More and more women, preparing for childbirth, want to make a so-called “birth plan”. How can you plan something in such a process as the birth of a child? Indeed, it is almost impossible to do this, since no one knows exactly how the body of a woman and child will behave at a crucial moment. On the other hand, this is one of the most important days in your life! And, not surprisingly, many people want everything to go as smoothly and comfortably as possible! Therefore, when drawing up a “plan” for your birth, it is important to understand that this is more of a wish list, which will be a kind of cheat sheet for your doctor, midwife and accompanying persons. What is important to consider when compiling this list?

First of all, you need to understand what exactly is important to you during childbirth. To do this, you need to study psychophysiology in detail. birth process, learn about the basic needs of a woman and child during the birth process, get an idea of ​​the main types of medical interventions, and form your opinion regarding anesthesia. The ideal option for collecting information is to attend prenatal training courses, where they will not only give you knowledge, but also help you understand what points are important to you, and in addition, they will be able to advise you on choosing a maternity hospital and delivery team.

No less important question– whether to take a partner with you, and who exactly this partner will be – husband, mother, sister, friend or professional assistant (doula). Since some of the points in the birth plan may concern just this person. This question is very individual. Every woman has the right to uninterrupted support and care during childbirth, but not everyone needs it!

What might the plan itself look like? As a rule, it is divided into blocks according to the stages of labor. Each block contains several points that reflect the main wishes and important points for a woman.

Typically, such a plan begins with a greeting in which the woman writes her name and writes that this is her birth plan, which she hopes the medical staff will adhere to. The full names of accompanying persons can also be entered here.

Several points may relate to preliminary meetings, which, as a rule, are prescribed by doctors before childbirth. For example, a woman may indicate her reluctance to undergo vaginal examinations before starting labor activity. The deadline may also be specified here, after which hospitalization will be recommended if labor continues.

The next block may concern the reception area. This may include such things as the partner filling out all the documents, a wish to undergo or refuse a number of routine procedures (enema, shaving, examinations by the doctor on duty, CTG, changing into hospital clothes).

Next comes the plan for the first period. Most often, we are talking about the possibility of free behavior, dimming the lights, using aroma lamps and candles, listening to music, taking a shower or bath. Also, a wish may be stated regarding the frequency of CTG use and examinations. Sometimes, women ask for minimal contact with them, or for contact through a partner. In this case, expectations from the partner’s actions are prescribed. Requests for the use of anesthesia, amniotomy and other interventions are also written down here. I would like to note that when prescribing any wish, it is important to understand and note this in your plan, that you are aware of your responsibility, trust the competence of doctors and, if necessary, for medical reasons, you are ready to give your written consent to the manipulation that will be necessary.

The block concerning the second stage of labor includes, as a rule, points about the possibility of childbirth in any position convenient for the woman (vertically, on the side, on all fours, water birth). Separately, “instructions” for the partner may be prescribed. Requests to the midwife, as a rule, concern the use of techniques for preserving perineal tissue. For some women, it is important that they are guided to a minimum at this moment, and the pushing period is carried out gently, based on signals from the body (most often such wishes are found in multiparous women).

In the final part, you can write down your wishes for early contact with the child (when it is carried out, how long the child lies on the mother’s chest), pulsation and treatment of the umbilical cord, photo and video recording, examination of the child by a neotologist and basic manipulations with him (washing, vaccination , first breastfeeding, supplementary feeding). One of the points may concern the placenta, the method of its birth and further manipulations with it.

A very important block in the plan will be your wishes in case of complications - the use of a Caesarean section, the necessary resuscitation actions for you and the child. In this block, you can again write down the role of your partner, your wishes for supplementary feeding (for example, if it is necessary to provide supplementary feeding only from a syringe, spoon or pipette), the possibility of being near the child in case he needs medical care after birth.

The range of questions may be limitless, but it is important to understand that all our wishes should not contradict the legislation of the Russian Federation and the internal protocols of the maternity hospital.

PREGNANCY MANAGEMENT PLAN

1) prevention of fetal RDS (2 doses of betamethasone IM at 12 mg every 24 hours or 4 doses of dexamethasone IM at 6 mg at an interval of 12 hours; or 3 doses of dexamethasone IM at 8 mg every 8 hours)

2) prevention and treatment of chronic infection;

3) dynamics of blood pressure, blood pressure to detect gestosis;

4) prevention of premature birth;

5) delivery with increasing signs of intrauterine suffering of the fetus.

BIRTH MANAGEMENT PLAN

I period - cervical dilatation

1. In the prenatal room, clarify the medical history, conduct an additional examination, a detailed examination of the woman in labor, including external obstetric examinations.

2. Carefully monitor the condition of the woman in labor in the maternity ward. Find out your health and condition skin, listen to fetal heart sounds, calculate heart rate. measure blood pressure, pulse.

3. Delivery through natural means.

4. Controlled. HELL.

5. Observe the nature of labor, monitor the frequency, duration, strength and pain of contractions

6. Observe the condition of the fetus, listen to fetal heart sounds by auscultation every 15-20 minutes, when amniotic fluid is released every 10 minutes. If the heart rate is less than 110 and more than 106, check the CTG.

7. Monitor bowel movements and Bladder every 2 hours.

8. Thorough toileting of the external genitalia after each urination and defecation.

9. Eating easily digestible food.

10. When elevated level Blood pressure is above 160 mm Hg. perform an amniotomy.

11. When labor weakens, labor is enhanced with oxytocin.

12. If signs of heart failure appear, a cesarean section is performed.

II period - expulsion of the fetus

1. Follow up general condition women in labor.

2. Observe the nature of labor, monitor the frequency, duration, strength and pain of contractions.

3. Conducting an obstetric examination to determine the progress of the presenting part of the fetus along the birth canal.

4. Monitor the condition of the fetus (heart rate after each push)

5. Monitoring the condition of the external genitalia and the nature of vaginal discharge

6. Regulation of pushing

7. Reducing perineal tension.

8. Monitor the correct course of labor.

9. Control the biomechanism of labor in posterior occipital presentation:

The first moment is flexion of the fetal head. In the posterior view of the occipital presentation, the sagittal suture is installed synclitically in one of the oblique dimensions of the pelvis, in the left (first position) or in the right (second position), and the small fontanel is directed to the left and posteriorly, to the sacrum (first position) or to the right and posteriorly, to sacrum (second position). The head is bent in such a way that it passes through the plane of entry and wide part the pelvic cavity with its average oblique size (10.5 cm). The leading point is the point on the sagittal suture, located closer to the large fontanel.

The second point is the internal incorrect rotation of the head. An arrow-shaped suture of oblique or transverse dimensions makes a rotation of 45° or 90°, so that the small fontanelle is behind the sacrum, and the large one is in front of the womb. Internal rotation occurs when passing through the plane of the narrow part of the small pelvis and ends in the plane of the exit of the small pelvis, when the sagittal suture is installed in a straight dimension.

The third point is further (maximum) flexion of the head. When the head approaches the border of the scalp of the forehead (fixation point) under the lower edge of the pubic symphysis, it is fixed, and the head makes further maximum flexion, as a result of which its occiput is born to the suboccipital fossa.

The fourth point is extension of the head. A fulcrum point (anterior surface of the coccyx) and a fixation point (suboccipital fossa) were formed. Under the influence of labor forces, the fetal head extends, and first the forehead appears from under the womb, and then the face, facing the womb. Subsequently, the biomechanism of childbirth occurs in the same way as with the anterior view of the occipital presentation.

The fifth point is external rotation of the head, internal rotation of the shoulders. Due to the fact that an additional and very difficult moment is included in the biomechanism of labor in the posterior form of occipital presentation - maximum flexion of the head - the period of expulsion is prolonged. This requires additional work of the uterine and abdominal muscles. Soft fabrics The pelvic floor and perineum are subject to severe stretching and are often injured. Long labor and high blood pressure from the birth canal, which the head experiences when it is maximally flexed, often leads to asphyxia of the fetus, mainly due to the disruption of cerebral circulation.

10. Provide obstetric assistance during childbirth:

Obstetric benefits during childbirth are as follows:

1. Regulation of the advancement of the cutting head. For this purpose, while cutting in the head, standing to the right of the woman in labor, place left hand on the pubis of the woman in labor, use the end phalanges of four fingers to gently press on the head, bending it towards the perineum and restraining its rapid birth.

The right hand is positioned so that the palm is in the perineal area below the posterior commissure, and the thumb and four other fingers are located on the sides of the Boulevard Ring ( thumb- on the right labia majora, four - on the left labia majora). In the pauses between attempts, the so-called tissue borrowing is carried out: the tissue of the clitoris and labia minora, i.e., the less stretched tissues of the Boulevard Ring, are brought down towards the perineum, which is subjected to the greatest tension when the head erupts.

2. Removal of the head. After the birth of the occiput, the head, with the region of the suboccipital fossa (fixation point), fits under the lower edge of the symphysis pubis. From this time on, the woman in labor is prohibited from pushing and the head is brought out outside the pushing, thereby reducing the risk of perineal injury. The woman in labor is asked to place her hands on her chest and breathe deeply; rhythmic breathing helps overcome the strain.

With the right hand they continue to hold the perineum, and with the left they grab the fetal head and gradually, carefully unbending it, remove the perineal tissue from the head. In this way, the forehead, face and chin of the fetus are gradually born. The newborn head is facing backward, with the back of the head facing forward, towards the womb. If after birth the head is found to be entangled in the umbilical cord, carefully pull it up and remove it from the neck through the head. If the umbilical cord cannot be removed, it is crossed between Kocher forceps.

3. Liberation shoulder girdle. After the birth of the head, the shoulder girdle and the entire fetus are born within 1-2 attempts. During pushing, the shoulders rotate internally and the head rotates externally. The shoulders change from transverse to straight size of the pelvic outlet, while the head turns with its face towards the right or left thigh of the mother, opposite to the position of the fetus.

When the shoulders are erupting, the risk of injury to the perineum is almost the same as when the head is born, so it is necessary to very carefully protect the perineum at the moment the shoulders are born.

When cutting through the shoulders, they provide next help: the anterior shoulder fits under the lower edge of the symphysis pubis and becomes a fulcrum; after this, carefully remove the perineal tissue from the back shoulder.

4. Removal of the body. After birth, the shoulder girdle is carefully grasped with both hands chest fetus, introducing index fingers both hands in armpits, and lift the fetal body anteriorly. As a result, the body and legs of the fetus are born without difficulty. The born baby is placed on a sterile heated diaper, and the woman in labor is given a horizontal position.

11. After birth, the baby is placed on the mother’s stomach and 1 ml of oxytocin is administered intramuscularly.

12. Maintain sterility to prevent purulent-septic complications.

13. Prepare a table for the newborn, notify the neonatologist and resuscitation specialist about the birth of the child

14. Prepare a ventilator, electric suction, catheters

15. Perform the first toilet of a newborn

16. Assess the condition of the newborn using the Apgar scale

17. Assessment of blood loss during childbirth.

III period - successive

1. Active wait-and-see tactics

2. Monitoring the condition of the woman in labor

3. Definition of VSDM

4. Bladder catheterization

5. Estimation of acceptable blood loss

6. Signs of placental separation:

· Schroeder's sign: immediately after the birth of the fetus, the uterus is round and its fundus is at the level of the navel. If the placenta separates and descends into lower segment, the fundus of the uterus rises up and is located above and to the right of the navel, and the uterus takes on an hourglass shape.

· Alfeld's sign: a ligature placed on the umbilical cord at the genital slit of a woman in labor, when the placenta has separated, falls 8-10 cm and below the vulvar ring.

· Dovzhenko's sign: the woman in labor is asked to breathe deeply: if, when inhaling, the umbilical cord does not retract into the vagina, then the placenta has separated.

· Klein's sign: the woman in labor is asked to push; if the placenta has separated, the umbilical cord remains in place; if the placenta has not yet separated, then the umbilical cord is retracted into the vagina after pushing.

· Chukapov-Kustner sign: when pressing with the edge of the hand on the suprapubic area, when the placenta is separated, the uterus rises up, the umbilical cord does not retract into the vagina, but rather comes out even more.

· Mikulicz-Radicky sign: after detachment of the planet, the placenta may descend into the vagina, and the woman in labor may feel the urge to push.

· Hohenbichler's sign: when the placenta has not separated during uterine contractions, the umbilical cord hangs from the genital slit and may bleed into the veins

If there are positive signs of placental separation, the placenta is released on its own.

Biomechanism of placenta separation: after the birth of the fetus and the discharge of the posterior amniotic fluid, the volume of the uterus is greatly reduced and at the same time the internal surface of the uterus sharply decreases. As a result, a spatial discrepancy (displacement) of the areas of the uterus and placenta is created, since the tissues of the latter do not have the property of contraction inherent in muscle tissue.

When these ratios change, “folds” appear on the inner surface of the uterus at the location of the placenta, which gives impetus to the detachment of placental tissue. At the same time, intrauterine pressure also decreases sharply. This leads to the fact that the placenta gradually separates from the wall of the uterus, and then completely emerges from its cavity to the outside.

Detachment of the placenta is accompanied by a change in the contours (shape and standing height) of the uterus. The fundus of the uterus, which was located after the expulsion of the fetus at the level of the navel, after placental abruption rises higher with a simultaneous narrowing of the diameter of the uterus and the formation of a soft elevation above the symphysis (K. Schroeder’s sign), while the uterus changes its spherical shape to an ovoid one, its contours become clearer, and consistency - more dense.

Further in the process of blood clotting, which occurs in the placenta, which ceases to secrete the hormone into the uterus corpus luteum and thereby have a selective relaxing effect on the placental area of ​​the uterus. The own heaviness of the separated placenta, which pulls it down (out); as a result of the “sagging” of the placenta, irritation of the receptor apparatus of the uterus will inevitably increase; The resulting retroplacental hematoma in most cases is a consequence of the onset of placental abruption, and not its cause.

7. The placenta is examined: size, color, degenerative changes, examination of the umbilical cord for the presence of narrowing, true nodes, size.

8. Examination of the birth canal in a speculum, suturing ruptures.

period - early postpartum period.

1. Observe the general condition of the postpartum woman for 2 hours after birth

2. Monitor the newborn

3. Calculation of total blood loss

4. Identification and elimination possible complications in the postpartum period.

5. Strict compliance with sanitary and epidemiological requirements and personal hygiene rules.

clinical course of labor.

A multiparous woman was admitted, pushing, with regular contractions starting at 01:00. The bright amniotic fluid poured out at 01:55.

The condition is satisfactory, blood pressure is 120/70 mm Hg in both arms. In 10 minutes - 4 contractions of 35 seconds of a pushing nature. The position of the fetus is longitudinal, the head is present, and is embedded. The fetal heartbeat is 128-132 beats/min, clear. The amniotic fluid is light.

02:05 A live full-term hypotrophic girl was born, Apgar score 8-9 points.

Within 1 minute after birth, with the consent of the woman, 10 units of oxetocin were injected intramuscularly.

After controlled traction of the umbilical cord at 02:10, the placenta separated and came out on its own: without pathologies, dimensions 16x15x2 cm. All membranes. The uterus is contracted, dense, moderate bloody discharge. The birth canal is intact. The condition is satisfactory, blood pressure is 110470 mm Hg. Art., pulse 84 beats/min. The uterus is dense. Blood loss 250 ml.

Primary toileting of the newborn was carried out:

1. After the baby’s head passes through the birth canal, the baby is suctioned from the mouth and nasopharynx using a special device or a rubber bulb.

2. After this, they begin to process and ligate his umbilical cord. As soon as the baby is born, two Kocher clamps are placed on his umbilical cord, between which, after pre-treatment with alcohol or iodine, it is cut with scissors. After this, the Rogovin staple is applied and the umbilical cord is cut off. Then umbilical wound treated with a weak solution of potassium permanganate, after which a sterile bandage is applied to it.

3. Treat the baby’s skin, removing mucus and vernix from it with a special napkin soaked in vegetable oil. The groin, elbow and knee bends must be powdered with xeroform.

4. Prevention of gonoblenorea. To do this, 1% tetracycline ointment is placed behind the baby's lower eyelid.

5. Upon completion of the primary toilet procedure, proceed to anthropometry: measuring the weight, height and circumference of the newborn.

Postpartum period.

02:15 The condition is satisfactory. Blood pressure 100/60 mmHg, pulse 78 beats/min. The uterus is dense, the fundus is 2 cm below the navel. The discharge is bloody and moderate.

02:30 The condition is satisfactory. Blood pressure 100/60 mmHg, pulse 78 beats/min. The uterus is dense, the fundus is 2 cm below the navel. The discharge is bloody and moderate.

02:45 The condition is satisfactory. Blood pressure 100/60 mmHg, pulse 78 beats/min. The uterus is dense, the fundus is 2 cm below the navel. The discharge is bloody and moderate.

03:00 Condition is satisfactory. Blood pressure 100/60 mmHg, pulse 78 beats/min. The uterus is dense, the fundus is 2 cm below the navel. The discharge is bloody and moderate.

04:00 Condition is satisfactory. Blood pressure 100/60 mmHg, pulse 78 beats/min. The uterus is dense, the fundus is 2 cm below the navel. The discharge is bloody and moderate.

If you have already decided to give birth in a particular maternity hospital, have found a doctor whom you completely trust, but want your child to be born as naturally as possible, you should talk about this with the doctor in advance.

Of course, it is impossible to foresee everything - if any problems arise during the birth process, part of the plan (or even all) will have to be abandoned. However, if the health of yours and your child is not in danger, then a series of medical procedures remains at the discretion of the woman in labor and the obstetrician.

These points should be discussed with your doctor - here is an approximate list of such questions.

If you are determined to have the most natural childbirth possible, then:

• should be able to come to the maternity hospital with contractions - if, of course, you have the opportunity to get there within a reasonable time;

• during contractions you should be allowed to take a comfortable position, move freely, drink water;

• you should not have an amniotomy (opening of the amniotic sac), or have it only after the cervix is ​​almost completely dilated; it is desirable for the bubble to burst on its own;

• any work carried out on you must be agreed upon with you medical manipulations(unless we are talking about emergency actions), moreover, you should be aware of the indications for carrying them out, as well as the possible consequences;

• refuse to induce labor unless absolutely necessary;

• try to avoid epidural anesthesia - discomfort during natural childbirth there are, but they are quite tolerable;

• refuse episiotomy (surgical dissection of the perineum), in any case, it should not be planned;

• the umbilical cord should be clamped only after the end of the pulsation, the newborn should be on the mother’s stomach during this time;

• no later than half an hour later, the baby should be put to the breast and left with the mother for at least an hour;

• the newborn must stay with his mother around the clock;

• The baby should not be fed or given additional water - this is important condition for establishing breastfeeding;

• Vaccination of a child in the maternity hospital can only be carried out with your consent.

Why is it important to meet these particular conditions?

Drug induction of labor

During the natural course of labor, a woman has time to adapt to the gradually increasing pain, most moms describe them as “tolerable.” Oxytocin injections make contractions stronger and more frequent. Such artificial acceleration of labor not only forces the use of painkillers, but also increases the risk uterine bleeding. Moreover, the child may not be ready for such a high-speed birth - his lungs will not have time to prepare, which threatens him with asphyxia.

” Moscow neonatologist Tatyana Aleksandrovna Bachurina believes that additional portions of oxytocin in common system blood circulation of mother and child puts the baby in a state of stress, and even uses the term “children stressed by oxytocin.”

“These children have neurological symptoms, often in the form of hyperexcitability syndrome, and subsequently often neurotic reactions, emotional and behavioral disorders, difficulties in social adaptation“- she writes in her article on home birth.

Anesthesia

Indications for the use of painkillers and, especially, epidural anesthesia must be very serious - the pathological course of labor or the need caesarean section. Epidural anesthesia itself is a rather unsafe procedure - from 2 to 3.4% of maternal deaths (according to various sources) are due to complications from anesthesia. But even a procedure carried out without obvious violations can provoke postpartum depression in the mother, and in the child - complications during childbirth (oppression of the respiratory center).

Amniotomy

Piercing the amniotic sac is undesirable (at least up to 8-9 fingers), because it can involuntarily cause labor to be stimulated; if the anhydrous period after puncturing the bladder lasts longer than 12 hours, the doctor willy-nilly will have to decide which emergency measures resort to extract the child.

Amniotomy can fix which will lead to complications during childbirth (for example, facial presentation). To be fair, it should be noted that changing the presentation of a child whose head has already “stood” in birth canal, and it’s already very difficult, and an amniotomy performed at the wrong time can only aggravate the situation.

Piercing the bladder makes the birth itself more difficult. Blister pressing on the cervix with helps smooth and soft opening of the cervix.

” On the Internet you can find, for example, the results of a study conducted by specialists from the University of Liverpool (England), who studied the birth histories of 4,893 women and concluded that the group with amniotomy had a risk of having surgical intervention and the risk of having a low Apgar score was higher.

At the same time, amniotomy had virtually no effect on the duration of labor. Doctors considered that amniotomy could not be considered as standard procedure and should be prescribed only for strict medical indications.

Episiotomy

The Cochrane Collaboration is an international non-profit organization that studies the effectiveness of medical supplies and methods through randomized controlled trials, analyzed the birth histories of more than 5,000 women in 2009. The researchers concluded unequivocally that: “The policy of restricting the use of episiotomy appears to have a number of benefits...there are fewer posterior perineal injuries, fewer suturings and complications, no difference in most pain measurements and no difference in the incidence of severe injuries.” vagina and perineum. However, there is increased risk occurrence of injuries to the anterior part of the perineum."

Removing vernix

A baby wearing lubricant may not look as attractive, but during the first 24 hours it effectively protects the newborn's skin, allowing him to adapt to the new external environment.

Newborn eye treatment

A stage that most mothers simply do not pay attention to. Meanwhile, the need for this procedure is not obvious at all, not to mention the fact that in our maternity hospitals such potent agents as silver nitrate and sodium sulfacyl are still used. If the neonatologist considers that such treatment is necessary, be sure to ask what drug will be used; today, erythromycin phosphate can be considered the safest.

Tying the umbilical cord

” In five to seven minutes of pulsation of the umbilical cord after birth, the baby can “take away” 100-150 ml of blood from the placenta, which is not at all superfluous for him.

It is only important to ensure that the baby is below the level of the placenta (otherwise a backflow of blood is possible).

Early breastfeeding

Early breastfeeding (if possible, before clamping the umbilical cord) is not only an emotionally priceless moment of childbirth, a moment of very special closeness between mother and newborn, but an effective prevention of a number of pathologies - diathesis, dysbacteriosis, etc. allergic manifestations. The baby should stay at the breast for at least 15 minutes (preferably an hour). Even if he swallows just a little colostrum at this time, the intestines will still be inseminated with acidophilus bacillus. In addition, this is the first step towards strengthening the sucking reflex.

For the mother's body, the baby's first attempts to suckle at the breast are a kind of signal that everything went well, and you can start working on other tasks, for example, increasing lactation. Breast stimulation also increases uterine contractions, making it easier for the placenta to pass.

” The first skin-to-skin contact is similar in importance. This not only calms the baby, but also allows him to “get acquainted” with the microflora of the mother (preferably also the father).

Fortunately, today there are more and more maternity hospitals that are friendly to mother and child, where such desires of the mother in labor are not considered a whim and a whim, and even on the contrary - the mother is offered to put the baby to the breast and ensures that mother and child stay together from the first minutes of life. Choosing a maternity hospital and the doctor with whom you will find mutual language, and who will be sympathetic to your wishes - this is your first responsible maternal act. Don't miss the opportunity to do it!

Article updated 12/7/2014

Prepared based on material by Anastasia Gabetc,

perinatal psychologist at the School “Birth for Two”

A very important and exciting moment in the life of every expectant mother is childbirth. In order not to forget anything and not get confused at the most fussy moment, make a birth plan. In addition, it will help you tune in to the fact that the baby's arrival is close.

In this article, we will help expectant mothers create a birth plan and explain what mandatory items should be included in your plan.

Preparing for childbirth requires a special plan that will help you understand how you manage your birth, what your needs are, what you are afraid of, etc. With the help of a plan, you will be able to compare your needs with the possibilities maternity hospital, which you have selected. A birth plan can organize not only you, but also your family members.

So how and when should you make a birth plan?

If the pregnancy is progressing normally, you can safely start working on a birth plan at 6-7 months of pregnancy, or when you feel the need to sort everything out.

The birth plan must include all the procedures and things that you think need to be done at the birth of the child. Consider each point carefully, if the need arises, consult with a friend who has already given birth, and best of all, with a midwife or doctor.

Such a plan is very useful when labor begins, because it will not be easy to gather your thoughts at this moment, but every woman wants the birth to go as well as possible.

You shouldn't leave your birth plan in such a way that the obstetrician thinks her hands are tied. Remember that your plan will be considered in case of a normal birth, but if there are any complications, it will no longer be relevant.

What must-have items should you consider in your birth plan?

First, write all the necessary information about yourself, starting with your last name, first name and medical information - this is very important.
If you decide that someone will be present with you during the birth, be sure to enter the details of this person. Also, you can note at what stages of the birth this person will be present. Indicate all the nuances.

Write down the position you would like to take during the first and second stages of labor; you can discuss these positions in advance with your doctor and midwife. And if you also write down these positions, then no one will forget about your preferences.

Probably the most important point in your birth plan will be the point about medical intervention. Think about what you agree to and what you don't agree to. Write down why you would like to avoid certain procedures.

If you have special preferences, such as using alternative forms of care - massage, aromatherapy, bath or birthing pool, exercise ball - please indicate this as well.

Sometimes it is possible that interns will be present during childbirth; if you do not want to see them, you can safely refuse them. By the way, sometimes they are very useful as additional moral support, not only for you, but also for your birth partner.

If everything goes well, you can even prescribe a condition that the child’s father, for example, will cut the umbilical cord.

Everything you want to do after giving birth should also be included in your plan. Write what the baby should wear after he is bathed.

If you refuse vaccinations for your baby in the first days of his life, also write this down.

Take care of a special statement refusing vaccination - this is necessary for your wish to be fulfilled.

The plan you create will help the maternity hospital staff understand what you want and what you don’t want. It will become an assistant for you; a birth plan will help you focus on the process and not think that you might have forgotten something. This is additional peace of mind for you at such an important and exciting moment.