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Sample natural birth plan with minimal medical intervention

Keep it short.

Doctors and nurses are busy and do not have time to read an entire page (or two) of your natural birth plan preferences.  Keep in mind that most likely things will go in an unpredictable manner so look at this list as your “list of preferences”.  Get a doula.  GET A DOULA!  I cannot stress that enough.  It does not matter what kind of birth you are planning to do, natural or epidural as soon as you get into that room…  A doula is your advocate that knows your birth plan and is there for you.  The WHOLE time.  Doctors, nurses and midwives are barely there.  A doctor often comes in when you are already pushing.  Nurses and midwifes check on you every 30 minutes and the rest of the time you are on your own.  Your husband and other supportive family members may or may not be as comforting as you expect.  Often times it is difficult for them to watch you in pain and they may panic.  A Douala will bring piece, and an organized atmosphere.

See all of the products mentioned in this article

Here is my natural birth plan for reference.

  • No medical/chemical interventions unless life threatening or approved by me.
  • Prefer no IV.
  • Wireless baby monitor only if necessary.  No internal fetal monitoring please.
  • Minimum vaginal exams – no students please.
  • No urinary catheter even if epidural is administered.
  • No episiotomy unless risk of urethral or clitoral tear.
  • No stripping of membranes (manual breaking of water).
  • If Cesarean, I would like to be fully conscious and father and doula to be present.  Double-layer stitching only; please no single-layer stitching.
    • If Cesarean, place sterile gauze in my vagina preferably at least 1 hour before the birth and swipe baby’s mouth, face and skin with that gauze when baby is born.
    • If Cesarean is emergency, place gauze in my vagina as soon and for as long as possible and swipe baby’s mouth, face and skin within 2 minutes of birth.
  • Deliver placenta unassisted.
  • Please save placenta, I would like to encapsulate it.
  • NO Pitocin after birth.

Baby

  • Delayed Cord Clamping – please have Father cut cord after it stops pulsating.
  • Immediate skin to skin contact with baby.
  • Father to accompany baby if he/she needs to leave the room for any reason.
  • No eye ointment.
  • Oral Vitamin K.  NO injections please.
  • No Hep B.
  • Any baby evaluation to be approved/done while I hold the baby.
  • Room-in at all times – no nursery time.
  • No First bath.
  • No circumcision (if applies).

BIRTH PLAN

Lets elaborate:

Prefer no IV. – They will usually insist on installing the peripheral venous catheter and not hook you up to anything so you can move around freely. That is fine, being hooked up to an IV will leave you in bed and not able to walk around.  Physical activity speeds things up, so move around, take a stroll…

Wireless baby monitor only if necessary.  No internal fetal monitoring please. – No monitor is best.  And I really do not love the ‘wireless’ part but it is better than “A tiny electrode is inserted through your vagina onto your baby’s scalp and a catheter is placed in your uterus or an external pressure gauge is strapped to your abdomen to measure the strength of your contractions.” (source)  Radiofrequency (wireless) EMF is dangerous as it is, read my post on it here, and especially near/on a newborn’s head.

Minimum vaginal exams – no students please. – Vaginal exams are really not necessary.  Your experienced doula will tell you when you are approaching second stage of labor.  Frequent exams increase a risk of introducing unneeded pathogenic bacteria into your vagina.

No (urinary) catheter even if epidural is administered. – When I was in labor with my son (with epidural) and with my daughter (no epidural) I was not offered a catheter.  I did need to urinate for them to make sure I am OK after labor.  They bring a bed pan and it takes a bit of concentration and silence but it is doable.

No episiotomy unless risk of urethral or clitoral tear.   Self-explanatory…  Instead ask for a perineum massage during labor to avoid tearing.

No stripping of membranes (manual breaking of water). – There is absolutely no reason for this at all.  Babies are born in amniotic sacs all the time.

 If Cesarean, I would like to be fully conscious and father to be present.  Double-layer stitching only; please no single-layer stitching. – “A recent
evaluation in Montreal covering 1990-2000 found a five-fold increase in uterine rupture associated with single-layer versus the traditional double-layer method. …  Single-layer suturing could have a particularly large impact on the rate of uterine rupture among those women induced or give augmentation during labor.” (read more here)

  • If Cesarean, place sterile gauze in my vagina preferably at least 1 hour before the birth and swipe baby’s mouth, face and skin with that gauze when baby is born. 
  • If Cesarean is emergency, place gauze in my vagina as soon and for as long as possible and swipe baby’s mouth, face and skin within 2 minutes of birth. 
    • – These two are certainly ‘different’, but please consider being ‘different’.  Read this article, but to summarize… “Previous research has shown a correlation (though not causation) between people who were born via C-section and an increased risk of obesity, asthma, allergies and autism.  One reason might be is that babies who are born via C-section do not pass through the mother’s birth canal and do not get exposed to the healthy microbes living there” … “In the new work, Knight and his colleagues found that the microbiome of infants birthed vaginally were enriched with Lactobacillus and Bacteroides, two species of bacteria that are abundant in the maternal vagina and have been shown to teach an infant’s immune system how to recognize and not attack other species of helpful bacteria.” … “After sequencing the DNA of the different communities of microbes found on and in the babies, the researchers found that the microbiota of C-section babies swiped with vaginal fluid were more similar to vaginally birthed infants than to those who were delivered by C-section and not swiped.”

 Deliver placenta unassisted.  – It really should not be ‘yanked’ out as it often is.  It needs time to separate and be ‘birthed’.

 Please save placenta, I would like to encapsulate it. – I chose to encapsulate but ended up not taking it.  I am still on the fence.  Some swear by it, some don’t.  I had an oversupply of breastmilk and I read it really boosts your supply.  In addition, a personal note – placenta is a ‘cleaning’ organ, so in theory (mine), it may contain the toxins it did not allow to get to the baby..?  I don’t know.  But many, many women report very positive changes when they take their encapsulated placenta pills.

 NO Pitocin after birth. – Apparently this is standard practice and is done without asking you, the mother, the patient.  There is IV Pitocin and there is a similar drug in pill format.  The pill or pills are put into your rectum (yes your butt even though you just pushed a human out).  I have not done much research but it seemed the pills were a better alternative.

*A note – if you plan on having an unmediated child birth (no epidural), in case of emergency C section you will need to go under full anesthesia.  If they do put in a catheter in your spine and do not use epidural, in case of an emergency C section, you will be under partial anesthesia.  Personally I would still opt for no catheter in the spine.

Baby

Delayed Cord Clamping.  – please have Father cut cord after it stops pulsating.  – This takes a couple of minutes.

Immediate skin to skin contact with baby. – Ask for baby to be put on your chest.  If you cannot due to Cesarean, let father hold baby skin to skin.

Father to accompany baby if she needs to leave the room for any reason. – Room in with your baby.  No need for the nursery or your child to leave your room for any reason.  And when they take him/her for a hearing test or the like, have dad follow.  And ask for them to do the test in a place where dad can see everything.

No eye ointment. – unless you have an STD.

Oral Vitamin K.  NO injections please. – here are the details, brands and doses; according to published research, oral dose is not only just as effective, but is more effective for late onset VRKB.

No Hep B. – many many articles on this.  Including this one from PubMed 

Any baby evaluation to be approved/done while I hold the baby. – or at least in a full unobstructed view.

Room-in at all times – no nursery time.

No First bath. – that white stuff, vernix, is so good for your baby.  It acts as a shield and protects your baby from all kinds of bacteria.  In fact, rub it in!  You’ll give your baby first bath when you get home.  A bath using gentle, non toxic soap, not the junk they use in hospitals.

No circumcision (if applies). – I realize it is a very personal decision.  Get your facts straight and make an informed decision.  Remember, it cannot be undone so do the research prior.

 

Miscellaneous notes

Request a room with tub or a shower.  Laboring in water can take the edge off the contractions pain.

Move, move, move.  Take a walk, or change positions often.

Take advantage of gravity, sit, stand, squat etc…  When my labor was stalling, I was advised to get on my hands and knees (kind of like a dog/cat); it made me go from 2cm to 6cm within 30 min.

When baby is born, ask for at least one hour to be left undisturbed so you may bond with your baby and your partner.

Encourage breastfeeding, try to get the baby to latch or ask doula/nurse to help.

Schedule an appointment with a good lactation consultant.  Sometimes it takes a few to get good advice.  First lactation consultant to see us did not even look in my daughters mouth.  Breastfeeding was excruciatingly painful.  This was my second child after all, I knew what I was doing yet it was so painful.  We got lucky and at the next shift another lactation consultant checked for tongue and lip ties.  My daughter had both.  Join a breastfeeding support group, see several professionals…

Vaccines…

SO much conflicting information out there.  To be truly confident in your decision, consider reading this book.  Do not blindly do what your doctor told you.  Sometimes they just do not know.  My firstborn suffered a vaccine injury because I did not know the risks.  Unfortunately most begin their research once they experience an injury…  To make a truly informed decision, please, read the Dissolving Illusions book.  If you decide to proceed with vaccination, at least you have made an educated decision.  Additional reading:

 

On a lighter note, I read SO many pregnancy and childcare books.  They are all very similar, however this one is really an eye opener and is certainly ‘different’.  It is worth a read.

And this one is a keeper too.  The breathing exercises definitely took the edge off during labor contractions.

My number one advice stands.  Get a doula.  And prepare to enjoy your labor and birth of your child.  No matter what it will be like.  It is the most beautiful, empowering event I ever had the honor of experiencing.

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10 Comments

  • Reply Jessica October 27, 2016 at 9:43 pm

    I am impressed. have been looking for a truly natural birth plan for weeks, read multiple plans and made my own. thought i had it all figured out. I had no idea about pitocin being standard practice or that oral vitamin k is just as safe. thanks!

  • Reply Summer October 31, 2016 at 2:54 pm

    well I guess I am hiring a doula

  • Reply Juliana November 3, 2016 at 7:28 pm

    Another great read. The most detailed natural birth plan I have seen. Some really good points, thanks for going into detail and explaining.

  • Reply Mia Porter November 7, 2016 at 9:09 pm

    Glad I found this.. I know I want a natural birth, but without knowing what actually happens during birth and all the possible interventions, it is hard to know exactly “what” I wanted… This really clarified it! I feel I am much better prepared.

  • Reply Celina November 7, 2016 at 9:11 pm

    I literally JUST read something about how C Section babies do not get the bacteria that vaginally born babies do. Makes total sense to “colonize”! Awesome info! I am definitely including it in my birth plan

  • Reply Tracy Ellen November 16, 2016 at 4:44 pm

    This is perfect, my sister is expecting and although i had what i thought was a natural birth i wanted my sister’s to be even better. Some very good points.

  • Reply Bridget J November 22, 2016 at 3:34 am

    …and I actually thought my birth plan was natural. Pitocin after birth and they don’t even tell you?!

    Glad I found this guide. And thank you for explaining.

  • Reply Les December 2, 2016 at 5:12 am

    Exactly what I was looking for and more! So glad to have found a like minded mama. Great tips throughout by the way, I really enjoy your posts. Throwing away my baby monitor and dragging the crib into our room so we can hear the baby instead!

  • Reply Brittany February 18, 2017 at 5:05 am

    Thank you for this information! Can you also advise about wether to allow the Metabolic Screening/PKU blood test (heel prick) for disorders and Group B strep antibiotic during labor?

    • mm
      Reply Anele February 20, 2017 at 4:37 pm

      Hi Brittany,

      We did the heel prick, I felt it could provide us with potentially valuable information if there was a problem.

      The Strep B antibiotic is a tough one.. I was Group Strep B positive my first pregnancy and before I knew better, took a week of antibiotics at 13 weeks and then two IV doses during labor. My OB at the time said probiotics have not been researched in pregnant women, so naively, I sterilized my gut without any probiotic offset.. What my OB did not tell me or did not know, is that there are medical studies showing a connection of antibiotic exposure during pregnancy and eczema. In our case, I feel those antibiotics had a lot to do with our struggles.

      With my second child, I did lots of research and a blog post on the subject is in the works. Talk wit your midwife, but… As you may have read, Group Strep B comes and goes, in fact, according to some, there is a significant false negative risk with the 35-37 week test. In theory, there is a percentage of women who are a false negative, having a child with no complications. …Additionally, just because one is colonized and the child becomes colonized, does not mean that that child will develop the actual infection. Unfortunately I do not have the source, but I remember reading, that women that are colonized have antibodies to Group Strep B, so the child may or may not have those same antibodies from the mother.

      As a precautionary measure, with my second, I ate 2-3 minced cloves of garlic a day. Took Jarrow Formulas Fem Dophilus probiotic daily (Whole Foods), and eliminated all sugar. All sugar, nothing processed and nothing that becomes sugar in our bodies – grains, starches, and sweet fruit. In addition, I requested the sample for the GBS be taken only around the vaginal area, not the anus. With my second, I tested negative.

      There is also a Hibiclens wash that is available for pre-birth use. Your midwife and doula would probably be more qualified to advise on the topic. Several European studies showed that it is an effective treatment for Group Strep B. It will however kill the microbiome exposure that the baby needs during labor.

      If you do decide to use antibiotics, consider taking Klaire Labs ABx Support yourself and infant probiotic for your child. (google for practitioner code to buy directly from manufacturer).

      I hope this helps a little bit. Good luck!
      Anele

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