During pregnancy, a mother-to-be has a lot of choices surrounding childbirth. Barbara Higham shares ten tips for your birth plan to help guide you toward making your own decisions about this life-changing experience. (Photos: Belle Verdiglione)

1. Choose a place where you will feel comfortable, at home, in hospital, or in a birthing unit. Choose a place in which you will feel safe and uninhibited. When I was pregnant the first time, I went to have a look at the local hospital’s maternity facilities. What struck me first was the sick patients. The coughing, ashen-faced man with whom I shared the elevator made me feel distinctly uncomfortable (as did the glaring lights and overheated, windowless rooms). I was not sick. In fact, my blooming radiant good health was completely at variance with the surroundings. Patients lined up to use the bathroom. To be frank, I knew I’d find it hard to ‘let go’ to ‘open up’ sufficiently to give birth to a baby in an environment where I wouldn’t feel comfortable enough to go to the bathroom. Your medical team is unlikely to quiz you on such a delicate matter. It is however a pertinent concern because giving birth is similar in some respects, it involves contraction and relaxation of muscles and is a process similarly affected by feelings of agitation. Some people simply are not happy using strangers’ bathrooms.

Ten Tips for Your Birth Plan
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2. Choose a health care provider who supports practices that promote normal birth, even if you intend to have a medicalized birth. This can help you avoid a cascade of unnecessary interventions that may have unfavorable consequences. Don’t request or agree to induction of labor unless there’s a medical indication for doing so. Inform yourself about:

Check, too, whether your maternity facility is designated ‘baby-friendly‘ in accordance with the global criteria developed by UNICEF and the World Health Organization. The Baby-Friendly Hospital Initiative (BFHI) is an effort to ensure that all places where mothers give birth, whether free standing or in a hospital, become centers of breastfeeding support. Hospitals and maternity units set a powerful example for new mothers and it’s important that those assisting you are knowledgeable about how best to support you with starting to feed your baby.

3. Plan to move around freely during labor. You’ll be more comfortable, your labor will progress more quickly, and your baby will move through the birth canal more easily if you stay upright and respond to your pain by changing positions. Just adopt the positions in which you feel least uncomfortable. I found swaying, circling my hips helped in early labor and later I wanted to sit on a bucket! It seemed to help. One of my labors, I spent a long time kneeling stretched forward with my bottom in the air. I spent the last few hours in a birthing pool semi squatting or leaning on the side.

Ten Tips for Your Birth Plan
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The Fourth Trimester
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4. Consider hiring a doula or professional birth/labor supporter, particularly if you do not have a known and trusted midwife assisting you. Birth can be unpredictable. Someone who knows you and your wishes can speak up about your choices and help you retain control of any situation. http://evidencebasedbirth.com/using-a-doula-for-pain-relief/

5. Think about the people you do or do not want to be present during your labor and the birth. Will your partner be a support or will he add to your anxiety? Labor can take many hours and birthing women do not want to feel scrutinized or troubled by anyone’s observations. Do you want your other children present? These are very personal decisions. If you feel you would be in any way constrained by someone’s presence—you may want to moo like a cow or curse like a sailor—then take this into consideration. I was fortunate enough to have a very sensitive independent midwife for my home births. She understood when I needed privacy and made sure that my partner was there at the times I needed him and that I knew he was attending to our children upstairs when I wanted to focus inwardly on the work at hand. You might arrange to have a friend or family member with you, but when you go into labor might decide that you actually want to be alone or alone some of the time. Be sure to let this possibility be known in advance so as not to upset anyone.

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6. Ask that the baby’s heartbeat be monitored intermittently rather than continuously, as continuous monitoring restricts your movement in labor. An experienced midwife will also have no need to measure the dilation of your cervix.

7. Eat and drink as your body tells you to give you energy and prevent dehydration.
Use non-medical pain management strategies, try focused, paced breathing and comfort measures such as warm baths and showers, massage, and birth balls.

8. Don’t give birth on your back! Upright positions (sitting, squatting, or standing), on all fours, or on your side enable you to make use of gravity to push when your body tells you.

9. Keep your baby with you after birth. These hours are precious and only come once in each lifetime. Skin-to-skin contact helps to regulate your baby’s heartbeat and breathing and helps get breastfeeding off to a good start. Separating mother and baby interferes with breastfeeding and bonding.

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Ten Tips for Your Birth PlanThe many choices to be made around childbirth should be yours. Inform yourself of the decisions there are to be made while you are still pregnant, and learn about the implications of each. Attending prenatal classes and talking with other parents and midwives will help you prepare for the birth that you want and help you to decide which matters are of particular concern for you as an individual mother-to-be.

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Ten Tips for Your Birth Plan
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