your arms or chest. Some things (weighing, for example) can even wait for a little while- until you’ve had time to enjoy each other’s company, breathe in each other’s scent, feel each other’s heartbeat outside, and even until baby has had their first latch and breastfeeding. This assumes your baby is breathing well and shows no signs of distress or unusual complications. If you’re still not certain what your plan will be, check out this article for some ideas.
If you need a C-section, do you have any special requests?
There is no doubt that vaginal birth trumps C-sections, but surgical intervention is necessary in approximately 1 in 5 childbirths. This is Plan B for most women, but a plan should still be in place. Skin-to-skin contact is still possible immediately after delivery if the baby is not in severe distress. If the baby (or mama) requires immediate medical attention whisked away, your partner should be able to stay right with the baby, touching them (even if it’s just holding food or a hand) and talking to her (the voice will be recognized). Knowing the dad, partner, or another loved one is with the baby makes the mother feel much more at ease during what is bound to be a stressful situation – the baby will be in constant contact with someone who loves them as must as possible.
We hope you’re planning to breastfeed your baby, but if not, please do dedicate at least the first day or two (if not longer) to breastfeeding or pumping. Your breasts are producing colostrum and breastmilk that is custom-designed for your baby. It will optimize the health of your baby’s gut, immune system, and overall physical development. Seek assistance from the hospital’s lactation consultant(s) as much as you need it – that’s what they’re there for. If one doesn’t resonate with you, ask for another or have your partner contact a local La Leche League. The sooner you have the proper assistance, the better for you and the baby.
Looking for a labor and delivery team that will prioritize your birth plan? Contact us here at Overlake OB/GYN and schedule a consultation. Our fantastic team of physicians and midwives do our best to put our patients’ best interests first.