I am frequently asked to share different aspects of my birth plan. Usually I end up emailing off the whole thing, because it speaks for itself, mostly. There are a few points I am asked about a lot, so I figured I’d put up a post to explain the why behind each choice I have made.
Before we get started, understand that these are MY preferences. No birth is ever the exact same as another. I’ve had four totally different birth experiences so far and ended up compromising on some of these things. This list of birth preferences is what would happen ideally in my crunchy mama mind. It is practical but life often has curveballs for us. Don’t get hung up on sticking to everything if it doesn’t fit your situation.
I’m including a link to the formatted copy of my birth preferences on Google Docs. No need to subscribe for it or anything! Simply save it to your own Google Drive or copy and paste into a word processor, and edit as needed. You’re welcome!
I suggest reviewing it with your care provider a few weeks ahead of time and letting them keep a copy in your file, and then giving one to whomever is at your birth when you first go in. Keep a couple copies in your hospital bag or purse to hand out or refer to as necessary when you’re in labor or during your hospital stay.
If you’re having a home birth, your midwife probably knows your preferences but putting it in writing is always helpful. Let her keep a copy, as well as her assistant just in case, and have one at your home for reference, too. I would also suggest keeping one in your purse/diaper bag/hospital bag in case you transfer like I did.
This article originally appeared on my old blog, Townsley Times. If you came here looking for this particular article but thought you were going to a different site, never fear, you’re actually in the right place. 🙂
I’ve broken this down into three sections: labor, delivery, and postpartum. That way, if you need to review it with your postpartum attendant for example, you can just skip straight down to that section. Also note that the bolded parts below are what I have on the printout, verbatim. This shows you are educated and not just being obstinate. The normal type on this post are my additional comments for your benefit. 🙂 Please let me know if there are any questions or clarifications you might need!
PIN IT FOR LATER! Continued below….
- Hep-lock okay. I am okay with this because on my list of things to fight about, this is not one I’m overly concerned with. It does allow quick IV access in case of emergency.
- I DO NOT consent to routine cervical checks – unless there is a need to check baby’s position, or if I ask. Each time they check you, a number of things can happen. First, they are introducing bacteria into the vagina. Second, there is a risk they could break the amniotic sac if it’s not already broken. Third, consider if you really want to know how far you are. Cervical changes don’t really mean that much in the grand scheme of things.
- I will ask for pain meds if necessary – please do not offer anything. This is a choice I have to make when the time comes for it. I do not want anyone asking because it’s easier to cave. (And for the record, I have caved 4/4 times.) Also note that you can ask for pain relief aside from an epidural. They can give you something in your IV which can take the edge off, and in the UK, they use “gas and air” quite a bit, which is nitrous (possibly contraindicated for those with MTHFR so please look into that). An epidural is not your only option here.
- Freedom to move, with monitoring as necessary. Women who move around during labor can get into the positions that will naturally help baby come down (and ultimately out). Monitors may mean wires that confine you to small area of the room or even the bed. Ask for a wireless monitor if they are dead set on forcing the monitors on you.
- I DO NOT consent to Pitocin or labor augmentation (AROM, etc.) – unless medically necessary with informed consent. Practitioners like to overuse Pitocin if they fear labor is going to stall, or to try to speed things up. The evidence shows that use of Pit can result in a higher risk of c-section, so I choose to decline it unless I feel the risks of not using it outweigh the risks of using it (<— did I phrase that correctly, or do I have it backward??). As far as artificial rupture of membranes (AROM), that is not always indicated as it increases the risk of cord prolapse if baby is not already engaged. It might help contractions along, but there is no clear evidence that this will always happen.
- Episiotomy, forceps, and vacuum strongly NOT desired. I had nerve damage from forceps delivery with my first, so I added this here. I do recognize that it could be necessary again if there is an emergency, but I feel it’s good to express that this is something I specifically want to avoid. Some docs are cut happy.
- Delayed cord clamping – at least 5 minutes, preferably wait until the placenta is delivered. Any procedures can be done with baby attached, even in some emergencies as baby is still receiving oxygenated blood through the placenta. This is a big one for me, as babies who receive more of their own blood (especially their red blood cells) have fewer problems with anemia of infancy. There is no risk with waiting till the placenta is delivered, but I don’t see any reason to not cut it at that point (lotus birth is not for meeee!). If you want to take the placenta for encapsulation or other purposes, you’d want to add a line here to include that. We did with #3 but did not see benefits and I’m not sure it’s a good idea biblically, so they can keep it. 😉
- Immediate skin to skin, DO NOT wipe vernix. Skin to skin time helps to regulate baby’s body temp, and vernix is sooo good for the baby! It helps keep their skin from getting that flakiness that often happens with newborns, and it is full of good bacteria to help populate their gut flora. Rub it in, mama! I had looked into “vaginal seeding” in case of a c-section, but decided the vernix would be good enough.
- I DO NOT consent to erythromycin – I do not have gonorrhea or chlamydia. ‘Nuff said, right? Some states require this and will call CPS on you for declining. Some hospitals don’t care and won’t push it on you, though. And other states have a religious exemption. Be sure to explore your options well before the time comes. Here is an article to back you up.
- I DO NOT consent to vitamin K shot – we use the oral form. You can get the vitamin K from Bio-K-Mulsion on Amazon. You can find the Danish study showing efficacy and dosing schedule of the oral form here.
- I DO NOT consent to any vaccines, specifically hepatitis B – this will be discussed with our pediatrician. That will save you the headache of declining outright, if that’s what you want to do. You don’t need to get into a big discussion about this with them.
- Third stage – Pitocin only if already in use, no cord traction – will reevaluate after 15 minutes pass or as circumstances require. There are varying opinions on this. Some providers yank a bit much on the cord and that can cause hemorrhage or retained placental tissue if the placenta has not already started detaching. Traction IS an accepted method, but ONLY once the placenta has started detaching and there is no positive way to know that since they can’t see inside the uterus. They like to use Pit for this stage also since it can help eject the placenta faster. But my opinon is that we need to let the body do its thing, and then intervene later if a problem starts to arise. The placenta really should be out within an hour.
- I DO NOT ACCEPT BLOOD PRODUCTS – please use saline in the case of hemorrhage. This one often trips people up. This is a personal conviction and your mileage may vary. I personally do not feel we should be mixing our blood with that of others, nor do I think it’s a good idea to take others’ blood when there is all sorts of stuff that would get transferred and might cause eventual autoimmune dysfunction. There is little reserach in this area. You can refer them to the JW site if they give you a hard time about this (I’m not a JW, btw). Bottom line: Saline can get your blood volume up fast if you’re bleeding out. It will buy the RBCs some time to multiply and get your iron levels back up, which takes a few days. There are iron infusions that would be preferable to a transfusion if necessary.
- Regarding a medically necessary c-section – please delay cord clamping for as long as possible, immediate skin to skin if not under general anesthesia (only use in an emergency), baby will go with Dad (INSERT DAD’s NAME) and he will be present for all procedures. All of the above still apply. I will always ensure that our child is with a trusted adult to avoid any medical “mistakes” happening while I’m not able to keep an eye on things. I have not been in the c-section situation but you never know, so I like to include this on here.
- I DO NOT consent to any vaccines or injections for me or baby. Reiterating the above for the postpartum nurse.
- I DO NOT consent to circumcision under any circumstances. This must be made very clear, since they automatically assume it will be done for all baby boys.
- Baby stays in the room at all times – we do not utilize the nursery. Again, keeping that eagle eye on my brand new baby is a must. It’s good for breastfeeding and bonding anyway.
- Necessary tests will be performed in the room with me present. Always be present for everything they want to do! And feel free to decline what you feel is unnecessary. We do opt for the hearing test and metabolic screening.
- NO bath – I will bathe baby as necessary at home. This goes back to not washing off the vernix. And, did you know the smell of your newborn triggers hormonal releases in your body? Our Creator is amazing.
- 24 hours/minimum stay only – please be prepared for us to leave right after baby’s metabolic testing. Why stay longer than necessary? This is especially important since we have other kids at home. I want to get back to my babies! But, while I have to be at the hospital, I pretend it’s a mini-vacation with my newbie. Not cooking or worrying about what messes are being made and getting to watch grown-up shows on TV is a treat. Haha!
- Lactation consultant to check for lip/tongue ties. I would like to find this out sooner than later, if there may be a problem. But, just because there is a tie doesn’t necessarily even mean anything. But I’d be more prepared to handle it if it was spotted from the get-go. Not all hospitals have an LC on staff, so check into that.
- NO pacifiers, bottles or formula. This can interfere with nursing.
- PLEASE LET ME REST – I will call for a nurse if I need something. This is so important. I really don’t like the revolving door of people right after a baby is born. You can’t always control it, but when I tell them I’m not new to this, they tend to leave me be. 😉
I then add “thank you” with a smiley face at the bottom in a footer. A little kindness can go a long way.
What did you include in your birth plan? Please share in the comments so we can learn from one another.