Birth Plan guide for expectant moms.

birth-planHave you been asked about your birth plan yet? What do you think about them?

When I was pregnant, I totally didn’t get the whole birth plan thing, and I know a lot of ladies don’t. It seems like just asking for disappointment when things don’t go according to ‘The Plan’.

I ended up caving and wrote a birth plan, but then I was induced early and didn’t end up getting to even mention my birth plan. I can see now where having a birth plan would have helped out immensely.

Why? Well, I completely forgot about all my pain management options! Ideally, I would’ve tried the shower, and the gas, but ended up going straight to morphine and an epidural.

So, here’s what I think about birth plans now:

A birth plan should be flexible and detail your preferences and things you want to try during labor and delivery.

I would even include contingencies in it, for ‘if I have to have a c-section, I want to x’. ‘If I have to have to be knocked out for a c-section I want x (eg. my husband to be in the room and have skin to skin with baby immediately, where able).’ In my opinion, having thought through these options, and expressing your preferences it’ll be less disempowering if you end up having to go through that situation.

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What to Include In Your Birth Plan

  • What pain management techniques you want to try and what assistance you are willing to use. For example, I’m going to use a TENS machine and would like to be offered gas if I need it.
  • How do you want to deliver the baby? For example, squatting, lying in bed, on a birth stool, in the birth pool.
  • What are your preferences for assisted and augmented labor and delivery? Are you open to any interventions if labor slows down? What about ventouse or forceps delivery?
  • Do you want a managed third stage of labor? This is where you receive an injection to speed up delivery of the placenta. Or do you want to deliver it normally?
  • When to clamp and cut the cord? Do you want to delay clamping? Who should cut the cord? You? Your husband?
  • Do you want to be skin-to-skin with your baby immediately after delivery? Say so!
  • Do you plan to breastfeed your baby exclusively? Include it on your birth plan.

Pain Management

If you can attend antenatal classes at your hospital, it’s a good way to get an overview of what your hospital has available for you. For example, at the hospital I delivered at, they were running a clinical trial on water birthing. I didn’t qualify (high blood pressure), but it could change what your options are when it comes to pain management and delivery.

You’ll probably have these options:

Non-medical Pain Management

Your hospital provides some things you can use – for example, you’ll have access to a bed. Maybe a shower and a bath, and you might have access to a birth ball.

You can also bring your own props to help. If you want to learn actual techniques to help you get through labor naturally, I can’t recommend this book highly enough. Want more info? I wrote a post about it here.

You might want to bring along essential oils, music that calms you, a hypnobirthing track, or a TENS machine (your hospital may hire these out).

Gas

One of the most common pain relief options in labor is nitrous oxide (gas). It’s a short-lived pain relief method that works for you during the contractions. Basically, you start breathing on the gas when your contraction begins and you should feel the effects by the height of the contraction. You then stop breathing the gas until the next contraction begins.

Gas requires a little bit of timing. It takes about 15 seconds to be effective so you need to start breathing it at the start of your contraction.

Gas can also cause nausea, vomiting, and disorientation.

Read more about gas in labor here.

Pethidine

The next level of pain relief is an injection of pethidine or morphine. Ask your midwife which they will use.  Generally injected into your thigh or buttock, and takes about 10-20 minutes to become effective.

This can have an effect on the baby, especially if the baby is born within 1-3 hours of being given.

Read more about Pethidine during labor here.

Epidural

An epidural is a very seductive form of pain relief during labor. Unlike all other methods, it can take away to pain completely.
I had no intention of getting an epidural. Big, scary needle in the spine? Uh uh! But, I ended up getting one while going through transition. And then I had a nap (yep, a NAP!) before starting the pushing stage of labor.

Read more about epidurals during labor here.

Delivery Methods

There’s been a lot of research recently into delivery methods and it seems that the feet in stirrups, lying on the back method of delivery is NOT ideal.

Instead, squatting, standing, or kneeling works with gravity to get baby out.

Assisted Delivery

If the second stage of labor isn’t progressing you doctor may recommend an assisted delivery using ventouse or forceps. Basically, both methods enable the doctor to get the baby out faster.

Ventouse – works via suction.

Forceps – surround the baby’s head.

The Third Stage of Labor

This is the stage where the placenta is delivered. It will happen naturally after your baby is born, but can be speeded along by an injection if your caregiver ‘manages’ the third stage.

The benefits of managing the third stage of labor is the lower risk of heavy bleeding. However, there can be side effects from the drugs used.

Read more about managed vs. physiological third stage labor here.

Delayed Cord Clamping

Once your baby has arrived, the cord is clamped and cut. This usually happens within the first minute after birth, however, if you want to do delayed cord clamping (and your health/condition of the cord and baby’s health allows) you can leave the cord unclamped until it stops pulsing.

Why delay cord clamping?

A newborn’s circulatory system involves the placenta and the umbilical cord. At any one time, much of a newborn’s blood is actually outside it’s body. Delaying cord clamping means:

  • More blood volume
  • More red blood cells
  • Higher iron levels

Read more about delayed cord clamping here.

Skin to Skin

Many hospitals now recognize the importance of the first hour after birth for mother-baby bonding. Unless your baby has a medical need, he should be able to be held skin to skin immediately after birth.

Read more about skin to skin care here.

Breastfeeding

Your baby’s instinct will kick in after birth and she will seek the breast for her first feed. If you intend to breastfeed your baby, make it known to your caregivers.

And here are our best tips to help you breastfeed successfully!

Now it’s your turn

Are you ready to write your birth plan? Let us know!