Sample Birth Planning

Making out a list of goals, known as a Birth Plan, will help you reduce the fear and pain of labor, have a safer more fulfilling birth, and enjoy healthier, less stressful days after the birth.   Presenting this to your caregiver can help open lines of communication and clarify what your goals are.  It can also signal if you need to change birthplace and/or caregiver to meet those goals.  Additionally, it will help you make contingency plans for the unexpected, such as a transfer or cesarean, less traumatic and can lend to a more positive outcome.    Draw up this plan and present it to your caregiver and ask for his signature, as nurses cannot adhere to anything that isn't signed.  It's also essential that your doula have a copy as well.  Be sure to have about 5 copies on hand to give to others or incase someone loses one.

WHAT TO INCLUDE

~ Your names, due date, any complications if applicable, caregiver, birthplace, back up caregiver and birth place, baby's caregiver.

~  You may want to do an introductory paragraph telling the staff  that you don't intend this to be a script, but a list of goals you'd like to achieve conditions permitting.

1.    Our  greatest hopes for labor.  This could include:

~  monitoring preferences (continuous vs. intermittent)

~  Clothing preferences (no clothes or wearing your own vs., hospital gown)

~  IV and nourishment preferences (no IV, hep. Lock, continuous IV, eat and drink freely)

~  Staff attitude (supportive vs. aloof or negative)

~  Documentation preferences (videotape, camera)

~  Any religious ceremonies or customs

~  Drug preferences (epidural, pitocin, narcotics, etc)

~  Draping preferences (using a sterile drape vs. nothing)

~  Perineal preferences (episiotomy, tearing, support to perineum, anesthesia for repair, etc.)

~  Pushing preferences (choice of position, directed vs. instinctual pushing, length of pushing stage, etc)

~  Crowing preferences (use of mirror, touch as it crowns)

~  Type of delivery (Spontaneous vs. forceps or vacuum extractor)

~  Father and mother participation (Would you or dad like to catch or assist)

~  Suctioning preferences (baby to be suctioned vs. waiting to se if he can handle his own mucus)

~  Bed preferences (keeping the bed together allowing for more position options vs. breaking bed down and limiting to one position)

~  Waterbirth preferences

2.  Our greatest fears:  refer to above items and also consider:

~  cesarean preferences (be specific especially if you're a VBAC)

~  Other interventions and why

3.  The comfort measures we think we may like to use:

~  Positions

~  Water use option (tub or shower?)

~  Atmosphere (music, low lighting/noise, restrict # people in room)

~  Vocalization

~  Visualization

~  Massage

~  Verbal feedback

4.  The mother's preferences for drugs are:

~  Epidural, spinal, tranquilizers, sedatives, analgesics, general, etc if any

5.  If a cesarean becomes necessary, we hope that:

~  What support persons would you like to accompany you? (husband, midwife, doula, family)

~  Anesthesia preferences (epidural, spinal general)

~  When to hold the baby (conditions permitting right away, after surgery)

~  Uterine repair (uterus repaired inside vs. outside your body)

~  IV relaxant preferences (avoid or accept?)

6.  After the baby is born, our greatest desire is:

~  Timing preferences (immediate skin to skin vs. staff whisking baby off )

~  Cord preferences (immediate vs. delayed clamping and cutting)

~  First nursing preferences (baby to remain with mom until breastfed vs. doing newborn routines than breastfeeding)

~  Newborn routine preferences (eye drops, vit K, Hep B, PKU).  If choosing, timing of those routines (immediate vs. delayed)

~  Breastfeeding preferences (demand exclusive vs. bottled and scheduled with pacifiers)

~  Rooming in preferences (baby to room in vs. nursery care)

~  Circumcision preferences (no vs. within hospital stay or delayed)

~  First bath (to be done at all, by parents vs. staff)

7.  If our baby requires medical assistance we hope that:

~  Transporting (loved one to go with baby?)

~  Kangaroo vs. isolation care

~  Breastfeeding and newborn routine preferences