Choosing a Birth Plan - and How to Tell Your Mother She Can't Be in the Delivery Room
Truth be told, choosing a birth plan should be simple. In fact, there's really only one thing you need to know.
Throw any expectations that you have for labor and delivery out the window. It will not go the way you plan it to.
Now that we've got that out the way, you should also know that it can be incredibly helpful to have well researched -- but flexible -- preferences for how you would like to deliver. Think of your "birth plan" as more of a "birth preference" and be open-minded to last minute changes that could be necessary to ensure a safe and/or more comfortable experience.
Before delivering my first baby, one of my closest friends warned that I not get hung up on my own birth plan. For her and many other first-time mamas, last minute changes to their plans left them feeling crushed and disheartened -- sometimes for months, even years -- after the birth. Many wondered why their body hadn't functioned they way they expected or prepared for, feeling frustrated rather than grateful for the miracle of life they just experienced.
Much can be made during pregnancy about creating an elaborate birth plan, fueled in part by social media posts, books and blogs that tout the benefits of things like home birth, water birth, unmedicated birth, or even the allure of a scheduled c-section.
The fact of the matter is that each and every birth story is different, and there's no crystal ball that can predict how yours will go. Some babies glide into the world effortlessly in a bathtub. Others can find themselves stuck in the birth canal needing medical intervention.
After nine long months of pregnancy, all we can hope and plan for at the end of this journey is a healthy, squishy baby to hold in our arms. How they get here is, at the end of the day, less important.
So, how will they get here?
In my own experience, I always expected and planned to deliver in a hospital. I hoped and prayed that I wouldn't get stuck in Los Angeles rush hour traffic on the way there, giving birth in the backseat of a car -- but, like anything else, I had to accept that it was within the realm of unpleasant possibilities. I also hoped to avoid a c-section, but knew that I would move forward with one without hesitation if it meant a safer delivery for my child.
But all the uncertainty surrounding the "What Ifs" of childbirth left me feeling lost on nailing down specific details for a birth plan. Would my water break at home? How quickly would my contractions come on? What time of day would it happen?
Because my doctor did provide a worksheet on which to write out my "Birth Plan" for the hospital, this is what I put to paper:
Sophie's Birth Plan:
Go to the hospital
See what happens
This is not to say that I didn't do my homework -- or that there's anything wrong with having a more specific plan, if you want one.
As I do with most things in life, I asked around about what to expect. I talked to countless mamas about their experiences and heard stories that ran the gamut. I found them all to be fascinating and felt that I had a healthy understanding of many different scenarios, complications and tips. All that to say, my actual birth experience was unlike any I had heard about... natch.
BUT! BUT! BUT! If you feel you may develop anxiety or fear from hearing someone's graphic birth details, don't listen to them! Feel free to offer a swift, "Thanks, but I'd like to enter into this with a clear mind" to cut any storyteller short. You are not obligated to listen to someone else's horror story -- and you are absolutely not guaranteed to have a similar experience to anyone else.
I also read the book "Hypnobirthing" at the recommendation of several mamas. It simply wasn't for me. That said, I know women who have had incredible success with the method. I know others who did not.
What was perhaps the most helpful preparation for both myself and my husband was enrolling in a one-day labor and delivery class offered by our hospital. There, an experienced L&D nurse walked us through many different medical scenarios, options, and offered tangible advice on how we would know when we were actually in labor. We watched a live birth video. (For my husband, who attended a Catholic high school without much "health" education, it was definitely the first time he'd seen anything like that.) Afterwards, we toured the maternity ward to see the size of the rooms, amenities offered, and figure out where to go when it was time to check in.
When I returned several weeks later to be induced, both my husband and I were equally well versed in everything from Cervidil to Foley Balloons to Fetal Monitors. (But we did still need to ask a security guard where the heck to check in.)
The moral of the story is this: educate yourself in whichever way you feel most comfortable, nail down a few key details, and be mentally prepared for last minute changes.
And don't forget to include your partner in your preparations! Having an educated and empowered birth partner can improve the experience for you both, allowing them to have an understanding of what to expect and how to support you.
How to Write Your Birth Plan in 4 Steps:
-Where would you like to give birth?
-Who would you like to have in the room?
-How do you feel about medication?
-What would you like to do with baby immediately after birth?
I'll break down each of these points.
Where would you like to give birth?
This one is pretty straightforward. The most common options tend to be a hospital, birthing center or home -- but more specifically, you should have a plan for which hospital or which birthing center and make sure you take care of any necessary pre-registration paperwork ahead of time. If you'd like to give birth in your home, be sure to iron out arrangements for a midwife and equipment (like a birthing tub or waterproof mattress pads) well in advance.
Who would you like to have in the room?
This one can get a little more complex.
The first step is to set aside any worry about hurt feelings. If you feel that your mother or sister... or mother-in-law... has their heart set on being in that room with you, but you aren't totally sold, just know that they absolutely will get over it as soon as they hold that precious baby for the first time. (More on how to address this later on.)
I had been on the fence about allowing close family members in the room for my daughter's birth. On the one hand, I had previously experienced viewing a close relative's live birth from the sidelines and found it to be an incredibly valuable, special experience that I was profoundly grateful to have had. On the other hand, I wasn't sure I was quite comfortable with an audience, myself -- especially when it came to my first baby.
In the end, one piece of advice struck a chord with me: "If they weren't there when you made the baby, they shouldn't be there when you deliver it."
So, it was just my husband and I in that hospital room -- alongside two nurses and one doctor. And it was perfect for us.
(It also didn't hurt that when go-time arrived, it was about 3 a.m. on a Thursday and everyone else I knew was asleep in bed. Those few hours alone as a family of three were wonderful, and we were just as thrilled to have visitors shortly after.)
How do you feel about medication?
This one can be a hot button topic and seems to be the most prevalent source of disappointment for new moms. Many women hope to deliver without the aid of an epidural, only to beat themselves up afterwards when the pain becomes unbearable and they ask for relief.
I don't know who needs to hear this, but: Epidurals are nothing to be ashamed of.
Delivering without medication does not earn you a prize. Receiving medication will not make you a bad mother. This is an intimately personal choice, and neither one is right or wrong for everyone.
I recommend going into this with an idea of your own personal level of pain tolerance -- while giving yourself tons of grace and wiggle room.
To use myself as an example: I planned to labor for as long as I could without medication, knowing that I might want it at some point -- and that was OK. My ultimate goal was to preserve some of my strength and energy for pushing without fully exhausting myself In the hours of lead-up contractions.
For me, it worked. For more specifics on that, you can read my full birth story here.
Now, with baby no. 2 on the way, I am approaching this aspect of my birth plan a bit differently. Since second babies tend to come a bit faster than the first, I am curious to see whether I will be able to go longer without receiving an epidural. But, like the first time, I am keeping an open mind to all the possibilities and plan to listen to my body's needs in the moment.
What would you like to do with baby immediately after birth?
By this I mean, would you like to practice immediate skin-to-skin contact or wait until baby is cleaned off and examined first? There are also several options regarding delayed cord clamping and cord blood banking, as well. (More on this later.)
Some hospitals/birthing centers have established practices on this topic, so it's worth talking to your doctor or midwife ahead of time about what they generally do. Barring an emergency situation, the hospital where I delivered almost always practices immediate skin-to-skin contact.
I confirmed with the nursing staff and my doctor that I would like to have immediate skin-to-skin contact after birth, and we were fortunate to be able to experience that without complication. I also reminded my doctor ahead of time (as in, very shortly before pushing my daughter out) that we would like to delay cord clamping to allow her to continue receiving blood flow from the placenta. (As such, we did not do any cord blood banking.)
What Is Delayed Cord Clamping?
In short, Delayed Cord Clamping (DCC) means that your doctor will wait to clamp the baby's umbilical cord until at least 30-60 seconds after the birth, sometimes longer, to allow additional blood flow from the placenta to your baby.
According to the American College of Obstetricians and Gynecologists (ACOG), DCC "increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes." There are additional benefits for pre-term infants.
According to ACOG, the risks associated with the practice appear to be minimal, including a small increase in the incidence of jaundice. There is said to be no increased risk of postpartum hemorrhage with the practice. In fact, it is officially recommended by the World Health Organization "for improved maternal and infant health and nutrition outcomes."
How to Tell Your Family They Can't Be in the Delivery Room:
When deciding who should be in the room with you during delivery, ask yourself this question:
Are you comfortable being completely naked, most likely pooping, in the most primal state of your life in front of this person?
Chances are, that's a tall order even for a spouse. (I'm kidding: your spouse should be there. Though, you may want to have a conversation ahead of time about their expected vantage point for the birth and what you are both comfortable with.)
Once you've made your decision... you actually don't owe anyone an explanation about anything! You can absolutely choose to say nothing at all, waiting until after baby arrives to share the news and welcome visitors.
If you'd like your family and friends close at hand, but not too close, you can let them know ahead of time that you'd love to have them in a nearby waiting room so that they can meet the baby right away and share this life-changing experience with you! Assure them that, barring any complications, your partner will be happy to give them a phone call when go-time is approaching. (Labor can be long, y'all. No one wants to sit in that waiting room for more than a few hours.)
If you sense any disappointment or receive pushback, stand firm and know that those feelings will soon be replaced by the joy and excitement of meeting the baby. In a nutshell: they WILL be just fine.
If you still don't feel comfortable asking so-and-so to leave the room, or to keep them out in the first place, most nurses will gladly be your bad cop. In fact, they are often asked to do so.
Have a conversation with your nurse at the start of labor if this is the case, even if it's just to establish a code word/signal for when things get intense. Your nurse will know to ask that person to leave on their behalf, not yours. Hurt feelings, avoided!
Regardless of where or how you plan to deliver, having a support system that you trust and respect is key -- whatever that means for your situation! Sending you love and good vibes on your journey.
Please don't hesitate to comment below or find me on Instagram with any additional questions, and check out the links below for more helpful info about giving birth!
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