Creating a birth plan can feel very overwhelming, ESPECIALLY as a first time mom. I remember having no idea where to start. My friend sent me her birth plan and it was SO helpful to use as a template. So, I’m here to give you my birth plan to use as a guide to create yours!! I gave birth in the hospital and I really wanted a vaginal birth with no intervention – this birth plan was created to achieve just that (which I did, yay). You should edit/add/delete whatever you want to create your dream birth plan!
Template
Patient Information
- Name (mother to be):
- DOB:
- OBGYN:
- Due Date:
- Expecting (boy or girl):
- Baby’s Name:
- Father to Be:
- Doula:
Birth Preferences for Vaginal Delivery
Induction
- Natural induction methods until 42 weeks, unless there is a medically necessary reason or an emergency
- Membranes to remain intact until they release naturally.
- Bag of waters to break/rupture naturally, unless after an informative discussion has been had and mom and dad understand the reasoning and agree with them being manually ruptured by midwife or doctor
Equipment:
- Birth ball
- Peanut ball
- Birthing stool
- Extra pillows
- Tens unit
IV and Monitoring:
- Intermittent Doppler monitoring or Bluetooth monitoring that allows me to be able to move around
- IV only if medically necessary
During Labor:
- Hypnobirthing
- Labor at home as long as possible
- Lights dimmed and quiet room (only disturb if medically necessary)
- Tens unit
- Music – we have playlist
- Bag of waters to break/rupture naturally
- Wear my own clothes
- If labor is not progressing, discuss most natural methods to help
- Standing, walking and position changes
- Vaginal checks – only if requested by me
Pain Relief:
- Please actively suggest non-medical labor strategies/position changes
- Massage, counter pressure, hip squeezes
- Breathing techniques
- Relaxation techniques
- Hot/cold packs
- Water therapy, using whirlpool or shower
- Ask LEVEL OF COMFORT not Pain scale
- NO Medicine – please do not offer. Desire only if I request it
During Pushing and Delivery:
- Use squatting bar on the bed
- Use birth stool
- Lie on my side
- Be on hands and knees
- Deliver in any position I choose – side lying, hands & knees, squatting, etc.
- Allow time to breathe baby down before suggestion of pushing
- Wait to push until I feel the urge or pressure
- Allow me to determine if I need coaching during pushing, who to coach and in what way
- Push without a time limit (as long as mom and baby are safe)
- No mirror
- Use oil and/or hot compress on perineum during pushing for comfort + help avoid tear
- I DO NOT want an episiotomy, only allowed with my consent
- Mom will receive baby
- Delayed cord cutting 1-2 minutes or until it stops pulsating
- Cord cut by father
- I want to see the placenta, do not want to save it
- No Placenta Encapsulation
Post Delivery:
- I do not want Pitocin post birth, unless medically necessary due to significant blood loss
Newborn Care:
- Breast feeding
- Circumcision (NO – will be done later at doctor’s office)
- NO Vitamin K
- NO antibiotic eye ointment
- NO Hepatitis B vaccine
- NO baby formula
- NO sugar water
- NO Erythromycin
- Please do not wipe vernix from baby
- Skin to Skin with mom immediately following birth
- Hearing screening – performed in room with mom + dad
Notes
This plan should cover most of the questions the nurses/doctors have for you. Remember, the staff is working for you! You are allowed to say no to anything OR ask for a new nurse if you don’t feel comfortable with yours. When they present things to you it often feels like you have no choice, but you do! You’re the boss. My husband and I did a lot of research on labor, the birth process, and vaccines so we were prepared to respond when they offered certain things to us. I would definitely recommend doing the same!
To note: I didn’t talk about a C-section in my plan because I wasn’t planning to have one, however it might be wise to add in case of emergency!
Let me know all your thoughts/questions about birth plans in the comments below! Click here to read the birth story of my firstborn son!
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