How to Handle Cesarean in Your Birth Plan

A birth plan isn't really a "plan" in the traditional sense, but it's a tool that helps you prepare in advance of your birth. Writing a birth plan also allows you to open discussions with your care provider and birth support team during prenatal appointments. Think of your birth plan as a list of "preferences." It's impossible to plan a physiological (naturally occurring and unpredictable) event like birth any more than you can plan how and when tulips will bloom in the spring.

The process of creating a birth plan is an important part of your educational, mental, and emotional preparation. Below, we share with you language to include in your birth plan for how you would like to avoid a cesarean as well as language for being supported and cared for in the event that a cesarean becomes necessary. For the latter, it's extremely important to discuss with your care provider as early as possible as these "family friendly" cesarean preferences are routinely in use only in some hospitals across the United States. But those hospitals are finding that including the changes in procedure make a world of difference for parents and babies, and they are relatively simple to implement. The more people demand family-centered cesarean, the more we will see it becoming standard!

Preferences for avoiding a cesarean:

• I plan to let my labor begin on its own
• I would like to be monitored intermittently, unless there is a solid medical reason for continuous monitoring
• I plan to move and change positions as desired
• I would like my birth partner and doula to be present at all times
• I plan to eat and drink as desired
• I plan to use as many non-drug comfort measures as possible before considering an epidural
• Please don't ask me if I would like an epidural -- I will let you know
• I plan to push in positions other than on my back

Preferences should a cesarean be necessary:

• I plan to have two support persons in the OR
• I would like to keep one hand free during and after birth
• Please lower the curtain when my baby is born so I can see my baby
• I would like to have my baby skin to skin in the OR
• I would like to initiate breastfeeding/chestfeeding in the OR or immediately after surgery in post-op
• I would like for there to be no separation of birthing parent (or partner) and baby

The above are just a few of what is available during and after a cesarean. Ultimately, what is important is up to you. A birth plan should include your most important desires, and should always be discussed during a prenatal appointment, well in advance of birth. If your care provider or place of birth isn't on board, you can consider seeking an alternative provider if that choice is available to you.

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