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Writing a Family-Centered Cesarean Birth Plan: A Menu Guide

Writing a Family-Centered Cesarean Birth Plan: A Menu Guide

Things to Specify About Your Birth Plan

Family-centered cesarean is an emerging trend in cesarean birth, which sometimes goes by the names “gentle cesarean” or “natural cesarean.”  It’s an effort to make cesarean birth more respectful of families’ emotional and physical needs, and elements of it are catching on in many hospitals.

Whether you’re expecting a planned cesarean or want a backup plan you’re comfortable with, it’s worth exploring how family-centered cesarean might fit into your plans.

In the past, we posted a podcast interview on family-centered cesarean, and thought we’d share some ideas for how to write a birth plan which reflects these ideas.

MENU OPTIONS FOR YOUR BIRTH PLAN

Below is a sort of menu, with statements you may or may not want to include in your birth plan.  Pick and choose what sounds good to you!

Introductory statement: 

“I respectfully request the following procedures during my planned cesarean birth/should a cesarean be necessary, assuming that my baby and I are healthy at the time of delivery and are not experiencing any unforeseen complications.”

  • “I would like my (choose more than one if desired) partner/other support person/doula present in the OR during the birth.”
  • “I would like to have music of my choice playing during the operation (if not an emergency cesarean).”
  • “I would like my partner/other support person/doula to be able to take pictures and/or video during the birth.”
  • “I would request that the talk in the operating room among my providers focus primarily on the birth, and not traffic, sports, weekend plans, etc.  Please remember that I can hear what is being said during the birth, and will carry memories of it for many years.”
  • “I do not want my arms strapped down during the operation.”
  • “I would like the IV catheter, oximeter, and blood pressure cuff all placed on my (non-dominant) arm to give me a completely free arm to touch my baby.”
  • “I would like ECG leads to be placed on my back, to make my chest free for skin-to-skin contact.”
  • “I’d like a non-drowsy, anti-nausea med if possible (i.e. Zofran).”
  • “I do not want to have the surgical drape form a ‘tent’ over my head, making me feel trapped or isolated from other people and the birth.”
  • “I would like to use a mirror/have the drape lowered/use a clear surgical drape so that I can see my baby being born.”
  • “I would appreciate a warm blanket during surgery if possible.”
  • “I would like you to ask me ‘Are you ready to have your baby now?’ before operating.”
  • “Please explain the surgery to me as it happens.”
  • “I would like to have a slow delivery, with the intent of simulating the ‘vaginal squeeze’.”
  • “I would like for my partner/support person to be the one who announces the sex of the baby, even if I already know what it is.”
  • “If possible, please keep the umbilical cord long for my partner to cut while baby is in my arms.”
  • “I would like to see and touch the placenta and cord.”
  • “If possible I would like the cord to continue pulsing after the birth so that my baby may start breathing on his/her own while still attached to the placenta.”
  • “I would like the baby to go directly to my chest as quickly as possible.”
  • “I would like all newborn tests, measurements, and procedures performed with the baby on my chest, not in the warmer.”
  • “I would like to hold my baby skin-to-skin in the OR.  I may need help to do this.  If I am physically unable to hold my baby with support, I would like my partner/other support person to hold the baby.”
  • “Please don’t swaddle my baby or put a hat on him/her while he/she is skin-to-skin.  I’d like my baby to be able to move and I’d like to see him/her unobscured.  To keep us warm, once my baby is on my chest you can cover both of us with a warm blanket.”
  • “I would like to have the opportunity to breastfeed in the OR.  I may need help to do this.  If I am physically unable to hold my baby with support, I would like my partner/other support person to hold the baby.”
  • “Please do not give me sedatives after the birth. I want to remember my baby’s first day of life.”
  • “I would like to have minimal separation from my baby.  If the baby and I need to be separated for medical reasons, I would like my partner/other support person/doula to accompany our baby to the nursery.”
  • “I wish to delay my baby’s first bath until the second day of life so that I can get breastfeeding and bonding off to a good start.”
  • “I am willing to be up and walking as soon as possible.”
  • “I would like my catheter out early the morning after surgery.”
  • “I would like to eat and have the IV removed as soon as possible after surgery.”

Of course, not all providers and hospitals will be comfortable or even familiar with these modifications to the traditional cesarean birth.  So plan ahead if these things are important to you, and discuss these ideas well in advance of your birth.

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