In this post, I discussed the various reasons for creating a birth plan and provided an example of my birth plan that I wrote in case I was transferred to the hospital during my homebirth. Check out that post if you are interested in a free downloadable birth plan checklist that only takes about 5 minutes to complete and that you can bring with you to the hospital. In this post I asked midwife, Maria Chowdbury to get into the details of creating a Homebirth Birth Plan.

birth ball doula

As a midwife, of course I love birth. Much of my job involves waiting and watching as birth unfolds. But I also love the process of anticipation that comes before birth. The way a woman prepares, expects, and dreams of birth is absolutely beautiful, and I am honored to be a part of it. The birth plan is a central part of this process. Over the years, I’ve helped hundreds of women write their homebirth birth plan, and one thing I notice about the women that felt good about their births (no matter how it unfolded) were realistically prepared for the intensity and reality of birth. They were not simply lucky. They actively prepared their mind, body, and partner for their birth. I’ve created some simple guidelines for you to consider as you plan and prepare for your homebirth.

Writing a Homebirth Birth Plan

Birth is an active process, so planning to give birth at home does not passively grant the birth you’re envisioning. The purpose of a written birth plan is to give your midwife, partner, and other support team members, as well as yourself, a clear picture of your informed choices and essentially what you are choosing to say, “yes” to or what you are choosing to say, “no” to. This confirms that you have gone over everything, and everyone is on the same page, so you can focus in on your birth experience.

What a Home Birth Plan is Not

A birth plan is not a script or set of rules. A birth plan does not hold any guarantees.

What a Birth Plan Is

A birth plan is the written reference point of your informed choices. It is meant to help reach your goals and have your preferences known, so when you are fully engaged in the birth process, you can focus on your breath and you feel confident knowing that your birth team remembers your desires for your birth.

When you are writing your home birth plan, ask yourself these questions:  

  • Who am I physically, emotionally, and spiritually?
  • What will bring me physical comfort?

Think about things like the lighting, music, pillows, yoga mat, birth balls, birth supplies, hot packs, ice chips, nourishment, showers, and water birth pools.

  • What will bring me comfort emotionally?  
  • Who is with me?  
  • What environment do I feel safe in?  
  • What do I need when I’m in pain?  
  • What helps me stay motivated to get through tough stuff?  
  • What words or affirmations will help me stay focused and engaged with the birth instead of trying to resist and escape it?

Spiritual Considerations

What will bring me comfort spiritually? Some people don’t specifically bring spirituality to their birth. For other people, their birth is a spiritual experience. I’m bringing this to the table because one of the main reasons I see women choosing homebirth, is so they can be themselves and express themselves through their births uninhibitedly.

Here are a few more practical questions to ask yourself

  • What are you going to eat in labor and after birth?  
  • What about your family and other children? Are they going to be at the birth?  If so, who is with them? If not, where do they go?
  • Do you want your partner to catch the baby and cut the cord?  
  • Do you want photographs?
  • What are you going to do with the placenta?

Sometimes, these preferences change during birth, but sometimes we simply forget. Having a written birth plan allows your support team to ask you, “You had planned on this specific thing—would you like to try that now?”

Considering Variables at a Homebirth

Even when you are planning a homebirth, it’s possible that the unexpected might happen and a hospital transfer could occur. It’s a good idea to know your midwife’s plan for transfers and what a hospital transport might be like. It’s important to include a hospital transport plan as an attachment to your homebirth birth plan.

Hospital Transport Plan

Transport plans are slightly different because they are more concise. Just know that if you are transporting, you will need some medical attention and your midwife can give you more specific details based on your local hospital policies. But as a general overview, think about things like who could be allowed in the room (include your midwife or doula on that list, by name, if you’d like them to come with you). Any allergies to medications, instructions for interventions such as an episiotomy or induction. If you’d like to be skin to skin with baby as soon as possible. You want your partner is with the baby at all times, etc.

Thinking about unexpected occurrences in terms of active participation can help to break down some of the fear of the unknown and turn worry into empowerment. I’ve included some examples in my homebirth birth plan template below.

Putting it All Together

All in all, a birth plan is a tool,  it should be relatively brief, clear, and easy to reference. Please go over it with your midwife at your home visit about a month before birth, so that you can ask each other questions and make any necessary adjustments, so you are all on the same page. You should have a copy of your birth plan in your chart, have a copy at home, and keep a copy in the car or your transport bag in case of transfer.

A homebirth birth plan is an essential component of an active and informed birth — one where the parents and the birth team work together to give the baby the best possible start in life. And at the end of the day, that’s what we’re all here for, anyway.

Homebirth Birth Plan Template

Remember this is a template, so you can choose which option is right for you. There will be several options that seem similar, so read carefully and find your best answer.  You want to customize and personalize your birth plan so that it realistically fits you and not you trying to fit your plan.

Name:
Expected Due Date:
Partner’s name:
Midwife team:
Doula:

In Early Labor I plan on

    •   Eating and drinking light foods
    •   Taking walks and stretching
    •   Resting
    •   Taking showers
    •   Doing light activities to keep my mind off the clock
    •   Making plans for the other children
    •   Calling and update my birth team
    •   Setting up my birth supplies

In Active Labor I’d prefer

      • Minimal cervical checks
      • Whatever cervical checks the care provider deems necessary
      • To be asked whenever a cervical check may be required
      • Intermittent fetal monitoring with a doppler
      • Intermittent fetal monitoring with a fetoscope
      • I am GBS positive and I agree to prophylaxis IV antibiotics at the start of labor and have made the appropriate arrangements (discuss in great detail with your midwife)
      • I am GBS positive and I DO NOT agree to prophylaxis IV antibiotics at the start of labor and have made the appropriate arrangements (discuss in great detail with your midwife)
      • To be left to just myself and my partner while coping
      • I would like lots of privacy and to be pretty much left alone except to  listen to the baby and monitor my vitals as minimal as possible
      • That there is minimal touching or talking while I’m in labor
      • I would like to hear words of encouragement and to be told where I am in labor
      • I would like to have my birth team surround me and help me
      • I would like recommendations for pain relief techniques, hot compresses, cool cloth for my face, herbs, breathing techniques
      • To be reminded to make low deep sounds
      • To be reminded to relax and breath the baby down
      • To be reminded to change positions (hands and knees, squatting, standing, sitting on the birth ball, left side lying, sitting on the toilet)
      • I want freedom of movement
      • I would like to take a shower
      • To labor in the water birth pool
      • A specific playlist to be on
      • I want it to be silent
      • I would like to be massaged
      • I would like essential oils to be diffused in the air
      • Low lights and minimal sound
      • To have only liquids during labor
      • To be encouraged and reminded to eat and drink during labor
      • I would like to drink herbal teas like Red Raspberry Leaf Nettle and honey in labor to help keep me nourished in labor.
      • I would like fruit and herbal popsicles to help keep my energy up
      • A photographer to take pictures
      • The following people are allowed to be present:
      • The following people not allowed to be present:

In Birth (Pushing) I’d prefer

      • To deliver in water
      • To deliver “on land”
      • To push instinctively, in my own way, in my own time
      • To be reminded to make low deep sounds
      • To be reminded to relax and breath the baby out
      • To be reminded to change positions (hands and knees, squatting, standing, classic etc.
      • I want to push on the birth stool
      • To be offered a mirror to see the baby crowning
      • To be helped and guided when I’m pushing if there is slow progress
      • My midwife to count when I push
      • My midwife to give perineal support
      • My midwife to give perineal massage
      • My midwife to NOT give perineal support or massage
      • To have photos taken of the pushing stage
      • To support/deliver/catch the baby myself
      • For my partner to support/deliver/catch the baby
      • To remain in the water until the placenta is delivered
      • To leave the cord attached until it stops pulsating
      • For my partner or child to cut the cord
      • To have a lotus birth (cord never cut, placenta preserved until the cord falls off)
      • To save my placenta for a smoothie or encapsulation, etc.
      • For all the newborn exams and procedures to happen with me
      • No mother baby separation
      • To take an herb bath with baby after delivery
      • To have the following high in protein meal after birth:

Newborn Decisions

I have discussed and know the risk and benefits of the following newborn informed choices and I’d prefer:

      •   Administer Erythromycin Eye Prophylaxis
      •   Do not administer Erythromycin Eye Prophylaxis
      •   Administer Vitamin K injection
      •   Administer Vitamin K drops orally
      •   Do not administer Vitamin K
      •   Yes you can apply the Pulse Ox to my baby during the newborn exam
      •   Please do not apply the Pulse Ox to my baby during the newborn exam
      •   I’m GBS positive and I will make an appointment with an MD
      •   Please perform the Newborn Metabolic Screen
      •  Please do NOT perform the Newborn Metabolic Screen

In Case of Hospital Transfer I’d prefer

Discuss this in great detail with your midwife

      • To keep my birth team with me
      • To have a photographer take photos
      • To keep the following people with me:
      • To be offered pain medication
      • That you do not offer pain medication unless I ask for it
      • To avoid pain medication in case of vaginal delivery
      • I agree to an IV of fluids
      • I agree to an Heplock
      • I agree to the use of Pitocin to augment my labor
      • To have continuous fetal monitoring
      • To have intermittent fetal monitoring if it is appropriate
      • To avoid episiotomy
      • To have a pressure episiotomy if one is required
      • To be upright during pushing phase
      • To allow the cord to stop pulsating before it is cut
      • To allow the cord to pulsate for at least 1 minute it is cut
      • To place baby skin to skin as soon as possible after birth

In Case of a Cesarean Birth I’d Prefer

      • To be awake
      • To have my partner with me during the birth
      • I understand if general anesthesia is needed my partner is unable to be with me.
      • To place baby skin to skin as soon as possible after birth
      • To allow the cord to stop pulsating before it is cut
      • That my partner stay with the baby at all times after birth
      • That someone is with me in recovery

Postpartum Newborn Decisions I’d Prefer

      •  To be informed of all procedures that are being performed on my newborn
      •  To have rooming in with my baby.
      •  To keep my baby with me until they have breastfed successfully on both sides
      •  To exclusively breastfeed, please no artificial nipples, formula or sugar water
      •   Administer Erythromycin Eye Prophylaxis
      •   Do not administer Erythromycin Eye Prophylaxis
      •   Administer Vitamin K injection
      •   Administer Vitamin K drops orally
      •   Do not administer Vitamin K
      •   Please perform the Newborn Metabolic Screen
      •   Please do not perform the Newborn Metabolic Screen
      •   To administer the Hep B Vaccine
      •   To not administer the Hep B Vaccine
      •   To circumcise my son
      •    Do not circumcise my son

Feel free to use this template to create your home birth plan that works for you.  It is my sincere hope that you have a beautiful birth experience that you feel good about in the end of the day.

This guest post was written by Maria Chowdhury. Maria is a midwife and herbalist based in Fayetteville, Arkansas. Her own herbal experience throughout pregnancy and breastfeeding motivated her to make custom remedies for her midwifery clients. It did not take long to see a pattern of remedies that clients needed again and again, and thus, Birth Song Botanicals was born in 2009 and continues to be a resource for mamas in all life stages.

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