A Sample Birth Plan

a sample birth plan

I vividly remember someone asking me if I had a birth plan when I was pregnant with my first baby and immediately googling what this was exactly. I had no idea this was a thing. I mean how would I know? You don’t know until someone tells you. This blog is me passing along information that I did not once know, but now believe helped me achieve my birth goals. Feel free to modify and make this sample plan your own. Wishing you a beautiful birth and a peaceful postpartum.

Sample Birth Plan

Name:
Care Provider:
Pediatrician:
Birthing Team:

  • Partner:
  • Doula:
  • Midwife/OB:
  • Other:

To all present at the birth of our baby, we are so grateful. Without you, we know these preferences would not be possible. We appreciate your advocacy and commitment in providing the most natural delivery possible for the mother and baby.

ENVIRONMENT

Requested room with birthing tub, if available. Please help us keep the room restful by:

  • Closing the door
  • Dimming the lights
  • Minimizing noise

LABOR

  • I wish to be able to move around (including walking) and change positions at will throughout labor. Please do not restrict positions unless absolutely necessary.
  • I would like to use a birthing ball, moist heat wrap, massage ball, essential oils and affirmations throughout labor.
  • I would like to eat and drink as needed, including ice chips.
  • I would prefer to keep the number of vaginal exams at a minimum. Please ask for consent.
  • I do not want a hep-loc.
  • I do not wish to have continuous fetal monitoring. Intermittent checks are preferred.
  • I do not wish to have my membranes ruptured.
  • I would prefer to be allowed to try changing positions and other natural methods if the labor seems to stall. (walking, nipple stimulation, etc.)
  • I have been educated on the available pain medications. I will ask for them if I need them. Please do not offer them to me.
  • I prefer to tear and do not want an episiotomy.
  • Please do not verbally guide pushing. I would like to push when I feel the urge.

DELIVERY

  • I would like to be able to choose the position in which I give birth.
  • I would appreciate having the room lights turned low and having the room as quiet as possibly for the actual delivery.
  • I would like to have the baby placed on my stomach/ chest immediately after delivery.
  • Please delay the cutting of the umbilical cord until it has stopped pulsating.
  • I wish to keep the placenta. Cooler has been brought for transport to home.

 IMMEDIATELY AFTER DELIVERY

  • My partner wishes to cut the cord. In an event s/he is unavailable, the doula will cut it.
  • I plan to keep the baby near me following the birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.
  • I do not want eye ointment on my baby.
  • Please delay Hep B shot. We will discuss this with our pediatrician at our first visit.
  • Please administer Vitamin K.
  • If the baby must be taken from me for medical treatment, it is requested that my partner be with the baby at all times.
  • I would like to hold baby for one hour before he/she is examined.
  • In case of emergency, please do not cut the cord during resuscitation.
  • I do not wish to be separated from baby. Please speak with my partner or me first if required for health reasons.

BREASTFEEDING

  • I plan to breastfeed the baby and would like to begin nursing the baby right after birth.
  • I do not wish the baby to be given a pacifier.

 CESAREAN

  • If a cesarean delivery is needed, I would like my support team to be fully engaged in the decision making process.
  • I would like my partner to be present at all times.
  • If the baby is not in distress, I would like he/she to be placed on my chest immediately after delivery. If this is not possible, I would like baby to be given to my partner for skin to skin.
  • If baby is in distress, I would like my doula to be with baby at all times and my partner to remain with me.
  • I would like to attempt breastfeeding as soon as possible.

 

 

3 Quick Tips for Writing your Birth Plan

writing your birth plan

Writing your birth plan can feel like a daunting task. You want to make it concise and straightforward while still including all the necessary pieces. Before you even get to that though, be sure you have a care provider who is supportive and open to birth plans. If you have mentioned a birth plan to your care provider already and you felt disparaged, run, don’t walk, to a new, supportive provider. Providers who feel that they are the final authority regarding your birth, have no place on your support team. You deserve better than that, you deserve to be heard and collaborated with, not brushed off or made to seem less than.

The preparation that goes into creating a birth plan involves researching common practices in your choice of birthing location and then teasing out those things that are most significant to you and what learning what the potential alternatives may be. By educating yourself about the birthing process and the choices you have, prior to being in the throes of labor, you are increasing your chances of having the birth you desire. You will feel empowered and confident on the day of your child’s birth because you have informed yourself and you’re not simply at the mercy of the professionals and protocols surrounding you.

Marsden Wagner, doctor and author of the book entitled Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth, dives deeply into the details one may want to include in a birth plan. This book is highly recommended for you if you’re preparing to sit down and get your birth plan on paper so you can present it to your provider. The purpose of this post is to outline some quick tips from the book on how to best present your wishes and increase the likelihood of you and your care provider aligned regarding these wishes.

Keep your Birth Plan Flexible
Make it known in your birth plan that you fully understand your list of desires are a wish list for your ideal outcome. While you do anticipate having a smooth labor and delivery and you do expect your provider to respect your wishes, you’re also not blind to the fact that the process is not totally predictable. Wording such as “Unless there is an emergency…” or “If circumstances allow…” relay this message clearly.

Be Brief
A one page birth plan is the goal, but no more than two pages maximum is best. This helps to ensure that everyone on your birth support team will be able to read over and recall what you have listed. If you have specific details that go beyond what is necessary for your care provider/nurses to know, it’s a good idea to have a longer version with those details for your partner, doula, or other advocate to familiarize themselves with so that they can be addressed as needed throughout the labor process. A bulleted birth plan is best, making it easier to read.  Full paragraphs can be daunting for busy L&D staff.

State your Plan in the Positive
Rather than presenting your birth plan as a list of things you do not want done, phrase things in the positive. Keeping your phrasing positive helps decrease resistance from caregivers. Try stating what it is you do desire followed by the intervention or procedure you’re hoping to avoid. For instance, “I wish for my perineum to remain uninjured in the labor process; however, if the situation arises, I prefer to tear naturally rather than have a surgical cut.”

These three basic guidelines should really help jump start the creation of your birth plan. Having solid parameters for how to present your birth plan so it meets the least resistance among your care team is a huge step in the direction of a desired labor and delivery. While many considerations remain as far as what exactly you may want to include in your personal plan, knowing how to get those ideas on paper is the first phase of drafting your birth plan. You’re encouraged to purchase or borrow a copy of Dr. Marsden Wagner’s book, Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth for a full and detailed process for creating your birth plan.

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