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Creating a Birth Plan can be an empowering experience for expectant parents, as it helps outline their preferences and desires for labor and delivery. This important document typically includes sections on pain management options, types of support desired during labor, preferences for medical interventions, and important decisions around newborn care. It might also address the birth environment, whether you prefer a home birth, a hospital, or a birthing center. With this plan, parents can clearly convey their wishes to their healthcare providers, ensuring that everyone is on the same page regarding the birthing experience. Whether you envision a natural delivery or anticipate the need for medications, the Birth Plan serves as a guide to help tailor the experience to your needs, all while keeping the ultimate goal of a safe and healthy arrival in mind.

Birth Plan Example

TheBump.com

birth plan

Use this easy fill-in-the-blank birth plan to prepare yourself for delivery and communicate your wants and needs to your medical team.

Full name:

Today’s date:

Doctor’s name:

Please note that I:

Have group B strep

Am Rh incompatibility with baby

Have gestational diabetes

Partner’s name:

Due date/Induction date: Hospital name:

My delivery is planned as:

Vaginal

C-section

Water birth

VBAC

I’d like...

Partner:

Parents:

Other children:

Doula:

Other:

...present before AND/OR during labor

During labor I’d like...

Music played (I will provide)

The lights dimmed

The room as quiet as possible

As few interruptions as possible

As few vaginal exams as possible

Hospital staff limited to my own doctor and nurses (no students, residents or interns present)

To wear my own clothes

To wear my contact lens the entire time My partner to film AND/OR take pictures My partner to be present the entire time

To stay hydrated with clear liquids & ice chips To eat and drink as approved by my doctor

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birth plan

I’d like to spend the first stage of labor:

Standing up

Lying down

Walking around

In the shower

In the bathub

I’m not interested in:

An enema

Shaving of my pubic area

A urinary catheter

An IV, unless I’m dehydrated (and a heparin or saline lock IS/IS NOT okay)

I’d like fetal monitoring to be:

Continuous

Intermittent

Internal

I’d like labor augmentation:

Performed only if baby is in distress

First attempted by natural methods such as nipple stimulation

Performed by membrane stripping

Performed with prostaglandin gel

For pain relief I’d like to use:

Acupressure

Acupuncture

Breathing techniques

Cold therapy

Demerol

Distraction

Hot therapy

Hypnosis

Massage

External

Performed only by Doppler

Performed only if the baby is in distress

Performed with Pitocin

Performed by rupture of the membrane Performed by stripping of the membrane

Never to include an artificial rupture of the membrane

Meditation

Reflexology

Standard epidural

TENS

Walking epidural

Nothing

Only what I request at the time Whatever is suggested at the time

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TheBump.com

birth plan

During delivery I would like to:

Squat

Semi-recline

Lie on my side

Be on my hands and knees Stand

Lean on my partner

Use people for leg support Use foot pedals for support Use birth bar for support Use a birthing stool

Be in a birthing tub

Be in the shower

I will bring a:

Birthing stool

Birthing chair

As the baby is delivered, I would like to:

Push spontaneously

Push as directed

Push without time limits, as long as the baby and I are not at risk

Use a mirror to see the baby crown

Touch the head as it crowns

Let the epidural wear off while pushing

Have a full dose of epidural

I would like an episiotomy:

Used only after perineal massage, warm compresses and positioning

Rather than risk a tear

Not performed, even if it means risking a tear

Performed only as a last resort

Squattng bar

Birthing tub

Avoid forceps usage

Avoid vacuum extraction

Use whatever methods my doctor deems necessary

Help catch the baby

Let my partner catch the baby

Let my partner suction the baby

Performed as my doctor deems necessary Performed with local anesthesia

Performed by pressure, without local anesthesia Followed by local anesthesia for the repair

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birth plan

Immediately after delivery, I would like:

My partner to cut the umbilical cord

The umbilical cord to be cut only after it stops pulsating

To bank the cord blood

To donate the cord blood

To deliver the placenta spontaneously and without assistance

To see the placenta before it is discarded

Not to be given Pitocin/oxytocin

If a C-section is necessary, I would like:

 

A second opinion

 

My hands left free so I can touch the baby

 

To make sure all other options have been

 

The surgery explained as it happens

 

 

 

exhausted

 

An epidural for anesthesia

 

 

 

 

 

 

To stay conscious

 

My partner to hold the baby as soon as possible

 

 

 

 

 

My partner to remain with me the entire

 

 

 

To breastfeed in the recovery room

 

 

 

 

 

time

 

 

 

 

 

The screen lowered so I can watch baby

 

 

 

 

 

 

come out

 

 

I would like to hold baby:

Immediately after delivery

After suctioning

After weighing

After being wiped clean and swaddled Before eye drops/ointment are given

I would like to breastfeed:

As soon as possible after delivery Before eye drops/ointment are given Later

Never

I would like my family members:

(names:)

To join me and baby immediately after delivery

To join me and baby in the room later

Only to see baby in the nursery

To have unlimited visiting after birth

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birth plan

I would like baby’s medical exam & procedures:

Given in my presence

Given only after we’ve bonded

Given in my partner’s presence

To include a heel stick for screening tests beyond the PKU

To include a hearing screening test

To include a hepatitis B vaccine

Please don’t give baby:

Vitamin K

Antibiotic eye treatment

Sugar water

Formula

A pacifier

I’d like baby’s first bath given:

In my presence

In my partner’s presence

By me

By my partner

I’d like baby to stay in my room:

All the time

During the day

Only when I’m awake

Only for feeding

Only when I request

I’d like to feed baby:

Only with breastmilk

Only with formula

On demand

On schedule

With the help of a lactation specialist

I’d like my partner:

To have unlimited visiting

To sleep in my room

If we have a boy, a circumcision should:

Be performed

Not be performed

Be performed later

Be performed with anesthesia

Be performed in the presence of me AND/OR my partner

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birth plan

As needed post-delivery, please give me:

Extra-strength acetaminophen

Percoset

Stool softener

Laxative

If baby is not well, I’d like:

My partner and I to accompany it to the NICU or another facility

To breastfeed or provide pumped breastmilk

To hold him or her whenever possible

After birth, I’d like to stay in the hospital:

As long as possible

As briefly as possible

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File Breakdown

Fact Name Details
Definition A Birth Plan is a document that outlines a pregnant individual's preferences for labor and delivery.
Purpose The primary aim of a Birth Plan is to communicate the birthing person's wishes to their healthcare providers.
Components Common sections might include preferences for pain management, labor positions, and newborn procedures.
Flexibility While a Birth Plan outlines preferences, it is not legally binding. Flexibility is crucial during labor.
State-Specific Forms Some states may have specific guidelines or forms, often governed by existing health care laws.
Informed Consent Understanding medical procedures and giving informed consent is essential, even when a Birth Plan is in place.
Updates A Birth Plan should be revisited and, if necessary, updated as the pregnancy progresses.
Involvement of Partners Partners can play a significant role in developing and advocating for the Birth Plan during labor.
Legal Considerations Consulting with legal experts is advisable if there are specific legal concerns about the Birth Plan's contents.

Guide to Using Birth Plan

Filling out your Birth Plan form is an opportunity to outline your preferences for labor and delivery. By following these steps, you can effectively communicate your wishes to your healthcare team.

  1. Read the form carefully. Ensure you understand each section and what information is required.
  2. Gather necessary documents. Have your medical history and any important information ready.
  3. Start with personal details. Fill in your name, due date, and contact information.
  4. Choose your support team. List who you want present during labor, such as family or friends.
  5. Describe your labor preferences. Note your wishes regarding pain management, mobility, and any specific comfort measures.
  6. Discuss delivery options. Clarify your preferences for lying positions, skin-to-skin contact, and immediate care for your baby.
  7. Plan for postpartum care. Include your wishes for breastfeeding, visitors, and any special needs you may have.
  8. Review and sign. Carefully check all information for accuracy, and then sign the form to finalize it.

Once completed, share the form with your healthcare provider to ensure everyone is aligned with your wishes as you prepare for this significant event.

Get Answers on Birth Plan

What is a Birth Plan?

A Birth Plan is a document that outlines your preferences for labor and delivery. It serves as a communication tool between you and your healthcare team. This plan can include your wishes regarding pain management, labor positions, and post-delivery care for you and your baby.

Why is it important to have a Birth Plan?

Having a Birth Plan can help ensure that your wishes are respected during labor and delivery. It facilitates discussions with your healthcare provider about your preferences. While birth can be unpredictable, a plan provides a framework that helps align expectations and prepare everyone involved for the birth experience.

What should I include in my Birth Plan?

Consider including the following elements in your Birth Plan:

  1. Your preferences for labor positions
  2. Types of pain relief you wish to use
  3. Whether you want continuous monitoring during labor
  4. Your thoughts on interventions such as episiotomies or cesarean sections
  5. Who you would like to have present during labor and delivery
  6. How you envision the immediate care of your newborn

Can I change my Birth Plan later?

Yes, your Birth Plan is not set in stone. It can be adjusted as your pregnancy progresses or even during labor. Flexibility is important, as circumstances may arise that require a deviation from your initial preferences. Discussing any changes with your healthcare provider is essential.

How does the Birth Plan affect my care team?

Your Birth Plan provides vital information to your care team. It helps healthcare providers understand your preferences and expectations. Sharing this document early on allows for better planning and ensures that your wishes can be accommodated to the extent that medical considerations allow.

What if my preferences cannot be met during delivery?

While a Birth Plan is a valuable guide, unexpected situations can arise during labor and delivery. If your preferences cannot be fulfilled, your care team will explain the reasons. Their primary goal is to ensure the safety of both you and your baby. Open communication is key during such moments.

Do I need to submit my Birth Plan to the hospital?

It is advisable to share your Birth Plan with your healthcare provider and the hospital where you plan to deliver. This can typically be done during prenatal visits. However, there is no formal submission process necessary. Simply ensuring that your provider and care team have a copy will suffice.

Can I use a Birth Plan if I'm planning a cesarean section?

Yes, you can create a Birth Plan for a planned cesarean section. Outline your preferences for the procedure itself, including aspects like anesthesia, support persons, and immediate newborn care. Discuss these preferences with your healthcare team to address any specific questions or concerns.

How can I communicate my Birth Plan effectively?

Effective communication of your Birth Plan is crucial. Consider scheduling a dedicated time with your healthcare provider to discuss the document in detail. Be open to questions and discussions. Sharing a physical copy of your Birth Plan with your care team upon arrival at the hospital can also facilitate clear communication.

Common mistakes

Completing a Birth Plan form allows expectant parents to communicate their preferences for labor and delivery. However, many people make mistakes that can hinder the process. These errors can lead to misunderstandings between the parents and the medical staff, affecting the overall experience of the birth.

One common mistake involves failing to clearly outline preferences. A Birth Plan should detail specific desires regarding pain management, labor environment, and newborn care. When parents choose vague language or skip sections altogether, it creates ambiguity. This lack of clarity can result in healthcare providers making decisions that do not align with the parents' wishes.

Another prevalent mistake is neglecting to discuss the Birth Plan with the healthcare team in advance. A Birth Plan is most effective when shared and reviewed prior to labor. Parents who assume that hospital staff will read the Birth Plan without prior conversation often find that their preferences are not fully understood or implemented. Engaging in an open dialogue allows for adjustments and a mutual understanding.

Many also overlook the importance of being flexible. While a Birth Plan serves as a guide, unexpected situations can arise during labor and delivery. Some parents create rigid plans that do not account for potential changes in circumstances. Acknowledging that adaptations may be necessary is crucial for a smoother experience.

Lastly, failing to revisit the Birth Plan as the due date approaches is a common oversight. As pregnancy progresses, preferences may change due to new information or experiences. Regularly updating the Birth Plan allows for an accurate reflection of current desires and circumstances, ensuring the plan remains relevant and informed.

Documents used along the form

When preparing for childbirth, individuals may consider using a variety of documents alongside the Birth Plan form. Each of these documents serves a unique purpose and helps ensure that the preferences and needs of expectant parents are clearly communicated to healthcare providers. Here are five common forms often used in conjunction with a Birth Plan:

  • Admission Forms: These documents are typically completed upon arriving at the hospital or birthing center. They gather essential information about the mother, her medical history, and her birth preferences, ensuring that everyone involved is informed and prepared.
  • Consent Forms: These forms are important for obtaining permission for various medical procedures. They detail the risks and benefits of specific interventions, allowing parents to make informed decisions about their care during labor and delivery.
  • Postpartum Care Plan: This document outlines the expected care and support needed after childbirth. It may include preferences regarding breastfeeding, pain management, and support from family and friends during recovery.
  • Pediatric Care Plan: This plan addresses the immediate medical care and needs of the newborn. It may include preferences regarding vaccinations, feeding options, and any specific health concerns that should be communicated to the pediatrician.
  • Emergency Contact Form: Having a clear list of emergency contacts is vital. This form details whom to reach out to in case of complications or emergencies during labor, ensuring that support is readily available when needed.

Understanding these various forms can aid expectant parents in effectively communicating their wishes and ensuring a smoother birthing experience. Each document serves a valuable role, allowing for thoughtful planning and action to be taken during a significant life event.

Similar forms

  • Medical History Record: Similar to a Birth Plan, a medical history record outlines significant health information. It helps healthcare providers understand any previous conditions, surgeries, or medications you may have that could affect your pregnancy or delivery.

  • Advance Directive: Like a Birth Plan, an advance directive expresses your preferences regarding medical treatment. While the Birth Plan focuses on labor and delivery specifics, an advance directive covers end-of-life decisions and other healthcare choices should you be unable to communicate.

  • Patient Care Agreement: This document, similar to the Birth Plan, details your expectations from healthcare providers. It establishes a partnership, ensuring both parties understand the roles, responsibilities, and care choices during your pregnancy and childbirth.

  • Informed Consent Form: Just as a Birth Plan communicates your wishes for labor, an informed consent form gives healthcare providers an understanding of the procedures you agree to. It ensures that you are making informed decisions about your treatment and are aware of the risks involved.

  • Postpartum Plan: Much like the Birth Plan focuses on the delivery phase, a postpartum plan specifies preferences for care after childbirth. It covers topics such as recovery methods, infant care, and support systems in place for new parents.

  • Emergency Care Plan: This document parallels the Birth Plan by addressing potential complications during labor. It outlines your preferences for emergency situations, ensuring that your healthcare team can act quickly while respecting your wishes.

Dos and Don'ts

When filling out a Birth Plan form, it is essential to consider both your preferences and the practical aspects of labor and delivery. Here are some key points to guide you:

  • Do discuss your Birth Plan with your healthcare provider before submitting it.
  • Don’t be overly rigid about your preferences; be prepared for changes.
  • Do clearly outline your preferences regarding pain management options.
  • Don’t assume your preferences can be accommodated without prior discussion.
  • Do include important information, such as your partner or support person’s role.
  • Don’t forget to indicate any specific cultural or religious practices important to you.
  • Do keep the plan concise and to the point for clarity.

Misconceptions

  • Birth plans are legally binding. Many people think that a birth plan is a legal document that must be followed. In reality, a birth plan serves as a guideline and not a strict contract. Healthcare providers will prioritize the safety and well-being of the mother and the baby.
  • Everyone should create a detailed birth plan. Some believe that a birth plan must be exhaustive and cover every possible scenario. However, it's perfectly fine to have a simple plan or even none at all. Focus on the key preferences that matter most to you.
  • Birth plans prevent complications. A common misconception is that having a birth plan will eliminate the chance of complications during labor and delivery. While it can help express preferences, it cannot guarantee a complication-free experience.
  • Health care providers dislike birth plans. Some think that healthcare professionals are resistant to birth plans. In fact, many providers welcome them as a means to understand their patients’ preferences and foster communication.
  • Birth plans must be written in formal language. Many assume birth plans should be drafted in complex legal language. A birth plan can be written in everyday language. Clarity is more important than formality.
  • Only first-time parents need a birth plan. It's a common belief that only first-time parents benefit from a birth plan. However, experienced parents can also find value in outlining their preferences or reflecting on past experiences.
  • Making changes to a birth plan is frowned upon. Some fear that altering a birth plan during labor will disrupt the process. Flexibility is key; birth experiences can change, and it's acceptable to adjust your plan as needed.

Key takeaways

Understanding how to effectively fill out and use a Birth Plan form is essential for expectant parents. Here are seven key takeaways to help you navigate the process:

  • Communicate Your Preferences: Clearly outline your preferences for labor and delivery. This will help healthcare providers understand your wishes.
  • Update Regularly: Revisit and revise your Birth Plan as your due date approaches. Your preferences may change as you learn more.
  • Involve Your Support Team: Share your plan with your partner and support team. Ensure they understand your desires and can advocate for you if necessary.
  • Be Flexible: While a Birth Plan outlines your preferences, unexpected situations may arise. Stay open to adjustments to ensure the safety of you and your baby.
  • Discuss with Healthcare Providers: Schedule a discussion with your doctor or midwife. Seek their input to ensure your plan aligns with medical practices and protocols.
  • Keep It Concise: Aim for clarity. A concise plan is easier for healthcare providers to read and understand quickly during a busy labor room.
  • Bring Copies: Print multiple copies of your Birth Plan to distribute to your healthcare team upon arrival at the hospital or birthing center.

These points will help you create a Birth Plan that reflects your desires while maintaining clear communication with your healthcare providers.