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The Birth Plan

Is a Birth Plan Helpful or Troublesome?

By Marie Fellenstein Hale

April Tutino, a labor support doula, suggests writing a list of everything you want at birth. Sort the list in order, from the most important to the least important. Then take the top five or six items and drop all the rest. These should be the items that you truly care about.

Try to have your birth plan focus on the positive, instead of giving a list of what you don't want. Use words like, "We hope to" or "We plan to" or "We anticipate." Try not to use phrases like, "We don't want" or "We want to avoid."

Here are some suggestions: "We realize that many pain medications exist — we'll ask for them if we need them." "I am hoping to protect the perineum. I am practicing ahead of time by squatting, doing Kegel exercises, and perineal massage. I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch." "I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation."

Here are some topics to consider in your birth plan: (See the books listed in the resource section for many other ideas and considerations.)

Which support people do you want?
Will there be siblings present?
What activities or positions do you plan to use? (walking, standing, squatting, hands and knees)
How do you feel about interventions, such as fetal monitoring, medication and episiotomy?
How do you plan to keep hydrated? (sips of drinks, ice chips, IV)
Wat will you do for pain relief? (massage, hot and cold packs, positions, labor imagery, relaxation, breathing exercises, tub or Jacuzzi, medication)
What are your preferences for baby care, feeding and rooming in?