by Elise Bowerman
A birth plan is your intention of this baby's birth. Your intention is just that: wishes, hopes, and ideas. As you build your birth plan keep in mind things may change, and you are fully capable of handling whatever comes your way.
"The power of a birth plan isn't the actual plan, it's the process of becoming educated about all your options!"
Birth is one of Mother Nature's truest lessons of teaching us we are not in total control... if you didn't realize already in pregnancy! For this reason, I suggest using the term Birth Intentions.
Why create a Birth Intentions worksheet?
It helps your providers (doctor/midwife, nurses, doula, friends, and family supporters) understand you have:
- educated yourself on the process of birthing;
- gained knowledge as to what your options are in birthing; and,
- spent time physically, emotionally, and mentally practicing for this big day.
Depending how long you are in a hospital or birthing center you may see multiple doctors and nurses. It's important for each one to visually see your intentions to keep everyone on the same page. (Even if you birth from home.)
With your intentions written down you will likely be interrupted less. Plus, whomever is your advocate (spouse, partner, doula, friend, etc.) can speak on your behalf as much as possible referencing this sheet. It will allow you to remain in a state of focus to birth baby from a place of calmness and attention. (No unnecessary distractions.)
Keep your intentions to one page, one side only. You may enjoy making a longer one for you, your birth partner, and doula; however, medical professionals will only be scanning your document. Keep it concise and easy to view.
Use bullet points. Lists are easy to read, rather than a novel of your ideas.
Please add or create modifications which fit your intentions.
Title: Birth Intentions for Birther's Name and Baby
List full names of the birther, other caregiver/parent, and anyone else who is allowed in the room during labor and delivery and respected relationship to birther or professional title.
Indicate baby's estimated due date (EDD.)
Write one to two sentences sharing your education in birthing, or previous experience(s,) and gratefulness for everyone's assistance.
Examples: "We have had a successful non-intervened hospital birth with our son, in 2009. Our intentions are to have another non-intervened birthing experience. Thank you for your support. We look forward to sharing our daughter's birth with you."
"It is my intention to have a non-intervened birthing experience as I have practiced HynoBirthing® and Prenatal Yoga throughout this pregnancy. Thank you for your support. I look forward to sharing my baby's birth with you."
If there is someone you would like to not enter the birthing space until you grant permission, then specify first and last name(s). The staff will typically do an excellent job at keeping anyone uninvited out until you say so.
During labor I would like...
to return home if I'm less than 4 cm dilated.
to move freely (i.e. walking, yoga postures.)
to not be offered pain medication. I will ask if desired.
to eat and drink water to maintain strength and hydration.
to have the option to labor in a tub.
the room to be dimmed & quiet, with few interruptions as possible.
as few vaginal exams & fetal monitoring as possible.
to have only my partner, doula, midwife and nursing staff present. (Please no residents or students unless they are passionate and on track to becoming a midwife.)
If labor augmentation is needed I would like...
to attempt natural methods first (i.e. nipple stimulation, homeopathic remedies which I will provide, sex, relaxation techniques, or visualizations)
if baby is in distress we are open to discussing other options like stripping of membranes.
For pain relief I would like to use...
movement (i.e. walking, various yoga postures)
meditation or visualization techniques
other non-medicated suggestions care staff may have
During delivery I would like to...
move in various positions (i.e. squatting, using a birth bar for support, side-lying, hands-and-knees, etc.)
hear encouraging words.
to push without time limits, as long as baby and I are not in distress.
avoid an episiotomy by allowing baby to slowly come out, and/or massage, and/or hot compresses/washcloths on perineum.
Once baby is delivered I would like to...
wait to cut cord until done pulsating.
have spouse cut the cord.
hold baby, if he/she is not in distress, for at least 45 minutes of skin-to--skin contact prior to any tests or procedures.
save my placenta for my doula to pick up.
only breast-milk if nursing is going well.
to remain in either mine or spouse's presence at all times.
Indicate whether or not you would like Vitamin K administered. (Oral dose is an option.).
no eye ointment to be given.
no vaccinations of any kind to be given to baby, myself, or anyone else visiting us.
"We understand during birth surprises occur and have to be dealt with quickly. We ask for you to clearly communicate with us our options as they arise, so that we may stay well informed. Thank you for your kind attention."
Optional addition: "We are prepared to sign any waivers you may require regarding no medications or vaccinations to be offered to baby."
Be sure to ask questions to your provider and educate yourself on their practice and hospital c-section protocols.
Advocate for a Gentle or Family Centered Cesarean Section:
Walk into operating room, so as to signify your are in control. This can be empowering for the birth experience.
Two people of your choosing, like partner and doula, in OR for you. One to be with/greet baby, if needed. The other to stay with you at your head to continue support.
Play music of your choice (using smart device) near your head.
Ask everyone who's participating in your birth of your baby to introduce themselves and state their job. This typically happens in vaginal births, so why not in c-section births?
If baby and you are not in distress, see if delayed cord clamping is an option - even for half a minute.
Ask if they have clear drape, and/or will lower drape at time of baby(ies) birth to allow you to see your baby(ies) being born.
See if you can have skin-to-skin immediately after birth on the OR table. If not, consider having your partner have skin-to-skin.
Have your birth partner continue to tell you what's going on. If you're unable to see baby, have your partner describe baby.
Unless absolutely necessary, advocate to have all newborn procedures delayed until you are both back in your room and have had a chance to bond and breastfeed.
Often the uterus is removed from the body for examination and repair. Ask to keep your uterus "in situ" (in position) as studies have shown greater postpartum pain after surgery when the uterus has been removed.
Have your uterus be double-layer sutured. If you may attempt a vaginal birth in a subsequent pregnancy, some OB/GYNs are more comfortable attempting a VBAC knowning a double layer suturing was done during repair.
Once in your room, begin holding (and breastfeeding) your baby. Keep visitors away for a little bit so you and baby can bond on earth-side. This time together is valuable, and as few distractions as possible is best to connect.
Understand that a vaginal birth or cesarean birth are both forms of birth.
Read books listed here.
As you continue to prepare for baby's arrival keep in mind that each baby and each birther need birth to go a certain way - for whatever reason that may be. We can do everything "right", yet, still have a birth we didn't imagine. It doesn't mean you failed. It means there's something grand going on to open your perspective beyond how the birth you imagined would offer you.