Your Pregnancy Matters

3 steps to turn your preferences into a birth plan

Your Pregnancy Matters

Dr. Duryea discusses birth preferences with a patient.
You know which baby names you prefer, how you want to decorate the nursery, and whether you want to breastfeed or use formula. And you’ve likely pictured every moment of your baby’s birth.

Labor and delivery can be a whirlwind. The excitement, nerves – and, yes, the pain – can make it difficult to focus. You can’t predict how your baby’s birth will play out, but being as prepared as possible can boost your confidence and allow you to more fully enjoy your baby’s entrance to the world.

That’s where a birth plan can help. In fact, a February 2016 study showed that women who had a birth plan or took a prenatal education class were more likely to have a vaginal delivery than women who didn’t. Vaginal delivery is less invasive than a C-section, and it tends to lead to shorter hospital stays, lower infection rates, and quicker recovery.

Researchers found that women who had a birth plan were almost twice as likely to avoid a cesarean section, and women who attended a class were about 25 percent more likely to avoid a C-section. While the exact reasons for the results were unclear, they suggest that more preparation before childbirth may increase your odds of a vaginal delivery.

Let’s take a look at what a birth plan is and three steps to create one.

Birth plan vs. birth preferences

A birth plan is a document that outlines your preferences for things during and after childbirth such as pain management and breastfeeding. We recommend thinking of it as “birth preferences” rather than a “birth plan.”

A plan sounds like something is set in stone. We can’t always control labor and delivery, and we must remain flexible to deal with the unexpected. By outlining your birth preferences, your medical team will know what you expect if labor progresses normally or if complications arise.

1. Decide what’s important to you

Every woman has birth preferences, even she doesn’t write them down. I kept my own pretty simple: I wanted a healthy baby and an epidural. How in-depth you go with your birth preferences is up to you.

I recommend you focus on the things that are most important to you. We find that when a woman’s birth plan gets bogged down in too many details, it tends to lead to false expectations and disappointment if they all can’t be fulfilled.

Along with talking with your doctor, there are plenty of online templates that you can use as a guide. Here are a few questions you may consider addressing:

  • Whom would you like to care for you? Depending on where you deliver your baby, you may have multiple providers available for your delivery. For example, at William P. Clements Jr. University Hospital, an obstetrician or a certified nurse midwife can attend your labor and delivery.
  • How do you want to manage pain? If you plan to use natural pain-relief techniques, you may request that pain medication not be offered. You also can ask to be offered an epidural as soon as possible. Or you may want to decide whether to use pain medication as labor progresses.
  • What is your partner’s role during the birth? Do you want your partner in the room during the birth? Will they cut the umbilical cord? Would you like them to announce the gender of the baby?
  • What are your preferences if a C-section is necessary? There are many variables when it comes to a C-section, but there are a few things you should consider beforehand. Would you prefer an epidural to general anesthesia? If so, you need to be aware that general anesthesia may be necessary in an emergent situation when a women does not already have a labor epidural in place. If your hospital has the capability, would you like to watch your baby being born through a window in the surgical drape? Do you want to hold your baby immediately if their condition allows it?
  • Do you have preferences about the cord blood? Would you like your doctor to delay cord clamping? Do you plan to bank your baby’s cord blood?
  • How would you like to feed your baby? Do you plan to breastfeed or use formula? Would you like to be consulted before your baby is given a pacifier?
  • Which vaccinations and screenings do you want your baby to receive after birth? Newborns typically are given several medications, vaccinations and screenings soon after birth. Are there any you would prefer they not receive?

By no means do you need to include all of these items in your birth preferences document. Similarly, if there is something that you are passionate about that is not on this list, feel free to address it.

2. Discuss your birth preferences with your medical team

When choosing an Ob/Gyn, ask about their philosophies surrounding issues important to you. Personally, if you have a preference for something I would not routinely do, as long as it doesn’t endanger you or your baby, I will work with you to give you the experience you desire.

Your best resource when developing birth preferences is your doctor. It’s important that you’re both on the same page before you go into labor. We want you to go into childbirth with realistic goals and expectations.

When you discuss your preferences with us before labor, we can talk through possible scenarios and alert you to something that may not be possible. This will avoid disappointment when the big day arrives. I often find that after I explain why one preference might not be possible, together we can find something else that will. The key is communication.

Bring your birth preferences document with you to the hospital when you go into labor, and discuss it with your medical team. It’s likely the obstetrician you saw during your pregnancy will not deliver your baby. Don’t worry. In most practices, the doctors have similar philosophies. Your delivering provider is unlikely to object to the preferences you discussed with your doctor during pregnancy.

3. Prepare to be flexible

Every labor is different. Just because your first pregnancy went one way doesn’t mean this one will follow the same script. You may need to follow a course of action that may not have been what you anticipated.

Keep a flexible attitude, and remember that your main goal is the same as ours: a healthy mom and baby.

Few moments in life are as exciting as giving birth. This moment can also be unpredictable. By thinking through what’s most important to you, keeping a line of communication open with your doctor, and being flexible, labor and delivery will end just as you pictured: meeting your new baby.