A certified doula’s working birth plan

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In my course, I teach a different way of making birth plans.  These  birth plans allow for planning as well as flexibility.  It is also not just a list of things the mom wants, but a plan for both the doula and the mom to follow as they work together.  The plan includes assessing your clients needs, figuring out the goals, making a plan, deciding what needs to happen and then continuing to evaluate and change the plan as needed.  This method is also taught in our doula foundations course.

Here’s an example:

Assessment data(get this from your interview):

This is her first baby. She is very healthy and works out daily. No other medical complications. She is over 40, so her doctor was pushing induction a little bit. She really does not want to be induced. She switched to a midwife and they are willing to let her decide what is best for her while still providing her with current information regarding the risks. She would like to have a natural birth, but is worried that she may choose to have an epidural during labor. She would like to have her baby with her right afterwards and wants to make sure that no supplements are given. Her husband will be there to help support her.

 

Needs Identification:

Anxiety due to a new situation and not knowing what to expect. She also is worried that the pain will be too much.

Seeking knowledge regarding natural birth and comfort measures.

Seeking information on breastfeeding.

Seeking knowledge regarding induction.

Seeking knowledge regarding knowing when labor has started.

I am anticipating needing to make sure that her basic needs are met(sleep, food, drink) particularly if this is a long labor.

Goals:

  1. Have a natural birth.
  2. Feel empowered during birth.
  3. Make sure that baby is placed on stomach immediately after birth.
  4. Avoid an induction.

Doula Actions(this will happen before and during birth):

  1. Discuss signs of labor and the normal progression of labor.
  2. Discuss ways that she will be able to work through labor, and the role that both the doula and her husband will play in helping.
  3. Reassurance that she has the ability to birth her baby.
  4. Provide her with a list of birth affirmations to help her decrease her anxiety.
  5. Discuss what we will do if she starts asking for an epidural(try something different, work through one contraction at a time, make sure that she has adequate time to make that decision)
  6. Provide her with different birth stories to show how variable birth can be.
  7. Discuss breastfeeding.
  8. Give video on breastfeeding.
  9. Give information regarding induction and risks associated with her age.
  10. Be prepared to provide reassurance during birth
  11. Be prepared to make sure basic needs are met.
  12. Make sure that the birth tub is available during birth.
  13. Make sure that she is able to have intermittent monitoring.
  14. Make sure the birth ball is available.

Evaluation(how did your actions affect your client? Where they helpful? Not helpful? If they were not helpful, go back to the beginning of the process and start a new plan):

I also encourage a more traditional birth plan to give to the medical personal.  It will look something like this.

I am planning on a natural birth.  I appreciate your help in achieving this goal.  I would like to use the birth tub and birth ball.  I would also like to have intermittent monitoring and a saline lock.  I plan on having my husband and doula with me.  Please discuss any interventions with me beforehand.  I would also appreciate it if you did not offer an epidural to me.  I will let you know if I want it.  Thank you for your support and help during my labor and birth.

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