In between deciding on nursery colors, which brand of stroller to buy and whether you want to breastfeed, it can be helpful to give some thought to your labor and delivery experience.
Sharing a birth plan ahead of time with your care team and loved ones can help them support you and make this moment as special and comfortable as possible for both you and your baby.
“A birth plan is not an exact plan or a binding agreement but instead a list of preferences about what you’d like to have happen during and after labor and delivery,” says Meg Berreth, a UNC Health certified nurse-midwife.
We talked to Berreth as well as UNC Health OB-GYN Katelin Zahn, MD, and UNC Health certified nurse-midwife Jessica Albrecht about what to consider when making a birth plan. Here are three tips on how to design a birth plan to best meet your needs.
1. Understand your options and what is important to you.
First, think about general preferences such as personal, religious or cultural considerations as they relate to your birthing experience.
“For example, Muslims say a prayer soon after the baby is born, so we know that we need to keep the room quiet at that time so that can be observed,” Albrecht says.
Other factors to consider: movement during the labor process, goals for fetal monitoring and cervical checks, pain management preferences, how you want the environment to look and whom you want to be in the delivery room with you.
“Typically, the birth plan includes things about how a birthing patient wants to behave during labor, such as whether you’d like to wear your own clothing, your plan for pain management, plans for positions, or ways you want to be supported during pushing that could be ideal,” Berreth says. “It might also include something about if there’s an unexpected cesarean section or even if a patient has a scheduled cesarean, it could include things about who they want with them in the operating room.”
There are also decisions to make about once the baby arrives such as plans for breastfeeding and when you want to initiate it, as well as what you want to do with your baby’s umbilical cord.
“Management of the umbilical cord is a frequent thing that comes up for my patients—do they want to do delayed cord clamping, or do they want us to immediately clamp and cut the cord?” Albrecht says.
While you may be thinking through and gathering information about labor and delivery throughout your pregnancy, the beginning of your third trimester—around 28 weeks—is a good time to start writing down your preferences.
“At that point, we also would have a little bit more information related to any medical problems that we will need to consider during the labor or birth experience,” Dr. Zahn says.
For example, if you have high blood pressure or a condition that could make your pregnancy high risk, it may determine recommendations for monitoring during labor and delivery.
2. Discuss your preferences with your care team.
Write down your wishes and bring them to your care team throughout your prenatal visits, and ask questions during appointments.
“We want to make sure we understand your preferences so we can align with them,” Dr. Zahn says. “As a care team, we have a shared goal of having a healthy delivery experience for you and your baby. We want to align that to the best that we can with your personal goals and vision, because your birth experience is a really important part of your life. I also think it’s empowering for patients to know that their care team supports their preferences.”
Be sure to include your birth plan when you pack for the hospital so you can share it with your labor and delivery nurses.
“They can also serve as advocates for you with your care team,” Dr. Zahn says. “If you’re planning on having a birthing support coach such as a doula, be sure you share your plan with them or anyone else that you would want in the room with you.”
3. Stay flexible.
Even with the best laid plans, sometimes things don’t go exactly as you hoped. Although you may plan for a vaginal birth, for example, your healthcare provider might recommend a C-section or have to switch to a C-section in mid-labor. There could be different reasons for this. It’s important to think about how your birth plan might need to be adjusted.
“Labor is a dynamic process, and things can change,” Albrecht says.
Dr. Zahn adds, “Even if we have to do something different than you had planned, the labor and delivery team will make sure to clearly communicate the rationale for their recommendation. If there’s a need to change our plans to keep you and your baby safe and healthy, we’ll do what we can to still support your desired birth experience.”
Looking for a midwife or an obstetrician? Find one near you.