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Birth plans are guides that parents-to-be make to help their health care providers best support them during labor and delivery.

Deciding About Your Birth Plan

There are lot of things to consider before you make a birth plan. This is a great time to learn about the various practices, procedures, pain relief methods, and other options that are available during childbirth.

Your birth plan can be very specific or very open. For example, some women know they want to try to have an unmedicated, or "natural," childbirth, and others know they absolutely do not want to have an unmedicated childbirth.

It's important to stay flexible. Keep in mind that some of the things you want may not be possible. So you may want to think about them as your birth preferences, rather than a plan.

• You may change your mind about certain things when you are actually in labor.
• Your provider may feel that certain steps are needed for your health or your baby's health, even though they are not what you wanted.

Talk to your partner as you make your birth plan. Also talk with your provider about your birth plan. Your provider can guide you in medical decisions about the birth. You may be limited in your choices because:

• Your health insurance coverage may not cover every wish in your birth plan.
• The hospital may not be able to provide you with some of the options you may want.

Your provider can also talk to you about risks and benefits of some of the options you want for your birth. You may have to fill out forms or releases ahead of time for certain options.

Once you've completed your birth plan, be sure to share it with your provider well before your delivery date. Also, leave a copy with the hospital or birthing center where your delivery will occur.

How to Write a Birth Plan

Your provider or the hospital where you will deliver may have a form that you can fill out to create a birth plan.

You can also find sample birth plans and templates in books and websites for pregnant moms.

Even if you use a form or checklist to write your birth plan, you can add other preferences that the form does not address. You can make it as simple or detailed as you like.

Below are many of the things you may want to think about as you create your birth plan.

About the Birthing Room

• What atmosphere do you want for labor and delivery? Do you want music? Lights? Pillows? Photos? Make a list of items you want to bring with you.
• Who do you want to be with you during labor? During delivery?
• Will you include your other children? In-laws and grandparents?
• Is there anyone you want kept out of the room?
• Do you want your partner or coach to be with you the entire time? What do you want your partner or coach to do for you?
• Do you want a doula present?

About Labor and Delivery

• What type of birth are you planning?
• Do you want to stand up, lie down, use a shower, or walk around during labor?
• Do you want continuous monitoring?
• Would you like to be mobile during labor and, therefore, prefer remote monitoring?
• Is there one birthing position you prefer over others?
• Would you like to have a mirror so you can see your baby being delivered?
• Do you want fetal monitoring?
• Do you want treatments to move labor along faster?
• What are your feelings about episiotomy?
• Do you want to record a video of the birth of your baby? If so, check with the birthing center or hospital ahead of time. Some hospitals have rules about video-recording births.
• Do you have strong feelings about assisted delivery (the use of forceps or vacuum extraction)?
• If you need to have a cesarean delivery (C-section), do you want your coach or partner to be with you during the surgery?
• Do you want a family-centered cesarean section? Ask your provider what is included in a family-centered cesarean section.

Pain Relief During Labor

• Do you want to try to give birth without pain medicine, or do you want medicine for pain relief? Would you like to have an epidural for pain relief during labor? Would you prefer only IV pain medicine?
• Would you like to be able to labor in a tub or shower, if allowed, at the hospital?
• How can your labor coach or partner help soothe your pain?

Right After Your Baby is Delivered

• Who do you want to cut the umbilical cord? Do you want to save or donate the cord blood?
• Do you want delayed cord clamping?
• Do want to keep your placenta?
• Do you want skin to skin contact for immediate bonding with baby after birth? Do you want father of baby to do skin to skin contact?
• Do you want to hold your baby as soon as it is born, or do you want the baby washed and clothed first?
• Do you have wishes about how to bond with your baby after it is born?
• Are you planning to breastfeed? If so, do you want your baby to stay in your room after delivery?

Postpartum Care

• Would you like to avoid pacifiers or supplements, unless ordered by your baby's provider?
• Do you want anyone from the hospital to help you with breastfeeding? Would you like someone to talk to you about bottle feeding and other baby care issues?
• Do you want a male baby to be circumcised (foreskin removed from penis)?

References

Hawkins JL, Bucklin BA. Obstetrical anesthesia. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 16.

Kilpatrick S, Garrison E, Fairbrother E. Normal labor and delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 11.

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