how to write a birth plan for a home birth
Would you want your midwife to do anything to speed up labor if you felt it was progressing too slowly? Home birth midwives will not use any drugs for this, of course, but some will strip or even break your membranes if you want them to. This can cause labor to get a lot more intense a lot more quickly, and it can increase the risk of infection as well, so do your research about this ahead of time so you can make an informed decision during labor. Some home birth midwives prefer not to do anything to augment labor, so you should know whether your midwife even considers this an option.
When do you want to cut the cord? After it stops pulsing, after the placenta is born, or not at all (if you’re planning a lotus birth)?
What do you want to do with the placenta?–dispose of it, plant it, encapsulate it, or eat it?
How do you want your midwife to support your perineum during crowning? Being in water can help prevent tearing, and many midwives like to use a warm cloth with water and herbs to support your perineum.
Will you want your midwife to perform perineal stitches if you tear, or do you want to heal naturally? If you do want stitches, talk to her about her experience with this and find out what severity of tearing she’s qualified to repair. What level of severity would cause you to want to go to the hospital for stitches?
Under what (non-emergency, of course!) circumstances would you want to transfer to the hospital? This is definitely a decision to reconsider during labor if necessary, but I think it’s important to discuss with your midwife ahead of time as well. If you start begging for pain relief in the middle of labor, do you want her to transfer you or encourage you to work through it? (Of course this depends on where you are in labor as well; if you’re pushing and everything is going well, it’s probably too late to transfer!) But you should find out how much your midwife is willing to encourage you in the middle of labor if you’re feeling discouraged and wanting to transfer, especially if you have a long early labor. Some midwives will believe you immediately when you say you want to transfer for pain relief, while others will work harder to encourage you to stay home and keep trying. Talk to your midwife about this so you won’t be disappointed in retrospect that she either didn’t respect your wishes in the midst of pain or that she didn’t encourage you to follow through with the natural birth you were planning for.
If you do have to transfer, you might want to have an emergency birth plan as well. Keep in mind that if you only plan to transfer in an emergency, then you do not want to be walking into the hospital and telling the staff what to do. However, you might want to have a written birth plan to give them regarding care for your newborn after it’s born, especially if the closest hospital to you has a lot of routine practices that can hinder breastfeeding. One important point to discuss with your midwife is what her role will be if you have to transfer. Some midwives are hesitant to accompany you to the hospital because of the legal status of midwifery in Georgia. Ask her if she’ll come and identify herself as your doula if she’s not comfortable telling hospital staff that she’s your midwife.
Do you plan to have any newborn procedures done like eye drops or vitamin K? Some midwives can offer these. If your midwife doesn’t and you want something, you’ll need to plan a postpartum visit to your pediatrician pretty soon after the baby is born.
Comfort and Atmosphere
Are you planning a water birth? If so, what temperature do you want the water, and how long do you want to stay in? Do you want your baby to be born in the water?
Do you want other natural methods of pain relief during labor like massage, acupuncture, aromatherapy or chiropractic adjustments? (Yes, there are chiropractors in Atlanta who will come to your house and adjust you during labor.) Can your midwife do any of these for you, or will you have someone who can do them come to your labor?
Do you want your midwife to offer pain relief methods like counter pressure during labor?
Are you using any specific methods like self-hypnosis, Birthing from Within, or Bradley birth? Is your midwife familiar with the method? How can she support your practice of this method during labor?
Which room do you plan to birth in? Of course this can change, but it’s a good thing to at least think about beforehand. Personally I’ve always thought it would be wonderful to birth outside, but I keep having winter babies.
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