Birth Plan

You may think that once the pregnancy test comes back positive, the biggest decisions left to make are choosing the baby's name and the border design for the nursery. Well, maybe. Choosing to create a birth plan can do a lot for you and your partner by giving you the opportunity to think ahead about how you want your delivery to proceed and turn out. Click here for a Birth Plan Checklist.

Many expecting parents are choosing to be proactive in the birth of their baby by creating a birth plan. This prompts expectant parents and caregivers to discuss details of the birth; everything from the birthing environment to how to be induced (if it becomes necessary), to post delivery instructions for mother and baby. It can all be covered in the plan. Doctors are recognizing more and more that expectant parents want to be involved in making as many decisions as they can. Some doctors routinely ask expecting mothers to complete a birth plan; if this is not a routine practice, most doctors are willing to discuss such a plan if their patient requests it.

The birth plan is not a legal, binding contract but more of a written understanding between the expecting parents, the doctor or midwife and the hospital or birthing center with the main goal of bringing all parties involved in the birth as close as possible to the parent's ideal experience, and avoiding major conflicts during the time of labor and delivery.

A detailed birth plan will cover a wide variety of topics. The exact content will vary depending on your requests, your doctor or midwife and the hospital or birthing center involved, as well as any particular conditions affecting your pregnancy. Some topics that you may wish to include in your birth plan are:

• Birthing environment - do you want a birthing suite or to deliver in water?
• Who will attend the birth - your husband, partner, siblings, doula, friends, and other relatives?
• If induction or labor augmentation is necessary, what method(s) are to be used - Pitocin, breaking of the membranes, enema, walking, acupuncture, etc.?
• How will you manage pain - acupressure, acupuncture, massage, relaxation techniques, medication, etc.?
• If drugs are used, what type do you prefer - regular or local analgesics, or anesthesia, sedatives, tranquilizers, narcotics, or epidural?
• Fetal monitoring - do you prefer externally, intermittently using a Doppler, or intermittently using a fetoscope?
• Is episiotomy an option?
• Delivery position - do you want to use a birth bar or are you fine with delivering on your back?
• Will you breastfeed or bottle feed?
• Time with the baby - 24-hour rooming in, baby in room during the hours you are awake, baby brought in for feedings only?
• If the baby is a boy, will he be circumcised?
• Are you going to collect the umbilical cord blood stem cells for banking?

Of course, with some of these items, your doctor's judgment or the hospital's rules will affect the final plan. Items such as dimmed lighting, music, videotaping and taking pictures are usually honored when expectant parents make requests for such.

However, expectant parents need to be realistic when putting a birth plan in place. While it's ideal if the plans can be carried out the way they were envisioned, it isn't always possible. There is no way to predict in advance how labor and delivery will progress and if complications will be encountered. Therefore the birth plans made before the process begins may not end up being in the best interest of the mother and baby. Things may have to change at the last minute. If this happens, try to keep in mind that the health and safety of the mother and baby are always the first priority and all other considerations must be secondary.