A Birth Plan? Make your baby delivery worry free!

Our takeaway:

1. Birth plan is worthwhile given the benefits vs efforts required.
2. Compare multiple birth plan templates to help you cover everything that matters to you. You might want to think about some edge cases.
3. Discuss your birth plan with your healthcare provider in advance so that they are prepared.
4. Being flexible both during the early discussions and during labor/delivery will help minimize stress and potential maternal and neonatal risks.

As crazy as it sounds, out of everything else we are busy doing as new parents, we need to work out a plan just to give birth! Yep, I was shocked too when I first read about it from Expecting Better by Emily Oster (Chapter 21). However, after I researched more, it appears to me that a birth plan is just a wish list — A wish list that enables us women to be in control of how we want the labor & delivery to be.

Birth Plan Benefits

1. Allow you to think through your options and preferences. Imagine if you have to decide whether to have episiotomy or not when you are in pain between contractions. I might be like “What does that even mean? Whatever!”.
2. Set expectations for yourself, your partner, helper (i.e: doula or midwives), and healthcare staff. Birth plan helps you visualize what is going to happen and what you will likely be doing. It also helps communicate your expectations to the stakeholders so that you know everyone by your side is on the same page.
3. Empower you to make the best decisions for yourself and your baby, and feel most comfortable when giving birth. This is important to ensure the most desired maternal and neonatal outcomes and your end-to-end experience.

Most hospitals have birth plan templates or you can easily find one online. So the work/effort to come up with this plan is minimum. Even if it might take longer/more work (if you have OCD like me), it will be worthwhile for a worry-free labor and delivery experience. Just think about the work we put in writing down our wishes to Santa as kids!

What We Will Include in Our Birth Plan

After researches and consolidation, our draft birth plan will include the following. Of course we are still early and therefore there are some items we are not sure yet as indicated by “?”).

Labor Stage:

1. Eating/drinking: fluid (energy drink)/water
2. Doula be present during labor
3. Labor augmentation if labor progression is slow (in this order): 1) Amniotomy (breaking water), 2) Pitocin
4. Free movement (i.e: hall walks)
5. Labor in tub Environment: 1) Dim lights, 2) Calming music

Intervention:

1. Broken water: induce if labor doesn’t start on its own within 12 hours
2. No episiotomy
3. Epidural is preferred
4. Intermittent monitoring
5. Limited cervical checks
6. Doctor will catch baby
7. C-section only if baby is breech
8. (If C-section): 1) Gentle C-section, 2) Lower segment incision to minimize risks for later pregnancies, 3) Dissolvable suture material, 4) One-/two-layer suture?

After birth stage:

1. Delayed cord clamping only if the baby is born before 37 weeks
2. Cord to be cut by partner?
3. Vitamin K shot
4. Pitocin after birth to prevent postpartum hemorrhage
5. No cord-blood storage. Donation is fine
6. Placenta delivery: active, traction/pull, or physiological?
7. If boy, circumcision?

Newborn care:

1. Immediate skin-to-skin with mom unless the baby is in distress
2. Partner to hold baby if mom is not able (if after C-Section)
3. Mom plans to breast feed or pump

A couple of final notes:

1. Compare multiple birth plan templates to help you cover everything that matters to you. You might want to think about some edge cases such as what to do if water breaks before contractions start. Most of the templates don’t cover that.
2. Discuss your birth plan with your healthcare provider in advance so that they are prepared. (Rather than handing them the plan on the day of). Ideally, have the discussion at 36 weeks pregnant.
3. Be adaptive/flexible. Know that your healthcare professionals may disagree with some of your preferences given your unique situations, facility limitation, and etc. Being flexible both during the early discussions and during labor/delivery will help minimize stress and potential maternal and neonatal risks.

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