Birth plans are fairly common for expectant parents who are preparing to deliver in a hospital setting. But is a birth plan really necessary for birth center or home births, where everyone supports things like freedom of movement and informed consent?
The answer is a resounding yes. The Magnolia Birth House team recommends that all clients prepare a birth plan. Why? Doing so will let your birth team know your preferences for your environment as well as your desires for labor, pushing, birth, and immediate postpartum.
In addition, while our goal at Magnolia is to help you achieve a natural delivery at the birth center, unexpected situations do arise. Clients sometimes require a transfer to the hospital. In that scenario, it’s especially important to include a backup plan that indicates birth preferences for the hospital setting.
What is a Birth Plan?
Before we delve too deeply into the how and why of a birth plan, let’s take a step back and examine the what. What exactly is a birth plan? First, it’s helpful to start with what a birth plan is not. A birth plan is not a bunch of rules or a script. Birth is too unpredictable to have guarantees.
In recent years, there has been a shift away from using the phrase “birth plan” in favor of discussing “birth preferences.” While it may seem like semantics, it’s an important distinction, one that doula Erica Chidi Cohen explains in her book Nurture.
“A plan is a prescriptive, rigid outline based on a predictable outcome,” she writes. “Birth is nothing like that; it’s unique, fluid, and unpredictable. For this reason, I like to think in terms of preferences — essential elements you’d like to implement or exclude if things go as expected (and perhaps some secondary preferences, in the case of complications).”
It’s also important to note that crafting and relying on a strict birth plan can leave you feeling like you failed somehow. For example, perhaps you decide you want a water birth, but your labor progresses so quickly that there’s not enough time to fill the tub. Going into birth with a mindset that you must absolutely deliver in the water might leave you disappointed, even if your birth team views your precipitous birth as normal and healthy.
As Cohen puts it, “It can be helpful to visualize the big moment and get your thoughts and preferences on paper, but it’s important to know that, as tempted as you might be to tightly embrace those preferences, you will also need to be able to completely let them go.”
How to Create a Birth Plan for Birth Center Delivery
Having your baby outside a hospital does not mean that you will automatically have the birth you are envisioning. Remember, birth is an active process, so writing down your birth preferences will give your midwife, partner, and other support team members, like a doula, clarity on your informed choices.
It will also help you as the birthing parent reach your goals because the process of discussing and noting your preferences gives you confidence. You will feel empowered to say “yes” or “no” to certain things, and your birth team will be able to support your decisions more effectively because they know your desires.
You might be wondering, “How long is a birth plan?” It should be concise, and one way to simplify your plan is to break up your preferences into several different categories: Environment, labor, pushing and birth, and immediate postpartum. In addition to thinking about your cultural and spiritual influences, here are some basic questions to ask yourself for each section.
As with all items related to your pregnancy, the midwives at Magnolia are happy to discuss your birth preferences with you.
Environment
Who do you want to attend your birth?
Will you have a doula?
Do you plan to have a birth photographer and/or videographer?
Would you like music playing, perhaps through headphones? Or do you want complete silence?
Do you want the lights dimmed?
Do you plan to use aromatherapy, such as lavender or clary sage?
Are there any comfort objects you want to have with you? This could include written birth affirmations, a photo, or a pillow.
Labor
What pain management techniques would you like to try? Hypnotherapy, breathing exercises, meditating, hydrotherapy?
Are there physical objects you’d like to have available? Birthing ball or rebozo?
Do you want to labor and/or deliver in the water?
What would you like to eat and drink during labor?
Pushing and Birth
What are your preferences on using tools that can help prepare your body for delivery? These can include perineal massage, hot compresses and oils.
Would you like to have a mirror available, so you can see your baby as you’re pushing?
Would you or your partner like to catch the baby?
Immediate Postpartum
Do you want your baby immediately placed on your belly or chest? We highly recommend this skin-to-skin contact.
Are you OK with delaying cord clamping and cutting until after your placenta has been delivered? This is our standard practice at Magnolia.
Is there someone you’d like to cut the cord?
Do you want to save your placenta for encapsulation or other purposes?
What would you like to eat after your baby is born? We recommend something with protein.
What are your wishes for procedures for your baby, such as the eye antibiotic and vitamin K injection?
How to Create a Hospital Transport Plan
Almost all of our transfers from Magnolia are non-emergent. That means, if we as a team decide a hospital birth is what’s best, you will go in your own car. We recommend North Shore Medical Center for non-emergent transfers, but you can decide on a different facility of your choice.
Your transport plan should be brief and include your preferences for some of the common hospital protocols as well as your desires if you end up having a C-section. If you’re planning a birth center delivery, it may feel defeating to consider these hospital preferences, especially those involving a C-section. But try to think of this process as a way to eliminate fear and instill confidence, even if it’s not your first choice of setting.
Many of the above questions still apply to a hospital delivery, but here are some additional points to contemplate in the event of a transfer:
Presence of your birth team
Pain medication
IV fluids and/or hep lock
Pitocin to augment labor
Continuous or intermittent fetal monitoring
Episiotomy
Pushing position
Rooming in with baby
Breastfeeding
Newborn metabolic screening
Hepatitis B vaccination
Finally, here are a few things to consider in case of a Cesarean birth:
Being awake
Having your partner present during surgery
Requesting skin-to-skin contact with your baby as soon as possible after birth
Allowing the cord to stop pulsating before it’s cut
Permitting your partner to stay with the baby at all times
Asking for a support person to be present in recovery
As with all items related to your pregnancy, the midwives at Magnolia are happy to discuss your birth preferences with you. To learn more about prenatal care and birth center delivery at Magnolia, request a free consultation by filling out our online form!
