Create a birthing plan

A birthing plan simply outlines and clarifies your preferences for how you would like your pregnancy to be carried out. The process of thinking through your options and discussing them with your doctor beforehand is much more important than actually showing up at the hospital with an itemized list. Your coach or partner can help make sure your wishes, where possible, are carried out on the delivery day.

Most first-time moms have mixed emotions and endless questions when it comes to labor and delivery. You may wonder how you will know when you're having a contraction, or when you should go to the hospital. You may be worried about what you can take for the pain. One of the easiest ways to get answers and ease your fears is to arm yourself with knowledge: Read books on childbirth, take notes during your childbirth education class, consult your health care practitioner, and ask friends and family to share their experiences.

Many women put together a birth plan to delineate their wishes for labor and delivery. It’s probably better to think about your “birth preferences,” because the inherent unpredictability of labor and birth makes it hard to have a plan.

So what’s to prefer? Births are a little like weddings – you’ve probably been to weddings that you think are lovely and tasteful and elegant, and you’ve been to others that you thought were vulgar and tacky. But the bride and groom chose to spend their day with that cake, those flowers, and that DJ – and it was right for them. Similarly, some women want to have a birth without any pain medicine and minimal medical intervention, and want to hold and bond with their baby immediately after birth, amniotic fluid and all. Other mothers would happily have an epidural placed before the first contraction, and would like their baby washed, with lots of soap, diapered, and dressed before touching him or her for the first time. Within the realm of what’s safe, there are lots of different “right” ways to have a birth. You and your partner should think about what works best for you.

The following are some of the key issues to think about what your preferences are, then ask your practitioner or talk to the hospital to learn about general policies. Discuss the risks and benefits of the various options. You may have to fill out specific forms or releases concerning many of these items ahead of time.

• How do you feel about using medication for pain relief in labor? Do you want to try to go without pain medicine, or would you prefer to have anesthesia as early as possible?
• Would you like to be able to labor in a tub or shower, if one is available at your chosen birthing center or hospital?
• Is there anything you want to bring to the hospital? Check the hospital's guidelines about video cameras, music, pillows, lights, etc. Some hospitals may have rules regarding video taping the birth.
• Who do you want to be present during labor? During delivery? Is there anyone you specifically want kept out of the room?
• What is the role of your coach?
• Is there a particular delivery position or procedure you would like follow? How do you feel about the use of stirrups to brace your legs? If you do not want to use stirrups, who will be with you to help hold your legs when you push?
• Would you like to have a mirror in the room when you are pushing, so you can watch your baby emerge?
• Do you have strong feelings about assisted delivery methods (forceps, vacuum extraction) or cesarean delivery?
• Would you like to avoid an episiotomy, if possible?
• If you have a cesarean, would you like your partner or coach to be present during the surgery?
• Who do you want to cut the umbilical cord?
• Do you want to hold your baby immediately after birth, or do you want her washed and swaddled before you meet her for the first time?
• Do you have specific desires about a bonding period with the baby after birth?
• Do you have strong feelings about receiving a routine IV to replenish your fluids?
• Are you planning to breast feed? If so, how do you feel about having your baby stay in your room after delivery? Would you like to avoid pacifiers or supplements, unless ordered by your baby’s pediatrician?
• Do you want anyone from the hospital to help you with breastfeeding, or to explain bottle-feeding or other baby care issues?
• Do you want a male baby to be circumcised?

Some other issues routinely come up in books and web sites about birthing plans, but are rarely used at hospitals today. Check with your health care provider to make sure, but generally, you won’t be offered an enema, nor will your pubic area be shaved, unless you specifically request it.

Review Date: 12/1/2010
Reviewed By: Zev Williams MD, PhD, FACOG, Reproductive Medicine and Infertility, Weill-Cornell Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M.'s health encyclopedia is accredited by URAC, also known as the American Accreditation Healthcare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.