Resource List for Birth Plans

I felt motivated to revamp some of my emails/handouts/resources for the women I work with and came up with a fun (well, fun to me) way to encourage women to research their options for labor and birth in order to start writing a birthing plan. There is a lot of discussion and disagreement over if to write or not write a birth plan, what it is and what it isn't, etc... but this email is about education and options.

I welcome additional feedback, links, options, and articles that you found/find helpful and interesting.

It’s time to think about your birth options and what you want out of your experience. A great way to know this is to take a quiet moment, perhaps in the tub, with candles lit and a glass of sparkling grape juice. Let your mind wander and then ask yourself – how do I envision my birth? Dream up as many details as possible.. now start to consider how you can make this happen in the place of birth you have chosen. This is a great way to start working on writing a birth plan.

A birth plan is a GREAT way to facilitate good communication with your birth team before labor even begins. So, your homework this week is to start writing out your birth plan. I broke the email down into sections, much like what you might see in a typical birth plan. The Pre-labor section is for your education and your/my conversation, I recommend only putting in a birth plan what happens once you get to your care provider - as that is when they typically have access to it. Try to keep your birth plan short and sweet, with a positive voice, less than a page long, and not a list of "DON'T"s. Be open minded as birth is as organic as you are... and let's get researching!   

Pre-Labor

• Due Dates - the average for first time moms is 41 weeks and 1 day. Maternal family history, how many prior children she has, and other health matters come into play as well.
• Do Due Dates Mean Your Baby is Due? 
• Later Term u/s for size and due-ness
• Cervical Checks in Pregnancy - oftentimes done from week 36 and on to establish 'baseline' before labor begins
• Myth of the Pre-Labor Cervix
• Myth of Vaginal Exams During Pregnancy
• Pelvic Exams Near Term
• Inductions - starting labor from nothing.... but also good information for if/when augmentation is recommended.
• Perinatal Pitocin and ADHD
• Induction, Encouragement, Eviction
• Avoiding the Pit
• Cochrane Review of Induction before 41 weeks

Labor

• GBS - a naturally occurring bacteria in many of the population. Testing done around 36 weeks by swab. Treatment options, studies, and alternatives are shown below.
• Giant Bothersome Stumblingblock
• GBS Prevention and Alternative Treatments
• GBS Information from a Midwife - very clear

• Evidence Based Birth Considerations for GBS 

• Cervical Checks in Labor - oftentimes recommended every 2-3 hours during labor.
• Imaginative Cervix'
• Vaginal Exams
• How To Check Without Checking
• Failure To Progress
• Water Breaking/PSROM and AROM - only about 10-20% of women start labor with their waters breaking, and sometimes it takes awhile for contractions to start. It is common practice for a care provider to assume consent of AROM or breaking your water for you during labor unless otherwise specified. If you have feelings either way, be sure to share them with your provider.
• Pre-Labor Rupture

•  What if my water breaks before labor? 

• Doesn't It Have To Break?
• In Defense of the Sac
• Keeping My Sac Intact
• Medical Recommendations for AROM
• Active Birth Practices - labors are more comfortable and manageable, and labor progresses better, when women remain upright and don't recline in bed.
• Healthy Birth Practices
• Positions For Labor
• IVs or Self-Hydration and Nourishment - most hospitals don't want you to eat during labor, but that doesn't mean you can't.
• Eating in Labor
• IVs and Newborn Weight Loss
• Music During Labor - an option for Relaxation
• Music In Labor
• One Mom's Playlist
• Another Mom's Playlist
• Fetal Monitoring - monitoring baby during labor
• Types of Monitoring
• CEFM vs EIFM
• Medications - medicated options for pain management
• All About Medications
• Cascade of Interventions  

• Epidurals  

• The Process of Epidural Placement

Birth

• Positions for Birth - more than just on your back
• Pushing Positions and Their Benefits
• Healthy Birth Practices
• Positions For Labor
• Pushing - more than just counting to 10
• Purple Pushing
• Push - types of pushing
• Pushing Upright
• Episiotomy vs Tearing - differences between them and how to minimize risk
• Would you Rather

Postpartum/Newborn Care

• Cord Clamping - the cord is generally clamped and cut within seconds of birth unless you note otherwise prenatally to your provider and remind them during birth.
• Penny Simkin and Cord Clamping
• What About Afterward
• 15 Minutes Could Change Your Life
• Essential Resuscitation Equipment
• Cord Clamping and Preemies
• Skin-to-skin vs. heating lamps - baby can be brought immediately to your chest with a blanket over the two of you, or baby can be brought to the heating lamps to be cleaned and wrapped up.
• The Importance of Skin-To-Skin
• Skin-To-Skin Contact
• Effects on Newborn and Mother
• Guess What Makes 'Em Happier and Warmer
• Early Skin-To-Skin
• Breastfeeding - benefits, when, why, and how. 
• Colostrum and Baby's Stomach Size
• What About Afterward
• Common Pitfalls of Newborn Breastfeeding
• Timeline of a Breastfed Baby
• The First 24 Hours
• The ABCs of Breastfeeding
• Nursery vs. Rooming In - in the nursery, your baby will be in a warming bed, rarely held, oftentimes a pacifier and/or formula will be offered to baby as a compassionate gesture to allow mom to sleep longer. Also, when baby is brought to mom for nursing, oftentimes baby is already upset and crying. On the other hand, rooming in may mean shorter sleep periods for mom, but will ensure you hear babies early cues for breastfeeding, ensure baby learns to self-regulate body temperature faster, and give you a better start for bonding and sleep synching.
• Ask Dr. Sears
• Sleep and Wake Patterns
• External Gestation
• Effects of Rooming-In on Anxiety
• Bathing of the Newborn - normally done before discharge, more often than naught, in 'transitional nursery' or within 2-4 hours after baby is born - either in room or in the nursery.
• Baby's First Bath
• Vernix
• Booby Traps 
• Vitamin K - given postpartum to baby as an injection unless otherwise requested through oral administration or declined. Normally administered within 2-4 hours after birth.
• Newborn Shot
• What's The Big Deal
• What About Afterward    

• Evidence for the Vit K Shot
• Refusal Form With Studies Cited
• Eye Erythromycin - administered into the eyes of the newborn normally within the first 2 hours after birth.
• Eye Erythromycin
• What About Afterward
• Refusal Form With Studies Cited
• PKU - a blood test done to baby through a heel stick normally within the first 2 days of life. One discrepancy is that the PKU results have a high false-positive result until after the baby has received 24 hours of breastmilk (not colostrum). Breastmilk doesn't normally come in until days 3-5.
• Timing is Everything
• What About Afterward
• Hep B/Vaccinations - an injection given to baby usually within the first 2 days of life to protect against Hep B transmission/infection.
• Heb B and Baby's Liver
• What About Afterward
• Refusal Form with Studies Cited
• Circumcision – removal of the prepuce (foreskin) of a boy’s penis. Done in hospital before discharge unless requested of a mohel, in which case it is done on the 8th day after birth.
• Circumcision Information 
• What About Afterward 
• Placenta/Postpartum Pitocin – normally a placenta is either discarded by the hospital staff or sent to pathology for testing and medical practice. You can ask to take it home with you, or just ask to be shown it after birth.
• Cord Traction/Active Management (the midwife uses the term Syntocinon instead of Pitocin because of where she lives and what is available to her)
• Afterbirth, After Birth

Cesarean

All options for family or mother-centered cesarean can be found in the following links.

• Feminist Breeder 
• ICAN’s Family Centered Options 

• Sample Cesarean Plan 
• Medical Paper on Facilitating a ‘Natural Cesarean’ 
• Best Cesarean Care Plan – most information is for a planned cesarean

• Gentle Cesarean 

• Kangaroo Care after Cesarean 

• Family-Centered Cesarean

Remember the  basics of writing a birth plan:

• Keep your plan to one page.
• If you can't, consider having two to three plans: a birth plan, a cesarean plan, and a newborn plan. Separate sheets for each - this also allows you to put the baby plan in the warmer so that the nursery staff can read it while you're birthing your baby and have less questions postpartum.
• Keep out the unnecessary (i.e., they no longer shave you and give you an enema for a vaginal birth, so don’t include that information). 
• Keep it on purpose – if you are writing a birth plan, you don’t need to include information about your pregnancy care.

So, there we have it! Thoughts? Recommendations on other links, articles, resources, or videos?

And for some comic relief...