The Birth Plan(s)

After some serious nudging from That Husband I finally sat down and put my birth plans together. I’m approaching the point where I could go into labor any day and he knows how important it is to me that I have him there helping to control and be a part of what is happening as much as possible. It took several hours, but after reading through a variety of birth plans from different sources around the web I was able to put together comprehensive plans for a few different scenarios we might encounter.

I think every woman should research and write out a birth plan, even if it’s just for herself to look over. Websites like this one walk mother’s through common scenarios and preferences and help you pick and choose what works best for you. If you read a term or phrase you don’t understand, look it up! It’s important to know what providers are talking about when they speak of pitocin/episiotomy/rooming-in/etc, and knowledge will only help you get the care that makes you feel the most satisfied.

Please note that these birth plans I created are not for TH and Sarah, not the hospital. I think birth plans in a hospital setting are most effective when you are working with a specific care provider the you have the ability to sit down and overview your preferences with. It wouldn’t do me any good to show up at a hospital several hours into my labor waving my sheet of paper around and declaring that anyone who approaches me should read it first. I believe that hospitals are an environment where routines are established and followed in order to maximize efficiency and effectiveness and thus not always excited about birth plans, especially from home birth mamas. The plans you see below are written out for That Husband and intended for him to read through and remember as much as possible so that he knows how to best respond in many of the common situations that happen during a birthing situation. I’ll of course be running through them with Sarah as well to make sure we are on the same page in various areas.

I’m sharing these  in hopes they help others who are attempting to write up their own plans, as I found many other personal birth plans sprinkled throughout the sites and forums I visited to be immensely helpful in ensuring I didn’t leave anything important off of the list. I’d love to have any women who’ve given birth previously comment and let me know if they think I’m leaving anything off that was important to them!

The Home Birth Plan

The Non-Emergency Hospital Transfer Plan

The Cesarean Plan

130 thoughts on “The Birth Plan(s)

  1. I think this looks really great Jenna! I would strongly urge you to check with your local hospital to see what their rules are for some of these things. I know that my birth plan included many of the same things that yours does, but despite having my doctor’s okay prior to heading up there (even had the plan put in my chart ahead of time), I later discovered that the hospital rules trump everything else. For instance, I really wanted to eat and drink during labor. Unfortunately, it was against hospital policy (I guess for liability reasons) and they hands down wouldn’t let me do it.
    In the end, I didn’t want my birth memories to be ones filled with fighting and screaming at the nursing staff so I gave in. I decided that sometimes you can be 100% right and still be wrong. I didn’t get the birth that I wanted, but I also didn’t create a hostile environment with the staff who are just trying to do their jobs and not get in trouble.
    So anyway, check it out. Save yourself a headache later.

    Good luck! :-)

    Crystal Reply:

    A hospital can’t make you do anything though. Especially if you don’t ask you just do it. What are they going to do, rip the water out of your hands and force you into bed? They’ll argue, pressure you, yell and pull the dead baby card, but that’s all they can do.

    Jenna Reply:

    This is my thinking as well. I’d be interested to hear stories from women who defied the eating/drinking policies but I’m not sure where to find such re-tellings. :)

    Crystal Reply:

    i think most women who want to eat/drink in labor just do it and don’t ask. I drank and I didn’t ask. If I would have felt like eating (food was the last thing on my mind) I would have just waited until the nurse left.

    MrsW Reply:

    The ACOG now recommends clear liquids during labor, so pull that on them if someone tries to confront you. Of course, you may find that eating is the last thing on your mind.

    Katy W Reply:

    I believe the concern about eating is if Surgery is required not only C-section, but life saving procedures a full stomach can lead to vomitting and choking if you are unconcious. It is the same reason you have to be fasting when you go in for any surgical procedure. I was always starving 1-2 hours after delivery but not during labor at all. Oh and if you do eat, no red food. You don’t want anyone thinking you vomited blood

  2. (Found you through Weddingbee but not sure if I’ve commented before.)

    We’ll be trying to get pregnant in the relatively near future and reading these kind of freaks me out. I think you’re a great resource, though, since you research so much. Will have to re-read your pregnancy posts when the time comes. One question, though…there was a mention of birthday cake on your Home Birth Plan. What is that about?

    Good luck! I hope it goes smoothly!

    Jenna Reply:

    As long as I’m home I should have lots of time before baby comes and labor gets bad enough that I can’t talk through contractions and have to call the midwife. While I’m waiting for that time I’m going to bake baby a birthday cake!

    *Michelle Reply:

    That just might be the cutest thing I’ve ever heard! I really hope that baby’s birthday is everything you’ve hoped and planned.

    Kristin Reply:

    That is a great idea!

  3. I really hope things go the way you planned. The home birth plan sounds really wonderful. I HAVE TO KNOW, though… what in the world is the garlic for???

    Amy Carter Reply:

    This got the best of my curiosity as well!

    Marissa C Reply:

    Dying to know too!

    Korey Reply:

    Same here!

    Erin Reply:

    Me too!

    MrsW Reply:

    yeah, I’m wondering too!

    Jenna Reply:

    Haha, I’ll have to remember to ask Sarah at my next appt. I actually have no idea myself!

  4. i just found your blog and i am so glad i did! i am just over 12wks preg. i really would love to do a home waterbirth. your blog is very helpful and i look forward to reading how your delivery goes. good luck! :)

  5. The home birth sounds really interesting and I can’t wait to hear how it all goes.

    One question though – why in the home birth plan do you say that you want to catch the baby yourself, but in the hospital plan TH will help catch the baby? Also, why are you saving the placenta in the hospital birth, but not the home birth? Just thought there might be a reason for these differences and I was curios to know what it was.

    Kristin Reply:

    I was going to ask the same thing.

    Jenna Reply:

    If i birth at home I’ll be free to move around and do as I please, if I transfer to a hospital I’ll be confined to a bed, hooked up to an IV/pitocin/epidural, making my ability to “catch” the baby much more difficult.

    I only want to save the placenta for photos, then we’ll be discarding it. The instructions for the hospital birth are just to save it because I have less control in that environment and I’d rather they just save it altogether and let me enjoy my time with baby, where if I’m home I’ll just let Sarah know what I want done with it and she’ll take care of it.

    Brandy Reply:

    I just wanted to say Jenna that you won’t necessarily have to deal with any of those things at the hospital. When my sister was induced she was able to walk around the hospital, eat, drink, sit on a ball etc up until she had the epidural which was hours later. You can decline the IV it’s your choice. They really can’t stop you from doing anything(well they might if you start jumping on the bed or doing cartwheels.) If they are insistant on an IV hook up ask for just the valve to be inserted, that way you are still free to move around and labour how you want.
    Just wondering if you took a tour of the local hospital l&d, you seem to have this preconcieved notion that all hospitals are even bad places where they will tie you to the bed and cut you open and then steal your baby. If you saw the recent video of the Kardashian woman giving birth she does so in a hospital and reaches down and pulls her baby out.
    As for nurseries, in the past 16 years I have only had one friend have their child in one at the hospital and that is because he was born 2.5 months premature. Hospital nurseries seem to be a thing from our parents generation and long gone.

    You did a lot of research on homebirth so I’m just wondering how much you did on birth at your local hospital?

    PS. I’m having a homebirth too so I’m not being all “hospitals are better” I just want you to know that you will have more control over your birth there than you seem to realise.

    Brie Reply:

    I think Jenna is under the impression that if she transfers to the hospital, she will be going for all that stuff that she wouldn’t normally want (drugs, IV, etc). That is how my transfer went. And my baby was the only one in the hospital that didn’t go to the nursery. Literally (and she’s only 9 months). My husband would go with her in there at night so I could get some rest, and he would hold her and she would listen to all the babies crying because nurses were ignoring them. Most of my friends told me that they had their babies in the nursery at night also, so it’s really not that out there. I also know Jenna witnessed a hospital birth where the baby was essentially held hostage in the nursery and forced a bottle, so this may be where she is coming from also.

    Brandy Reply:

    Ahh thanks for shedding some light.

    I’m Canadian so I’m basing everything I’ve seen on our hospitals. My sisters labour was suppose to be in the new l&d wing of her local hospital, it had birthing tubs, various rails on the wall to hold on to during labour, the bed looked like a regular bed, there was a sofa and flat screen tv and she could either order food any time she wanted or bring in food from outside. Of course the week before my sister was induced a water main in the ceiling broke and flooded the whole ward! So she had to go to the old ward, which was ok but not as nice although her room was the size of my living room and then some.

    You American woman seem to have to fight so hard for the birth you want.

    Amber Reply:

    I had an induced labor/delivery with pitocin and an epi, and had I not had a baby with a big head/shoulders coupled with a non-cooperative pelvis, I could have reached and pulled her out. I wasn’t strapped to the bed, I did have the IV but I had free reign of the place. I also had fruit punch (which I vomited up later).

  6. You may have written about this already, but have you decided to decline all vaccines for your children? If so, can you expalin why?

    Jenna Reply:

    No, we aren’t declining all, and likely won’t be delaying that long. I just don’t see the need to load up the baby with any type of shot/vaccine within the first 48 hours of life. I want to enjoy my time with my little one, not have him/her be in a nursery for testing or experiencing painful pokes and prods.

  7. I love reading your plans & seeing how well-versed and prepared you are for contingencies as well as your ideal. Especially specifics on the type of cuts & stitches if a cesarean is necessary!!!

    Since Addie was a planned hospital birth I only did one b.p. and unfortunately, our doctor didn’t follow through with some of our stipulations as we requested. I think the worst memory Chris has is when the doctor yanked out the placenta (despite our birth plan) amidst me saying it hurt…

    I’m so excited for you!!! It’s gonna be great Jenna! It’ll be the most trying thing you ever experience physically, but talk about the rewards!

  8. Thanks for posting this Jenna – admittedly, I got a little misty eyed while reading the home-birth plan. I’m so excited for you.

    We’re planning to have kids in the next 3-4 years, so I don’t have anything intelligent to say in the way of constructive criticism or general remarks …. Although it’s not immediately applicable, I’m definitely bookmarking and will reference back when the time comes.

  9. Im impressed! Those are so well thought out and clearly done – I truly hope this turns out to be the experience you are hoping for. oh – and uber brave wanting to catch the baby yourself!
    Have a few questions though –

    Like Ellen said, why discard placenta at home but keep if at hospital?

    Why wait until the cord stops pulsing? (I have no kids so I just haven’t clue on this one.)

    Is the decision not to circumcise (if a boy) a religious choice? Or simply a personal one?

    It blows my mind that anyone should have to say “no hysterectomy without my consent”. I’m sure its a good idea to explicitly say, its just crazy to me that it needs to be said!

    Sophia Reply:

    Michelle *Jenna hope you don’t mind that I answered this part*- waiting until the cord stops pulsing ensures that the baby has all of the oxygen rich blood it contains. I forget the exact figures, but there is an awful lot of blood, with an awful lot of oxygen, still “in transit” in the cord. When it stops pulsing, you know all the goodies are in the Baby. This may be way oversimplified, but that’s my understanding :)

    *Michelle Reply:

    thanks for the info! I did not know that, though it makes sense (which makes me wonder why would anyone want to cut it earlier? I know, logic does not always apply.) :) Learn something new and different every day!

    MrsW Reply:

    The logic I heard on NOT cutting it (from my SIL, who is a labor and delivery technician) is that if the baby is held below the level of the placenta, they can receive TOO much blood, and their blood pressure can rise dangerously high. However, I think that is kind of an old way of looking at things and the conventional wisdom is swinging back towards letting the pulsing stop. The baby on the mom’s belly is a great position for keeping the blood pressure stable.

    Jenna Reply:

    I answered the placenta question above.

    I believe the percentage of blood that baby misses out on when the cord is cut before pulsing is 40%. Less babies would suffer from anemia if we would just let them have the blood that belongs to them at birth. They’ve been using it for the past 40 weeks after all!

    The circumcision decision is personal, as the LDS Church has no official statements on the matter.

    As for the hysterectomy statement? I just want to be safe. And if TH, for whatever reason, is approached by someone who says “Here are your options, hysterectomy is one of them” I want him to know that for me losing my ability to bear children is a last resort.

  10. Thank you for sharing these. They are very thorough, and clearly very personal. I have some questions as a completely baby/birth novice.

    Should you have to be transferred to the hospital, how do you ensure that in the chaos, all your requests are met?

    Do you have a hospital already picked out and a doctor that you would ideally be transferred to? If so, are you going over this plan with that doctor and staff prior to the birth?

    Does your insurance allow you to stay in the hospital as long as you feel you need to?

    I fully support the fact that you’ve done so much of you own research. I’m just unclear as to how one puts these plans into practice, specifically with regards to the less preferred option for you, transferring to the hospital.

    Jenna Reply:

    I can’t ensure they will be met, which is why the plans are really for TH and myself and not the hospital. Laying it all out in one place will help both of us remember what the idea situation is, and we’ll work to get as many of those requests met as possible. There are plenty of women who write out birth plans, go over them with their doctor, have everything “approved” and the find out that it’s all gone out the window once they check into the hospital in labor, so I’m assuming that some, if not most, of this won’t happen. Plan for the best and expect the worst :)

    If I have a non-emergency transfer we’ll move to the hospital and doctor where my midwife has previous experience and a relationship. If I need a faster transfer though we’ll go to the hospital across the street from us.

    We really haven’t looked into what our insurance does/doesn’t cover, but I know from the experiences of the wives of TH’s co-workers that the coverage is really amazing.

  11. Oh -one quick thought on your c-section plan:

    #7 – Baby is not to be bathed until I choose to do so personally

    Will you be able to move around if you’ve just had a c section? Or maybe you say unless TH does so personally?
    Just an observation from a non-mom!!

    Oh -and whats with the garlic for the homebirth?

    Be proud of yourself for having such comprehensive plans!

    Brie Reply:

    My baby didn’t get a bath until she was 6 days old and had a major poopy blowout. My husband did wash gunk out of her hair the day after she was born, but nothing else. Especially with a cesarean, babies aren’t dirty!

  12. My husband brought me wendy’s nuggets, fries and a frosty while I had an epidural. It’s not like they have eyes on you at all times, what are they going to do? We just acted like it was his food when someone came in. I hadn’t eaten hardly anything for 2 days (it was hard to eat much during labor), along with maybe 3 hours of sleep in 3 days, I needed food. I never threw up, but I would rather eat and throw up than not eat at all.

    Also, I made it clear that I didn’t want the vernix rubbed off with those stupid rough blankets. They did it anyway. Hyrum tried to stop them, but the nurses made a big deal about her feet and hands being purple and he didn’t know that that was normal, so he let them. Tell TH that unless baby is limp and totally blue, to get you your baby!

    Had I tried to hold Claire while they were sewing me up, I would have dropped her. Not only is it an awkward position, but I was shaking uncontrollably and generally freaking out. Kelli had to hold my hand (another good reason to have someone else there). Hyrum held her near my face and I held her hands and kissed her though. They also put her in my arms as soon as they were done and we were wheeled to the recovery room together. For a cesarean, make sure they have those leg cuff things to help circulation.

    We had no problems with Hyrum staying with her at all times. They did say they couldn’t do some of the things in the room, but Hyrum never left her side. Oh, and check your insurance bill if end up with a hospital birth, because we got charged for routine things we didn’t do (hep B). Another thing they might push is blood sugar levels if baby is too small or too big (ugh).

    For your homebirth plan- I thought I would want to be left alone with Hyrum and just do my own thing. After a day and a half and after my water broke, I really needed my midwife and her assistant to help me. I needed women to tell me what to do. I needed a lot more support that I thought I would. I didn’t get it. I couldn’t vocalize what I needed (and I may not have even realized what that was at the time). Maybe talk to your midwife about how she will know when to step in. Or you can have a way to tell her to back off or something. I wish I had a doula despite the assistant being a doula (and I really did like her, it was just so long). Just something to think about.

    Good luck! I bet everything goes just amazing!

    Jenna Reply:

    Thanks Brie, I always love hearing from your experiences (and you’re always adding to my list of things TH needs to know in case we end up at the hospital).

  13. Jenna, these are great. It is very helpful to read them as I prepare to make birth plans too. Thank you for sharing them!

  14. I get excited when I see a post from you about birth. I love all the details, thought and research that goes into them. It’s fascinating to see all that goes into planning for birth. I also think it’s so wonderful how these plans are mainly for TH, what great communication. What a great way to empower each other to work together and support each other during such a big moment.

    2 quick questions – Are the comments in blue from TH? Also, what’s up with the garlic?

    Kimberly Reply:

    I think someone cruel broke into the document to write those comments in blue.

    R Reply:

    Haha! I was sure it was either her sister, close friend, or other female relative.

    Jenna Reply:

    Haha, these comments made me laugh so hard because the comments in blue *are* from TH! He would circumcise if I wasn’t against it and that was his way of fighting back. :)

    And no idea on the garlic.

    Katie Reply:

    !! Wow, my boyfriend is Polish (born there, passport, whole nine yards), obviously isn’t circumcised, and is against it. Interesting how seemingly similar situations breed completely different viewpoints!

    Genavee Reply:

    Oh good. I thought they had more of a fun, teasing vibe than a mean one.

  15. I feel like if you had shared these way back when you wrote the “mountain” posts, you would have received so much less criticism – because so many people were concerned that you hadn’t thought about what you wanted to happen when you went to the hospital. Clearly you have given it a lot of thought.
    One of my friends used Sport Beans during her labor (basically gatorade in jellybean form), which, while not on your Real Food diet, are delicious, very easy to swallow, and even easier for TH to hide in his pocket.

    And I say kudos to no circumcision. It’s so unnecessary and painful! (I’m assuming this has something to do w/ TH being European.)
    Also, you are totally making me want to go maternity-birthing-center instead of hospital. Because I can’t not eat for 24-48 hours, and I’m way too much of a slob to give birth at home.

    Brie Reply:

    This totally reminded me for some reason, that you should have mints or gum on hand for TH’s breath. Bad Breath is not good to a laboring woman!

    Rebecca Walters Reply:

    Totally Brie! My mother-in-law warned me and Tyler that I would think his breath stunk really bad when I was in labor and sure enough, even though he doesn’t have bad breath and it has never bugged me ever before, during labor I was just like, GET YOUR STINKY BREATH AWAY! Luckily we had Tyler’s toothbrush in the bag like the MIL suggested:)

    Evelyn Reply:

    Haha! Such an important tip! =) [and I'm not being sarcastic!]

  16. Puzzle and Birthday cake? Do tell! :-)

    Jenna Reply:

    Baking and doing puzzles — two of my favorite activities, and what I plan on doing in the time while I’m waiting for labor to get intense and crazy!

  17. Thank you for sharing something that can be so personal.

    While I understand why hospitals have policies, I cannot understand why they seem so restrictive. One would think that if you choose to eat or decline services they would have just one more piece of paperwork to say you were informed of such-and-such but you opted out. In my opinion so long as the hospital can document that they are not responsible, what should it matter? Not a question that needs an answer; I’m just thinking outloud. :-)

    It’s been really neat to follow your story here online. So once again, thank you for sharing.

  18. just a couple things I observed. You will probably want to make sure you have a water bottle handy for all birth plans. and also Make sure your camera and all other electronic devices have charged batteries. It is the worst when you go to use something and the batteries are dead!

    Also just to note, maybe put your mind at rest, if you do have to transfer to a hospital both hospitals I delivered at, rexburg, and richland, they actually don’t even have a working nursery. You deliver and do everything in the room you stay in and the baby stays with you at all times. they even do all of the baby stuff right there. So hopefully your hospital is the same way. but hopefully you don’t even have to go to the hospital. oh and if you have a c section – I had major complications so I did, seriously walking around as soon as you can is the BEST. my last c section they told me as soon as I could feel my feet I could get up. It was less then two hours after he was born! and then more you walk to faster and better you heal. and no blood clots! Good work, and good luck!

  19. I’m curious about the puzzle! Is it just something to keep you occupied/focused while you wait? Also, the birthday cake? Do you mean a literal cake? (Yum!)

    Jenna Reply:

    Yep, a literal cake. I’ve heard stories of families baking bread and cakes, etc, and there is also a lovely story that I heard a midwife tell once of a woman who mixed together the ingredients of a cake, went in and laid on the bed, pushed the baby out,t he time went out, and they had a snack to celebrate! I realize that’s totally unrealistic but I liked to dream about it anyway.

    The puzzles are indeed to keep me focused. I’m like Ross from Friends, I *love* puzzles!

  20. One thing to consider, if you sign papers to leave the hospital against medical advise, you may risk the chance of insurance refusing to cover part of your costs.

    Brie Reply:

    Oh yeah, declining PKU risks the chance of the insurance not covering it also. In my state anyway, it’s the law, I don’t know about yours.

    Jenna Reply:

    I’ve read that signings against medical advice papers could cause your insurance to deny you coverage on claims you may file for future claims that could be related (aka, you develop blood clots after your c-section but you signed out AMA and now they won’t cover your blood clot treament) but I honestly haven’t looked into it with my insurance company personally. The chances of it happening are very slim and we’ll deal with it if it happens. I popped that in there to educate TH on the option so he can take care of looking into it if it’s something we are interested in.

  21. I am definitely using this as a guide for my birth plan(s)! I’m not even pregnant yet and I’m already so dead set on certain things (skin-to-skin and rooming-in, for instance).

  22. These are awesome–my mother had 4 homebirths–I’m going to have to show this to her.

  23. Props to you for deciding to not circumcise! I think too many people do it because it’s “what Daddy looks like” and “everybody will make fun of him if we don’t”. My boyfriend isn’t, and is pretty vocal about the fact that he’s never had any issues in the locker room or otherwise. Why should people do it just because “everyone” else is? I don’t have as much of an issue with it for religious purposes, as I don’t feel that there’s much risk involved, but it just seems completely unecessary otherwise.

    Hannah Reply:

    If you don’t think there s much risk involved, why do you have a problem with it at all?

    I’m Jewish, so for me circumcision is a part of life, just curious because most anti-circ people seem to think that it is wrong, even for religious reasons.

    For the record, I have seen many a circumcision, it’s not nice but it sure isn’t as bad as it is made out to be by anti activists. That being said, I don’t know that I’d do it if I weren’t Jewish.

    Katie Reply:

    I wouldn’t say that I have a “problem” with it per se, it’s just that I don’t see the point if you’re not doing it for religious or cultural reasons. I realize that there isn’t much risk involved, but I also see very few pros to having the procedure done from a medical standpoint.

    Another reason that I don’t really “get” why it’s done (when the parties concerned aren’t doing it for religious purposes) is that if this situation were reversed and some minor cosmetic procedure were regularly performed on girl infants’ genitalia (aside from FGM, which is extremely invasive and life-altering), is that we’d be rallying against this idea that we should perform it so that they’d look “normal”. Our views about our genitals are already somewhat messed up (they’re “dirty”, we worry that they don’t look “typical”), why add on some human-designed procedure to feed into that? It’s really very strange that we see a body part that is generally cosmetically altered (in the US, in Jewish and Muslim circles, and really not in any other groups) as the “norm”, and not performing the procedure as “strange”. I guess my issue is that more people don’t question it for their own purposes.

    I’m just generally against any invasive procedure that isn’t necessary. If you decide for yourself after investigating that you feel it’s necessary, go ahead. I just wish people were more open to question things like this.

    Sophia Reply:

    Katie, I totally agree, for all the reasons you eloquently outlined.

    Jenna Reply:

    I wish I could find the article but I was recently reading something that talked about FGM and pointed out that there are actually varying degrees of FGM, with one procedure that is incredibly similar to male circumcision, involving the clitoral hood only. The author pointed out that we accept the removal of the glans, which results in less sensation, as completely normal, but if someone were to argue that they were going to perform the same procedure on a woman we would all recoil in horror.

    That being said, to Hanna’s comment above, I’m not opposed to circ for religious reasons. I think God instituted the practice for a specific purpose and it’s a beautiful thing for someone honor what they believe the wishes of our Father in Heaven to be.

    Aubree Reply:

    The glans is actually the head of the penis–I think that most men would argue that’s a horrific idea :P

    Jenna Reply:

    Oh man, can you believe I took anatomy in college TWICE!?? Actually now I’m probably helping people understand why I took it twice.

    I knew that the glans was the head and that what I meant to refer to was the foreskin. I really did! :)

    phruphru Reply:

    Ha, my husband (uncircumcised) says the exact same thing about teasing in the high school locker room. “If any guy looked at another guy’s junk, he got his ass kicked.” If we have a boy, we won’t circumcise.

    sarsk624 Reply:

    My brother isn’t and I have never really discussed with my parents why they didn’t. But my husband is. I don’t honestly think my brother or a former BF, who also was not, ever were teased. But that BF did feel a need to tell me ahead of time he was not. One interesting thing I just found, when googling for reasons to that are not religious, it is thought to reduce the rates of HPV and thus cervical and penile cancer. I’m sure an argument can be made that if you’re having responsible, safe sex you wouldn’t get HPV. But look at the rates. Condoms don’t prevent it. Here is the article from The Journal of Infection Disease http://www.idsociety.org/Content.aspx?id=12952

    That’s not to criticize Jenna in anyway. I’m impressed by how thorough her birth plans are and commend her for making them available.

    It is something that I just looked up after reading the comments because I don’t know what my personal feelings on circumcision would be.

  24. Jenna I actually have a recipe from a British natural birth book for something called “Labourade” off the top of my head it has agave nectar in it, I can’t find the exact recipe online although there are a few recipes online in the similar vein. If your not up for making your own I’d use something other than Gatorade, very harsh for your system if you’ve been eating whole foods.
    Also consider Emergen-C.

    You might want to add:
    - warm blanket, sometimes the adrenalin rush after you give birth makes you start to shiver.
    - Some tennis balls for TH, they are really good for massage.
    - a small batter operated fan, every woman I have ever watched in labour wanted a fan.

    One other thing that I know sounds silly but trust me with your long hair you will thank me later, get someone to braid your hair and then get the braid off your neck. As well head bands to keep the front at bay. When my sister went into labour she started with a pony tail and within an hour I was doing two french braids down the sides of her head and tucking and pinning the ends off her neck. Seriously if a single hair touched her face she lost her mind.

    Oh and lip balm is a must!

  25. Good for you for having such a detailed plan!

    One question that struck me – have you informed your neighbors that you will be having a home birth? I assume that is what the “Labor in progress” sign is for, but I imagine if they heard straining next door they might become alarmed?

    P.S. Thank you for your candid attitude on this blog. It is one of my favorites!

    Jenna Reply:

    Nope, we aren’t telling the neighbors. I’m not convinced I’m going to be a yeller during birth (we’ll see!)

  26. Thanks for sharing these Jenna! You’ve definately garnered enough questions for multiple follow up posts.

    As someone who works in a hospital (i know there are several readres that do), I strongly suggest that you research the hospital’s policies on dress, food, and some of the medical interventions you mention. As other readers have written, hospitals policies are sometimes the result of insurance company’s restrictions. Other times, they’re cautionary because of malpractice reasons. While I totally understand your desire to eat/drink, I know you know that to many providers, this is non-negotiable. According to those I asked today, this is because should you vomit and asphyxiate, you may require further medical treatment. Then either A) you sue the hospital for endangering you and not forcing you to do what is “medically necessary” or B) you require additional treatment and your insurance company says that your additional treatment is the result of poor doctoring, potentially opening you up to greater financial liability. Again, i totally understand that you believe you know the risks of vomiting/asphyxiating in labor. But – its a good idea to do a test run with your nearest L&D department of the hospital to see if there ARE forms you can fill out in advance saying you’ve been advised of XYZ and decline.

    Also – it says that TH will fight to keep the baby close if s/he’s taken immediately after labor. But it doesn’t say what will happen if other conditions aren’t met. I don’t know that you need to publish those, but its probably worth exploring with Sarah what your options are, given her experience.

    YEAH for you and YEAH for birth!! These plans were fun to read and I can’t wait to see how the process unfolds for you.

    Cristin Reply:

    Sorry, just re-read that these are NOT for the hospital but for TH to know how to respond in certain situations. That totally makes sense in the situations that require consent from you or him to proceed. But for things like “I will labor in my own clothes” – isn’t that more directed by the hospital than TH? Or is this so he can go to bat for you?

    Even with that though, I’m wondering how much research you/Sarah have on the hospital’s policies (like with double stitch or transverse incision, etc) ? Mine has a “baby rooms-in with Mom until Mom protests” policy :) Our nursery is too small!

    Jenna Reply:

    Thanks for chiming in Cristin! I was hoping those with past experiences or practical hopsital experience would do so as these birth plans are most certainly an “ideal”. More than anything I want TH to be aware of what I want if everything could go my way, so he’s not asking me questions and annoying me, you know?

    You touched on one area where I’m crazy passionate, and that is how much I despise the NPO rule. Reuters linked to a study that showed no significant difference in aspiration between those who only had water and those who ate lightly: http://www.reuters.com/article/idUSTRE52O56K20090325 and one of the authors noted ” the results reinforce what has already been shown in many observational studies and show that low risk women may eat lightly during labor.” WHO says labor”requires enormous amounts of energy. As the length of labour and delivery cannot be predicted, the sources of energy need to be replenished in order to ensure fetal and maternal well-being” and that “The correct approach seems to be not to interfere with the women’s wish for food and drink during labour and delivery, because in normal childbirth there should be a valid reason to interfere with the natural process.”

    My problem with the NPO policy is that it’s not made to help the mother, it’s done to protect the hospitals behind, particularly in cases where anesthesia was administered incorrectly (my reading suggests that the majority of cases where aspiration led to serious complications was due to medical error, not because mom had food in her stomach). The biggest reason that I find this so ridiculous? The assumption that telling her she can’t eat will mean she has no food in her stomach to aspirate. With many of the short labors seen by multiparous women, how can this possibly be true? If it really was dangerous to have food in one’s stomach because having food present was dangerous, then we should be emptying the stomachs of laboring women in some way when they are admitted, to make it safer for ALL. Instead the labor room is turned into some torture chamber where only ice chips are offered, and women continue to throw up food they’ve ingested previously anyway.

    Obviously I really, really despise this policy. :) That being said, my chance of hospital transfer are less than 10% anyway, so it’s likely these plans won’t even be necessary. It’s also likely that I’ll be so exhausted (because I won’t transfer unless I’ve been laboring for many, many hours with no progress, or of course unless there is a very bad emergency) that I”ll just do whatever they tell me so it can all be over.

    I like the idea of filling out forms ahead of time though, could I really walk into the hospital and ask for them, even though I’m a home birther? The medical system doesn’t tend to be very cooperative with those who choose to birth at home.

  27. I am so glad that you posted this. I watched one of the documentaries that you suggested in an earlier post and after reading this, I’m seriously considering a midwife and going to a birthing center rather than a hospital when the far away time comes for me to have a baby. Thanks for showing a different way of doing things and backing it all up with plenty of research! Good luck!

  28. Hi Jenna! I think it’s so interesting to read all your posts about your pregnancy and birth plans. I, too, am curious as to why you are declining screenings, specifically PKU? My brother has PKU, and to the best of my knowledge, there is no other way to determine whether or not your child has it than the heel prick.

    Jenna Reply:

    I actually will probably have them do the heel prick, I just don’t want it done within the first X hours of birth. I’ve photographed one birth, and the mom had a c-section, and she wanted for many, many hours to see her baby for the first time while the nurses went about their business checking things off their list. My plan is to just deny deny deny and get the baby to me, then I can always go back and say “Go ahead, do your heel prick, I’d like a break from baby now.” :)

    Rebecca Reply:

    Maybe I was just lucky with my first birth…(obviously with the second I didn’t get to see my baby for awhile or even hold him for a week) but everything was just perfect and I didn’t even have to ask…I think I was at a really good hospital. They gave me my baby right away and she was always with me. It sounds like many other women have had some really bad experiences (or just not good ones). I think the hospital you choose (as a back-up) makes a big difference. In my case I picked the hospital without the NICU over the one with the NICU because I had heard from so many women that it was so much better. They even had this spa-like bathroom area where you could go and shower and feel pampered rather than just getting ready in the small one in your room. Yep, I think I was really lucky…I think I just take so much of the way things went for granted.

    Even with #2 who was very very sick at birth we selected the hospital with great care and traveled to Philadelphia to live there several weeks before he was born to make sure he was born there since transfers were too dangerous for his condition.

    Kara Reply:

    I’m a genetic counselor, Jenna, so I highly recommend newborn screening(the “PKU” test)! It’s such an important thing to have done-they are pretty much all recessive diseases so you would be unlikely to know if you and TH were carriers for the same disease unless you’d had yourselves tested (which I don’t think you did). Texas, though, actually screens for the fewest number of diseases (29) but it’s so important to do-the whole point is to catch diseases that can be treated within the first 2 weeks of life!! Sorry if I sound intense-I work in a metabolic clinic and see all the babies with abnormal screens!

    Lexie Reply:

    I strongly agree with Kara, and I just wanted to add some additional information. I’m a 4th year medical student who just spent two weeks working with the pediatrician in the nursery. The newborn screen actually can’t be done accurately until the baby is at least 24 hours hold. Many of the diseases that are tested for cause errors in baby’s metabolism, and the actual test looks for the buildup of the byproducts. If the test is done too early, these byproducts haven’t had a chance to build up yet, and there can be false negative results.

    Kara Reply:

    Absolutely, Lexie. Thanks for adding that. Jenna, they shouldn’t be doing it on That Baby’s first day so since it won’t be affecting them giving him/her to you…I hope you will allow them to do the test!!

    Jenna Reply:

    One of the biggest reasons I wanted to post my birth plans was so that people like you would help me understand things that Google sometimes doesn’t do a very good job of explaining. :) I’ll be fighting to have the PKU test done in our room with baby right next to me (or in my arms?) but after comments like yours I won’t be denying. Thanks!

    kara Reply:

    So glad to hear it, Jenna. :) Let me know if you have any questions about it!

  29. Oh, Jenna, these are wonderful. Really inspiring to read. Following along with all the research you’ve done makes me way more confident to choose a home birth for myself when we get pregnant.

    I love how you have several different contingencies and I’ll be praying for all of you. I’m so excited to hear about how it turns out!!!

    THANK YOU for sharing these. I really appreciate it.

  30. I only got to #7 and then I burst into tears:
    7. Jenna starts on birthday cake and puzzle

    That is the sweetest, most beautiful idea – to bake a cake. I would like to do that someday. Oh, how I wish I were pregnant right now. Such a happy day you are planning!

    Jenna Reply:

    I can’t take credit for it. One woman’s birth story I read spoke of baking a loaf of bread. Another I read made a cake with her daughters while she labored to celebrate the impending arrival of their new sibling. I hope to make it a family tradition. :)

    And I just really really like puzzles.

  31. I never even though about having a birth plan for a homebirth. We’re having one and now I’m definitely going to write one. If I don’t DH and the midwife will have no idea where anything is and I do not want to be telling people where teh extra blankets are while I’m in labor.

  32. Something to keep in mind in the event that you do need a hosptial-assisted birth is to have a health care proxy form for TH – to give him the legal right to make decisions for you in case if you are incapacitated so that he has the backing of an actual legal document to advocate your wishes if they are against “hospital policy.”

    Helena Reply:

    It’s never a bad idea to document a proxy, but rest assured that her legally married spouse is her decision maker by default. (Too bad for all those gay couples out there – in those cases we are forced to hunt down parents unless they come with paperwork in hand).

  33. I’ve already started looking through other women’s birth plan. I will be delivering at a hospital and plan to take mine with me. Even if hospitals are made to be machines of efficiency they are providing me with a service and I expect to get the best care possible while I am there. I don’t think its too much to ask of my health care providers to read my birth plan and take me into consideration when assisting me on one of the most important days of my life, the day my child is born.

    Jenna Reply:

    I hope that very thing happens for you Rachel Elizabeth! I agree, your wishes should be taken into consideration. Good luck.

  34. Also, do you have a plan for the possibility of being massively overdue or otherwise needing an induction? I just ask because I had to revamp my birth plan the night before I went into the hospital because I ended up having an induction.

  35. Hey Jenna,

    Wow! You are so prepared and informed! I don’t think I have ever been this prepared or informed about any event ever. Good work!

    I noticed the words “fight fight fight” quite a bit in the plans outlined if a hospital becomes part of your birth day. My suggestion as a friend is to find a way to not feel so “us” and “them” if a hospital comes into play. It just seems to me that those types of feelings will take away from your day. I would think that positive feelings towards everyone involved would be something that will enhance your experience and make it a positive one even if things don’t go exactly as planned.

    Also, have you considered getting an impermeable mattress protector or pillow protectors? My bro manufactures them and recently had a customer contact him saying the mattress protectors were the best things ever for home births. He only sells them wholesale, but he is always happy to send them to my firends so lemme know…he could mail one tomorrow if you want…I think the friends and family price is $18 for any size plus $12 shipping for the protectors (usually 80$+ in the store) and the pillow protectors are 12$ a set.

    Lemme know:)

  36. Here’s something to add – not necessarily to your birth plan, but as an FYI. Consider getting one of those cute hospital gowns that you can purchase online and elsewhere (though if you don’t find it likely that’ll you’ll be at the hospital, it may be an uneccesary purchase). I had the pukiest, ugliest color green hospital gown and didn’t pack a robe for some reason. All our new baby/new family pictures have that horrid gown in them! Next time around I’m definately purchasing a cute, picture worthy hospital outfit or just bringing a cute robe. I have to print those pictures in black and white because I hate the color so much!
    (trivial-yes, but it’s something I regret!)

    I’ve never understood all this talk of eating/no eating. I was not the least bit hungry either time!(in fact, just before Kyle was born I vomitted at the hospital!) Maybe I labored at home longer or I went pretty quickly, because I never remember thinking one bit about food. Handling the pain was a *tad* more at the forefront of my mind I guess. :)

    Aahh! You’re getting close now! I’m going to flip out when we actually get the news and get to see him/her!

    Jenna Reply:

    It’s true, I might not even want to eat at all so it won’t be an issue!

    Rebecca Reply:

    Ya, I threw up my last meal, so if you eat, think about what it will taste like coming up…

  37. Now you have me reminiscing and I can’t stop thinking about how my births went.

    One more thing to add…I think skin to skin is so important! With our son, he was in the NICU as you know, for 5 weeks and was the most fragile baby in the NICU for the first few weeks. Even talking in a normal voice rather than a whisper would set off all his machines. Because of all of this he was not held very much during those first five weeks.

    I was vigilant next to his tiny bed and would often just place my hand on top of his head where he would tolerate it and I held him as much as possible and nursed him as soon as he could eat and pumped and pumped and pumped some more, but I later wrote about how he needed “Snuggle Therapy” (my own invention) to make up for all of those early weeks of not enough human touch. And I definitely did not bond with him at first in the way I did with our daughter since it was not possible to hold him.

    But, I am so grateful he is alive and well, and such a good snuggler now:)

  38. I always that the no food rule was related to the possibility of a need for eventual c-section?

  39. I read the hospital one (my midwife will deliver the baby but we’ll be in the hospital). I love the notes to TH (Do not…!!!!!). It’s good to have a plan, and I’m glad you’re open to it being changed. I feel like modern birth plans (at least examples that I’ve seen), require you to be SO specific about everything, and I keep thinking to myself “who knows what I will feel like doing?!” So my birth plan has things like “have a mirror available but do not use it unless mother asks” My next task for myself is to get a list of hospital rules, so that we know what to expect.

    I, too, think the no eating/drinking thing is so stupid. If I am in there for 12 hours, I’m going to want some food, and ice chips is not going to do it. I would rather throw up than feel hungry!

  40. I don’t know that you need to plan to put a sign up as early as you are… Every woman is different, but honestly, it wasn’t until my contractions were about 3, maybe 4, minutes apart that I started getting vocal. Before that it I was definitely moving around a lot though. Can you make a notation that once you start being vocal he should put the sign out, you might freak some neighbors out and have to deal with apartment politics if you do it too early.

    TJ Reply:

    I think putting the sign out…well, frankly I think the only way it would actually be useful is if the neighbors see it well beforehand. (If it were me, I would tell them in advance.) If I heard my neighbor giving birth, I wouldn’t go knock on her door; I’d call 911 and say “there is an axe murderer next door killing my neighbor, come quick!”

    Evelyn Reply:

    Haha. I see your point, I just think most women who labor naturally make different sounds that aren’t usually very disruptive. The high-pitched screams are definitely not helpful for alleviating pain, most women (especially when coached, but often on their own) seem to trend towards low-pitched moans often referred to as Moo-ing. The neighbors might make some interesting associations with that sound, but I doubt it would be with an axe murder. ;)

  41. I think it is smart to have three separate birthing plans, even if it’s just so TH knows all of your expectations and can help them be met!
    For me, during labor I didn’t want to eat anything! I also had an epidural but could still feel my toes and the “urge” to push was stronger than anything I’ve ever felt–maybe that means my epidural didn’t take. I don’t know, but wow, it did not numb me the way I have heard other women describe it. I still feel like I got the whole birthing pain/experience.
    I’m so anxious to hear how your labor goes!

  42. Great plans/lists Jenna! I love your ideas for occupying your mind during early labor. I wish my labor had started during the day or even in the early morning so I could have spent my early labor doing something *interesting*. Since things started happening right before bedtime, I was tired and wanted to sleep. And I couldn’t because I was too excited. Blah. I really hope my next labor starts during the day so I can keep on doing my housework, go on walks, etc.
    Also, I noticed in your birth plan for transfer that it will most likely be in the case of “failure to progress”. I hope this is the midwife’s idea of failure to progress rather than the common hospital idea of failure to progress. Having had a 26-hour-labor, I am positive I would have ended up with a c-section if I had been delivering in the hospital due to this very thing. Obviously it would have been totally unnecessary as my son was born with absolutely no complications and both of us were perfectly fine. Also, don’t assume that because you have a longer labor means you will be too tired to push. I have heard this reason used for getting an epidural (in hospital deliveries) more times than I can count and it is total BS. Sure, it’s one thing to be pushing for hours and hours and being to worn out to push anymore- it’s completely a different animal to have a long labor before pushing stage. No matter how tired you are by the time you get through transition, you will have the energy to push. TRUST ME! The urge to push is so strong you don’t NOT have the energy. It really is amazing. I am so grateful for the midwife I had for G’s birth- at around the 12 hour mark in labor, after laboring all night long, she offered me a narcotics (Demerol?) to take the edge off contractions and help me get a little sleep. I said no at the time but kept it in mind. An hour or so later (by this time I had lost all sense of time), I voiced my concern that I would be too tired to push once I was FINALLY at 10 cm. Midwife very confidently said, “No, you won’t be too tired to push. You’ll be just fine.” And I did do fine. After 26 hours of labor, finally had my first pushing contraction and pushed my son out 8 minutes later. Seriously- it was the easiest, bestest, most *fun* part of labor for me. But all that too say- don’t let anyone tell you that you’ll be too tired to push because of “prolonged” labor! You can do it!

    Jenna Reply:

    One of the things I look forward to most in regards to my unmedicated birth is feeling the desire to push. All women who birth drug free talk about how powerful the urge is, and I think listening to your body tell you what to do is a wonderful thing.

  43. While I will give birth in a hospital (when the time comes!), reading your posts has made me decide that I’d like to have a midwife/doula along for the ride – to offer support and encouragement, of course, but also to be an advocate for me while in the hospital. Northwestern actually has an extensive midwife program, so it could all work out pretty well!

  44. i just want to thank you jenna for this post. it is truly wonderful. i wish you the best with your birth plan.
    p.s. looooove the cake and puzzle plan. love it.

  45. From helping at my mom’s homebirths I just have a few additions:
    -I second the advice about taking your own gown to the hospital and having your hair pulled back/braided. My sister hates the pictures of her with matted-down hair and ugly hospital gown from when her baby was born a few weeks ago.
    -This might sound gross, but go to Lowes/Home Depot and get those plastic sheets that have adhesive on them and put down over your carpet. My mom’s births were never very messy, but when carrying towels/blankets, etc, it’s just better not to have to worry about the carpet. Using the self-sticking plastic is so much easier than trying to stay on trash bags or non-sticky plastic.
    -Have lots and lots of detergent on hand. We (my sister and I) always got one load of laundry going about halfway through labor, and it would take a couple washings to get them clean. Sometimes she used plastic or disposable sheets, but most of the time, she wanted those thick, “real” blankets around her.
    -Your midwife might tell you this already but if your baby has baby acne or dry skin soon after birth, rub some extra virgin olive oil all over him/her and it’ll never come back again. Mom says that’s also really good to use for perineal massage (don’t know if that’s what you’re currently using for it)
    -This is completely subjective but you might warn TH about the placenta. I’ve seen numerous labors but the only thing that ever made me turn green was when my mom delivered the placenta. I don’t know why. But I’m just saying, it looks a lot different coming out than in pretty pictures of placentas, you know? So you might want to talk that through with TH if he’s going to be there when you deliver it.

    Good luck!

    Jenna Reply:

    Today I showed TH a picture of a meconium filled diaper. Maybe I should call him over and point out pictures of the placenta as well!

  46. Jenna – to help out with your hospital transfer plan, I’d ask to see the hospital packet from location that you plan on being taken to in case of an emergency.
    I had a choice of 3 different hospitals, and while all are highly regarded, they each had drastically different policies regarding many of the things in your plan. My hospital had pretty much all of my “wants” in their normal routine (skin-to-skin, rooming-in, etc.) so I didn’t need a birth plan. The only thing I added was that my husband would be the skin-to-skin recipient if I had an emergency c-section.
    Oh… and as for the photography at the hospital, most require that YOU get permission in order to record the staff on film or video. At least that was the policy at all of our hospitals. So if a nurse said no… then you couldn’t have them in any photos. Just something to be aware of!
    Last thing — have the name of your chosen (and insurance covered) pediatrician ready for the hospital. They’ll need that information at check-in.

    Amber Reply:

    I totally agree with all of this!! My hospital was chosen because of the practices it performed.

    Jenna Reply:

    If I were hospital birthing I would definitely choose the place based on their policies. I won’t have that luxury though if I have to transfer in the middle of labor (which is, of course, a risk I’m willing to take).

    And now I need to bump “contact pediatrician” up on my to-do list. So much to prepare!

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