As a first-time mom, no one told me anything about creating a birth plan. I knew I wanted a natural birth, but I knew nothing about how to prepare for a natural birth.

If you have not already guessed, my first delivery did not go as I had expected. I could not bear labor pain and took epidural.

Once the epidural kicked in, I felt like I lost all my senses. I was not feeling any contractions or the urge to push.

They had to induce me, the nurse broke my water, and my son was delivered using forceps.

The second time around, I was determined to give birth naturally, without any medication and intervention.

It was not just wishful thinking, but I was serious about natural delivery.

I sat down and started to write my plan, describing every step of the intense labor process and how I would handle it.

What is a Birth Plan?

Does it sound lame to you that I keep talking about a birth plan, while nothing about birth can be ‘Planned’?

Consider a birth plan to be your wish-list or a set of preferences that you choose for your labor and delivery.

A birth plan is a document or set of procedures that you would like to avoid or wish to practice.

Example: A sample birth plan can list that you would like to avoid epidural but practice hypo birthing or water birth to relieve pain instead.

Keep in mind that your birth plan is only your expectations of what you would like to happen, but reality can differ as no one has control over how labor unfolds.

Depending on your situation and the health conditions of the mom and/or baby, you and your doctor may make a joint decision to take an alternate route.

The health and safety of you and your baby precedes any plan you might have made.

What To Include in Your Birth Plan?

1.Talk about the ambience:

Giving birth to your baby is no ordinary event. You can ask for things that makes you comfortable or decline things that might bother you.

You get to say who you want to stay in the labor and delivery room with you. You can list your partner, doula, family or friends.

Some hospitals do have a condition on who or how many people can stay in the delivery room, so talk to your hospital about this early on.  

2.Labor Preferences: 

This is the place to specify how you would like to labor and where. Most of the births happen at hospital but it is increasingly popular to give birth at home or in a birth center.

Atmosphere:

I highly recommend you talk to your doctor about how to labor at home safely as long as you can.

How long you can stay at home depends on your pregnancy history, health conditions, how far away your home is from the hospital etc.,

This away you can feel rested during the early stages of labor and have energy to go through active labor at the hospital.

Once you reach the hospital the room settings are also important to consider.

Even small things like the light setting can tip you off. I encourage moms to have dim lights (bright lights gives me headache), a silent atmosphere with fewer interruptions.

You can choose to have only your support team around you and avoid students or medical interns.

Fetal Monitoring: 

Fetal monitoring is a way to measure the heartbeat of your baby in the womb.

Most hospitals have two kinds of fetal monitoring available – continuous and intermittent.

Depending on your doctor’s advice, and if you have no known pregnancy complications, you can request to have intermittent monitoring.

The benefit of intermittent monitoring is that it allows you to stay active and walk around instead of lying tied to the bed.

That said, it your baby is in any kind of distress during labor, you might have to be monitored continuously to ensure baby’s safety.

IV:

Hooking laboring women to an IV used to be a common practice but not anymore.

Some hospitals still practices this but most are open to accept your request if you choose to decline it.

An IV is used as a back-up when something goes wrong and you need to be medicated.

An IV is used to keep a check on mom’s hydration, it is used to administer Picotin (to induce labor) if need be. 

I always encourage moms to decline having an IV to start with.

You can always get one if you need to, so there is no need to be strapped to your bed when you can be moving and walking.

What to wear:

This is a very personal decision. Some choose to use hospital gown; some bring their own. Choose what makes you comfortable.

Food:

Women were not allowed to eat or drink anything other than ice chips previously due to health risks associated with general anesthesia. Since many hospitals now opt for epidural that numbs only certain parts of the body, this rule is more relaxed.

Personally, I would not eat a heavy meal during labor, but you don’t have to starve yourselves.

If you are a low risk pregnancy, and if your doctor gives you an OK, you can have water, popsicles, apple sauce, a few crackers, etc.;

If you are going for a planned C section, or if there is a higher chance of C section, then your doctor will tell you to have an empty stomach.

I encourage you to talk to your doctor about your pregnancy risks and get her suggestions about food and drink during labor.

Active labor:

As you progress into active labor where your contractions are more intense and frequent.

This is when most women feel like they want to give up and turn towards some kind of pain relief.

Even if you want to go the natural route, it is still good to discuss the pain relief options available at your prenatal visit.

The most common pain medications available as epidural, spinal block and nitrous oxide. You can read more about them here

However, I feel it’s important to explicitly tell your caregivers to not offer epidural as an option when you are screaming in labor pain.

Instead, you can ask your support team to keep your focused on other methods to manage pain.

Position:

If you haven’t already thought about different laboring positions, I highly encourage you to talk to your doula about this.

Instead of lying on your back, you can try various positions including squatting, lunging, leaning over the wall to take the pressure off your back.

You can ask your partner to give you a warm massage while you are kneeling or lying on your side. One other thing you can do is to get into a bathtub or even take a shower.

Pain Management:

To encourage things go as natural as possible, you can try some of the pain management techniques below

Hypnobirthing

Water

Breathing

Labor Augmentation:

when labor does not progress as speedily as expected, then your doctor might bring up the topic of augmenting labor.

Labor augmentation is a process to increase the intensity, the length and frequency of contractions. 

Various things can be done to increase uterine contractions, a doctor might offer to break the water (if it’s not broken already), or offer Pitocin (Oxytocin) through IV.

Sometimes when labor augmentation takes place, there is an increased chance of C section or your baby delivered using forceps or vacuum.

This is what happened to me during my first delivery, and I highly encourage to exhaust all the natural ways to increase contractions before opting for medical procedures.

Delivery:

Now is the time to start pushing and bring our baby out into this world. Here are things to go through with your doctor regarding pushing and delivery. 

Tearing: 

Vaginal tearing is common especially with first time moms where the muscles around vaginal are less stretchy.

If you have baby has a big head or if labor progress too quickly not giving enough time for the vagina to stretch, tearing can happen.

Episiotomy used to be a common routine but that belief has changed.

Many hospitals now only do episiotomy only when absolutely needed (in case of fetal distress or inconvenient baby position).

Having stitches in your private parts sucks, I had an episiotomy (with my first) and it took me months to walk like a normal person again.

When you do have to take an episiotomy, there are things you can do to reduce the level of tearing like giving a warm compress, or a perineal massage before the procedure.

Placenta:

If you have had a natural birth, delivery of the placenta can also be natural. In some cases, oxytocin is given when pushing the placenta out.

Unless you are at a risk of postpartum hemorrhage, you might not need this additional dose of oxytocin.

Again, talk to your doctor about preferences and your health conditions.

Some parents would like to preserve the placenta to consume it, you can talk to your doctor about the hospital policy regarding placenta encapsulation.

 Sample natural birth plan template:

Here is a sample example birth plan to understand how to write one.

For Early Labor:

  • To listen to music that I bring
  • Lights to be dimmed
  • Fewer vaginal exams as possible
  • I choose to wear my own clothes 
  • To eat and drink unless there is a concern
  • My partner and Douala to be present with me
  • Intermittent Fetal monitoring unless it is needed

For Active labor:

  • I would like to move freely – use a birth ball, walking, swaying as much as possible.
  • I would like warm massages to relieve pain
  • I would like to get into the bath tub/shower
  • I would like to practice hypnotherapy/breathing techniques 
  • I would not want to be offered Epidural, unless initiated by me
  • I would like to try natural ways to induce labor (Like nipple stimulating, membrane stripping) instead of Picotin
  • I would like the labor to be progressed naturally without medical induction.

For Delivery:

  • I would like the doctor to guide my pushing to avoid tearing
  • I would not like an episiotomy performed.
  • I would like to practice delayed cord clamping
  • My partner to cut the cord
  • To bank the cord blood
  • To deliver placenta naturally

Newborn Care:

  • Immediate skin to skin contact
  • I would like to breastfeed as soon as possible
  • Medical examination only after bonding,please.
  • No pacifiers, water or formula
  • Leave the vernix unwiped
  • Would prefer oral Vitamin K shot 
  • please do not bath the baby

Final Word:

It is so imporant to have a birth plan in place to go over and talk to your doctor in detail.

Once you have the birth plan ready, schedule an appointment with your doctor and go through this with her. 

I hope that you experince the birth you wish for.

 

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