Labor & Delivery: Some Moms Choose Plan B

A written birth plan can help you think through the labor and birth process with your healthcare provider.

Is the nursery ready? Check. Got your overnight bag packed? Check. Is the doctor on speed dial? Check. Has the fastest route to the hospital been mapped out? Check.

For many soon-to-be parents, preparing for the arrival of a baby consists of little more than a few checkpoints such as these. For others, a written birth plan is an integral part of welcoming their new little one into the world.

What is a Birth Plan?

Most birth plans are lists of specific wants or concerns parents have regarding labor and delivery of their baby.

“A typical birth plan is a set of guidelines a patient has for when she gives birth,” said Dr. Grant Cox, an obstetrician-gynecologist with Tulsa OBGYN Associates. “It’s a list of ‘rathers’ – she’d rather walk around during labor, she’d rather let the water break on its own.”

But just because a patient prefers that the requests on the list be followed during labor and the birth of her baby, does not mean that everything will be done exactly according to the plan. Certain medical procedures may be necessary to ensure the safety of the baby or mother.

Things to Consider When Making a Birth Plan

The key to incorporating a birth plan successfully is to make sure you communicate with your physician and remain flexible to possible alternatives, said Cox, who estimates about 20 percent of patients have some kind of birth plan. Some requests may not be possible due to hospital policies, while others may not be followed for safety reasons. Labor and delivery are an intense process and changes that arise during this process may necessitate medical intervention.

Issues that may come up in the creation of a birth plan include what kind of environment the mom would like for the birth of her baby, such as dimming the lights in the delivery room or keeping noise to a minimum, whether or not she would prefer to be mobile throughout labor, and if she would prefer certain family members to be present during the delivery. A mom may also request to wear her own clothes during labor and delivery instead of a hospital gown.

A mom considering a birth plan may also list preferences regarding fetal monitoring (continuous monitoring is necessary for some moms); pain relief options; labor induction and augmentation procedures such as rupturing of the amniotic sac or the administration of pitocin; the position she wishes to be in to give birth; whether or not she would want an episiotomy (medically necessary in some cases); and whether or not she would like to be able to eat or drink freely during labor.

Concerns about planned or unplanned cesarean sections, care of the baby following birth, feeding of the baby, circumcision and whether or not the baby sleeps in the room with the mother also are topics that may be addressed in a birth plan.

Once a mom has a birth plan drawn up, it’s a good idea to go over it with her physician and anyone else who will be present during labor and delivery.

“You want to be sure you are on the same page as your doctor and that you understand what you are requesting, why you want those things and why it may or may not be possible for safety reasons,” Cox said. “Patients can use birth plans as an opportunity to bring up discussion with their healthcare providers before their due dates.”