During the last few months of pregnancy, it is wise to write a "Birth Plan." This is a list of your wishes during your baby's birth. Discuss with your doctor (or midwife) his/her standard practices during labor and delivery. You may also want to visit the place where you will deliver, the staff of the hospital or birthing center can tell you what their standard procedures are. While some hospitals allow the parents a wide range of choices, others offer only a few. Your plan can be as simple or as detailed as you want. It can be a brief paragraph specifying your choices about medications during labor, the people you want present during delivery, breastfeeding after the birth, or where you want your baby to sleep - in the nursery or with you. Your birth plan can be longer, detailing your preferences from your arrival at the hospital until you are discharged. If you've hired a doula, she can be a great help when you're writing your birth plan. She'll know most of the options you may want to consider for you and your baby. When you're in labor, she can help ensure that your wishes are respected and followed as long as the situation allows.

Some options you may have when planning your birth:

• THE LABOR

  • Hospital Prep (pubic shave, enema)

  • Partner allowed to stay during prep and exams

  • Constant electronic fetal monitor

  • Freedom to walk, shower, sit in a rocking chair

  • I.V.

  • Pitocin given to speed labor

  • Pain relief through medication
    

• DURING THE BIRTH

  • Push the baby out in position of choice

  • Prolonged breathholding and bearing down for expulsion

  • Limit two hours for pushing, then forceps or cesarean birth

  • Mother allowed to touch baby's head when it crowns

  • Episiotomy

  • Forceps or vacuum extraction

• AFTER THE BIRTH

  • Suctioning of baby's nose and mouth

  • Immediate care of baby done out of sight of the mother (identification, Apgar test, heat lamp, replace hemostat with cord clamp)

  • Manual extraction of the placenta

  • Pitocin given to contract uterus after placenta is born

  • Baby allowed to nurse soon after birth

  • Partner allowed to cut umbilical cord

• BABY

  • Baby to isolette or nursery while mom goes to recovery room

  • Silver Nirtrate eye drops applied shortly after birth

  • Baby's first feeding, breast or bottle

  • Baby mainly in nursery or stays with mother

  • Circumcision for boys

  • Home as soon as possible, or remain in hospital a little longer
    

• UNEXPECTED SITUATIONS

  • Scheduled surgery, or surgery after labor begins

  • Partner present during surgery

  • General anesthesia, or epidural

  • Screen lowered at time of birth or baby held up for mother to see

  • Mother to wear her glasses or contacts

  • If baby's not in distress, partner allowed to hold baby

  • Mother allowed to breastfeed in recovery, if her and her baby's conditions permit.
    

• PREMATURE / SICK INFANT

  • Cared for by professionals, or parents allowed to help

  • Baby rushed to intensive care, or allowed to stay with mother a little while

  • Mother and baby close to each other in same part of hospital

  • Baby is sent to another hospital, father accompanies, and mother - if she is able

  • Limited visits, or family allowed to see and hold baby

  • IV and bottle, or mother breastfeeds or expresses her milk for baby

A lot to consider, the birth of your child. It's an experience you'll never forget. Having a birth plan can help it be a wonderful memory, by letting those who will be caring for you know, in writing, what you do and do not want for you and your child. Make several copies of your birth plan. Give it to your doctor, the hospital, those who will be with you during birth, your doula, and keep one for yourself. While anxiously awaiting your baby's birth, planning out in your mind and on paper how you want things to go can help you feel calmer and prepared. There may be some points your doctor may not permit, some he will, and some will be negotiable. It's important to discuss your plan with him in your last few months of pregnancy, so that you have time to work out any problems. With everyone concerned well informed, you can better achieve a satisfying birth experience.