It’s said that “life is what happens to us while we are making other plans.” And if we’re being honest, this applies to a birth plan too. Life will happen. The fine details about when and how you give birth are often unpredictable.
But we can have goals.
As you put together your birth plan and map out your and your partner's preferences, you may find that you learn a lot about birthing in the process. This is a good thing. What you learn as you lean into a birth plan will empower you to make choices that you can feel confident in.
Tiny Health’s Birth Plan begins with your microbiome and the microbes you may share with your baby during delivery and postpartum.
From there, whether you give birth in a hospital or at home, we make suggestions to optimize the transfer of beneficial bacteria from a mom to her baby. Because how you give birth impacts what microbes your baby’s gut will first be colonized by - a process known as microbiome seeding at birth.
Your baby’s gut health starts with you.
Gut-friendly birth plan checklist
We’ve put together a list of things that you may want to consider as part of your birth plan or “birth wishes” during labor and birth, and immediately after birth.
Remember that as long as labor is progressing well and there are no medical contraindications, the choice is ultimately yours.
This means that a big part of your labor and birth preparation can focus on preparing for a smooth labor. Tools and tips, like those offered through Spinning Babies Parent Class, can help get your baby into position and reduce the pain of childbirth. Other options include classes from Dr. Nicole Rankins, Lamaze, Birthing From Within, or Childbirth and Postpartum Association.
Regardless of what method you choose, during childbirth classes you will learn many of the things you can do to prepare yourself for labor.
During labor and birth
- Spontaneous labor. Birth typically does not follow a calendar. Your body will tell you when your baby is ready to be born. And, with the okay from your medical provider, this often means the best outcome for you and your baby. In other words, fewer interventions and a greater likelihood for a vaginal, medication-free birth .
- Free movement: walk, rock and move. One of the most beneficial ways to cope with labor is movement. Walking, rocking, or moving during contractions, and changing positions between contractions, can all help you deal with the pain and keep your labor progressing .
- Natural water rupture. You may want to talk to your medical provider in advance about allowing your labor to progress on its own timetable and giving your body the time it needs. There is a slightly increased risk of C-section when breaking the bag of waters is done for induction and before active labor begins .
- Membrane sweep. Membrane sweeping is a physical method of labor induction. Medical interventions during labor, such as membrane sweep, may increase the risk of infection to mom and baby, and interfere with early microbiome seeding . You may want to wait for spontaneous labor unless your medical provider has suggested that induction will protect the health of your baby. Even with a membrane sweep, there are ways to keep labor as natural as possible.
- Pitocin. Pitocin is a synthetic form of oxytocin, the hormone that helps the uterus contract during labor. Many women have more intense contractions with Pitocin compared to natural contractions. Also, if too much Pitocin is given, the contractions can be too frequent and not allow mom or baby to rest. This may cause fetal distress since contractions are artificially regulated and this, in turn, can lead to an emergency C-section . If possible, you may want to use Pitocin only when absolutely necessary.
- Fetal monitoring. Fetal monitoring can be done electronically (continuous, external or internally), or use a stethoscope or fetoscope (intermittent, externally). Since internal monitoring requires rupture of the bag of waters, this may increase the chances of infection, and the chance of a C-section or vaginal birth with forceps , . Check with your provider and see if they’re comfortable with monitoring your baby’s heart rate and the strength of your contractions externally and intermittently.
- Limited vaginal exams. Current WHO guidelines recommend that vaginal exams are offered at intervals of not less than 4h and only when justifiably necessary. Multiple vaginal examinations during labor can be a risk factor for maternal or baby infection . When receiving a vaginal exam, double-check with your provider that it’s medically necessary. Also, be sure your provider asks for your consent before a vaginal exam is to be performed.
- Pain medication. Almost any medication given during birth, including painkillers like epidural, has the potential to cross the placenta and reach the baby . If you’d like to avoid pain medication, you can explore natural pain relief options like breathing techniques and relaxation, a TENS machine, massage, having your partner as a birthing coach (the Bradley Method), water submersion, or complementary therapies such as acupuncture and reflexology. In some cases, you may require pain relief to support a healthy labor and delivery, so be sure to check in with your medical provider.
- Nitrous oxide. Nitrous oxide or “gas and air” is a pain relief method that is delivered through a face mask. It’s relatively easy to use and requires no special safety equipment (hence can be used in homebirths), and can be started very quickly, providing pain relief within a minute. Nitrous oxide doesn’t appear to alter the outcomes of labor compared to other interventions or have an effect on the length of labor . Also, nitrous oxide does not cross the placenta .
- Forceps delivery or vacuum extraction. When medically necessary, the use of forceps and vacuum extraction can be life-saving. That said, forceps and vacuum extraction can also increase the risk of infection to a mom and her baby while also interfering with early microbiome seeding . To reduce the risk of these interventions, keep a close watch on your baby's position as you inch closer to your due date.
- Labor position. There are a variety of laboring positions you can choose from. For instance, being upright or squatting when it's time to push allows the pelvis to open and can allow gravity to assist you in your labor , . You may want to explore different birthing positions or consider working with a doula who can help you find a position that works best for you and your baby.
- Delayed cord clamping. The WHO recommends that the umbilical cord, which links your placenta to the baby, is clamped at least 1-5 minutes after you give birth. This allows the blood from the placenta to continue being transferred to the baby even after they are born, which helps with their growth and development.
- Immediate skin-to-skin. If you can, cuddle your baby close to your bare chest and start sharing those beneficial microbes as soon as possible. Skin-to-skin contact between a parent and their baby helps parents to quickly get acquainted with their baby's cues, making them more responsive. It’s also a fabulous way to help regulate your baby’s body temperature, keep your baby content, and promote a breastfeeding relationship . If you're not in a position to have your baby placed on your chest, you may want your partner to hold your baby instead for immediate skin-to-skin contact.
- Delay exams for bonding. First impressions are important. The first hour or so after birth when mom has uninterrupted skin-to-skin contact with her baby is often called the “golden hour”. Placing your baby naked in your bare chest immediately after birth (if possible) has numerous benefits . Skin-to-skin contact within 24 hours of giving birth - and especially in the first hour or so - has been shown to improve the quality of breastfeeding your baby . Making eye contact will also help nurture your feeding relationship. If there are no complications at birth, you may want to request that any newborn procedures be done while the baby is on your chest to prioritize bonding or to delay them until after the sensitive period immediately after birth.
- Breastfeeding within the first hour. If it’s an option, seek out support to help you breastfeed immediately after birth, even if you just had a C-section. Breastmilk contains HMOs, which feed the beneficial gut bacteria that help your baby thrive. Beyond HMOs, breastmilk has other benefits like supporting your baby’s immune development, protecting against infection, and reducing the risk of sudden infant death syndrome (SIDS). A mom also benefits from breastfeeding, as it has been found to decrease the risk of postpartum depression.
- Formula feeding. Formula feeding can cause significant changes in your baby’s microbiome. For instance, babies that are formula-fed have a higher diversity and an accelerated microbiome maturation compared to babies that are exclusively breastfed. This is because formulas lack all the valuable contents of breastmilk - HMOs, beneficial bacteria, and antibodies - all of which are essential players in your baby’s developing immune system.
- Pacifiers. Introducing a pacifier too early could get in the way of your baby’s ability to latch on and breastfeed. This is why the American Academy of Pediatrics recommends that parents begin introducing pacifiers after breastfeeding is well established. Generally, this means after 3 to 4 weeks of age, if you decide to use a pacifier. You can read more about the pros and cons of pacifier use here.
- Antibiotic eye ointment. If you tested negative for gonorrhea and chlamydia, which is now a routine test during pregnancy, the application of antibiotic eye ointment (erythromycin) at birth may not be necessary for your newborn. The application of the eye ointment can potentially interfere with the “golden hour”.
- Baby bath. There are many benefits to delaying the bath of your newborn until both you and baby are ready . Babies are born with a natural skin protectant called vernix, which has immune properties , . After delivery, a variety of microbes will colonize the skin of your baby and early bathing may interfere with seeding. Therefore, delayed bathing right after birth may be an important step in the transition of the newborn to the outside world.