Preparing a Detailed Birth

Plan
Educate yourself about your options for delivery day and create a birth plan with this
handy checklist.
By Debra Jo Immergut from Parents Magazine

BrandX

Every labor and birth is different, each miraculous in its own way. It's a situation full of
unknowns -- and the best way to approach it is to familiarize yourself with the possibilities. Start
with this rundown of birth and labor options.
To create a simple birth plan, print this page and check off the elements that appeal to you -- then
share your choices with your healthcare provider. Make sure a copy of the plan gets into your
medical records, which will be available to staffers at your birthing site.
Remember that formulating a birth plan doesn't guarantee a seamless experience. No matter how
you go about it, labor and childbirth call for a flexible attitude and a sense of adventure!

Where would you like to give birth?

Hospital -- Ninety-nine percent of all births occur in a hospital. For a homier setting, look for a
hospital with birthing rooms. These specially equipped facilities feel more like a bedroom than a
traditional delivery room, and you can stay in them fromlabor through recovery.
Birthing Center -- Certified nurse-midwives usually provide the bulk of care at a free-standing
birthing center (also known as a maternity center). These facilities tend to emphasize low-tech

approaches to childbirth and are best for low-risk pregnancies. If complications arise, you may
have to be transported to a hospital (each center has a relationship with a specific hospital). for a
different level of care or emergency care -- if you want an epidural, for example, or if the labor is
not progressing properly.
Home -- A very small but growing number of couples opt to give birth at home, assisted by a
qualified physician or certified nurse-midwife. This is a safe option only for women in excellent
health who have had low-risk pregnancies, and optimally, who have already been through at least
one complication-free childbirth. Back-up plans should be in place in case a transfer to a hospital
is needed.

Describe your ideal labor environment:

I can walk around, try different positions, etc.

The lights are dim.
Our favorite music is playing.
There's a TV/VCR.
There's a bath or shower available.

Who do you want present during labor?

Be sure to ask if your birthing site limits the number of people who can be in the room with you.

Spouse
Other labor coach
Doula
Other family members and friends

Is there a special birthing apparatus and/or position that

appeals to you?
Birthing bed -- Many birthing sites now have special beds that are designed for both labor and
delivery. The back can be raised or lowered to support different laboring positions. Options
(which vary from one setting to another and should be discussed with healthcare providers) may
include:

Birthing chair -- Some birthing sites have these special chairs or stools, designed to support a
woman in a squatting or sitting position. They allow women to benefit from gravity, and see
more of the birth, but may cause increased tearing of the perineum (tissue between vagina and
rectum)
Lying down -- On your back, with your head flat or elevated, and your legs elevated
Side-lying -- With one leg elevated (this option is particularly good if you're tired or having
trouble with your blood pressure level)
Kneeling -- On the lower part of bed with your arms or upper body resting on upper section (this
posture eases backache)

All fours -- With your stomach facing down, supported by your hands and knees (this position
takes advantage of gravity and eases backache)
Squatting -- On your feet, with support from bed or partner (this position takes advantage of
gravity and shortens the depth of the birth canal)

Birthing chair -- Some birthing sites have these special chairs or stools, designed to support a
woman in a squatting or sitting position. They allow women to benefit from gravity, and see
more of the birth, but may cause increased tearing of the perineum (tissue between vagina and
rectum)

Which would be part of your ideal labor and childbirth?

Intermittent external fetal monitoring (usually allows for moving around).

Continuous external fetal monitoring (usually requires you to stay in bed).
Pain relief medication (see our ultimate guide to pain-relief).
No pain relief medication (see our ultimate guide to pain relief for drug-free options).
Episiotomy (an incision in tissues of the perineum, beneath the vaginal opening) to enlarge the
vaginal opening and to prevent tearing.
No episiotomy (may use local massage, warm compresses, etc., to lessen discomfort and reduce
the chances of tearing).
Partner cuts the umbilical cord.

Which postpartum options interest you?

Umbilical cord-blood donation or banking -- The blood in a baby's umbilical cord was once
routinely tossed away, but now it's seen as a valuable medical asset. Cord blood is enriched with
stem cells, which can be used to treat over 50 life-threatening diseases. Drawing the blood is
quick and risk-free -- and it's definitely painless, since it's done when the cord is no longer
attached. But you do need to arrange for a collection ahead of time, because cord blood banks,
where the collected material can be stored, are not available in every community. Some parents
choose to bank the cord blood privately, so that they can have access to it later; this is seen as a
sort of biological insurance against possible illness in their child's future. This is a costly option,
though, and the American Academy of Pediatrics encourages donating the cord blood or blood
stem cells to a public cord blood bank instead. Parents should consider privately banking the
blood only if a family member has a current or potential need for a stem-cell transplant. Discuss
the matter with your healthcare provider. For more information on cord blood donation, contact
the National Marrow Donor Program, 800-Marrow-2.
Circumcision -- Circumcision is the surgical removal of the foreskin, which covers the end of
the penis. The procedure is usually done in the first few days after birth. As of the late '90s, about
63 percent of baby boys in the U.S. were circumcised, but the practice is much less widespread
in other parts of the world. Though medical research shows some medical benefits of
circumcision, the American Academy of Pediatrics states that the benefits are not sufficient to
recommend the procedure as routine for all boys. Some parents may want their sons circumcised

for religious, social, and cultural reasons. Others are concerned that circumcision desensitizes the
tip of the penis, causing a decrease in sexual pleasure. Since circumcision is not essential to a
boy's health, parents should choose what is best for their son by talking it through and exploring
the benefits and risks.
Rooming in -- Some hospitals allow parents to keep their newborn with them in their room,
rather than in the hospital nursery. You can state your feelings about this before birth, but feel
free to change your mind later on.
Rooming in at all times from birth on
Delayed (baby with you after an initial recovery period)
Partial rooming-in (baby with you during the day, but not at night)
Nursery (baby brought to you according to your schedule and baby's needs)