Example Birth Preferences (Plan)

 

We reviewed these preferences with our medical team ahead of time and printed multiple copies to bring to the hospital. We set our copies next to a basket of snacks we brought for our team, and they were all very appreciative!

This plan was written specifically for Miss F’s unmedicated birth, so the goals will reflect those preferences. Be sure to read the unmedicated birth blog and Miss F’s birth story to learn more about this route.

P.S. I prefer the term “birth preferences” to “birth plan,” since births very, very rarely go perfectly according to plan. In my opinion, it is best to view your plan as a list of preferences and to hold them openhandedly. You want the mental freedom to make the best decisions for you and your baby in the middle of labor, rather than feeling pressure to stick to a “plan.”

Tips when preparing your birth preferences:

  • Print multiple copies and put them in your hospital bag. You will want ever member of your medical team to review them both during and after labor, and copies are easy to misplace.

  • Be sure to write your preferences with an appreciative tone. An OB who is a good family friend shared with me that many doctors and midwives feel disrespected by the tone new parents use in their plans; they’re more likely to respect your wishes if you respect them.

  • Keep your preferences to one page. Your medical team will be trying to digest these quickly and frankly, if your list is too long, they’ll probably miss important points.

 

The most important goal in a birth is a healthy mother and baby, and all decisions around the birth process should be made with a healthcare professional. These birth preferences are from Miss F’s birth and are intended to just serve as an example, NOT medical advice. I purposefully omitted our preferences on the antibiotic eye ointment, vitamin K shot, and hepatitis B vaccine from this shared version as those are very complicated decisions that should be discussed in detail with your medical team and ideally a pediatrician.

Birth Preferences for Baby

Our top priority is health and safety for mom and baby, and we have full trust in our healthcare team to provide that. Our biggest request is that our wishes are understood and accommodated as much as possible throughout the process, and that any deviation from them is explained to us.

Ideal plan:

  • Unmedicated birth

    • No pain medication

    • Free movement during labor as much as possible - walking, birthing ball, showering, in tub, etc.

    • Dim lights, quiet, encourage relaxation techniques

  • Wireless heart rate monitoring during labor (or intermittent fetal monitoring up to 4-5cm dilated)

  • Drink clear liquids and popsicles during labor

  • Hep/saline lock only (not hooked up to IV bag), until/unless needed

  • Provided the baby’s heart rate is healthy, limited number of cervical checks

  • Keep membranes intact as long as labor is progressing

  • Avoid Pitocin unless needed, and avoid Cytotec

  • Avoid forceps or vacuum unless baby or mother in distress

  • Mother-directed pushing, with various pushing positions:

    • Squat bar, all fours, lying on side, etc.

    • Avoid laying on back unless mother requests

  • Avoid episiotomy if possible

  • Delay cord clamping - wait until cord stops pulsing (3-5 minutes)

  • Baby put immediately on mother’s belly/chest, even before cord is clamped

    • Delay washing, weighing, shots, eye drops, and any other tests until initial bonding and breastfeeding has taken place

    • Rub vernix into baby’s skin (do not wipe off)

    • APGAR scoring from mother’s chest

  • Attempt natural passage of placenta (i.e. no tugging on cord). If spontaneous passage does not occur, use Pitocin with notification and consent

  • No formula or pacifiers for baby

  • Request baby is with mom or dad at all times (e.g. accompany baby to hearing test)

If intervention is believed necessary and time allows, we request all options and recommendations be explained to mom and dad

“Plan B” Preferences:

If episiotomy is required, perform a median, not mediolateral, cut

If induction is required to start or speed up labor, discuss all options and start with least invasive option (such as a Foley balloon)

If unplanned C-section is required, gentle C-section technique requested:

  • Epidural or spinal block; avoid general anesthesia unless an emergency

  • Do not strap both arms down

  • Do not automatically give drugs to relax - inform first

  • Use a clear drape

  • Still bring baby immediately to mother’s belly/chest and breastfeed as soon as possible, while mother is being sutured. If mother is unconscious, give baby to father right away for chest-to-chest bonding

  • Breastfeed in the operating room

  • Re-close the uterus in 2 layers, not 1

  • Delay washing, tests, etc. until after initial bonding and breastfeeding

  • Discuss option of vaginal swab to colonize baby with mother’s bacteria