You may have read about creating a birth plan to discuss with your doctor or mid-wife. If you haven’t, it’s a list of preferences for your doctor, nurses, husband/partner or other care givers. It’s important that others know what you want so they can be advocates for you if you’re not able to answer for yourself. I prefer to call this your Birth Preferences vs. a Birth Plan as you never know what type of labor you are going to have. You can’t control how things unfold, all you can control is the decision you make once different options are presented to you.
Here’s a list of all the things you should think about and decide on beforehand. Make sure that you review this with your doctor and anyone else present at the birth. Some of the decisions you make below will affect what type of medicine you can be given or how your doctor will perform the birth, so again, make sure you go over it with them so you can discuss what you want and they can advise on any effects of those decisions.
- walking while in labor (yes/no)
- changing positions at will throughout labor (yes/no)
- music (yes/no, type)
- quiet environment (yes/no)
- number of vaginal exams
- IV hep lock (yes/no)
- continuous fetal monitoring (yes/no)
- internal monitor (yes/no)
- Break water artificially (yes/no) If yes, under what circumstances?
- Pitocin (yes/no) If yes, when is it ok?
- Epidural in Standard / Low Dose / None
- Injection of narcotic (yes/no)
- Delivery Positioning
- Mirror to see baby coming out
- Touching baby’s head when crowning
- Delivery room environment
- People allowed in delivery room (relatives, coach, medical students)
- Episiotomy or natural tearing (your doctor might do an episiotomy if they think you will tear, would you rather tear naturally or have them cut you so that you won’t tear?)
- Perineal massage
- Guidance when pushing
- local anesthetic to repair a tear or an episiotomy
- How do you feel about a cesarean? Avoid at all costs? Indifferent?
- Request cesarean second opinion (yes/no)
- The presence of partner or labor coach in OR
- Screen (lowering to see the baby?)
- If the baby is not in distress, but my labor has slowed then ______
- Cord cutting, who?
- Cord saving?
- Holding baby after delivery for how long before/after examination
- Pitocin post delivery to aid in placenta delivery
- Eye medication
- Hep B shot
- Vitamin K shot
- Placenta, discard or keep (some people keep the placenta and get placenta pills made to take postpartum)
Breastfeeding & Postpartum
- Breastfeeding or bottle
- If bottle is ok, formula, glucose water, water. What is ok.
- I do or do not plan to breastfeed my baby
- Lactation consultant
- Baby in room or nursery
- Circumcision (yes/no)
- If yes, performed in hospital?
I am sure this seems like a lot, but you probably already know how you feel about most of this stuff. If you aren’t sure what something is on this list, just post a comment and I’ll explain. Here was my birth preference list and what really happened:
- walking while in labor – yes
- changing positions at will throughout labor – yes
- music – yes, rythmic or drum beats. Ended up with no music bc labor was so fast, I didn’t miss it!
- quiet environment – yes. This ended up being very important. I couldn’t have anyone talk while I was having a contraction
- lighting – low
- number of vaginal exams – as few as I need.
- IV hep lock – no. I ended up getting one because my doctor strong recommended that I do. I am still annoyed that I was requested to get one. It wasn’t used and hurt!
- continuous fetal monitoring – yes
- internal monitor – no, unless needed because baby’s vitals can’t be found
- Break water artificially – no, not unless emergency
- Pitocin – no, only OK if labor slows and a cesarean is being considered.
- Epidural – none
- Injection of narcotic – no
- If no medication, still offer medication? – no
- Delivery Positioning – not sure, how ever I feel at the time
- Mirror to see baby coming out – no
- Touching baby’s head when crowning – no
- Delivery room environment – tranquil
- People allowed in delivery room (relatives, coach, medical students) – husband, mother, doctor, doula, nurses and any medical staff
- Episiotomy or natural tearing – natural tearing
- Perineal massage – ok
- Guidance when pushing – yes
- local anesthetic to repair a tear or an episiotomy – yes
- How do you feel about a cesarean? – Avoid at all costs
- Request cesarean second opinion – yes
- The presence of partner or labor coach in OR – partner only
- Screen (lowering to see the baby?) – yes
- If the baby is not in distress, but my labor has slowed then _I want to keep progressing naturally, wait, do not perform cesarean. If we must, I’d take pitocin to help get labor going again.
- Cord cutting, who? – father
- Cord saving? – no
- Holding baby after delivery for how long before/after examination – 1 hour before exam
- Pitocin post delivery to aid in placenta delivery – no, but ended up being given it without my knowledge.
- Eye medication – no
- Hep B shot – no
- Vitamin K shot – yes
- Placenta, discard
Breastfeeding & Postpartum
- Breast feeding – yes, right away
- Pacifier – no
- I do plan to breastfeed my baby
- Lactation consultant – yes
- Baby in room
- Circumcision – no
Hopefully that helps give you an idea of all the things you need to consider and think about beforehand. You will not be in the proper state to think things through when you’re having strong contractions. If you want to try and do a non-medicated birth, have a “secret word” with your partner that you say only when you want pain medication. Ours was cupcake. If I said cupcake 3 times that means give me the pain medication. I never used our secret word or even thought about it really, I was so set on delivering naturally. My labor was pretty smooth but I have many friends who weren’t as lucky — make sure you go in with an open mind and that in the end a healthy baby and healthy mom are most important no matter how you get there.
Lastly, you have the right to say no. Just because you’re in a hospital or at a birthing center with doctors doesn’t mean you have to do what they say. You can refuse any treatment and you can ask for second or third opinions. Don’t let them bully you into doing something you don’t want to do — just know that you have the power over what is done to your body AND your baby’s body. For example, we refused the eye ointment (used to protect the eyes from certain STDs, if you don’t have those STDs then your baby doesn’t need it) and hepatitis B shot (we are delaying this vaccination until Archer is a bit older since neither his father, I nor any of his caregivers have hepatitis B). We had to sign a waiver saying we refused these standard post delivery medications for our baby, but I am so glad we did!