Being pregnant and going into labor can be daunting, but crafting a carefully laid out birth plan can help alleviate some of these fears and help you concentrate on what is the most important thing during labor: bringing your child into the world safely. Birth plans are a useful tool to help stimulate conversations with your doctor or midwife to ensure that what you assume is a given is the way they usually operate and that a birth plan is a starting point to managing expectations during labor and delivery, according to labor and delivery RN Marguerite Chambers. Oftentimes, a mother’s wishes for her birth experience do not align with her doctor’s typical practices, and this is better found out early in the pregnancy rather than during labor. With careful thought and time, you can create the perfect birth plan for you and your spouse.

Start with the basics. Who do you want present during your labor? While this is entirely up to you who is with you, many labor and delivery rooms have policies of how many individuals can be in the room while a woman is laboring, so it is a good idea to check with your delivery hospital first. People could include the father of the baby, your mother or mother-in-law, a doula or a sister.

Next, determine whether you will be having a vaginal birth or a caesarean. If you have previously had a caesarean and want to try for a vaginal this time around, that is something to discuss with your doctor. Some doctors are not comfortable with certain risk factors involved in a vaginal birth once a woman has had a C-section. If you and your doctor do not agree on this birthing method, you should look into other providers who can accommodate your goal of having a vaginal birth.

Once it has been determined if you will progress as planned with a vaginal birth or must have a C-section, you will want to think about medications, movements and pain relief. If you are having a vaginal birth, determine whether you will want an epidural or forego labor medication. Hydration is key during labor, but do you prefer an IV hydration, ice chips or water? Figure out how you will want to stay relaxed during labor.

You may determine that taking a short walk around the floor, doing simple stretches or even meditation is your perfect solution. You may also find that resting and being less mobile is actually more comfortable, but you should have inclusions for both in your birth plan. Finally, is there any specific music you would like playing while your child is born? If so, ensure you have a music player and speaker ready for your delivery day.

Finally, once you determine your preferences for during labor and delivery, determine your preferences for post-labor and delivery. You will be exhausted and largely unaware of your surroundings at this point, so it is important to make clear ahead of time what you want for your new baby. Do you want to delay cord clamping? Have you thought about doing  skin-to-skin contact? Are you considering immediately breastfeed? Will you want your baby to receive their first Hepatitis vaccination, a Vitamin K shot, and/or an antibiotic eye cream?

While creating a birth plan can be extremely helpful, it is equally as important to remember that childbirth can often be unpredictable. Have an idea of what you want, but remain flexible to unforeseen circumstances and the advice of your labor and delivery team. Advocate for yourself and know your rights as a patient, but make every effort to establish a trusting relationship with your medical team during your pregnancy so that you can trust their knowledge and experience during your labor and delivery.

According to Gloria Franklin, RN, the most common issue with birth plans is that moms are unwilling to deviate from their plan, often at the risk of her own or her baby’s health and safety. Remember, you may have a birth plan together but sometimes there are medical reasons that make it necessary to deviate from the plan said Chambers and, “it doesn’t mean a patient shouldn’t question their medical team is something doesn’t seem right. But patients and family need to be focused on more medically critical events.” Try not to get discouraged if things do not go according to plan because, at the end of the day, you get to bring home a sweet bundle of joy to love.

By Jessica Franklin