So Prince Baby #3 is due any moment and I realized that when I packed my hospital bag the other night that I didn’t have my birth plan copies on there.  My midwife and I already discussed everything, and I’m confident that she won’t even need to read it.

But I want my nurses to know what the plan is, and what it is when all else fails.  So I put together my simple birth plan and knew that you’d want a printable birth plan form as well.  It’s hard gathering all your thoughts and trying to remember every single detail about what you want to happen at best during your birth.  Now you won’t miss a thing.

What’s In Sarah’s Birth Plan?

First off, here’s my simple birth plan.  You can find a variety of versions for free in many places, like the Sample Birth Plans page.  But actually reading once from someone who’s been there and back….twice, may actually be refreshing and better understood than the all the medical jargon or concepts that aren’t preferred.

Sarah Prince
BIRTH PLAN – Baby Boy
Practitioner:  (my midwife’s name here)

We desire to have as natural a birth as possible.  Though we know we cannot control every aspect of our birth experience, please keep us aware and involve us in any changes to circumstances that may need to be made.  Please do not implement any procedures or administrations without our consent. 

Labor

• Ability to move around and position as desired
• Limited and minimal monitoring as needed
• Use of any relaxation methods: tub, birthing ball, squat bar, etc.
• No medication whatsoever
• Any personnel or visitors beyond limited necessary staff need our permission to be present
• Don’t want water broken unless requested

Pushing & Delivery

• Any position that I desire, mainly upright and/or on all fours
• Do not direct pushing, will follow bodily cues
• Perineum support with warm compresses, if possible
• Don’t want baby pulled out after head emerges, prefer complete natural expulsion

Post Delivery

• NO CORD CLAMPING, hold baby level until pulse has ceased in the cord
• Immediate skin to skin after delivery
• Natural expulsion of the placenta
• No Pitocin unless there is heavy blood flow
• Baby to NOT have antibiotics on his eyes
• Baby does not need to be dried off quickly, cleaning can wait

Recovery

• Baby with mother at all times possible for nursing and skin to skin
• DO NOT provide formula to baby
• Mother to do fundal massage herself

In the case of an emergency, we do not wish a cesarean unless it is the last option where the life of the mother or baby is at stake.  We trust our healthcare team will make the best decisions possible in this case.

CONTINGENCY

• Mother & Father together all times possible while staying awake through procedures
• Use a low transverse incision
• Allowed to hold and nurse baby in NICU as much as possible
• Inform us of any procedures that need to be done with our consent

Thank you! 🙂 

So why did I choose a few of the things that I did?  I’ll just touch on a few points that I know will also be important to you, then I’ll get you to your printable form.

1. Do not direct pushing – I have had two posterior babies and have torn pretty bad each time.  I don’t want to repeat that.  So this time I’m going to do my best to NOT push as much as possible.  Why?  Because I know that my body and uterus have natural ejection responses once I’m fully dilated.  Yours does too.   That urge you feel to push, you know?  You actually don’t HAVE to push because your body is doing it all on its own.  I’m really good at pushing; I mastered it with baby #2.  But I don’t want to tear.  So we’ll see what happens when I try to just breathe my baby out.  Part of all that is me wanting my perineum supported too.  Hopefully, the warm compresses will help.
2. No cord clamping – Delayed cord clamping has been shown to provide a lifetime of benefits that you don’t want to lose.  A third of your baby’s blood is still in the placenta upon delivery and I want mine to get every drop.  I don’t keep my placentas, but I sure want my baby to keep all of his blood.
3. Baby to not have antibiotics on his eyes – In the state where I live I can deny this practice.  It’s for the babies whose mothers have been confirmed with cases of gonorrhea.  The antibiotics limit the exposure and transfer of the condition to your baby.  But I don’t have gonorrhea and feel it’s unnecessary.
4. Use a low transverse incision – I sure hope and pray that I don’t have to have a cesarean, but I am not closed to the possibility if it means it will save my child.  However, there are a number of different ways a surgeon can cut open your belly in order to pull that baby out.  A low transverse cut has been shown to be the best option for successful vaginal births after cesareans.  And if I have more children, this is what I want.

Let me know if you have any questions about other things that I put in my plan.  Feel free to comment below or use the contact form to send me an email.  I respond quickly to everyone. 🙂

Printable Birth Plan Form

I don’t think a new mother should simply copy directly ANY birth plan she comes across.  More complex ones can certainly be referenced to, but you need to understand what you’re actually reading or asking for and why.  Things you want may be disagreeable with your doctor.  So I encourage you to always communicate clearly with your practitioner about your wants and desires while also being open to changes.

Here are all of the questions you can consider when you fill out the form to help you make the right decisions for your family:
Or Jump Right To The Form Below  ⇓

• • Who do you want present at the birth?
  • Do you want your husband or birth partner with you always?
  • Are there allergies or physical conditions you have that your nurse and doctor need to be aware of?
  • Do you prefer a hospital gown or your own clothing?
  • Are there preparatory procedures that you don’t want, such as enema, shaving, automatic IV lines or membrane rupture?
  • Do you want the lights dimmed or not?
  • Do you want personnel to keep their voices and conversations to quiet levels and at a minimum?
  • How do you want your birth documented with cameras, if at all?
  • What foods, snacks or refreshments do you want allowed while in labor?
  • Do you want to be able to use the restroom yourself, or prefer a catheter?
  • What level and type of fetal monitoring do you prefer for your baby?
  • How often do you want cervical checks for dilation?
  • What types of pain relief options are desired?
  • What tools and or facilities to you want to have access to and use in order to provide greater pain relief?
  • Do you want your labor to be augmented with pitocin if the need arises?
  • Do you prefer tearing or an episiotomy if the need arises?
  • If an episiotomy is needed, how do you want the incision to be cut?
  • What positions do you want to be in for your pushing and delivery?
  • Do you need help with directed pushing or guidance during the baby’s descent?
  • If intervention is needed with baby in the delivery canal, do you prefer the vacuum extraction or forceps for help?
  • Do you want the father or birth partner to catch the baby?
  • Do you want the baby placed on your chest immediate after birth for skin to skin contact?
  • When do you want the cord clamped and/or cut after delivery?
  • What newborn procedures do you wish to take place, and those you don’t?
  • Do you want assistance in placental separation or prefer it to be done on it’s own?
  • How do you want to leave the delivery room for recovery?
  • Do you want your baby to have supplemental formula?
  • Do you want to breastfeed your baby or have assistance with it?
  • If an emergency arises, what are your most preferred courses of action for yourself and your baby?
  • How do you want to be treated during a c-section if needed?
  • If baby requires time in the NICU, what allowances do you want to have in order to provide care to your baby?
  • Who is to be with your baby at all times?

• Do you want your baby in the nursery during your stay?

Just tell me where to send your printable birth plan form using the box below.  Then just check the boxes you prefer and you’re set!

If you’re looking for sample plans that have been written out and not in a checklist type form, you can explore the Sample Birth Plans post for more ideas.  Feel free to add, change, take away and make things your own.

Nobody can dictate what you feel is best for you and your baby’s delivery.  My own birth plans have changed a little bit each time I’ve had another baby.  There’s nothing wrong with choosing and sticking with what you’re comfortable with.

Then take it to your doctor or midwife, go over it, and clarify any standard procedures your birthing facility will require, or if there’s anything of concern from your provider.  Be SURE to take it with you when you go into labor!  Have it in your hospital bag, multiple copies too.

>> Remember Your Excellent Postpartum Delivery Bundle Too <<

You’re likely to have multiple nurses or staff you get to deal with and one copy just might get lost or set aside and forgotten about.  Staying informed with the people who are there to take care of you makes for such a better birthing experience.

What questions do you have for me?

Did you pin this? Make sure you do. 🙂

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