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The Birth Preferences Grid

By Erin Erenberg 

You’ve probably heard of the birth plan. Setting intentions and visualizing what we want is a great way to set ourselves up for the results we want, in just about every experience we value. But the idea of a birth plan is a charged topic.

For one thing, healthcare providers who enter into a woman’s birth experience all come with their own ideas, goals, and background. Doctors are taught to value risk. They are calculating the risks for mother and child and are trained to eliminate risk as a whole. But a woman facing her own labor and delivery is having a more singular experience. Many times, she’s prepared mentally and physically for the birth that she wants and has an attachment to how the experience will unfold. We cannot pretend that a woman doesn’t have the right to become emotionally involved with her vision. But sometimes complications arise that keep a woman from the experience she’d hoped for, and that’s where the need for flexibility and a softer grip on that vision becomes important.

We wrote a “birth plan” for baby number one, a “birth vision” for baby number two, and then were introduced to the idea of a “birth preferences grid” by Erica Chidi Cohen and her book Nurture, just before baby number three. We found this tool to be a straightforward way to communicate an intention while providing the flexibility needed in case a woman’s vision is recast by the unexpected. Here’s our example. Maybe it will help you or a friend clarify and communicate your vision.

Be informed, be empowered, mama,

Erin 

Birth Preferences Grid

Name: Erin Erenberg
Partner: Victor
OB-GYN: Dr. Sara Klevens
Goal: unmedicated vaginal delivery if mom and baby are healthy; have had two unmedicated births at St. John’s (2012, 2014)

Starting Labor

Non-medical Induction Methods 

  • Acupuncture, chiropractic adjustment, squats etc.
  • We would like to avoid medical induction unless there is a risk to mother or baby

Pushing & Delivery

  • Spontaneous, with varied positions.
  • No "purple pushing" or encouraging mom to hold breath during pushing process.

Perineal Care 

  • Guided pushing and positioning, counter-pressure, massage with mineral oil
  • No episiotomy unless medically necessary

During Labor

Monitoring

  • Intermittent; want to be free to move about during labor
  • No IV or IV fluids unless medically necessary

Food & Drink 

  • Access to liquids/ice according to thirst

Newborn Care & Nursing

  • Delay cord clamping and cutting
  • Quick transfer to mother for skin to skin contact and breastfeeding for as long a possible
  • Allow/assist mother to breastfeed within two hours of delivery
  • No pacifier/bottle/formula unless requested
  • If mother is asleep for feeding, please wake her

Pain Relief

  • Breathing, movement, relaxation techniques
  • No epidural desired
  • Narcotics - do not offer; Tylenol only if requested after birth; allergic to Advil; bad past experience with narcotics (Vicodin) after first birth

Placenta

  • Please save for encapsulation

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