A Birth Plan is a way for you to communicate your wishes to those who will care for you during your labor and after the birth of the baby. Every birth is a unique experience. Creating a birth plan will empower you to become informed of all your options during labor.
Decatur Morgan OB/Gyn feels your birthing plans should be your personalized care and you should discuss all the options with your physician.
Sample personalized Plan
To help you craft a personalized plan, here’s a template to consider (you can circle the options you’d like and cross out the ones you don’t). Be sure to list your and your partner’s names at the top, as well as that of your doctor and hospital.
Basic information:
• Name: ______________
• My support person's name: ______________
• Hospital/birthing center: ______________
• Due date/induction date: ______________
• Practitioner's name: ______________
Before labor:
• My health factors include: ______________
• My planned delivery is: ______________
• My birth team includes: ______________
During labor:
If medically possible, I would like to (circle all that apply):
• Eat and drink during labor if my practitioner allows it
• Be out of bed (walking around or sitting up) during labor
• Play music, dim lighting, use incense, scented candles
• Have partner take photos or videos
• Labor with an exercise ball,
• Use specific birthing positions
• Other:______________
Medical interventions:
I would prefer (circle all that apply, or make a note next to any you'd like to avoid):
• Artificial rupture of the membranes
• External and internal electronic fetal monitoring
• Intermittent fetal monitoring
• Doppler fetal monitoring only
• The use of an IV or catheter or enema
• The use of oxytocin to induce or augment labor contractions
• Episiotomy
• Natural tearing only
• Vacuum extraction or forceps to assist in the birth
• Other:______________
Pain relief:
I would prefer (circle all that apply, or make a note next to any you'd like to avoid):
• Epidural
• Acupuncture
• Acupressure
• Breathing exercises
• Massage
• Meditation
• Reflexology
• Other:______________
Delivery:
I would like to (circle all that apply):
• Use mirror to see baby crown
• Have partner help catch baby
• Allow partner to suction
• Allow partner to cut umbilical cord
In case of a C-section:
If medically possible, I would prefer (circle all that apply, or make a note next to any you'd like to avoid):
• To be conscious
• Clear drapes be set up so I can watch as my baby emerges
• To breastfeed as soon as possible
Newborn care:
I would like to (circle all that apply, or make a note next to any you'd like to avoid):
• Hold the baby immediately after birth, allow baby time to creep from belly to breast
• Breastfeed immediately
• Have a lactation consultant help me breastfeed
• Bank the cord blood
• Donate the cord blood
• Give my baby formula
• Give my baby breast milk only
• Offer my baby a pacifier
• Room-in with baby
• Let my baby sleep in the nursery
• Have circumcision performed if baby is a boy
• Give my baby vitamin K
• Give my baby antibiotic eye treatment
• Other:______________
