Category: Labor

Birth, Labor

How To Write a Birth Plan

What is a birth plan? How do you write one? Is there a specific way to do it? In this post, we will explore strategies for writing a birth plan and why you should have one in the first place.

The Reason for a Birth Plan

The goal of a birth plan is to clearly communicate your wishes to your birth team and have them written down for easy access. It is always important to talk over your birth plan with your care provider and doula. This way they can be aware of your wishes and help you work towards achieving them. Your partner should also be familiar with your birth plan in order to advocate for you.

What is a Birth Plan?

Birth plans are a list of choices and preferences for your labor, birth and immediate postpartum period. They do not guarantee a certain outcome but communicate your wishes for birth. They specify the kind of care you would like to receive and what you would also like to avoid.

Birth plans range in length from a short list of bullet points to multiple detailed pages. The point of a birth plan is to communicate your wishes clearly and concisely. Dividing it into categories can make it easier to navigate. Ideally, a birth plan should be between one and two pages in length to make it easy to reference.

What Subjects Should Your Birth Plan Include?

Since your care team will be referencing your birth plan, consider focusing on specifics that regard the care that they provide and describe what you do and do not want to happen during labor.

Consider mentioning your preferences on pain relief, medications, ​comfort measures​, position changes, how you want to push, whether you do or do not want various interventions, and which support people you want in the room.

For your baby, indicate what you do and do not want for their care immediately after birth. This might include when to cut the cord, whether or not they receive shots, and your feeding preferences.

Yes or No

It can be helpful to have a “yes” section and a “no” section in your different birth plan categories. For example, during labor, you may say yes to free movement, changing positions, and using counter pressure. On the other hand, you may say no to an episiotomy or certain medications. Whether you use this system or something else, the goal is to make it easy to read and navigate.

Other Things to Think About

While it is not necessary to list all of your preferences regarding the environment of your birth, it is a great idea to brainstorm and decide these things ahead of time. Let your partner and doula know these preferences so they can help you with them. Consider creating a playlist of your favorite music, writing out encouraging birth affirmations, and using essential oils. You can also hang up cozy string lights, wear a comfortable gown, keep the lights dim, and use a fan. These simple strategies go a long way in making you feel safe and comfortable which supports labor progression.

How To Use a Birth Plan

Once you have written your birth plan, print multiple copies to have on hand. During pregnancy, talk over your birth plan with your doctor or midwife. This is a great way to get on the same page, encourage good communication, talk about your preferences, and learn how they can help you achieve your goals. It is always good to acknowledge with your provider that plans might change and communicate that in such cases, you would like to be informed of your options and make the decision that is best for you.

Often doctors will include a copy of your birth plan in your patient portal or file for easy access. When going to the hospital, it is wise to bring multiple copies for staff that may need them. Some parents display a copy of their birth plan in the room or give a copy to their nurse so that their care team is informed of their wishes.

What if Plans Change?

While birth plans outline your preferences and decisions for your care, there is always a chance that plans will change. While this is not something to be afraid of, it is wise to be aware of this possibility. When writing your birth plan, think of alternative options as well so that you are familiar with them. Ask your doula to help you consider different scenarios and prepare for possible changes in plan.

A supportive care team who knows your needs and desires can help you navigate changes. They will work to do what is safest and best for you and your baby while staying in accordance with your wishes as much as possible.

It is very important to give your permission and informed consent before something is done to you or your baby. This gives you the power of decision making and the ability to advocate for yourself. Knowing your options ahead of time will make it easier to make decisions in the moment.

Bottom Line

To sum it all up, birth plans are a helpful communication tool. They do not guarantee a certain outcome, but they state your preferences and desires for your birth. They save you the trouble of having to answer lots of questions during labor and make it easy for your care team to serve you. Creating a birth plan also encourages you to research, consider your options, and determine what you feel is best for yourself and your baby.

Did you learn something from this post? I’d love to hear from you in the comments!

~Hannah

Birth, Family, Labor

Dads and Doulas: Do They Get Along?

Have you ever wondered how doulas and dads can work together? Do doulas get in the way at births or take over the dad’s support role?

Let’s talk about it!
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Doulas don’t just support moms during pregnancy and labor! They support the family too, especially dads. During the pregnancy, doulas teach dads and partners how to assist with comfort measures and labor positions. They also guide them in ways to support, reassure, encourage, and advocate for the mom.

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Contrary to assumptions, doulas don’t get in the way or take over the supportive roles of dads and other loved ones during labor. Instead, they acknowledge that these relationships are most important, and they seek to encourage them.

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Doulas help take the pressure off of loved ones so they can focus on being present and supportive without having to worry about all the details of what’s going on. Doulas explain what is happening, suggest questions to ask the doctors and nurses, pay attention to detail, and give guidance to help dads offer the best support to the mom.

I always tell my clients that they are going to feel the most comfortable and safe with their partner during labor. That relationship should be nurtured, encouraged, and given space to thrive. Doula support comes alongside to equip partners and provide additional physical, emotional and informational support during pregnancy, labor, and birth.

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One dad said “Thank you again for everything…you were a huge help! I think just knowing someone was here… allowed me to just be there [for her].”

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Another dad said he was telling all of his friends that everyone should use a doula!

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Doulas and dads work well together and tag-team to best support the mom. One does not replace the other. Both play a vital role as part of the birth team!

~Hannah

Birth, Labor

Listening To Your Body’s Intuition

Your body’s intuition is often ignored during labor, but there are many reasons why you should listen to what it naturally wants to do. When it comes to ideal labor positions, many times you don’t need outside help. All you have to do is listen to your body and how it wants to move. Depending on where your baby is sitting in your pelvis, your body will want to move in various ways. At one point, you will want to sway front to back while later you will probably feel better swaying side to side. Squatting, lunging, sitting on the toilet or birth ball, walking and side lying will feel good when those positions are helpful to your baby.

Pregnant Stock Photos, Royalty Free Pregnant Images | Depositphotos

This Mama Trusted Her Body’s Intuition

I witnessed this when I was supporting a mama who beautifully labored and birthed her baby. She could feel where her baby was in her pelvis, and as her doula, I was so proud of her as she worked with her body. The positions she chose to do where exactly what I would have recommended to open up her pelvis. The amazing thing was that I didn’t need to tell her how to move. She trusted her body and did what felt good. To this amazing mama, it felt good to walk and lunge up seven flights of stairs in the hospital! And what do you know, the baby was born soon after!

Break the Stereotype

Our culture has a stereotypical way of giving birth. Movement is limited which makes the pain and discomfort worse. Interventions are pushed. If we were more educated about birth as a society, we could trust our bodies more. God gave women everything they need to give birth. Sometimes there are emergencies or the need for interventions. In general, however, our bodies are capable of birthing our babies.

Prepare Your Body

It is important to exercise and practice labor positions during pregnancy to prepare your body for birth. This is another thing that my client did. In the weeks leading up to her birth, she practiced positions that helped her body prepare for labor. These things also encouraged her baby to descend into her pelvis. Exercise during pregnancy helps you build endurance and coordination and conditions your body for labor. Labor is like a marathon so building up to it with exercise, practicing positions and mentally preparing are all wise.

Prepare Your Mind

Whether planning for an unmedicated birth or one with pain management, it is vital to prepare for labor mentally. Labor is not easy, but it doesn’t have to be scary or insurmountable. Educate yourself on what to expect and how to work with your body. Choose a supportive birth team, and write a birth plan that clearly communicates your desires. Write down encouraging reminders and motivations that will help you during your labor. Your partner and birth team can remind you of these things, or you can have them on display.

Listen to Your Body’s Intuition

As you prepare your body and mind for birth, remember the fact that you were made to do this. Your body knows what to do. You will go into labor when your baby is ready to be born, and you can listen to your body’s intuition on how to move effectively. Outside support is wonderful but listen to your body first. As you work through labor, remember that you will meet your precious baby soon!

~Hannah

Birth, Comfort Measures, Labor

Water For Labor and Birth

There are multiple ways of using water in labor as a comfort measure. Whether you desire to give birth in a birthing pool or utilize water during your labor, there are both benefits and risks to consider. Is it safe to have a water birth? What are the benefits of laboring in water? Are there safety precautions that should be addressed? Which care providers allow water births? We will delve into these topics in this post.

Where Can I Have a Water Birth?

Water births are a common occurrence when giving birth at home and also at birthing centers. Due to common protocols in hospitals such as continuous fetal monitoring and IV fluids, laboring in water is often not allowed. If planning a hospital birth, learn all you can about that hospital’s policies and the tools they have available to you. Some hospitals have tubs and showers that can be used during labor, and you can talk to your care provider about your wishes. If you plan to use water during labor, add this to your birth plan and make sure your birth team is informed about your wishes.

Water In Labor – The Midwife’s Epidural

Using water in a tub or birthing pool during labor has been nicknamed “the midwife’s epidural” because of how much relief it brings to the laboring mama. When striving for an unmedicated birth and skipping an epidural, the birth pool can bring much pain relief and help your body to relax. Regardless of your birth plans, water can be used in early labor. Midwives are typically more comfortable with using water in labor and advocate water births more often than other providers.

Laboring In the Shower

A hot shower is a great comfort measure utilizing water and heat to bring pain relief, especially in early labor. Using a handheld shower wand to direct water onto specific painful or tense areas of the body is extra helpful. Getting in the birth pool for extended periods of time before reaching active labor has been known to slow labor down. Once labor starts, it should be allowed and encouraged to progress, so it is wise to wait until active labor before spending much time in the tub. For this reason, showers can be a lifesaver by still allowing the use of hot water outside of the tub. By standing or sitting in the shower, you are also utilizing gravity to encourage your labor to progress and baby to descend.

The Birthing Pool

A birthing pool or tub can be a bathtub, inflatable pool or other tub lined with plastic. It is important for your birth team to pay attention to the water temperature, especially if you plan to give birth in the tub. The accepted temperature range is between 98 – 100.4 degrees. If the water gets too hot, it can make mama’s temperature get too high and cause a fever. Your body is already working hard and can easily get hot during labor so be careful not to get extra hot by being in the water. Your birth team can help by supplying you with fans and cool wash cloths. When the baby is born into the water, the goal is for the water temperature to be similar to mama’s body temperature so they will not be too hot or cold. If the water is too cold, it could cause baby to breathe too soon under the water, which is dangerous.

Benefits of Water in Labor

There are many benefits to laboring and giving birth in water. Mamas love the relief that the warm water brings and the fact that it helps them relax. When submerged in water, there is less tension on your body and joints, which helps your body release and labor more productively. This is a reason why being in the birth pool has been seen to help labor progress. When a skilled provider is present who is trained in water births, giving birth in the water is considered safe for low-risk pregnancies.

Risks and Precautions with a Water Birth

Water births are not without risks and precautions so make sure to address these with your care provider. These risks include the baby getting an infection from the water, breathing prematurely under the water, a slight increased risk of snapping the umbilical cord and a less visible environment when assessing bleeding after the birth.

To prevent the possibility of baby getting an infection, midwives have ways of keeping the water clean, including using a net to scoop out any floating material. If the water becomes soiled, they will have you get out of the water. To help keep the baby from breathing prematurely, it is important to keep the water between 98 -100.4 degrees. A simple way of protecting against the rare occurrence of snapping the umbilical cord is to slowly and gently bring the baby up out of the water when it is born. This helps to keep tension off of the cord. If either you or your provider are concerned about the possibility of excess bleeding, get out of the tub before or immediately after delivering the baby.

When You Should NOT Have a Water Birth

There are times and circumstances when water birth and laboring in water are dangerous or unadvised. In high-risk pregnancies, cases of high blood pressure, active infection or pre-eclampsia, history of postpartum hemorrhage, twin pregnancies and other high-risk circumstances, your provider will warn you against water birth because the risks outweigh the benefits. Research your options, learn alternative comfort measures and work with a provider you trust to guide you through your specific situation.

Different Standards Between Providers

Depending on your care provider, they will have different standards and ways of doing things. Some providers are comfortable with water births, while others will only allow you to labor in the water. Other providers, usually in hospitals, may not allow any use of water during labor. Due to the potential risks associated with water births, some midwives and providers are more comfortable with allowing you to labor in the tub but give birth outside of the water. It is also less convenient for providers to allow water births. Your care provider will have to get into awkward positions in order to assess you if you are in the water. It is admirable when they lay these inconveniences aside in order to do what feels best to you.

Change of Plans

Sometimes there are changes of plans in labor and birth. One of my clients planned to have a water birth, but it worked out better to get out of the water to use gravity in birthing the baby. She enjoyed the benefits of laboring in the water, and it turned out to be better to give birth outside of the water. It is important to listen to your body and the advice of your birth team to make the best decisions for yourself and your baby.

More Comfort Measures

While it is sometimes necessary to get out of the water or forgo it altogether, there are other comfort measures that can be used instead. Position changes are extremely important in order to help your baby descend. Changing positions also encourages labor to progress and helps you feel most comfortable. Experienced mamas like to resort to positions and comfort measures that helped them in previous labors. Listening to your body and its natural movements and instincts is vital. Your care provider and doula can also give you helpful suggestions to try. The use of counter pressure, hip squeezes, massage, movement, heat, cool cloths and fans are other amazing comfort measures.

Now that you have been introduced to the benefits and risks water births, what are your thoughts? Would you choose a water birth? Does water sound soothing to use in labor? I’d love to hear your thoughts and experiences in the comments below!

~Hannah

Labor

Labor Positions Matter

Labor positions are super important when it comes to giving your baby room to fit through your pelvis. Changing positions in labor not only aids your baby, but it helps you to be more comfortable and makes labor more efficient. But did you know that certain positions are much more effective than others at different points of labor?

Your Pelvis

Your pelvis has three parts – the inlet (top), the mid-pelvis (middle), and the outlet (bottom). As your baby moves through each part of your pelvis, certain positions are helpful in opening up that specific part. For example, the stereotypical position of pushing on your back with legs wide is not actually ideal for multiple reasons. Gravity is an important factor when it comes to labor positions and so is opening the pelvis. Opening your legs wide while pushing actually narrows the outlet (bottom) of the pelvis which should instead be fully open. Understanding the pelvis’ structure and how it moves is key to understanding why it is important to use ideal positions.

Labor Positions for the Inlet of the Pelvis

The inlet (top) of the pelvis is the first part that your baby passes through. Positions with your knees wide and ankles close together open this part of the pelvis. Towards the end of pregnancy, try these types of positions. Deep squats, sitting on a birth ball with knees wide, propping your feet up on a squatty potty or books while sitting on the toilet, and side lying with pillows between your knees are all good ways to open the inlet of your pelvis. Movements that tuck the pelvis such as “cat cow” and rocking front to back on a birth ball are also helpful.

Some babies move through the inlet and settle into the mid-pelvis by the time labor starts. This is what it means when it is said that baby is engaged in the pelvis. If your baby is engaged when labor starts, utilize positions that open up the mid-pelvis to make more room for baby. If baby is not engaged, continue these positions with knees wide and ankles turned in to open up the top of the pelvis.

Labor Positions for the Mid-Pelvis

The mid-pelvis is the narrowest part, and uneven hip movements help to make the most room for baby. Doing asymmetrical or uneven movements allows the mid-pelvis to open on one side or the other, making more room for baby to descend. Side lunges, curb walking, propping up one foot while sitting on the toilet or birth ball and swaying side to side are examples of uneven hip movements. Your body will help you know which positions are ideal at a given time by what feels most comfortable. If you naturally want to sway side to side in labor, then it is quite possible that your baby is in your mid-pelvis.

Labor Positions for the Outlet of the Pelvis

The outlet (bottom) of the pelvis is the last part that baby has to navigate. Labor positions at this stage should be the opposite of what is done to open the inlet (top) of the pelvis. Pointing your knees in and keeping your ankles apart is ideal for opening up the outlet. Without feeling awkward or exaggerated, the goal is to keep your ankles wider than your knees so the bottom of the pelvis can open wider. Try doing the hands and knees position with your ankles wider than your knees. You can also try side lying with pillows or a peanut ball between your ankles while keeping your knees close together. Sitting on the toilet or birth ball with your knees in and ankles out are other simple ways to encourage the outlet of your pelvis to open up.

Knowledge Is Power

Understanding how your body works and is made to give birth is so important as you head into labor. Work with your body and intuition as you labor your baby into the world. By learning about the different parts and functions of the pelvis, you now know how to move and position your body most effectively. Practice these different types of positions in pregnancy so they will be familiar to you when you utilize them in labor. I hope this introduction to ideal labor positions and your pelvic structure will empower you to be confident in your labor and birth. You were made to do this, and you are capable of birthing your baby!

~Hannah

Comfort Measures, Labor

Comfort Measures

Comfort measures are a helpful bag of tricks when it comes to labor. They are often used in the absence of pain medication or epidurals, but a number of them can be used regardless. Comfort measures used in labor include position changes, controlled breathing, massage, counter pressure, hydrotherapy, heat and ice packs.

Doulas are trained in these comfort measures and teach the mother and her partner how to do them during pregnancy so they can practice them before labor begins. Your doula will help you perform them during labor, but equipping your partner to assist you is helpful too. Regardless of your birthing location, these comfort measures can be utilized at home in early labor as well as throughout the birthing process.

Position Changes

Movement during labor is super important, and changing positions can help mama’s body to open up and give the baby an easier way out. Depending on the stage of labor, some positions are better than others to help open up the pelvis for baby to descend. Squats, lunges, walking, swaying, moving on a birth ball, getting on hands and knees, side lying and using a peanut ball are all effective ways to move and change positions during labor. Your doula can give suggestions about position changes and ideas for how to let your body work most effectively.

Controlled Breathing

Learning and practicing controlled breathing during pregnancy helps prepare mama to breathe effectively and stay calm during labor. Both mama and baby need plenty of oxygen during the labor process. Various types of controlled breathing include deep breaths in early labor, shorter and more shallow breaths in active labor and panting as baby is crowning to keep from pushing hard. Controlling your breathing will help you get enough oxygen, stay calm, and keep you from hyperventilating. Your doula and partner can give you reminders and help by breathing with you when necessary.

Massage

Massage can help relax painful areas during labor. Each mama is different and has her own preferences. Some women like to be touched and massaged while others do not want any physical touch. Let your birth team know what feels best to you. Hand and foot massages can be done to ease tension and are often helpful if a mama has been walking a lot during her labor. Lightly touching a tense brow, jaw or shoulder can remind mama to let it go and relax that part of her body.

Counter Pressure

Mamas often love when pressure is applied to a painful area such as their back or hips during labor. This is usually done by her doula, partner or both. Steadying her back with one hand, they can apply firm, steady pressure where she directs, usually through a contraction and then taking a break. The “Double Hip Squeeze” is a form of counter pressure and is done by applying pressure at the same place on both hips. Your doula and partner can take turns doing this or do it together by each applying pressure to one side.

Hydrotherapy

Water is an amazing pain reliever and helps mama to relax. In early labor, taking showers can be soothing and help with the pain. A handheld shower wand can be used to direct hot water onto the painful spot. Mamas who decide to have unmedicated births often like to use a birth pool. These are commonly referred to as “the midwives’ epidural”. Talk to your midwife or doctor about the preferred time to get in the pool. It is wise to wait until active labor before getting in the pool for very long. By getting in too soon, labor could slow down in the early stages. Mamas should ALWAYS have supervision while in the pool to ensure safety.

Heat – A Relieving Comfort Measure

Utilizing heat during labor is a simple and effective comfort measure. A heating pad or hot water bottle wrapped in a towel can be applied to a sore spot to bring relief. Hot water in the shower is soothing and helpful too. Never apply heat, however, to any part of the body that is numb.

Cold – Another Simple Comfort Measure

Labor is hard work, and mamas often get hot. Cold, damp wash cloths can be applied to her forehead, neck and chest to help her stay cool and comfortable and keep her from overheating. Ice packs on her sore back can bring relief as well. As is the case with heat, never apply cold packs to any part of the body that is numb.

Support

Encouragement and affirmation are so important and can go a long way. Choose a birth team that will support you and the desires you have. Partners can learn helpful ways to encourage and give practical reminders so that their input is well received.

Comfort measures help by giving pain relief, encouraging relaxation and letting your body work effectively as it births your baby. Learn them during pregnancy so you can come prepared and use them in your labor and birth. You won’t regret it!

~Hannah

Photo Credit – Lauren Reed