How to design a birth plan that meets your needs

Pregnant woman in hospital bed

Pregnancy and childbirth can be very exciting, emotional and personal events. Many women feel strongly about how they want their labor and birth experience to unfold. Creating a birth plan will help ensure those wishes are carried out.

A birth plan is a written statement that describes an expectant mother’s expectations, desires and preferences during labor and postpartum. It explains how she wants to give birth and how she wants to be supported.

“Women who develop a birth plan that they share with their provider have a greater knowledge of labor and birth and feel more empowered during their birth experience,” says Alyssa Fischer, APRN, CNM, Nebraska Medicine certified nurse-midwife. “It’s a great communication tool for the patient, family and providers. Studies show that women who have a more comfortable and trusting relationship with their provider feel like they had more control in the birth process.”

Fischer recommends starting to think about what you may want in a birth plan within the first trimester. This will allow you to create a partnership with your provider and let you begin preparing for your childbirth experience based on your wishes.

“At Nebraska Medical Center, we discuss birth preferences with each patient and then provide a recommended birth plan tailored to each new mother that can be modified further to fit her wishes,” says Fischer.

Our team of experts can care for all types of pregnancies and deliveries, from low to high risk. “Providers are prepared to care for low-risk and high-risk pregnancies, mindful of patient’s needs and desires,” says Fischer.

If your pregnancy is high risk, Nebraska Medical Center has maternal-fetal medicine specialists and trained specialty teams to ensure you receive the highest level of care.

What should be included in a birth plan

When developing a birth plan, Fischer recommends you consider the following:

Comfort measures – Include your wishes for things like mobility during labor, eating and drinking, hydrotherapy, massage, birth balls, music and positioning.

Pain relief – Are you open to an epidural, nitrous oxide or intravenous pain medications, or do you prefer using repositioning and hydrotherapy?

Support – Who do you want as your support persons during labor and birth? “Having good support during labor is so important,” notes Fischer. “Women who have continual support during labor and birth have a decreased use of medication for pain relief, slight reduction in length of labor and improved maternal satisfaction. Your support person should be supportive of you both emotionally and physically. They should be aligned with your desires and beliefs and empower you during labor and delivery.”

Some women have found using a doula to be very valuable, notes Fischer. A doula is a trained professional who provides continuous physical, emotional and informational support to the expectant mother before, during and shortly after childbirth. The goal is to help her achieve the healthiest, most satisfying experience possible.

Medical procedures – What interventions, if any, are you comfortable with? This may include medications to induce labor, contraction monitoring, fetal monitoring, intravenous access or amniotomy, an artificial membrane rupture (breaking your water) to induce labor.

Newborn care – This should cover whether you want skin-to-skin with the baby after delivery and whether your baby can have standard medications before going home. This includes vitamin K, hepatitis B vaccine or erythromycin to protect against infection.

Finalizing your birth plan

Fischer recommends reviewing the birth plan with your provider about 30 weeks into your pregnancy to discuss and determine if you need to make any changes. You should also review it with your support person to ensure they understand your desires and expectations.

Also, bring copies of your plan to the labor and delivery unit. This will allow all providers involved in your labor and delivery to get to know you and become familiar with your desires, notes Fischer.

While a birth plan is a great tool to help you have the best birth experience possible, you should also understand that a birth plan is about preferences and should be flexible, explains Fischer. The plan may need to be modified should your labor and delivery become complicated.

“We recommend you discuss a backup plan with your provider in case interventions are required,” says Fischer. “Discuss how you will cope and what can be modified, so it still meets your wishes. This will enable you to feel like you still have some control over your birth decisions, so you will feel good about it in the end.”

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