How to Make the Most out of your Birth Plan

Filling out a birth plan or making your birth plan is much more than just deciding yes or no to a list of questions.

Don’t get me wrong, these questions are very important but after having gone through birth, I realize now I should have considered my birth plan in three parts:

• How to prepare before birth
• How to prepare for birth
• How to prepare for the aftermath.

I have also learned that not only should you be prepared on all three parts but so should your other half.

Here are 10 ways you can accomplish this including specifics on filling out the actual birth plan.

If you are preparing for birth, make sure to sign up for our FREE crash course, Nest Smart, which will help you tackle items in this post with free printables.

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1. Prepare as a Team

The first step is to prepare as a team. This means include your other half.

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. Additionally, the more familiar your partner is with your birth wishes, the better advocate they can be.

For example, if as a team you decide delayed cord clamping is important, your partner will be in a much better position to ensure that happens.

The first way to prepare as a team is to fill out the birth plan together. Either use the one provided by your hospital or the one in our Nesting Planner and have each person fill it out separately.

For sections that are specific to you such as pain management, have your other half fill out that section with how they think they could help. Consider a variety of options for pain management as you have no idea how birth will actually go. Having your partner be familiar with these options as well will help you.

Then discuss the whole document and use a third copy to be the “final” agreed upon plan.

3. Decide on Pain Management

Instead of just considering pain management techniques as a yes or no, I encourage you to build a birth toolbox. Start by determining which techniques you want to try and learn about how to utilize them. Your final step here is to decide an order. Therefore, when one method stops working, you know what to try next.

Try to remember that your birth plan is more birth wishes so having a lot of tools to utilize during birth will help.

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 breath coaching, relaxation strategies, massage, and laboring positions. Most also provide emotional support and motivational encouragement.

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.

If your plan is to have your partner providing these things, it is important to prepare. Choose a birth class that will allow both of you to attend. If you can’t find one in your area, try online. Your partner is not a professional in this field and therefore a class could really change how the experience goes for both of you.

4. 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.

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.

5. 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 learning as much as you can about breastfeeding before baby. Start now by taking our Nurse Smart Course.

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.

6. 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.”

7. 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).

8. 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.

9. 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 and lactation consultants 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.”

10. Be prepared for the aftermath

Start by keeping a list of questions you have for the midwife/OB, lactation consultant and the pediatrician on staff. All of these medical professionals should be visiting you during your time at the hospital. Some will be able to visit you multiple times but you might only get to see the pediatrician once. You might draw a blank when asked if you have questions so start right now on these questions and keep the lists going.

You (and your other half) also want to become well informed on postpartum depression. It is very hard to understand what exactly your life will look like with a baby and it won’t always be glamorous or wonderful.

You are also about to have a new title, mom, and while right now that might not seem like a big change. It is. Make sure to take some time before that change to really be prepared for it. Be prepared for the good and the bad days to come.

After you leave the hospital, you will have family and friends come and see your new bundle of joy. This can be stressful so take some time now to determine what would be best. Consider a sip and see where you only have to clean the house once.

Conclusion

Working on your birth plan with your other half ensures you both are on the same page.

In addition to deciding yes and no to all of those questions, learn as much as you can so that you will not only know what you want, but also how to best achieve it.

Take some time to think about the before and after birth to ensure transition to motherhood is as easy on you as it can be.

Sign up for our FREE Nest Smart Course to be prepared for baby’s arrival in 7 days.

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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Sources

Benefits of having a doula
Benefits of breastfeeding
Breastfeeding in the first hour
Delaying routing procedures
Cord blood banking
Baby’s first bath
Rooming with baby

Trina Fitzpatrick

Dr. Trina Fitzpatrick is a wife, mom, blogger, and a breastfeeding advocate. She is the co-author of the Week-by-Week Bump Smart Course, the Nesting Planner and the Breastfeeding Handbook. She attributes her success at breastfeeding her own children into toddlerhood with working with lactation consultants in the hospital in the early stages and on a weekly basis afterwards. By writing at MomSmartNotHard, she educates mamas-to-be on all things pregnancy, birth and breastfeeding. Read more about Trina.