When it comes to planning your home birth, one of the most important things you can do is create a detailed, researched, and thoughtful birth plan.
Now I want to say right off the bat, I hesitate to use the term “birth plan”. My own midwife exclusively uses the term “birth wishes” because it’s impossible to know how your unique labor and birth will progress.
So call it what you want. But today, you’ll learn how to create the ultimate birth plan for your home birth. A birth plan that will include a plan for every scenario, not just your ideal.
We’ll be sure you get a chance to highlight all those birth wishes, but also ensure you’ve got a solid plan for logistics and what to do if things go awry.
Your perfect birth plan for your home birth should include:
- Details about your birth location and type
- Contact info and details about when to call your midwife, doula, and photographer
- Logistics to plan for childcare and/or pets
- Pain management techniques for labor
- Preference on cervical checks during labor
- Wishes for the actual birth like who will catch baby, cut the cord, etc.
- Newborn care procedure desires
- Special requests for the first hours after birth
- Emergency plan for hospital transfer(s)
While this is what your home birth plan should include at a glance, there’s so much to unpack within each of those bullet points up there! Take a deep breath. We’ll walk you through it step-by-step and you’ll feel confident and relaxed knowing you’ve thought through every detail prior to your big day.
1. Home birth logistics for your birth plan
Contact Info for Birth Team and Other Important People
You’ll want to compile all of the important contact information for your birth team, childcare, pet care, and any other people that need to know when labor begins. It’s also a good idea to make a note of when each person should be contacted.
For example, your midwife and birth photographer might want a “heads up” phone call right when labor begins, and then a “go-time” phone call once you’re at a certain point in your labor. On the other hand, your child and pet care providers will need to be called right away to arrive to help before things really get going.
Having all of this information organized in one place is going to make your (or your partner’s if they’re doing the phone calls…) life so much easier!
People whose contact info you may want to include:
- Midwife
- Doula
- Birth Photographer
- Childcare Provider
- Pet Care Provider
- Friends or Family you plan to have at the birth
- Friends or Family you want to give birth updates to
Last minute items or errands to remember
In this first section of your birth plan, I also recommend including lists of last minute items, errands, or chores that need to be done. Early labor, if you can’t sleep, can actually be a good time to get some things done. When strategizing your coping strategies throughout labor, remember that early labor is a time for sleep or distraction.
What better distraction than some errands, baking, or last-minute tidying around the house?
And if you CAN sleep during your early labor, these lists will be nice and organized for your partner to complete, or to delegate to a loved one. For example, my mom handled a grocery store run for us where she stocked our fridge with fresh fruit, deli salads, cheeses, etc. for after birth.
Some examples of “last minute lists” you may want to include:
- Perishable items to stock the fridge
- Cleaning or tidying you’d like done around the house
- Errands you’d like to complete
- Recipes for baking or a crock pot you’d like to do during your early labor
2. Labor wishes for your home birth
Once the planning and contact info part of your birth plan is complete, it’s time to get into the details of the big event. Remember that your birth “plan” is a road map for you, your partner, and birthing team of things you’d like to try and honor.
Planning all of these small details out ahead of time will help you know your options, and allow you to better visualize your home birth before it happens.
Birthing location and type of birth you are planning
First and foremost is the how and where of your birth. If you are planning a land birth, where do you want to give birth? Many women choose their bedrooms/beds. If you are planning a water birth, note the location of the birth pool and water access point for filling if it might not be intuitive.
This is important to have noted at the beginning of your birth plan because your birthing team can make sure you are well positioned for the birth you desire when the time comes. They’ll know at what point you should definitely hop in that tub for a water birth, or when it’s time to move to the bedroom because pushing is imminent.
General atmosphere
Next, I want you to think about the atmosphere you’d like to maintain during your labor. When considering this you should reflect on your own personality.
For example, are you the kind of person who thrives on the energy of others, responds well to music to pump you up, and wants lots of cheering?
Or maybe you are very private and would prefer nature sounds or silence during your home birth? This is the beauty of home birth; you get to decide on this!
What to consider and make note of in your home birth plan regarding atmosphere:
- Preferred lighting source
- Preferred music, soundscapes, etc.
- Aromatherapy candles or essential oil blends you plan to diffuse
- Presence of birth team throughout the labor (do you prefer them to be more hands off, or present and encouraging throughout)
- Types of affirmations you do (or don’t) want
- Temperature control (windows cracked, AC, heat, etc.)
Pain management strategies
One of the huge benefits to your home birth will be your ability to move and listen to your body’s desire when it comes to laboring positions. You will have access to your entire home and whatever supplies you’ve gathered to help with your labor process.
Before your birth, you may want to learn specific strategies to help with a natural birth. You may also want to take childbirth class or practice hypnobirthing techniques leading up to the birth to use during labor.
It’s a good idea to list any and all techniques and props you’re open to using during your labor and birth. And ones you definitely don’t want to try. I know that I was mentally stuck during my labor, so having a list of things I wanted to try was really helpful for my husband. He could consult the list in the birth plan and suggest a change of scenery or new strategy.
Here’s a list of pain management/labor strategies to help get you going:
- Massage/counter-pressure
- Laboring in the shower
- Laboring in the bathtub
- Use of a birthing ball
- Yoga positions (squatting, cat/cow, whatever feels good!)
- Using a yoga block or yoga mat
- Birthing stool
- Laboring on the toilet
- Use of pillows for side-lying and other restful labor positions
- Heat therapy in the form of a hot water bottle or heating pad
- HypnoBirthing strategies
- Orgasmic birth
- Bradley Method
- Breathing exercises
- Essential oils (list of the best blends for your labor)
- Aromatherapy candles
- Movement like walking, stair climbing, lunging
- Dancing
Check out the article, Must-Know Positions for Laboring During your Home Birth for more ideas!
Care preferences
During your home birth, you will likely have a lot of say in how hands on your home birth midwife will be. Your entire birth plan should be discussed with your midwife, but this section especially.
She may require, or highly prefer, a certain standard of care when it comes to fetal monitoring, cervical checks, etc. Or she may not! But before you get your heart set on one way or the other, find out what her norm and comfort level is.
Types of care preferences to discuss with your midwife and make note of on your birth plan:
- Cervical Checks
- Fetal Monitoring (Doppler vs. Fetoscope)
- Monitoring birthing Momma’s Vitals
- Other specific variables in my birth (GBS, VBAC)
3. Pushing and birth wishes for your home birth
Once you’ve reached 10cm your body will naturally have the urge to push. Now, some of this section will or will not apply depending on if you are planning a land or water birth.
Here we’ll discuss some of the pushing preferences you should think through prior to the big day, and decisions about the umbilical cord and placenta.
Pushing Preferences
Preferences for pushing is another section to discuss at length with your midwife. She may have a stance on things like perineal support or massage. She might also feel strongly one way or the other on coached pushing, breathing, etc. Get her to weigh in on these decisions before you make your final choices.
Things to consider for when it comes time to push:
- Do I want perineal support and/or massage?
- Midwife counting or “coached” pushing
- Reminders to breathe
- Verbal encouragement while pushing
- To be left to follow my own pushing urges
- To use a mirror to watch the baby for motivation
- To have pushing positions suggested (or not)
Catching the baby
It’s best to decide ahead of time who will be catching the baby. Some women support and catch their own baby during a home birth. In other cases, your partner may want to do the honors. It’s also totally okay if you both feel more comfortable having the midwife handle this job.
In addition to deciding who will catch the baby, decide who will be announcing the baby’s sex if you are waiting until birth to find out. Maybe you want to see for yourself, your husband can’t wait to yell it out, or again, you’d prefer the midwife’s expert voice to handle this big moment 😉
Umbilical Cord
Delayed cord clamping
Delayed cord clamping is typically considered standard care for most midwives and home birth. Delayed cord clamping is the practice of waiting a length of time before clamping the umbilical cord from the placenta.
The benefit of this is that it allows the maximum amount of blood to transfer from the placenta to baby. This can increase baby’s blood volume by as much as 1/3! (source) Additionally, it can decrease the risk of iron deficiency.
The World Health Organization recommends an optimal 1-3-minute delay when practicing delayed cord clamping. But some mothers and practitioners opt to wait until the cord stops visibly pumping.
Cord blood banking
During a home birth, you will not be able to donate cord blood, however, you can collect cord blood to store in a family bank if you’d like to. In order to do this, you will need to contact a private company prior to birth and they will provide you with a cord blood collection kit. Then, the cord blood will need to be collected by a sterile blood draw. (source) This is something your midwife can probably help facilitate.
If you decide to do cord blood banking, be sure to discuss this with your home birth midwife to make sure she is comfortable with and aware of your plan.
Lotus birth
Lotus birth is where the umbilical cord is not cut from the placenta until it naturally detaches. This can take anywhere from 3-10 days. In a lotus birth, the placenta is kept connected to baby and usually held in a bowl or basket.
Lotus birth is not well researched, and generally not advised due to the risk of infection. However, if you are curious, discuss this with your midwife and learn more about exactly how to execute this practice safely. Perceived benefits are a gentler transition into the world for baby.
Preferences regarding the placenta
This section of your birth plan is also the perfect place to mention your plans for the placenta. Some mothers might opt to ingest their placenta or find another way to honor this amazing organ. Alternatively, you can note that you’d like it disposed of.
Our article, 8 Things to Do with Your Placenta After Birth, has lots of ideas about how to celebrate your placenta and a discussion of placenta encapsulation and ingestion safety.
4. Preferences for immediately after birth
After birth, there are still some decisions you’ll want to think through and plan for ahead of time. Here we’ll look at the first hours after birth, your postpartum care, and newborn care decisions.
“The Golden Hour”
The golden hour is a term for the immediate and uninterrupted skin-to-skin bonding between mom and baby after birth. Keep in mind that this time will begin immediately, but until the placenta is delivered it will be necessary for your midwife to standby.
However, you can request her to be silent and hands-off. You can also request that once the placenta is birthed and things are stable that you have privacy with your partner and newborn.
Just a few benefits of this special time after birth include:
- Baby’s heart rate and temperature are stabilized
- Promotes mother to baby attachment
- Allow for baby-initiation of first feed
- Linked to a higher likelihood of exclusive breastfeeding
- Boosts baby’s immune system
- Breastfeeding in the first hour reduces baby’s risk for infant mortality by 33% (source)
Treating possible tearing
You’ll want to find out what to expect if you experience tearing after birth. Most home birth midwives are equipped to suture minor tears. However, in extreme circumstances, there is the possibility of needing your tear repaired in a hospital.
Find out from your midwife what would require this and how it might impact other immediate after-birth plans.
Newborn care procedures at your home birth
Just like tear treatment, your midwife will also be equipped to perform many of the standard newborn care procedures. During your home birth, you will have control over when these happen and how delayed they are.
Here are the “typical” newborn care procedures you’ll want to discuss and plan for:
- APGAR Testing
- Measuring baby’s weight and length
- Administration of eye drops
- Injection of Vitamin K
- PKU Testing (usually done in the first few days, discuss with pediatrician)
Head here for more information on newborn screenings and tests.
5. Planning for emergencies
Now that we’ve covered the plan for the home birth you desire, all the way from start to finish, let’s make a plan for the birth you don’t want. This might be one of the most important aspects of a home birth plan. Planning for emergencies will help streamline a hospital transfer and get everyone they help they need as quickly as possible.
First, you’ll want to understand the most common reasons that a hospital transfer would be necessary for mom (source).
Non-emergency reasons for transfer to a hospital, usually done by personal car:
- Meconium present in amniotic fluid
- Baby’s positioning (breech or sunny-side up)
- Slow or stalled progress in labor
- Issues with mom’s vitals (blood pressure or fever)
- Mom feeling the wish or need to go to the hospital for any reason
- 3rd or 4th degree tearing after birth
Emergency reason for hospital transfer, these would be done by ambulance:
- Excessive bleeding in mom during labor or after birth
- Cord prolapse, when the umbilical cord falls below baby. The midwife is trained to manually hold baby’s head off of cord internally, but would need an additional team of medical support to proceed
Common reasons baby would need a hospital transfer:
- Acute or ongoing issues with transitioning after birth
- Keep in mind that your midwife will be trained in newborn resuscitation, but in some cases your baby may need specialized care after resuscitation (source).
Things to consider in your emergency birth plan:
- All of the medical reasons for a hospital transfer
- Address of the nearest hospital
- Your midwife’s transfer rights at nearby hospitals
- If you midwife works directly with a specific OB/GYN or team
- How your partner will get to the hospital?
- Notifying loved ones of emergency situations or transfer
- Asking your midwife questions about her prior experience in emergency home birth situations and how she handled them
Take your time making all of these big decisions, momma
As you complete your birth plan, don’t expect to do it all in one sitting. Research your decisions and make notes of topics you want to discuss in detail with your midwife. Be sure to consult our library of Home Birth Articles for more information on many of the topics mentioned above.
Specifically, 102 Questions to Ask Your Midwife Before Your Home Birth, will be an invaluable resource to accompany this home birth planning guide.
Anything you’re including on your home birth plan that we forgot? Let us know below!
