Birth Plan Template: 5 Key Factors to Include in your Birth Plan
Let's elaborate a little.....
What is a Birth Plan?
Should a Birth Plan include BREASTFEEDING ?
You may be asking yourself, "Do I need a birth plan?".
Please understand that this is not about whether you do or don't NEED a birth plan.
That decision is 100% yours to make as a unique woman, and we support every woman in the choices that she makes.
This post is for particularly for those women who are interested in learning about what they may like to consider including in their birth plan from Dr Robyn Thompson, midwife and breastfeeding specialist with over 45 years experience.
Photo: Dr Robyn Thompson works with a mother and her 6 day old baby.
In Dr Robyn Thompson's experience, many women are not aware that the events that occur during labor and birth greatly influence breastfeeding.
This makes the decisions that a woman makes during this time, super important.
This is why we encourage women to become well informed during pregnancy (first, second or third trimester), rather than waiting until you have your baby in your arms.
By gaining the knowledge, you'll have more confidence to make informed decisions, thereby reducing the risk of complications during your labor, birth AND with breastfeeding.
So, let's get back to writing a birth plan, which includes considerations for breastfeeding....
Every woman is unique and every birth plan is unique.
This is not to tell you how to write a birth plan...
It's to share some considerations that may help you in the process of creating your own unique, gentle birth plan.
And of course, it's important to acknowledge that things don't always go to plan.....
But if you take the time make a birth plan, you'll be increasing your knowledge about what some of the common complications are, what's likely to be recommended for you and most importantly, what's important to you.
A birth plan is also an important tool to have clear communication with your partner, your advocate and/or the professionals who will be looking after you.
Let's talk about the 5 Key Factors you may like to consider for your Birth Plan...
Key Factor #1: Routine Vaginal Examinations
What are routine vaginal examinations?
In many hospitals, policy is that vaginal examinations are carried out every 4 hours, from the time that a woman is in labor. These 4 hourly routine vaginal examinations are often carried out by different people, depending on availability and shift changes.
Are Routine Vaginal Examinations necessary?
Dr Robyn Thompson suggests that an experienced midwife will be able to mindfully observe a woman’s body language, her facial expressions and the sounds she makes, without needing to carry out a vaginal examination. Careful observation assists in interpreting how a woman’s labor is progressing, with respect to the significant changes that go on with each woman in her unique transitions of labor.
Pic: An experienced midwife will be able to mindfully observe a woman’s body language...
This mindful skill, involving patient and careful observation is being replaced by routine vaginal examinations, which often interrupts a woman's space as she calmly and gently navigates her own unique labor and birth.
Many women are not aware that they have the right to say 'NO' to routine vaginal examinations and this is one of the reasons why Dr Robyn Thompson encourages women to include this as a consideration in their own unique birth plan checklist.
It's important to be aware that there may be times when a vaginal examination is necessary, for example, in the event of a specific medical concern. Under these circumstances, a woman may consent to a vaginal examination. However, the question remains as to whether routine vaginal examinations are necessary.
The vagina is a very important part of the female body and it should be respected. Dr Robyn Thompson encourages her professional colleagues to sit down and talk with a woman about informed consent, because informed consent means that she understands why someone is wanting to carry out a routine vaginal examination. Is it necessary? What are the benefits? What are the risks? What are the alternatives and most importantly, what are her rights? This is paramount for all women, particularly for women who are survivors of sexual abuse.
Please remember, hospital policy is not law.
Anything that a woman chooses to include in her birth plan, may be reconsidered or reviewed at any particular time during her labor.
Watch Dr Robyn Thompson talk about routine vaginal examinations.
Key Factor #2: Induction of Labor and your birth plan options
Whenever induction of labor is recommended, it’s okay to ask why.
In fact, Dr Robyn Thompson encourages women to ask "why" and to be informed of the benefits, risks and alternatives. It’s not uncommon for women to report being coerced in some situations when unnecessary induction of labor is recommended. This often creates fear, leading to an increase in adrenaline (cortisol), which may then lead to a woman to start doubting herself and her instinctive knowledge.
Of course, if there is an urgent or emergency situation, then that's a different outlook altogether.
When is Induction of Labor Necessary?
The Cascade of Intervention is a well-known phenomenon and often starts with the recommendation of induction. Dr Robyn Thompson goes on to explains that one form of intervention often leads to another, then another and so on. Each intervention increases the risk of opiate pain relief such as epidurals, spinal blocks, regional and general anesthetics, which increase the risk of further intervention. This cascade of intervention increases the risk of birth and breastfeeding complications.
You get where we're going with this.
Dr Robyn Thompson talks about the cascade of intervention.
Do epidurals have an effect on the breastfeeding baby?
In the absence of urgent or emergency situations, it’s preferable that a woman’s labor is not unnecessarily interfered with.
Breastfeeding may be achieved more easily, because the baby is not subjected to opiates, often administered to the mother by way of local anesthetics, epidurals and general anesthetics. These are a big problem for newborn babies, it's a big problem.
And it’s a problem for mothers when they’re drowsy and not able to coordinate as well until the effects wear off.
Based on over 45 years as a midwife and breastfeeding specialist, Dr Robyn Thompson has observed that opiate pain relief does affect the newborn baby and may complicate breastfeeding, increasing the risk of what's known as the 'sleepy baby'.
Should I create a birth plan for c section?
Breastfeeding after a c-section is possible. However, it's advisable to create a birth plan for c-section so that those around you are aware of what's most important to you, particularly when it comes to breastfeeding.
Key Factor #3: Routine Procedures
What to expect with a hospital birth
When planning to give birth in the hospital system, it's important to be aware that hospital systems are designed for efficiency with the aim of rapidly processing women in, through and out. This is not always in the best interests of the breastfeeding mother and her newborn baby. Dr Robyn Thompson’s encouragement, if possible, is for a woman to have her own midwife to be with her, gently guiding her through her pregnancy, labor, birth and with breastfeeding.
Having a birth plan for hospital staff increases the likelihood of open communication.
Avoid Unnecessary Separation of Mother and Baby
With an Apgar Score of 7 or above, the newborn baby belongs with the mother from the moment of birth. The newborn baby should not be taken from the mother, particularly for the purpose of carrying out routine procedures, because boxes need to be ticked! A newborn baby needs to be with the mother, because the sensory skills are alive and well and that little baby needs to know that he or she is safe with his or her mother.
It's preferable that routine procedures wait, so that they do not interrupt or delay the newborn baby receiving colostrum from the first breastfeed (The 3 Golden Hours).
What are routine procedures?
Weighing, measuring, bathing, rubbing, injecting are examples of routine procedures that are not immediately necessary. It’s not out of the question that a mother may request that the scales be set up and brought to her. Perhaps a woman's partner can weigh the newborn baby. Dr Robyn Thompson suggests to take things into consideration in the moment. What's happening. Is it urgent? If it's not urgent, or not an emergency, take a step back. There’s much to be learned by observing. It can be quite stressful for a mother to be separated from her newborn baby.
Dr Robyn Thompson encourages women to consider including in their birth plan whether they would prefer for routine procedures wait until after the first breastfeed, so that the newborn baby can receive the colostrum. This consideration may be in contrast to hospital policy, but remember, hospital policy is not law. Open conversation with the professionals who will be looking after you may be necessary for you to create an environment of respect and reassurance for you, your partner or advocate for you and your baby.
Dr Robyn Thompson talks about the 3 Golden Hours that are critical for the newborn baby
Key Factor #4: Colostrum and The First Breastfeed
How important is colostrum for your newborn baby?
Not all newborn babies will go straight to the breast, immediately following birth. However, Dr Robyn Thompson talks about the 3 golden hours, giving time for your newborn to feel secure. Colostrum is thick and rich in nutritional qualities and is the perfect preparation for the newborn baby's gut. It's important to consider the first breastfeed (The 3 Golden Hours) in your birth plan, so that your baby has the best possible chance of receiving your colostrum.
How to avoid breastfeeding complications
In Dr Robyn Thompson's experienced and PhD research, many common breastfeeding complications may be avoided if the first breastfeed is uninterrupted and not delayed. This is why she refers to the 3 Golden Hours as being so important to a woman's breastfeeding journey.
By including the first breastfeed (The 3 Golden Hours) in your birth plan, you communicate to hospital staff that, in the absence of urgent or emergency procedures, your baby is to be in your arms.
Once a mother is separated from her baby, breastfeeding complications are statistically significant. Unnecessary separation, interruption or interference with the mother and the newborn increases the risk of breastfeeding complications. In Dr Robyn’s experience, it may take up to an hour before the newborn is even interested in going to the breast by itself. Skin to skin time is important for both mother and baby, especially babies affected by opiates, as they may not be as coordinated.
Including the importance of skin to skin as a preference in your birth plan will reduce the risk of being unnecessarily separated from your baby.
Skin to skin time is important for both mother and baby
Key Factor #5: Unexpected or Emergency Situations
What is the APGAR Score?
Dr Robyn Thompson encourages women to understand the Apgar Score and to include in their plan plan, that they would like to be informed of their baby’s Apgar score. The APGAR score is based on a test, 1 minute following birth to assess the health and well-being of your newborn baby. The test is repeated again at 5 minutes to ensure that your baby is continuing to progress well.
An APGAR score of 7 or more is considered a healthy baby without any need for assistance, such as suctioning of airways to help with breathing. The reason why it's so important that you are informed of your baby's APGAR Score is because if your baby's APGAR Score is 7 or above, your baby belongs in your arms. Your baby should not be taken from unnecessarily.
Birth plans don't always go as planned
Dr Robyn Thompson encourages women to avoid unnecessary medical intervention wherever possible. However, it's important to be aware that, as things change or unexpected things occur, a reasonable discussion may take place, where the woman or her partner or advocate may be required to make an informed decision.
As we've mentioned earlier, it's important to acknowledge that things don't always as planned. But by being prepared and well informed with a birth plan, you'll be in a better position to reduce the risk of common complications experienced by so many women.
Preparing for the unexpected
If you find that you are separated from your baby for an urgent or emergency procedure, it's important to be prepared to know what you can do to reduce the risk of complications with breastfeeding. Dr Robyn Thompson informs women to simulate what the baby would be doing under normal circumstances so that your baby can receive your colostrum. This process reduces the risk of nipple trauma, breast engorgement mastitis and will help you get breastfeeding off to a good start.
Where can I find the best birth plan template?
There are number of free birth plan examples or sample birth plan, with birth plan questions and suggestions for you to choose from. When choosing your birth plan template, it's important to consider what's most important to you, so that key considerations are not omitted. Remember, this is your birth plan, designed to help you achieve the most natural and gentle birth experience for you and your baby. There may be some things you will need to further discuss with hospital staff, but remember, it's your body, it's your baby and it's your birth and breastfeeding experience.
Read stories below from real women who created their own unique birth plan using Dr Robyn Thompson's gentle birth plan template for her signature Thompson Method Breastfeeding Program...
"I was able to have a strong birth plan that the hospital and my OB followed so perfectly, and then three golden hours where she latched and fed for most of the time."
"We welcomed our sweet baby girl, Claire Addison on Tuesday and have done so well so far! I just wanted to say a huge thank you to this group. I was able to have a strong birth plan that the hospital and my OB followed so perfectly, and then three golden hours where she latched and fed for most of the time. I started to have a little pain but watched the videos about fine tuning and large breasts. They helped SO MUCH! Propping a rolled blanket under each breast while feeding has been a game changer during these cluster feeds. Again, thank you so much!
"I never would have gotten through such a smooth Labor and delivery as I did if it weren’t for my detailed prepared birth plan and being so well Informed."
"I have to say a massive thank you to Dr Robyn Thompson, The Thompson Method and the lovely Admins of our group 💕. Today is not only my birthday but marks 9 months strong of breastfeeding my one and only little love 💖. Thanks to finding this group when I was around 35 weeks pregnant we have been going strong since day one. I’m so grateful for the bond that we share 💝. The first few days are hard,even when everything goes according to plan like it did for me but every day it gets easier and before you can blink it’s second nature. I never would have gotten through such a smooth Labor and delivery as I did if it weren’t for my detailed prepared birth plan and being so well Informed. The Nurses at the hospital were so impressed by what I knew and asked me if I was a nurse 😂. So here’s to Dr Robyn and hopes that one day every women will be able to have such a smooth transition from birth to breastfeeding. There’s no end in sight to our breastfeeding journey 💖💝❤️💜💗💓"
"Preparation is the key to successful and pain-free breastfeeding."
"Dear Dr.Robyn and the team, Thank you thank you thank you!!!!
On Sunday we have celebrated 7 months birthday of my little boy but also 7 months of EBF journey! I would NEVER think that I would breastfeed at ALL, never mind this long. All I've heard about breastfeeding before, was how it hurts, how stressful it is, Mastitis and lumps in boobs...etc. I would like to encourage all ladies who are currently pregnant, don't underestimate the preparation! I'm so happy I enrolled into Breastfeeding course and studied before baby arrived . After he was born I would have zero time to even breath. Thanks to this course videos and amazing support group, I could prepare my birth plan considering so crucial Golden hour, i could asked the right questions to the medical stuff and demand my rights. Preparation is the key to successful and pain-free breastfeeding. If I could do it, you can also:) reward is priceless-bonding several times a day with my baby, look in his eyes when he feeds and falling in love over and over again knowing he is getting the best I can give him. So, thank you Dr. Robyn for all your experience and hard work, thanks to admins for being there 24/7 and answering my questions by return. Without you I would never manage To get this far."
"...when I arrived at the hospital I had a great midwife who listened to me, read my birth plan and went out of her way to follow it as closely as she could. "
"I wanted to say a big thank you to Dr Robyn & team for this amazing course and for the gentle birth & breastfeeding plan template. Without it I wouldn't have had the confidence to go into hospital and outline my wishes for the birth. I was told at the last minute that there was no chance of a home birth for me and I would need to be induced and there was no other option. I was extremely nervous & upset about being induced without my husband. Luckily when I arrived at the hospital I had a great midwife who listened to me, read my birth plan and went out of her way to follow it as closely as she could. I had a sweep, ARM, gas & air and gave birth in the pool. I managed to get one golden hour with no interruptions and a great first feed (it would have been more but I had complications). Thank you for helping me begin my breastfeeding journey! x