What to Include in Your Birth Preferences – Part I

This is probably the #1 question I get from clients, friends, and prospective clients – what should I include on my birth preferences list? Let’s briefly discuss what birth preferences are. Simply put, they are a communication tool between you and your provider that helps generate a conversation about what’s important to you throughout your labor, birth, and immediately postpartum.

Now you may have heard your OB/midwife, friend, sister, cousin, etc. call it a “birth plan.” But as you all know, I’m not a big fan of birth plans. So what’s the difference? Plan, preferences, isn’t it all the same? No, it isn’t. Let’s dive a little deeper into why.

Birth Preferences vs. Birth Plan

I primarily don’t like calling them birth plans because words matter (check out this helpful article all about priming) and using “plan” insinuates that you have some control over your birth. And we all know that simply isn’t the case.

I think it’s important that we change the verbiage to reflect that so you’ll never hear me say “birth plan.” The word “preferences” can also be interchanged with “goals,” “vision,” etc. The important thing is to use words that imply, “this is how I’d like my birth to go and this is what I’m working toward, but I’m also remaining open to all possibilities and outcomes.”

I’m also a fan of stacking all the odds in your favor for a positive birth experience. It’s why I teach and love GentleBirth classes – a couple of their main philosophies are to “control the controllables” and “stack the odds in your favor.” The gist here is that although we can’t predict the outcome, we can do everything in our power to make it positive while also understanding that we can only control so much. It’s a beautiful way to train your brain for the best birth possible, no matter what happens.

What to Include in Your Birth Preferences

Now that we’ve gotten all of that out, let’s chat about what to include in your birth preferences list. My best piece of advice is to keep it short and sweet. You want your nurses, doctors, midwives to be able to quickly glance over it and get a good feel for what you’re hoping for. If your preferences are pages long, the likelihood of this happening decreases dramatically. I like to lay it out in three sections of labor, birth, and immediately postpartum. Under each category you can put sub-bullets of what’s the most important for you during each stage.

I’ve listed out questions under each category to help you start thinking of what’s important to you. The answer to these question are what you would include in your list. Please note: this is not an exhaustive list and some of these things might not be important to you. This is just an example and I urge you to do sufficient research and talk to your care provider to determine what’s best for you and your family.

Labor

– Do you want continuous or intermittent monitoring, and do you want wireless monitoring or not
– Would you like a saline lock or are you okay with continuously being attached to an IV pole
– Do you want limited vaginal exams
– Would you like the use of the shower, birth ball, peanut ball, etc.
– Are you planning on using pain medications, if so which do you prefer
– Are you open to labor augmentation if needed (e.g. pitocin or getting your waters released)

Birth

– Do you want guided pushing or do you plan to push when you feel the urge (note: this may change if you have an epidural and can’t feel the urge to push)
– Do you want delayed cord clamping longer than the standard 1-2 minutes
– Do you want a warm compress on your perineum to help prevent tearing
– Do you want mineral oil and/or some sort of lubricant applied inside the vagina as the baby’s head is getting close to crowning
– Will your partner cut the umbilical cord
– In the event that your baby needs help breathing, would you like the cord to remain intact and all necessary treatments to be done while baby is on you
– Do you want pitocin after birth (this is a common practice to decrease the chances of postpartum hemorrhage)
– Do you want a managed third stage delivery where the doctor manually helps get your placenta to detach and be birthed or would you like a more hands-off approach

Immediate Postpartum

– Do you want 1 hour of uninterrupted skin-to-skin (also called the golden hour) to establish bonding and breastfeeding
– Do you want baby to be given all 3 medications offered (this takes place after the golden hour)
– Do you want your baby’s head washed (most hospitals in the Bay Area don’t bathe the baby as studies show it’s beneficial to leave all of the birth fluids on to soak into baby’s skin in the days/week following birth)
– Are you comfortable with the baby leaving the room or do you want baby in the room at all times and when a procedure or test in another room is necessary, do you want a parent to accompany them

Stay tuned for part II of this post, which will cover preferences for use of an epidural during birth. Part III will include preferences for a cesarean birth.

xo,
Katelyn