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Preparing for your new baby

Why you should develop a birth plan and what to include


Congratulations you’re pregnant! After the initial shock and thrill of sharing the news with loved ones, expectant parents find their minds reeling with a million different things to consider – finances, baby names, maternity leave and even how Fido will react to the new competition.

Expecting a new arrival to the family can be overwhelming and developing a solid birth plan is essential to planning and preparing for your little one.

Birth plans help to avoid misunderstandings between a patient and caregivers during labor by spelling out in advance what the parents expect. Plans should include, at minimum, direction on how to manage pain, whether your baby will be breast- or bottle-fed, if an obstetrician or midwife will deliver the baby and who may be present in the delivery room.

Some plans go into much more detail and can include everything from optimal delivery room lighting and any particular song the new mom would like played in her room, or whether video cameras are permitted, on which side of the bed her partner should stand and how many pillows she would prefer.

Nona Smith, a nurse midwife with Novant Health Midwifery Associates, said that she asks her patients if they have a birth plan in mind, and if they do, the plan is reviewed together. “We educate our patients about what options they have during labor and birth and advise them to keep it simple in order to really focus on the items that are most important to them,” she said.

In March, Heather Rothrock of Kernersville, North Carolina, gave birth to her new son, Levi, at Novant Health Forsyth Medical Center. She and her husband, Matt, worked with Smith to develop their birth plan.

“I wanted a birth plan because of my commitment to medication-free labor and delivery,” Rothrock said. “I also wanted to establish the immediate plans for my newborn, including NICU needs, vaccines and breast-feeding. Having a plan and a care team that understood it made me feel more comfortable with the labor and delivery process, which was otherwise intimidating and unfamiliar.”

And while Rothrock had one plan in mind, she was flexible and adjusted while in labor. “Even though my plan was for a medication-free birth, during labor I asked about my options for pain management and was given a low, quick-acting dose to help me regroup,” she said.

Dr. Andrew Lewis of Novant Health Valaoras & Lewis OB/GYN said birth plans are quite customized to each individual. “There is no right or wrong way,” he said.

Lewis, who has delivered babies for more than 17 years, has seen very detailed blueprints for labor and delivery that were multiple pages in length and others that were simple and fit on one page.

“Birth plans are not required,” he said. “Some women choose to be flexible and prefer that their obstetrician take the lead. It’s a very personal decision. At the start of the third trimester, we introduce the concept of a birth plan and if a mother chooses that route, then we are happy to assist. The delivery team will do their very best to honor all of the mother’s wishes.”

Novant Health offers a downloadable birth preparation guide on its website. “We tell patients to look at these sample plans and talk them over with their partner to develop their own unique plan,” Lewis said. “Then, we all sit down and discuss the plan and what could happen if the plan may not be able to be followed.”

He also noted that any birth can be filled with surprises and necessitate sudden actions that could derail one’s plan, such as an unplanned cesarean section.

“Most of the time, with good prenatal care, deliveries go as expected and we do everything we can to honor a mother’s wishes,” Lewis said. “Our priority is to have a healthy and safe mother and baby, so sometimes plans have to be adjusted.”

As for the outcome, Lewis said, “It’s a miracle every time.”





Published: 11/6/2015