Creating a Birth Plan - Part Two: Delivery

Now that we've covered considerations for labor, it's time to think about the main event - Delivery!  Again, I don't want to exclude any birth options here - just give you a few things to think about.  If you have additional items on your birth plan regarding labor or delivery, please let me know in the comments - it's always great to hear from other moms.

• Positioning: During labor you may have used specific techniques to work your way through contractions - now that it's time to push, do you have a plan?  Would you like to squat, have assistance with leg support, stand up, be in a birthing tub, lay on your side, etc?  Be sure to share your preferences with the staff at your hospital/birthing center, or have the area ready well in advance if you've chosen a home birth.
  
  
  Image (c) Health & Parenting
• Coaching: Are you going to "wing it" as you push, or are you going to have coaching support?  Following your body's natural instincts may seem a little scary, but I found that my body just took over once I began the final stages of labor - But what if you're not comfortable with that?  Perhaps you have a doula or you have developed a plan with your partner - regardless of your approach, let those around you be aware if you'd like to depend on them for guidance.
• How's it looking down there?  Would you like to watch as your child enters the world by aid of a mirror?  Do you want to keep your eyes as far from that experience as possible?  Some women enjoy the ability to watch as the baby crowns and then eventually makes it's way into the world - I wasn't one of those moms.  A good way to judge this is to either witness a birth in-person or watch a birthing video so that you know what to expect.
• Episiotomies and Tearing: I covered this last time as well, but it bears repeating - Have you thought about whether you would like to try alternatives like perineal massage before resorting to an episiotomy?  Would you rather tear naturally than have the incision?  Talk to your healthcare provider about their approach to tearing as well so that you're prepared for their advice during labor.
• The Big Moment:  Would you like yourself or your partner to pull the baby "up and out?"  Are you going to have the baby placed on your chest immediately after birth?  For C-Section moms, would you like to try for as much facial contact as possible once the baby is delivered - and will your partner follow the baby out of the operating room or stay with you?
• Cutting the Cord: This is both a question of "Who?" and "When?"  Would you like to cut the cord yourself or would you like your partner too?  Are you okay with immediately cutting the cord or would you like to delay this until the cord stops pulsating?  What about banking of cord blood - are you familiar with what that process is like and have you already paid to set up cord-blood banking?
• Placenta: When it comes to the delivery of your placenta, would you like to have spontaneous delivery?  Are you interested in viewing the placenta or retaining it?  Should your healthcare provider discard it?  It's become much more mainstream to consume your placenta after birth - are you aware of the options and the benefits? 
• Baby's First Exam: Often in hospital births the nursing staff will remove the baby to the other side of the delivery room to complete baby's first exam - Would you prefer that this process be completed while your baby is still on your chest?  If not, would like yourself or your partner present during the exam?  Also consider heel sticks - my son got one without my knowledge when he was born - be sure you're fully aware of everything that is happening to your baby!  If you are having a home birth, what is the plan if your care provider feels that your child needs medical attention?
• Post-Delivery Medications for Mom: Pitocin following delivery is common for the prevention of postpartum hemorrhage - would like this administered or would you prefer to skip it?  What about acetaminophen, percoset, stool softeners, or laxatives for pain relief following delivery?
  
• Post-Delivery Medications for Baby: Eye ointment is very common for babies, used to prevent blindness.  Vitamin K injections are also fairly common for bleeding prevention.  Do you have a preference for when these medications are administered?  Would you prefer that your child not receive one or the other?
• Bathing your newborn: Do you want your baby bathed after birth, or would you like to wait?  Do you know the benefits of vernix on your baby's skin and what a 24 hour absorption period can do for your child?

Next Up!

Postpartum, Emergencies, and Composing your Birth Plan are still to come in this series.  Keep updated on future posts by following or subscribing to The Cozy Life!