In most birth plans, the expectant mother fills out what she would like during birth, which typically has sections like pain management, breastfeeding versus formula, and informational details like name of OB provider. Here, I took that traditional birth plan added more sections, to help you feel more prepared. After having gone through a birth and preparing for one, I feel it is important to prepare with your partner, preparing your home before birth, and then preparing for the birth itself. To download the three part birth plan printable, subscribe using the form below and read on to find out what is in each part of the birth plan. As a side note, all sources are listed at the end of this article.
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Part 1: Preparing as a team
The first part is to prepare as a team, the expectant mother and partner. Labor isn’t an activity done in solitude. In addition to medical staff, your partner will be there the whole time. How helpful your partner will be during the process is dependent on how well you both prepare as a team. In Part 1, you will find questions that you will fill out each separately, followed up with discussion. This allows you both to be on the same page for the birth, especially regarding expectations from each other. In this part, I have also included a page for the expectant mother to jot down her fears and hopes. It is great to be able to put what you might be feeling into words and use it as a guide to share with your partner.
Part 2: The Ultimate Checklist
Before the actual labor and delivery part of your birth, there are SO many things that need to be done. While some are optional but beneficial, such as stocking up on non-perishables to minimizing shopping post-delivery, others are absolutely necessary, such as finding childcare for older children or pet care. The goal in using this checklist is to ensure you feel prepared and relaxed when you go into labor because everything has already been taken care of. Additionally, the checklist includes items that make the first few weeks home with baby much easier because you prepared so thoroughly before baby was born.
My favorite items on this checklist include: setting up photography (make sure your package includes digital rights), stocking your freezer full of ready-to-go meals (helped tremendously with breastfeeding and getting my body back after baby), and deciding on a visitor policy for the hospital and at home. Another important item that should be done before baby is born is determining whether you can get a breast pump from the birth center or if you need to get one ahead of time. Do not pay for one as breast pumps must be covered by insurance. Additionally, a lot of insurances also cover lactation consultant visits.
Part 3: The Birth Plan (Birth Wishes)
Of course, this couldn’t be a birth plan without the traditional section that allows you to outline your wishes for labor and delivery. In this article, I will outline the research I have found so you can make the best decision for your baby. To decide what pain management strategies you’d like to try, I suggest reading the birth stories (Trina’s birth story and Alli’s birth story) up on our blog to get some perspectives. A note to remember is that these are birth wishes and you choose the most desired outcome, but certain circumstances might occur which cause some of these wishes to not be possible, which is okay. It doesn’t mean you failed and you are not less of a mother, I promise.
Hiring a doula?
If you read my birth story, I explain that if a natural birth is something that is very important to you, you might want to consider hiring a doula. A doula is someone who specializes in helping you through the labor by employing a variety of techniques. These techniques include breathe coaching, relaxation strategies, massage, and laboring positions. Most also provide emotional support and motivational encouragement. While your partner could provide these things, it is important to note that they aren’t a trained professional and might be at a loss on how to best help you.
Many studies say that women who used a doula were less likely to have a cesarean birth, less likely to use pain medication, and were happier with their overall birth experience. Remember, medical staff are there to ensure you and baby are both medically stable and everything is progressing, the doula is there to support you through the process. Additional benefits of a doula are that they spend time with you before going into labor to help you prepare, and after delivery help you with the breastfeeding process. If paying for a doula is not in your budget, you might call around and see if by allowing a doula-in-training to accompany, you can get a free or discounted price.
Breastfeeding vs formula:
I personally recommend breastfeeding because the benefits of breastfeeding baby exclusively for the first 6 months, and then continuing to breastfeed with the addition of baby food, are immense. If you are looking for information on breastfeeding, check out my guide based on all the help I received from lactation consultants, along with a cheat sheet printable and a nursing chart.
Here is a non-inclusive, detailed list of all the benefits you are providing to your baby when you choose to breastfeed:
- Breastmilk easier to digest than formula
- Contains antibodies to prevent infection and disease
- Fewer ear infections, respiratory illnesses, and diarrhea
- Fewer hospitalizations
- Better bonding with mother due to physical closeness, skin-to-skin and eye contact. Did you know? Your baby when born sees best at the distance between your boob and your face, making you their first favorite object to look at
- Less likely to be overweight as a child
- Helps to prevent SIDS
Here are some of the benefits of breastfeeding to you:
- Burns approximately 500 calories a day once your colostrum changes to milk and your supply increases
- Releases oxytocin, which reduces uterine bleeding, helps shrink your uterus, and promotes bonding
- Lowered risk of breast cancer and ovarian cancer
- Lowered risk of osteoporosis
- You don’t have to spend time cleaning and prepping and warming bottles instead you just snuggle up with your baby and nurse
If you decide to breastfeed and it isn’t going well, don’t wait to get help. Get help immediately, even if it is just from your pediatrician. It is so important to keep baby well fed and hydrated. If you have heard of the phrase “fed is best”, it stems from a lot of times people choosing to breastfeed even when it isn’t going well, and the baby doesn’t get enough. It’s smart to find resources before baby is born because it is imperative that your milk comes in and your supply increases. I highly recommend you first try to find help. If at a complete loss, La Leche League has local chapters, find your chapter today and you can always contact them for help. Also, please remember if it doesn’t work out, and you have to switch to formula, you are just as good of a mother and you shouldn’t feel guilty, fed is best.
Breastfeeding in the first hour:
If you want to pick one thing to do to dramatically reduce the chances of mortality, then this is it. Studies show that breastfeeding in the first hour reduces chances of mortality by 33% compared to breastfeeding in the first 2 to 23 hours after birth. Infants who didn’t breastfeed until 24 hours after birth had a 2.19-fold greater chance of mortality. Why? Being separated from mom right away is not natural and puts baby into stress. When looking for a hospital birth center and when picking a midwife/OB, this was a must for me.
If you are currently trying to decide on a birth plan and want to initiate breastfeeding, I highly recommend taking the 12 Part Course, Simply Breastfeeding, which goes over how to start breastfeeding off during birth with lots of skin-to-skin while also giving you a solid foundation of information to succeed. I absolutely loved watching their videos and got to include my husband who was up for a movie night, but would never read a breastfeeding book.
Additionally, breastmilk is full of probiotics that help to coat baby’s digestive tract with good bacteria which help prevent disease and improve immune system function. Other ways to promote good bacteria is by having a vaginal birth as the baby is coated in good bacteria when passing through the birth canal and also skin-to-skin contact where the bacteria on your skin transfer to baby’s skin.
Delay routine procedures until after first hour:
At the birth center I picked, I was allowed to delay all routine procedures until after the first hour in order to have time to breastfeed and bond with baby. This was one of the reasons I chose the birth center I did. If you are in this process of choosing a birth center, check out Alli’s comprehensive guide on choosing a birth center. In the birth plan my birth center provided, they state that the following procedures can be delayed and the amount of time in which they can be delayed:
- Weighing, measuring, footprints, security bands: usually performed after the 1 hour mark
- Antibiotic eye ointment: Delayed up to 1 hour
- Vitamin K shot: Delayed up to 1 hour
- Blood test (Jaundice and metabolic disorders): No time given but can be delayed
- Hepatitis B shot: To be given in the first 12 hours
- Hearing Screening test: 24 hours after birth
During the first hour, on-going monitoring of baby, such as their temperature and breathing rate can be performed while baby is on you and/or nursing. Of course, if there is a medical emergency, the situation might change and baby might need to be examined or taken to a neonatal unit.
This academic paper beautifully explains the precious first hour of life and highlights why delaying these procedures was so important to me. Here is an excerpt from this academic study:
Based on decades of evidence, the World Health Organization and United Nations Children’s Fund (World Health Organization & United Nations Children’s Fund, 2009) recommended that all healthy mothers and babies, regardless of feeding preference and method of birth, have uninterrupted skin-to-skin care beginning immediately after birth for at least an hour, and until after the first feeding, for breastfeeding women. Skin-to-skin care means placing dried, unclothed newborns on their mother’s bare chest, with warmed light blankets or towels covering the newborn’s back. All routine procedures such as maternal and newborn assessments can take place during skin-to-skin care or can be delayed until after the sensitive period immediately after birth. First impressions are important and perhaps none more so than the newborn’s first moments of introduction to the world and the mother’s to her child.
This sensitive time, sometimes called the “magical hour,” “golden hour,” or “sacred hour,” requires respect, protection, and support. Disrupting or delaying skin-to-skin care may suppress a newborn’s innate protective behaviors, lead to behavioral disorganization, and make self-attachment and breastfeeding more difficult. Lack of skin-to-skin care and early separation also may disturb maternal–infant bonding, reduce the mother’s affective response to her baby, and have a negative effect on maternal behavior. This has been shown by rougher handling of the baby during feedings, lower affective responses, and fewer maternal behaviors in response to a baby’s cues at 4 days postpartum, at 1 and 4 months, and at 1 year compared to mothers who were not separated from their newborns.”
Delayed Cord Clamping vs Cord Blood Banking:
If you really want to hear about the amazing benefits of delayed cord clamping, watch this Ted Talk called “90 seconds to Change the World”. Essentially, when baby is born, delayed cord clamping means that baby is placed on your abdomen, and the umbilical cord is allowed to continue pulsating until it stops (around 3-5 minutes). Here are the benefits of waiting to cut the cord until it has stopped pulsating:
- Baby get one-third more volume of blood
- More oxygen: baby continues to benefit from the oxygen rich blood flowing out of the cord as their lungs start to operate. 1 out of 10 children receive sub-optimal oxygen in the first minutes of life, which can lead to cerebral palsy and decreased intelligence
- More iron: immediate cord clamping decreases the risk of anemia by 10 times.
- More white blood cells: help to prevent neonatal sepsis
- More stem cells
With delayed cord clamping, you give your child all of those benefits listed above for free. If you are thinking of going one step further and banking cord blood, you need to remember that it is a business who wants to make a profit and will use advertising tactics to sell you on their business, which might not be best for your family. Here is a list of items to consider:
- Most of the time, cord stem cells can not treat an adult weighing over 90 lbs because there aren’t enough stem cells in the cord
- 75% of cord blood donated to public banks is discarded because there aren’t enough stem cells to be able to treat diseases
- 70% of the time that someone choses to store cord blood privately, it is because a sibling needs a transplant. AAP only recommends cord banking if this is the case. Also if this is your situation, The Children’s Hospital Oakland Research Institute, will bank it for free.
- The company you store with could go out of business.
- There is no scientific evidence that has verified that the stem cells are still viable years later.
- For children who get a disease that needs to be treated with stem cells, most of the time doctors prefer taking stem cells from a healthy patient than using the cord stem cells that could be tainted.
Personally, with a PhD in Chemical Engineering and having worked in a research setting for a while, I chose delayed cord clamping but not cord blood banking because I knew my child would benefit 100% from that decision and that there is a high probability my child may never benefit from cord banking. Additionally, the field of bioengineering is rapidly evolving and there will be many new treatment methods developed in the near futures besides just banked cord blood (which hasn’t yet been proven to be effective).
When to wash baby:
Delaying the first bath has huge medical benefits. Traditionally, babies use to be bathed immediately after birth. Now that new research has shed some light on the immense benefits of waiting, delaying the first bath has become the more common practice. Here is a list of those benefits:
- Reduced risk of infection because the vernix that covers baby when born offers a germ barrier
- Reduces the risk of low blood sugar as baths can be stressful
- Better temperature control as a bath too soon can cause hypothermia and the vernix helps stabilize baby’s temperature
- Improved mother-baby bonding from breastfeeding and skin-to-skin contact, instead of a bath
- Improved success rate of breastfeeding as baby instinctively wants to breastfeed in that first hour
- No lotion needed as the vernix is the best moisturizer for baby
- Everyone will wear gloves if baby isn’t bathed to prevent being exposed to blood and amniotic fluid. Studies show that glove-wearing prevents infections in newborns
- You get to enjoy your first baby bath if you do it when you are at home, when you are more recovered and can actively participate.
I had a girl and didn’t personally do any research in this area, so I can’t provide any advice. If I have a boy in the future, I will update this section.
Rooming with baby:
While baby must sometimes be in a nursery for medical reasons, I think it is important that when at all possible, baby rooms with you. You might think that if baby rooms in a nursery all night you can finally get some rest but unfortunately, you are making life much harder on yourself. Not only will your milk supply suffer if you don’t have baby in the room and aren’t nursing on demand, but you also need this time to bond and learn about your baby. The more you can ask questions and learn about baby while nurses are around, the easier those first few days at home will be.
Here is an excerpt from an academic study:
“Rooming-in makes breastfeeding easier. Women who room-in with their newborns make more milk, produce a copious milk supply sooner, breastfeed for longer durations, and are more likely to exclusively breastfeed compared with women who are separated from their newborns. Rooming-in appears to have a dose-response effect. Women who roomed-in with their babies were more likely to be exclusively breastfeeding at hospital discharge compared to women who had partial rooming-in. Skin-to-skin care while rooming-in reduced maternal physiologic stress and depressive feelings after hospital discharge, which may help to empower women in their role as mothers. Duration of breastfeeding in mothers who had frequent skin-to-skin contact while rooming-in was longer compared to mothers who spent less time skin-to-skin with their babies during the first 5 days after birth. Research also suggests that skin-to-skin care while rooming-in also may be an effective intervention for mothers who have breastfeeding difficulties and are therefore at risk for breastfeeding cessation.”
In this printable birth plan, there is a section to put any questions you have for your midwife/OB, your lactation consultant, and the pediatrician on staff. It is very hard to remember all of your questions in the moment, and you might not get to spend much time with any of these providers as they are busy with many patients. As you come up with questions, either before labor while you are preparing, or during your hospital stay, write them down. We only met with the pediatrician on the last day for about 15 minutes and he asked if we had any questions. I couldn’t think of any in the moment but then had like five after he had left.
In picking a pediatrician:
My best advice here is that if you plan to breastfeed, make sure your pediatrician is pro-breastfeeding. A lot even have a lactation consultant on staff that you can see, which is a huge bonus. Another thing to consider is proximity, as babies have an insane number of appointments. It is also good to look and see if they have hours that match your schedule and if they have a person who answers during non-business hours, so you don’t have to go to the emergency room every time you don’t know what to do about a fever or illness.
Now that you have read about the different sections in the Three Part Birth Plan, download your own and start filling it out. If you have any questions please let me know in the comments. To further prepare yourself for labor and delivery check out the birth stories that we wrote as well (Trina’s, Alli’s). For more tips to prepare, check out my post on all the ways I wish I had prepared before my daughter arrived.
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