Birth Plan Decisions

Birth Decisions for you to be aware of:

(courtesy of Indie Birth (Doula Training Materials) and edited by Natalie Meade to suit Australian Birth Choices)

___ Home or hospital (no for real!…have you researched this? Interviewed a midwife?)

___ Hiring a doula (or getting a student midwife)

___ When you would be comfortable with induction or NOT (HUGE TOPIC)

___ When to go in (if hospital)

___ Monitoring baby for 20-30 min on arrival to hospital (not evidence based)

___ Eating and drinking throughout labour – what you’d like

___ Wearing a hospital gown, what to wear, when naked feels good?

___ Blood tests in labour

___ Vaginal exam on arrival

___ Staying or leaving if you are in early labour, not active labour

___ IV antibiotics for GBS in labour

___ Continuous monitoring of baby in labour vs intermittent monitoring (or less)                                       

___ Monitor clipped onto babies scalp whilst inside mother

___ Frequent routine blood pressure checks

___ Routine/offered/assumed vaginal exams throughout labour (typically every few hours, or more)

___ Syntocinon if cervix is not changing at the pace expected

___ Epidural plan (yes, no, at what point, how to decide?)

___ Nitrous oxide (laughing gas, is the word ‘laughing’ accurate? )

___ Hydrotherapy, pool in labour, stay in for birth? Are staff comfortable with that

___ Caesarean section (under what circumstances, how to decide?)

___ Pushing Position (does your provider support upright birth)

___ Starting to push (how to know, who can guide? What you wish for?)

___ Coached pushing versus physiological pushing

___ Perineal support, hands on vulva, warm pad to perineum

___ Episiotomy (what is this? Do you want it? How to do informed refusal)

___ Delivering the baby’s shoulders versus spontaneous birth (hands off approach?)

___ Who catches the baby? Who guides to mother, how fast?

___ Drying baby off (or leaving vernix on)

___ Skin to skin

___ blanket on baby vs. naked (Hat culture? Babies bare head is important for temp regulation))

___ Active management versus physiological placenta birth (routine at some hospitals to intervene)

___ Shot of syntocinon at birth

___ Immediate cord traction, pulling the placenta out

___ Uterine massage

___ Cord clamping [immediate, delayed (60 sec) or physiological, after the placenta]

___ Cord blood collection

___ Vitals on mom and baby immediately after birth

___ Baby latching (waiting for them to do it versus pushing baby to latch asap)

___ Newborn exam (away from you or next to you)

___ Hep B vaccine (day one of life, or delay to 6 weeks, or not at all)

___ Vitamin K shot/oral/not at all

___ Weighing and measuring baby

___ Newborn metabolic screen (heel prick, easier to get blood at about day 3-5 of life)

___ Baby’s first bath

___ Circumcision/intact

___ Checking mom’s perineum for tears, including a rectal exam (your choice)

___ Sutures for any tearing (different degrees of tearing have different recommendations)

___ Sleeping with baby

___ Placenta consumption

___ How long to stay post-birth

___ Rethinking your risk status – this is a huge topic, and one I would urge you to get a

midwifery perspective on if you’ve been told you are high risk!!!

Gentle Caesarean Choices

___ Epidural vs General anaesthesia

___ No additional meds to “relax more”

___ Music of choice, no extraneous conversation

___ Clear drape or lowering the drape as baby is born

___ Skin to skin immediately

___ Delayed cord clamping

___ Saving placenta

Induction Reasons/Topics to Learn About

___ Learn about the risks of induction

___ Big baby

___ Water broke

___ 40, 41, 42 weeks

___ Social reasons

___ Gestational diabetes

___ High blood pressure

___ Membrane sweeps at the end of pregnancy (ALSO, vaginal exams at the end of

pregnancy in general, since they are not helpful and are possibly harmful)

___ Breaking water to START labour

___ Cervadil

___ Foley bulb