Planning for Birth

Consider a birth plan

During your prenatal visits, talk with your doctor about your labor and delivery options. You may want to write them down as a birth plan. It's an ideal picture of what you would like to happen.

But try to be flexible. No labor and delivery can be predicted or planned. So give yourself permission to change your mind at any time. And be prepared for your childbirth to be different from what you planned. If an emergency arises, your doctor has a responsibility to ensure both your safety and your baby's safety. You may still be allowed to share in some decisions, but your choices may be limited.

What to put in a birth plan

When you are writing your birth plan, think about:

• Who will deliver your baby.
• Where you want to have your baby. Most women choose to work with a doctor and have their baby delivered in a hospital. Women at low risk for problems may choose to work with a midwife or have their baby at a birth center.
• Who you want to be with you. You may want to have family and friends around you or only the baby's other parent or another support person, such as a doula.
• Comfort measures you want to try. Breathing techniques, laboring in water, trying different positions, and having one-on-one support may help you manage pain.
• Your preferences for medical treatments. Consider what type of pain medicine you would prefer, even if you don't think you'll need it. Just keep in mind that you may not always get to choose.
• How your baby will be cared for after delivery. This might include having your baby stay in the room with you rather than going to the nursery, delaying some tests and procedures, and getting help with starting to breast-feed.

This is also a good time to decide whether you'll attend (if you haven't already) a childbirth education class, starting in your 6th or 7th month of pregnancy.

To help you get started on writing a birth plan, fill out the My Birth Plan form(What is a PDF document?). Take it to your next appointment to discuss your wishes with your doctor or midwife.

What to expect at the hospital

You may feel more calm and prepared for labor if you know what is likely to happen when you get to the hospital.

Most hospitals and birthing centers have birthing rooms where women can labor, deliver, and recover. Providing that you have an uncomplicated birth, you can probably be in the same birthing room for your entire stay. If your delivery becomes complicated, you can be quickly moved to a delivery room equipped to handle the problem.

If you arrive at the hospital or birthing center in early labor that is progressing quickly, you can expect some or all of the following:

• Your blood pressure, pulse, and temperature will be checked.
• You will be asked about the timing and strength of your contractions and whether your membranes have ruptured.
• Electronic fetal heart monitoring will be used to record the fetal heart rate as you have contractions. Fetal heart rate shows whether the baby is doing well or is in trouble.
• You will have sterile vaginal exams to check whether your cervix is thinning and opening (effacing and dilating).
• You may have an intravenous (IV) needle inserted, in case you need extra fluids or medicine later on.
• You may be encouraged to walk. Walking helps many women feel more comfortable during early labor.

Newborn care decisions

Before your baby is born, plan ahead about:

• Keeping your baby with you for at least 1 hour after birth, for bonding. (Many hospitals allow rooming-in, with no mother-baby separation during the entire hospital stay.)
• Preventing breast-feeding problems. You can plan ahead for breast-feeding support in case you need it. Check around for a lactation consultant. Some hospitals have them in-house. You can also make sure that hospital staff knows not to give your baby supplemental formula, unless there is a medical need.
• Delaying certain procedures—such as a vitamin K injection, a heel prick for a blood test, and the use of eye medicines—so that you have more time to bond with your baby in the hours after birth.
• Whether and when you'd like visitors, including children in your family.
• Whether to bank your baby's umbilical cord blood after the birth. (This requires advance planning early in your pregnancy.)

For more information, see:

Breast-Feeding: Should I Breast-Feed My Baby?

Pregnancy: Should I Bank My Baby's Umbilical Cord Blood?