My Birth Plan a.k.a. My Birth Wishes

In my early stages of pregnancy, I kept hearing the term ‘birth plan’ from other moms and moms-to-be. Wait, there’s a plan??? I thought you were just meant to show up at the hospital when your water breaks, pop out the baby, and boom! All done!

I found out that a birth plan is a document that you write to inform your birthing team about YOUR preferences for your labor and delivery. There’s a reason why I typed ‘your’ in uppercase: because your birth plan should ideally reflect YOUR own personal choices. Every pregnancy is different and every woman is different, so while it’s okay to get inspiration from other women’s birth plans, you shouldn’t completely pattern your birth plan after someone else’s because what works for others might not work for you.

After much research and preparation and after six Sundays of attending Lamaze classes, I finally got to drafting my ‘Dream Birth Document.’ Dim lights and soft music? Yes, please! Episiotomy? I’ll pass! Push in any position that I want? I put that in there too!

On my next visit to my OB’s office, I printed out a copy and talked it over with her. And that’s when my Dream Birth Document became just that: a dream.

See, a birth plan is a list of YOUR preferences for labor and delivery, BUT if you’re giving birth in a hospital, you’re also confined to the protocols of your hospital and your doctor. Basically, it’s really an agreement between you, your doctor, and your hospital. For instance, I asked to skip the episiotomy, but my doctor said, “I can’t do that. Otherwise, it will sag.” (By ‘it,’ she meant my, uh, flower.) As for the dim lights and soft music and all those niceties, she said, “You can definitely have this IF you will be getting the Lamaze room, but not if you’re in the regular labor room.”

That’s another thing. If you get the Lamaze room (also known as the ‘birthing suite’), you have more control and more freedom. You can move around freely, labor and push in whatever position you wish, have your dim lights and soft music, and best of all, have your husband (or whoever your labor coach is) with you at all times. Unfortunately, you don’t get those perks in the regular labor room. You’re restricted to the hospital and doctor’s rules and regulations. Well, what do you expect, right? Getting a birthing suite is like flying first class with all that extra legroom, Wi-Fi, and fine dining options, while getting a labor room is like getting a basic economy fare — you have to make do with your cramped space and airline food served in a plastic container.

I really, really, really want Mike to be with me all throughout labor, but when we computed the costs, we found out that getting a birthing suite is just waaay beyond our budget. Just to give you an idea, here are the labor room rates in Cardinal Santos, where I’m giving birth:

Birthing suite – PHP 2,000 for the first 2 hours + PHP 500 for every succeeding hour
Regular labor room – Free for the first 8 hours per day + PHP 250 for every succeeding hour

Obviously, getting a regular labor room (especially if it will be a very long labor) is much more practical. And what if I get the birthing suite, only to end up getting an epidural (which is around PHP 20,000) or end up having a caesarean? Eek! I thought of all the things that we could still buy for the baby with all that money, and that convinced me to just suck it up and go through the process without Mike by my side. I figured it wouldn’t be so bad since based on experience, the doctors and nurses at Cardinal are all really nice and friendly. I’m sure they would take care of me and do whatever they can to ease my fears and worries. Besides, the regular labor rooms are not bad at all! They’re actually… do I dare say ‘cute’? Haha!

The Lamaze room / birthing suite at Cardinal Santos. You pay a price for the bigger space, the exclusivity, and the freedom!

One of the regular labor rooms at Cardinal Santos. It’s cozy and clean, and it has a TV. All labor rooms are adjacent to the others, but you still get your privacy because of the divisions. You don’t need to share a room with other laboring moms.

So anyway… back to my birth plan. Actually, it should really just be called ‘birth wishes’ instead of a birth plan, because as you know, plans don’t always happen the way you want them to! Calling it a ‘birth wish’ seems more… adjustable. After further discussion with my OB, I revised my birth plan and pared it down from 8 pages to 5. I know 5 pages sounds long, but really, it only seems long because of the icons.

I made a visual birth plan with icons on the side. You don’t have to do it this way. If you just want a simple text file, that’s perfectly fine! In fact, that’s how most women do it anyway. I just added visuals on mine because I feel this will be more digestible. So here’s my birth plan, plus my comments on each section! (Click each photo to enlarge)

For my request for ‘a limited number of people entering and exiting the room,’ my OB said that this is okay IF I will be getting the birthing suite. Even if I’m not, I put it here anyway.
Taking photos (with no flash) is allowed in my hospital of choice. Strictly no videos though!

When people find out that I attended Lamaze classes, their usual question is: “So are you having a natural birth?” or “You’re not getting an epidural?” Well, my answer is in this document: I specifically said that I will TRY MY BEST. This means that I will hold off on the pain meds for as long as I can BUT if I really cannot take the agony anymore, I’m going to just go out and say “Give me the drugs!!!” No pressure! See, I have commitment issues. Haha!
Apparently, I can move around freely during labor. However, once the epidural is administered, I have to be hooked to some machine already. (Sorry, I forgot if it was a machine or an IV)

So this is the part that makes me sad: not having Mike around while I labor. No one to give me back rubs when the pain gets intense. No one to talk me out of the drugs. Oh well. Note that husbands are generally not allowed to stay in the labor room the whole time (unless your OB okays it, that is). If you’re lucky, maybe he can visit. One of my friends who gave birth said that her husband was allowed to visit for 15 minutes per day. Others that I’ve spoken to said that their husbands were not even allowed to visit at all! Again, it depends on your doctor and the labor room situation. If the labor room is too busy, visits might be kept to a minimum. I guess, in a way, that could be a good thing. My yoga classmate said that she was actually relieved not to have her husband there because she might have been so clingy and needy if he was there to ‘baby’ her. Being by herself gave her no choice but to toughen up.

Pretty self-explanatory, I guess.

For my request to have the IE done by one and the same person, note that I said “if possible.” Doctors and nurses have their own shifts, so the doctor and nurse that attend to me for the first few hours might be different from the ones that will see me for the succeeding hours. Again, I put it here just in case but I will definitely understand if this is not strictly followed.
Food and drinks are not allowed in the labor room, so I can only eat and drink if I’m in my room and only during the early part of labor. Oh boy, I’m going to be so hungry and thirsty after!

Check with your hospital if husbands are allowed in the delivery room! My OB practices in Cardinal Santos and Delgado Hospital (where I was born 33 years ago!). I was actually considering the latter since it’s cheaper, but Delgado does not allow husbands inside the delivery room, and that was a non-negotiable for us. In Cardinal, he will be called when it’s time for the baby to come out.

Apparently, you can’t push for too long. The maximum time to push would be 1.5 hours.
I don’t really know why, but your pushing positions are limited when you avail yourself of just the regular labor room vs. the birthing suite. It doesn’t make sense, but yeah, okay, whatever. Just get the baby out.
As much as possible, I don’t want the baby to be taken out using forceps. My OB said she doesn’t use forceps and uses vacuum extraction instead if needed.

As mentioned earlier, I originally put “No Episiotomy” in my birth plan. Since my Doctor said that she needs to perform an episiotomy, I just said okay, but requested that to have a small cut only if possible (‘if possible’ are the magic words here). I trust my Doctor, and I know that she knows what she’s doing, so I’ll leave this up to her. It’s going to hurt like hell after (I might cry when I pee!), but I know of so many women who have had this done and they turned out fine. I also read somewhere that my Doctor is good at stitching episiotomy cuts.

I’m hoping and praying for a normal delivery, but I’m also realistic and know that things may take a sudden turn and I could end up having a C-section, so I included this in my birth plan.
There are two kinds of cuts for the C-section: the classical cut and the bikini cut. I chose the latter because the healing time is faster and less painful. Also, it’s more hidden, so you can still wear crop tops and low-rise jeans after! (#priorities). Also, if you are having another baby and plan to have a VBAC (Vaginal Birth After Caesarean), a bikini cut is more advisable.

These are all pretty standard procedures that my hospital already practices, but I just included them anyway. To me, the most important is the immediate skin-to-skin contact.
Delaying the cutting of the cord has some health benefits for the baby, so there’s really no harm in doing this.
Frankly, I don’t care much about saving my placenta and bringing it home with me. (I think it looks gross, to be honest!) But Mike is so curious after learning from our childbirth class teacher that I can actually eat it! Eww!!! Apparently, this also has nutritional benefits. Also, I Googled “what you can do with your placenta,” and I was surprised that you can make stuff out of it… like shirts and jewelry! Haha!

The last few sections of the birth plan is more for the Pediatrician. Obviously, the items under ‘Newborn Procedures’ and ‘Breastfeeding’ have massive pros for the baby’s health.

There it is, my ‘Birth Wishes’! I haven’t given birth yet, but if you are asking for my advice on this, here’s what I can tell you:

Make it concise.

I always write long blog posts, long captions, long letters, etc. But with the birth plan, I had to be as concise as possible, because frankly, who has time to read a bloody novel when you’re in the labor room or delivery room? Not the nurses and doctors, for sure.

Manage expectations.

As with my case, I had a long list of wants for my birth plan, only to be told “nope, not possible!” unless I get the more expensive birthing suite. Since we only have a limited budget, and hence, can only go for a regular labor room, I had to manage my expectations and let go of some of the things I originally wanted. You can’t be choosy, unless you’re willing to cough up more money!

Be flexible.

Even if it’s called a ‘birth plan,’ things don’t always go according to plan. Anything can happen. Be prepared to throw your ‘plans’ out the window if the situation calls for it, especially if it means saving your baby. Don’t get too attached to your ‘dream birth.’ I think, more than anything, my ‘dream birth’ would be one where I get to finally see and hold my baby, who is alive and well, regardless of how I gave birth to her.

Trust your birth team.

They are in that profession for a reason. They studied and trained for this. Trust that they know their sh*t and that they will do what they can to keep you and the baby safe and healthy.

Don’t compare your birth with others’

As cheesy and cliché as it may sound, every birth is beautiful and special (unless of course it was really traumatic and you were disrespected and violated in any way, then I’ll probably use a different adjective for that). Just focus on YOUR goal, do what you can, and be kind to yourself. I think THAT is the best birth plan!