Writing Your Birth Preferences
Emily Kossila
Anyone who knows me knows I’m a big list person and am ALL ABOUT the plans! That being said, when I started preparing for my own children’s births I decided to not have a “Birth Plan” per say, but rather birth preferences.
I far prefer the term Birth Preference’s to plan because really who can plan birth? You can plan on researching and knowing things that you personally like, and then you can list those preferences of what you would prefer to experience during your labor and birth of your child. Granted, birth is unpredictable, but I’ve found that even if birth doesn’t go to plan, knowing and thinking about all your options before you go into labor is really beneficial.
Honestly, the best birth preferences won’t even be pulled out during labor, because you and your birth team (including your doula) will know you and your preferences so well because everything’s been talked about in advance. It really limits the surprises during a labor (wait what do you mean do I want to touch the head?!?) and helps everyone be on the same page.
Here are the steps I go over with my clients when they are making their birth preferences, and I’ve also included a free downloadable workbook for you to go through.
What to Include on Your Birth Preferences Sheet
Introduction
I encourage you to start off with a few sentences introducing yourself and your birth team, Explain what matters most to you and any important history you want your care providers to know (ex. past birth trauma, first baby, religious concerns, etc.).
An example:
Hello! My name is Mary Jane and this my wife Gwen Stacy and mine’s third pregnancy and child. We are so excited to be welcoming this child into this world and can’t wait to share this day with you. We are hoping to have a natural childbirth with minimal medical/drug interventions. We envision a calm, joyous environment to welcome our child into the world. We hope that these goals can all be met given that both the baby and mother are healthy. If either of their health is in jeopardy, we welcome discussions of alternatives to these preferences so we can be engaged and informed participants in all decisions. We welcome suggestions and advice!
Environment
List what aspects of your environment bring you the most comfort. Do you prefer lot’s of natural light or more of a dim “cave-like” environment? What will you be listening to? Do you prefer people to enter the room with lowered voices? You can also talk about preferred (or not preferred) visitors, and if you would like to include students or residents in your delivery.
This is also a great place to talk about what you’re bringing from home (pictures of other children, birth affirmations, essential oils, etc) so your birth team can know what to offer you from your bag as well.
Pain Management and Medical Intervention Preferences
This is the section most people look to first when reviewing your birth plan for the first time. How are you planning on managing your pain/discomfort during your labor? Are you planning on having an epidural around a certain time, or do you prefer to labor without medical pain management? Are there certain procedures (episiotomy, IV, fetal monitoring) that you do or don’t want? Talk to your doula, care provider, or childbirth educator about all the different medical interventions/procedure’s offered at your birthing place, and think about what you want your labor experience to be like.
Also, stating why you are prioritizing a certain kind of birth is really important. For example, maybe you don’t want to use nitrous oxide because of an allergy, or you DO want to use an epidural because of previous trauma. There’s a lot of different reasons people labor the way they labor, and it’s all about helping your care team know your motivators so that you can feel the safest and relaxed with all of your choices.
Even if you are choosing to use an epidural or more medically managed pain preferences, list your plans of non-medical pain management, so you have a lot of tools at your disposal. Think about what relaxes you and how you are prepared to cope with the labor because there will more than likely be plenty of times during your labor where you’ll have to rely on a variety of coping strategies. Do you plan to use water (tub or shower), aromatherapy, meditation, soothing touch, massage, etc? Research what kinds of coping techniques you want to use, and list them so they can be offered to you.
Second Stage (Pushing and Delivery of Baby)
I always encourage my families to talk to everyone on their care team a LOT about how they want pushing to look like. Because that’s especially the time in childbirth where you will be in no head-space to make any kind of a decision, so it’s very important that your birth team knows your preferences because you may not be able to articulate or remember them when it’s game time.
Research what kind of positions you want to deliver in and if you want directed pushing vs spontaneous pushing. Talk to your care providers about episiotomies and your preferences with them (and then write them down). Do you want certain pictures, do you want yourself or partner to catch baby (as care provider is comfortable with of course), are you planning a water birth? What are your perineal support preferences? There are a lot of options to think about and talk through, your doula will be a great asset in navigating those decisions beforehand.
What equipment would you like made available? Do you want to use a squat bar or a birthing stool? Do you want a mirror available? Talk about all of these with your birth team, and then write them in an easy to read list format.
Newborn Care
After baby’s born, you are thrust into parenthood of that little one, and a lot of split second decisions come with it. I highly encourage talking with your doula and care provider about what the immediate postpartum looks like, and what you want it to look like. Trust me that it happens very quickly, and you just had a baby so again not in the best headspace to be making decisions.
Take some time to think about your immediate bonding and feeding goals for baby are, and communicate those to your team. How long do you prefer baby to be attached to the placenta? What newborn procedures have you researched and are comfortable with being (or not being) administered? How long do you want to have skin-to-skin with baby? Is there a certain first song or family tradition you want to happen in your babies first hours?
All of these and more are things to think about how you want your baby to be spending it’s first few hours and days. I typically recommend having the newborn/postpartum on the back or on a separate sheet of your birth preferences so it doesn’t get too crowded.
Format and Examples
There a ton of different ways to format your birth plan. I’ve pinned some examples on my Pinterest page.
My preferred formatting for a birth plan is a short paragraph introduction introducing yourself and all the members of your birth team, and after that having clearly organized headers and bullet points, so that it’s easy to read.
Other people choose Grid or Picture Formatted birth plans, but I think sticking to bullet points is a great way to go. I’ve also seen birth plans as long checklists of what to do or what not to do. I think they are a great starting point, but please go through and reformat them. Do not hand your birth team a 5-page document of random checkboxes, I can guarantee they won’t read it.
Example of a Minimal Medical Intervention Birth Preferences Sheet
The Unexpected
I encourage all my families to develop a cesarean section plan/preference sheet as separate from their birth preferences, it's great to be able to get all your ideas down and put the paper away (out of sight out of mind).
Here’s some general information on Cesarean, along with this consumer booklet of "What Every Pregnant Woman Needs to Know about Cesarean Section".
Gentle Cesareans and Family-Centered Cesareans are just terms wherein a non-emergency cesarean (which many are) the birthing family has some time to create more of a birth experience for themselves and baby. A lot of Twin City hospitals are moving in this direction for their standard of care, but it's still nice to have an idea in your head of what it can look like. This article has a lot more in-depth information if you were interested in learning more.
Like I said though, once you prepare your cesarean birth plan, please put it in a deep pocket of your birth bag, chances are you won’t need to use it (but you’ll be glad you have it just in the rare chance).
Example of a Family- Centered Cesarean Birth Preferences Sheet
Thanks so much for reading!
Download my Birth Preferences Work Book today