Birth Plan Series: Holding space for a beautiful birth

What does your ideal birth look like? What’s your vision for your birth?
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A birth plan for a birth center or home birth is very different than one for a hospital birth. There are many resources online for hospital birth plans, but few available for a non-hospital birth. Rather than being about all of the things you don͛t want, this birth plan is much more about all of the things that you DO want! This is your opportunity to be very clear about your vision for your birth. What are your hopes and dreams? We all want a healthy mama and a healthy baby, but what do you want other than that? Here are some questions to get you started.
  • Who will be at your birth? Do you have feelings about whether a student may participate in your care? Do you plan on a birth photographer or do you have a doula? It will help your midwife to know who will be there and how to contact them.
  • What things do you want at your birth? Do you plan on aromatherapy? If so, what oils do you want to use? Will you supply those? How do you feel about waterbirth? Do you plan to actually give birth in the water, or do you plan to use water only for labor? Do you think you’d like to use a birth stool?
  • How do you feel about touch? Some people really dislike being touched, while others want a lot of physical attention. Is massage something you think you’d like or hate?
  • Do you have certain words you’d like to avoid? Some people don’t want to hear “relax” or don’t want someone giving verbal encouragement like “you’re doing great.” Others really dislike silence.
  • What kind of atmosphere do you want? Do you see your birth as a serene, zen-like experience, or are you more comfortable with a “party” type of vibe? Birth is a very intense experience, and some people need to lighten the mood with talk and laughter.
  • How do you feel about waterbirth? Do you want to just labor in the water, or do you want to actually give birth in the water?
  • Who will catch the baby? Sometimes, the partner will want to catch along with the midwife, other times, the mother wants to catch the baby herself. Do you have a preference?
  • What do you want to do with your placenta? For out-of-hospital births, you have a choice about your placenta. Some people want it thrown away with the medical waste. Others will want to plant the placenta under a tree. And many people choose to do placenta encapsulation. If you’re planning encapsulation, who is doing that for you? Do the midwives need to contact the encapsulator or will the parents take care of that? Does the encapsulator have a particular way they want the placenta stored?
  • How do you feel about medications? At Premier Birth Center, your birth assistant is a nurse and will be able to administer certain emergency medications if indicated (oxygen, IV fluids, and medications for hemorrhage). How do you feel about that? For example, in the event of a hemorrhage, would you prefer we tried herbs first, or would you want us to use our judgment, or would you want us to go straight to the medications?
  • If you have given birth before, what were the things about your last birth that you liked and didn’t like? Do you have any particular goals, hopes, or dreams for this birth that you’d like to share with your birth team? Do you have any fears you’d like to share?
  • After the birth, do you have any particular requests for your team? Do you want to be the first person to speak words to your baby? Do you want your older children to be present for the newborn exam? Do you have a prayer you want to say? Are you planning a lotus birth? How can your birth team facilitate your newborn wishes for you?
For home births, it’s important to communicate practical matters about your birth and your birth space, so that your birth team will not need to bother you with questions about those things while you are working hard during your labor. Include things like your WiFi password, what accommodations you have for a your birth team if your birth is long, and whether there are any parking restrictions for your community (expect at least 2 more cars in your driveway than usual). If you have pets, what are their names, and what does your birth team need to know about them? Do you have a quirky house or neighbor issues?
For birth center births, the practical considerations are less important. The midwives will likely have their own food and place to sleep if the birth is a long one, for example. If you’re planning a birth center birth, do you have certain people you don’t want at the birth center? Who is taking care of your older children? Do you dislike certain smells (some people hate lavender, for example)?
Part of planning for an out-of-hospital birth includes planning for the possibility of a hospital transfer. A hospital transfer plan (Plan B) is a little different from the usual hospital birth plan. Put together a one-page plan that is just bullet points about the most important things you want to communicate to the hospital staff. Understand that if you’re at the hospital, you’re there for interventions, so you should expect interventions there like IV fluids, medications, and monitoring. But, there are some parts of your birth plan that you may still be able to control– limiting separation from your baby, delayed cord clamping, making sure your midwife AND your partner can be with you in the operating room if you have a cesarean section (Plan C), skin-to-skin contact, etc. Certain things, like circumcision and the baby medications, require consent forms be signed at the hospital, so they do not necessarily need to be included in your birth plan, but you can certainly add them if you like.
Your birth plan is your opportunity to make sure everyone is “on the same page” about what you want for your birth. Be specific, but know that things may be different in the moment. A birth plan is about creating intention, not about creating a mandate. This is a time to be clear about your desires and expectations so your midwife can help you have the family-centered birth experience you want.
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