The Birth Plan: What It Is and How to Use It

In a birth plan, you can express your wishes and preferences about labor, delivery and puerperium.

Our society and the current pace of life often means that everything we do in our lives is very well planned. Today, we can count on good family planning and even decide more or less when to get pregnant. And, as we’ll discuss in this article, the birth plan also plays an important part in this.

When we’re pregnant, we try to plan what will happen or think about what will happen after the birth. We plan what clothes we’re going to buy and even start designing the room.

But what about the actual process of childbirth? During your pregnancy, it’s a good idea to take maternity education classes with your midwife, especially if it’s your first child. And, in these classes, you’ll be able to discuss your birth plan.

What is a birth plan?

The birth plan is a document in which you can express your preferences, wishes, expectations and decisions regarding the process of labor and the delivery of your baby.

Each hospital will have its own birth plan document, depending on its infrastructure and available resources. So, the first step is to decide which hospital you’ll give birth in.

The ideal thing is to draw up the birth plan after around 28 to 32 weeks of gestation. Your midwife can always help you prepare it and answer any questions you may have. The good thing is that you can modify the birth plan at any time.

When you go into labor at your hospital, you’ll need to hand it in to the health staff who are going to attend to you. However, even then, you can change your mind during the birth process.

The goal of your birth plan shouldn’t be to have everything happen exactly as you’ve planned. The purpose of it is simply to have all the information you need before you go into labor, to make decisions about what you want, and what you don’t want, and to be able to make new decisions calmly if your labor doesn’t go as planned.

In childbirth, sometimes, doctors need to take certain measures and actions that you didn’t expect. So, it’s important not to think that this means that your birth plan has been a failure. You also need to have the confidence to ask why they’re being carried out and what consequences they may have.

Although each hospital has its own birth plan, none of them will offer the possibility of choosing practices that aren’t currently supported by scientific evidence.

What does the birth plan usually include?

Accompanying person

It’s important that, during the dilation, labor and postpartum period, you’re with a person that you trust, and who will give you peace of mind. In the birth plan, you can make a note of who you want to be with you, as well as those you don’t want to be there.

Special needs

In this section of the birth plan, you’ll be able to mention any special needs you may have during delivery, such as cultural or language issues.

Physical space in the birth plan

This will depend entirely on each hospital. Other preferences are whether you want to use your own clothes or the clothing provided by the hospital.

Dilation

Regarding dilation, the ideal thing here is that, as far as possible, the same staff attend to you. It’s no longer recommended to administer an enema before delivery or to perform systematic shaving. Ideally, you should be allowed to drink fluids during dilation and you should have freedom of movement.

Medication for pain

In your birth plan, you can express your preferences regarding medication. You can state if you don’t want (in principle) any type of pharmacological analgesia, if you’d like epidural analgesia, or if you’d prefer other types of non-pharmacological analgesia, etc.

Interventions in the birth plan

In this section of the birth plan, you’ll express your preferences about fetal monitoring, and whether you want it to be continuous or intermittent (circumstances permitting).

As far as vaginal examinations are concerned, the minimum should be performed, only those that are necessary. A venous line isn’t essential in a normal delivery; you shouldn’t be routinely given drugs to speed up delivery.

As for catheterization, specialists will only do this when necessary, intermittently, and with your consent. The artificial rupture of the amniotic sac won’t be performed if you don’t want it to be, except in clinical situations that require it.

Expulsion

During the period of expulsion, in principle, the pushes should be spontaneous. However, some situations, or having had an epidural analgesia, could mean that they’ll have to be directed.

Regarding the episiotomy, at present it isn’t a procedure that doctors routinely recommend, but should be reserved for cases where it’s really needed.

Birth

After the birth of your baby, if everything has gone well, the only care they’ll need is to be placed skin to skin with you, in an intimate environment, without excessive lights or noise. It isn’t recommended to carry out the aspiration of secretions or catheterization on the newborn baby. The only thing you need for the first two hours is skin-to-skin contact.

Cutting the umbilical cord

The ideal thing, according to the latest scientific evidence, is to cut the umbilical cord when it has stopped beating, if the situation allows it. This can prevent anemia in the baby, as the blood in the cord is the baby’s blood.

It’s important to know, and keep in mind, that if you decide to donate a cord, whether it’s public or private, this late cutting won’t be valid.

Starting breastfeeding

If you’ve decided to breastfeed your baby, then the ideal thing is that, in their first hour of life, while making skin-to-skin contact, your baby starts to latch on to the breast spontaneously, without interference.

Placenta delivery

In some birth plans, you can express your preferences about whether you want to see the placenta.

Techniques to perform on the baby in the birth plan

Whenever possible, specialists will carry these out in front of you, with your baby having skin-to-skin contact. In many countries, there are only two measures indicated by protocol after birth.

One is the administration of the ophthalmic antibiotic, which prevents eye infections. This must be done after the first two hours, so as not to interfere with the mother and baby’s eye contact.

The other is vitamin K, which nurses will administer for the prevention of bleeding in the newborn baby. The most effective and recommended method is the intramuscular route, but there’s also an alternative oral route.

Puerperium

In this part of the birth plan, you’ll state your preferences on the care and hygiene of your baby, the hospital stay, the feeding of your baby, among other things.

In conclusion, the most important thing is that you’re completely informed and in control as you approach labor. This is important, as you’ll be able to live out this experience as your own. One in which you’ll be able to make your own decisions and accommodate any changes that may become necessary during labor and afterwards.

Please note that the information given here may vary depending on the hospital and country concerned. Please make inquiries in your own area to be sure of what to expect.