Sample Childbirth Class Session #4

Creating Your Birth Plan    


                        What is a birth plan?

                                              Suggestions for how detailed to be, and what others put on their plan.


                        Review of birth plan questions

                       What can I bring to my birth, to create the environment that helps me relax?

                         Who should come to our birth?

                         What is important to you? Learning to identify issues that concern you.

                         Good communication

                               Common situations you might face in pregnancy, labor and birth

                               Getting positive reactions to our birth dream plan, and having thankful heart

                               Coping with disappointment surrounding a birth that does not go as planned.


Be informed about standard choices and be flexible

            Some women get to do EVERYTHING on their birth plan. They get to try every position and pain relief technique and when complications arise, they even get to have a cesarean done the way they want.

             Other women get to do very LITTLE from their birth pan. The nurse keeps the right atmosphere, but labor moves so quickly that you don’t get a chance to try the tub and walk the halls.

Regardless of the circumstances of your labor, use your birth plan to help you determine how you will react to labor.

Birth Plan


Name ________________________________     Signature ______________________________________________


Care Provider__________________    Attending Birth: ______________________________________________


Most Important Issue:

Item                                                    Yes         No                            Comments

1. Labor to begin spontaneously, up to 42 weeks.




      I am bringing extra pillows or items to help with labor relaxation.




2.  Ability to move around during labor.




3..  Non-clinical pain relief during labor. Massage of hands, feet, back.  Optimal Fetal Positioning.




   Hydrotherapy- tub, shower, water birth,




   Herbs or Ideas for pain management. 




4. Spontaneous rupture of membranes if warranted




5.  Fetal monitoring, intermittent




6.  Ability to eat and drink during labor.  Plans for nourishment.




7. Choose position for pushing:

 Semi-sitting, squatting, supported stand, birth stool, side-lying.




8.  Perineal hot compresses & olive oil for management of perineum during 2nd stage.




9.  Touch baby’s head when crowning.




10.  I would like to lift baby out after head and shoulders are born.




11.  Cord stopped pulsing before clamping.




12.  Natural descent of placenta, if possible.





13.  Baby stays with me at all times.  Any procedures done at my bedside, if possible.








Partner’s Plan



Name ________________________     Signature _______________________________________________________


Care Provider__________________    Attending birth: ______________________________________________


Most Important Issue:



Item                                                                                                           Yes   No                           Comments

1.  In the room for the entire labor. 




2.  Will need to leave at some point.




3.  Want to be an active part of birth, or relax and provide emotional support for birth mom.




4.  Would like all procedures, tests, and other interventions explained.




5.  Am able to stand the sight of blood.




6.  Would like help coaching mom during labor from Midwife or Doula.




7.  Would like to play an active role in the delivery of the baby’s body.




8.  Would like to give baby first bath (Birth family provides little bath tub).  Would like to give baby bath in birth tub.




9.  Need help with taking pictures or video. 




10.  Can be up for long hours and handle lack of sleep.




























Newborn Plan


Name ________________________     Signature ______________________________________________________


Care Provider__________________    Caring for baby after birth: ____________________________________


Most Important Issue: ________________________________________________________________________________________________________________________________________________

Item                                                    Yes         No                            Comments

1.  Immediate skin-to-skin contact




2.  Warmed blankets for mom & I




3. Dim lights in room.  Quiet during transition and after birth.




4. I remain with mother for at least one hour after birth to bond.




5.  Any necessary procedures done on mom’s bed, if possible.




6.  Breastfeeding as soon as I desire.  Help from midwife, assistant or Doula, only if mom asks for it.




7.  I sleep with mom or in bassinette next to bed. (bring bassinette)




8.  Mom and dad would like CPR, infant care information.




9.  Newborn screening to be done while, I am nursing at bedside with mom.




10.  No lotions or soaps to mask mommy’s wonderful scent.




11.  First bath with mom in birth tub or Leboyer birth bath. (Mom and dad provide bathtub.)




12. Mom brings special food to eat for after birth.




13. Special “golden hour” of bonding immediately after birth.














What to gather for the birth:


Birth center birth:

*2 nightgowns, 1 shorter and older for the birth, one for afterwards to nurse in and a robe

*T-shirts, sports bras, or some things to get into the birth pool numerous times

*Personal towels for birth pool, showering, baby bath.  New package of washcloths for hot compresses

                                                ( plastic bag to carry home linens to be washed)

*Toothbrush, personal items, clothes to go home in

*4 – 5 receiving blankets for baby the first few hours

*Juices and drinks like sports drinks, chlorophyll, emergen-C, bottle of good water (birth center has filtered water)

***Please bring something to eat!  Easy digestible snacks for laboring mom, such as yogurt, cottage cheese, soup, fruit.  And food of after the birth.  You will be HUNGRY after laboring and the local eateries don’t open until 6:00am. Your body may need an extra boost in calories, to get the placenta out.  Consider bringing good breakfast items, that you like after working hard.

*Newborn diapers and clothes for baby

*Sanitary napkins large or over night type.  Depends if you wish to use those with a pad.

*Thermometer for baby and mom for postpartum

*Car seat  (Available for $20 through Families in Partnership, ask about details)

*2 cotton caps for your baby

*AfterEase: herbal tincture for afterbirth pains  Mountain Meadows is a good brand

*Anything else that makes you feel relaxed and at home:  DVD’s, music, massage oils, scents, candles,


For hospital birth you will need

Food for mom:  soft easy to digest foods:  yogurt, popsicles, grapes, soup, (microwave available) Small sandwiches available after hours.

 Food for dad:  Food for snacking.  Water is available.

 Extra pillows for mom.  Boppi pillow for nursing baby. Favorite blanket.

Blanket and pillow for dad.  Sleeping bags are great.  Chair in room folds out into a cot.

 Your own nightgown.  One for laboring in and one for nursing. Need to be able to access your arm for blood pressure and to do vaginal exams.  Bring your own slippers or housecoat for walking around.

Breastfeeding bra, postpartum support belt, and clothing to go home in (You will be skinnier!)

 Toiletries items:  toothbrush, hair ties, shampoo

Music on CD using your ipod.   Portable DVD player and favorite DVDs.  

Massage oils – lavender essential oils

Baby clothing you prefer little one to wear.  Going home clothes.  Outfit for hospital baby picture.

Birth plan (preferably a photocopy of the one given to your care provider)


 Who Will Be At Your Birth?

It can be difficult to decide who if anyone to invite to your birth. The following are some thoughts to help you in making that decision.

-The birthing mother’s needs must come first.

-Some people may be requesting to come to the birth or even worse assuming that they are coming. Remember that this is your sacred event and you are in control. You have the power and courage to talk with these people so that your needs are met.

-Birth is not the time to mend old relationships, heal old wounds, or do favors. Tension during birth can slow or halt labor. Contractions are unlikely to be effective if mom is under stress.

-The mother should feel she has emotional space and safety wherever she gives birth. Anyone invited to be present must be prepared to follow the wishes of the mother.

-Those invited need to understand that the final decision of who will be present may change at any time at the discretion of the birthing parents. At the last minute, guests can be asked not to come, or to leave and those invited must be prepared for this and not take it personally.

-People who are present should come with positive feelings about birth.

-Generally it is not advisable to have a large number of people present at the birth. Birth is an extremely intimate and private experience;

-Those invited to the birth should have assigned roles such as cleaning, cooking, caring for children

-Many couples don’t want anyone at their birth. They want the freedom and privacy to share this intimate experience without observers or family.

-If there are people you want to involve, but are hesitant to invite to the birth, you can ask them to come over shortly after the birth to bring food or help with household tasks.

-Any one who has been abusive to the laboring mother or has had a rocky relationship with the birthing couple, should not be present at the birth, unless a great deal of time, healing and effort has been made between all people to heal wounds. Women feel most vulnerable during labor, and they must feel safe and protected for labor to progress steadily.

-When making decisions regarding siblings at birth, keep in mind the children’s ages and needs, when the birth occurs (if the birth occurs in the middle of the night, it may be best to let the children sleep), the mother’s comfort level, and the child’s feelings about being present. Some couples decide not to have their children at the birth.