While Mother Nature is most definitely in charge when it comes to how your labor and delivery will unfold in real time, you can definitely play an important role in how the experience will go—if you have a birth plan sketched out.
“I like to think of this as labor and birth preferences,” said Szilvia Nagy, MD, assistant professor of clinical obstetrics and gynecology at Weill Cornell Medicine and director of labor and delivery at New York Presbyterian Lower Manhattan Hospital.
“It’s sort of like a planning guide, an outline that you’ll go over to make empowered decisions.”
A birth preference or plan serves another purpose, too: By writing down your preferences and bringing that document with you to your appointments, you can help ensure that everyone will be on the same page.
“The ideal way to approach this is for you and your partner to plan out what your wishes are, first and foremost,” she said. “Then, by sharing it with your health care team, it helps give everyone a shared understanding.”
Ultimately, no matter what you have in mind — if you’ve always wanted to have a water birth or take a warm shower or bath during labor — the goal is always to have the safest possible delivery for you and your baby.
“You may have a plan, but there are no guarantees that your labor and delivery will go according to that plan,” Nagy said. “That’s why it’s so important to discuss contingency plans and always stay flexible.”
Here’s what to know about your birth plan:
Zero in around the 20-week mark
While some expectant parents will bring a birth plan with them during their first prenatal appointment, Nagy urges couples to wait until they’re around 20 weeks into the pregnancy to think through their expectations. “That’s when I’ll provide some parameters to the plan and we can discuss specific goals,” she said.
Download a sample plan
While there are a plethora of online birth plans available to download, Nagy recommends the two-page birth plan developed by the American College of Obstetricians and Gynecologists, which is easily downloadable from the ACOG website.
In it, there’s a checklist of topics to consider, such as anesthesia options during labor, who you want with you during delivery, what you want to have happen during a vaginal birth (including who you want to cut the umbilical cord) and, should you need a cesarean delivery, who you want to hold the baby after delivery if you’re unable to.
Understand what matters
You can get very granular as you sketch out your birth plan, but the most important things to address are labor, comfort, hydration, pain management and how you want the baby to be monitored.
For example, when it comes to pain management, Nagy urges pregnant moms to really think through their expectations.
“If you already know you want an epidural, great,” she said. “If you’re unsure or open to it, I want to know that, too. Or, if your plan is to experience labor without medication and an epidural, I can guide you to the classes you should take to make sure you get the preparation you’ll need to achieve that.”
Make sure the hospital can handle your wants
Whether you want to try using a birthing ball, a birthing stool or a squat bar, for example, depends on what’s available at your hospital. “Different facilities will have different things available,” she said. “It’s good to research those options ahead of time and make sure the hospital you’re choosing has those things available to you if that’s very important to you.”
Plan way in advance of your due date
The last thing you want to do is to have the conversation about your preferences while you’re in labor, Nagy said. “It’s already a stressful situation, you’re in pain, you’re in labor, then maybe in distress, which means you might need to make a split-second decision. If you haven’t discussed this with your health care team, that doesn’t create a good environment, which can lead to a lot of stress, frustration and, potentially, birth trauma. It’s not just physical but emotional trauma, which can follow patients into subsequent pregnancies.”
Older moms may need to deviate
If you’re over the age of 35 (considered advanced maternal age) or have other health issues, you may need to make some tweaks to your birth plan.
“If you’re 40 years old and are having your first child, you might have some complications, like gestational diabetes or preeclampsia, which might not be the case when you’re 25 years old,” Nagy said. “If you’re 25 and don’t have any other medical issues, you might be able to be intermittently monitored during labor and you may not need as many medical interventions.”
Build trust with your provider
In the end, it’s best to consider your birth plan to be a key document that you share with your provider, knowing that this person has your best interests at heart.
“If you don’t feel a sense of trust with your provider, hard decisions become even harder,” Nagy said.
“You’ll think, ‘Am I being pushed into this decision?’ It’s way better for everyone to remember, ‘Oh yes, this is something we’ve talked about.’
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