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What is a birth plan and do I really need one?
A birth plan is a written document that details your preferences, fears, and wishes surrounding the birth of your baby. This document will tell all caregivers you encounter during the birth of your baby how you would like your birth to go (if possible).
A birth plan is certainly not necessary, but is a good way to learn about all the options that are available and also to begin a detailed discussion with both your partner and your prenatal caregiver about your preferences, wishes and fears surrounding the birth of your baby. During the actual labor and delivery, when you probably aren’t thinking with the clearest mind, may not be the best time to make decisions about what care you want. By having a written birth plan that was created when you were of sound mind can make the labor and delivery run a lot more smoothly, and can alleviate some of the need to make decisions under pressure.
What should be included in a birth plan?
A birth plan should begin with a brief paragraph about you and your partner. This section could include such things as whether or not you have other children, if your pregnancy has been healthy, if you have suffered from any complications and what they were, and information about your culture or religious beliefs that will impact the delivery. This would also be a good place to give any special details about the people who will accompany you to the birth. For example my husband is terrified of needles and does not handle hospital settings very well. I would include this information in my birth plan so the nurses and doctors can be aware of the issue and keep that in mind during our stay in the hospital. Remember to keep this section brief and too the point so that any caregiver reviewing the document can get all the key facts quickly.
The next section of the birth plan should detail any important wishes, fears, or concerns you and your partner have about the labor and delivery. If you have had any prior miscarriages, stillbirths, or a child born with an illness or birth defect in the past that will affect your emotional state during the labor this is the place to disclose that. By knowing ahead of time what issues may come up your caregivers can be conscious of the special care your may require. You should also include in this section if your partner will want to cut the umbilical cord and who exactly you want in the delivery room with you besides your partner.
A very important, probably the most important part of the birth plan, is the outline of how you want to manage your labor pain. If you have any specific wishes regarding the use of medical intervention during your labor for pain management this is the place to detail those preferences. When you are in the midst of painful contractions you may make decisions regarding your pain management that differ from your wishes earlier in your pregnancy. By writing your wishes down early you can help ensure your caregivers are aware of your feelings toward the use of pain management and can help you stay on course.
You will also want to include a brief section regarding your wishes should complications arise during your birth. We all hope for and expect our labor and delivery to go smoothly, but deep down we also know that there is a very real possibility that something could go wrong. By including this section in your birth plan you will force yourself to consider what might go wrong and how you would like to approach those situations should they arise. This would be a great opportunity for you to address your concerns with your partner and with your caregiver. Often decisions are made quickly when complications arise, by having your wishes in writing and read early on by those caring for you during your labor and delivery you can better ensure your involvement in the decision making process. Plus you will have educated yourself about what can go wrong and what happens as a result so you will better understand what is going on.
The bottom line:
A birth plan is by no means a necessary part of preparing for your labor and delivery. It is, however, a great way to force yourself to become familiar with the various aspects of labor and delivery as well as what complications can arise. If you decide that a birth plan is right for you here are a few books that might help you in the development of your birth plan. Your prenatal caregiver can also provide you with some resources that can help in the development of your plan.
- Creating Your Birth Plan
by Marsden Wagner & Stephanie Gunning
- The Birth That’s Right For You by Amen Ness, Lisa Gould Rubin & Jackie Frederick Berner
- The Birth Book by William & Martha Sears
Be sure to involve both your partner and your caregiver in the process as both will be key players in the birth of your baby. The birth plan can only work if everyone is aware of the plan, knows their role, and understands your position on the key aspects of your labor and delivery.
Folic acid is something I am sure all of you are aware of. Every woman of child bearing age is sure to have heard about it at some point or another. But what is it and why is it so important?
Well, folic acid and folate are members of the B vitamin complex group. Folate can be found in “foliage” foods like spinach, asparagus, and garbanzo beans as well as fortified foods like breakfast cereals. However, folic acid is rarely found naturally in food and must be supplemented in your diet. Folic acid plays an essential role in cell metabolism by helping cells grow and divide. Which explains why it is such an important player during the early stages of pregnancy when very important cell divisions and cell growth is taking place in your growing fetus.
During the early stages of pregnancy the fetus is growing at a very rapid pace, and the neural tube (brain, spinal cord, etc) are already developing. Folic acid plays a key role in this process. It is recommended that all women of child bearing age have a daily dose of folic acid of 400 micrograms, regardless of whether they are expecting or not. The Centers for Disease Control estimates that neural tube defects are reduced by 50% to 70% when the daily dose of folic acid is followed prior to pregnancy.
So how do you meet your daily dose of folic acid? The FDA requires that all grain based products like breads and cereals be fortified with folic acid to help ensure woman are getting more folic acid in their diets, however, the best way to get the recommended dose of folic acid is to either take a folic acid supplement on its own, or take a daily multivitamin that contains folic acid. Most multivitamins that are designed for woman contain the recommended daily dose of 400 micrograms.
When I talked to my OB/GYN about my pregnancy planning he directed me to begin taking a prenatal vitamin as soon as we stop using birth control and begin trying to get pregnant. He stated this course of action is recommended so a woman who is planning a pregnancy can better ensure she has the proper stores of the nutrients necessary in early fetal development. Remember, a lot of fetal growth takes place before you even find out you are pregnant. Since most pregnancies remain unplanned it is important to take a folic acid supplement all through your child bearing years.
If you have questions about folic acid, its importance, and whether how are getting enough folic acid in your diet talk with your doctor.
(source WebMD)
Each of us is different, just as each of our pregnancies will be different. Our outlook on how the pregnancy will be, what sort of control we want to have over our pregnancy and childbirth experience, and what degree of input we want from our prenatal caregiver will all influence the choice we make on who will be the best fit to provide prenatal care.
Before deciding on the exact caregiver that you want to work with you have to decide on what type of caregiver meets your needs. The decision might not be available if you are experiencing a high-risk pregnancy (you will likely have to receive care from an OB/GYN), but if your pregnancy is low risk then you certainly have some options.
There are basically three types of prenatal caregivers available to offer pregnancy and childbirth care. They are the traditional obstetrician, a family practitioner, or a certified nurse-midwife. Each caregiver brings something different to the table and depending on what you are looking for in prenatal care will influence your decision. Here is a brief over view of what each caregiver can provide.
Obstetrician: an OB/GYN is the most traditional and commonly used prenatal caregiver, according to “What to Expect When You’re Expecting” 80% of pregnant women use an OB/GYN for their prenatal, delivery, and post-partum care. An OB/GYN is a medical doctor who has gone through special training in obstetrical care. They can handle all aspects of your prenatal care, the delivery of the baby, and your post-partum care. If you are looking for a highly specialized caregiver, who can handle anything that may come up then an obstetrician is probably right for you.
Family Practitioner: I have to admit that I didn’t know your run of the mill family practitioner could offer pregnancy care…you learn something new everyday. A family practitioner is like a general practitioner, however, they specialize if being able to offer medical services to the whole family. They can render general health care, women’s reproductive care, and pediatric care. If you are looking for doctor that already knows you, and will get to know all aspects of your family then a family practitioner may be right for you. If you pregnancy becomes high risk they may need to refer you to an OB/GYN for care.
Midwife: Midwives offer a more holistic approach to treating pregnancy. They will provide more intimate care and likely spend more time talking to you about your concerns than a medical doctor. They offer the benefit of being more in control of your own pregnancy, and a variety of delivery options that may not be available with a traditional OB/GYN, for example the opportunity to deliver at home if you chose. A midwife is only for low risk pregnancies though, if your pregnancy is high risk you will want to find another type of caregiver. A midwife is ideal for those women looking for a caregiver that will give them the most control over their pregnancies and the most options when it comes to delivery.
Each caregiver provides their own unique approach to prenatal care. Once you have an idea of what type of caregiver you think will be right for you begin interviewing caregivers in order to find a personality match that is right for you. If you are not sure which type of caregiver will work best for you it might be a good idea to consult providers in each field before you make your decision. You are going to be spending a lot of time with which ever prenatal caregiver you choose so it is important to have a good rapport with them and to feel comfortable with their pregnancy care philosophy.
Here some good resources you can utilize to narrow down your search for a provider, or to get more information on the provider you have chosen.
Also, think about obtaining referrals from friends and family members who have recently had a baby. They can be great resources and can give some personal insight into the type of care they received.
Of course you may be limited on your options based on what types of caregivers are covered by your health insurance. It is always a good idea to call your health insurance carrier to get the low down on what types of providers they will cover for prenatal care, what types of locations they will cover for the delivery, and to get a list of providers that are within your network. Not all health insurance carriers will cover mid-wife administered care, and others will only cover the delivery if it takes place in a traditional hospital. It is always best to educate yourself ahead of time to avoid being surprised later when a huge bill arrives in the mail.
What is a pre-conception check up you might ask…Well a pre-conception check up is a consultation with your doctor about your plan to become pregnant and what you need to do to help prepare your body for an impending pregnancy. This type of thing would have been unheard of a generation ago. Most women wouldn’t have scheduled an appointment to see the doctor until pregnancy was confirmed by a home pregnancy test, or at least expected due to a missed period or two. And that may remain true for some women today, but more and more woman are beginning to understand the importance of being healthy before you become pregnant, and giving your child the best chance from the very beginning.
Times have changed since our parents were born, and even since we were born. Women today are focusing more on planning pregnancies into their lives instead of just letting nature take its course. And since more is known about the affects our lifestyle can have on the baby very early on in the pregnancy more women want to do whatever they can to ensure a healthy pregnancy from the get go. Women today are making appointments with their OB/GYN to discuss what they should do to prepare their bodies for pregnancy, getting physicals to make sure they are in tip top shape and don’t have any health issues that need to be addressed prior to conception.
I actually just had a pre-conception appointment with my OB/GYN. It wasn’t a hugely involved ordeal since he has been my doctor for several years now and knows my background fairly well, but it was very helpful. We discussed many topics including how my health prior to conception and in the early weeks of pregnancy can have a huge impact on the developing fetus. The early weeks and months of pregnancy are some of the most important when it comes to development so it is important to start out as healthy as you can.
When you visit with your doctor for your pre-conception check up here are some important things you want to make sure to discuss.
- Discuss any pre-existing health problems you have and what impact those may have on your pregnancy or ability to get pregnant. Your doctor will advise you as to what needs to be addressed before you start trying to conceive, and what health issues may impact your fertility.
- Discuss what current medications you are taking, either prescription or over the counter and determine what changes need to be made prior to conception and during pregnancy.
- Discuss your doctor’s recommendation for when you should begin taking a prenatal vitamin. Some caregivers will suggest you begin taking a prenatal vitamin as soon as you start trying to conceive since studies have shown the importance of folic acid to a developing embryo in the first weeks of pregnancy. A prenatal vitamin contains the recommended dose of folic acid, and other key vitamins and minerals necessary for fetal development.
- Discuss your use of alcohol, tobacco, illicit drugs, etc. Your doctor will want you to stop consuming all of them and will be able to help you quit if you are unable to do so on your own. Alcohol, tobacco, and illicit drugs can all damage a fetus during develop so quitting before you become pregnant is very important.
- Your doctor will discuss your medical, gynecological, and family history to determine if there is anything in your past that may hinder your ability to conceive or impact the pregnancy once you do conceive. It is important to be perfectly honest with your doctor.
- Ask you doctor for recommendations regarding fitness and nutrition both while you are trying to conceive and once you become pregnant. Discuss any concerns you have regarding your current diet and exercise regiment.
A pre-pregnancy check up is a great way to establish rapport with your caregiver prior to conception. It will also give you a good idea if the two of you are on the same page philosophically about pregnancy and conception. If you identify any potential issues you will have a chance to hash those out, or change providers before you become pregnant.
It is always easier to maintain a healthy lifestyle than it is to begin one. By getting a head start on healthy eating and exercise, and dealing with any chronic health issues before you become pregnant you will have a much better chance of having a healthy pregnancy and a healthy baby.