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A birth plan is an outline of the mother’s preferences and expectations for her birth. As her birth advocate, it’s important that you are well-aware of her birth plan beforehand so you can communicate her needs to nurses or midwives when the time comes. Meet up with the mother and bring a pen/paper or laptop to record her preferences so there are no misunderstandings. Here is a sample printable birth plan that you can fill out, or use as a guide during your conversation: https://www.babycenter.com/ims/Content/my_birth_plan.pdf In order to effectively advocate during childbirth, you must be aware of what the mother expects you to do. This will vary based on the location of the birth and her individual preferences. Ask whether you will be the only guest during delivery and what she specifically would like you to do. Some women might like you to provide comfort services, such as calming massages or encouragement during delivery. Others may want your role to involve only communication with medical staff. One of your primary responsibilities as a birth advocate is to help the mother defend her decisions regarding pain medication. Have a clear idea of what her stance is, but also be flexible and understanding if complications arise and it is necessary.  If she has firmly decided in advance that she does not want to use medication, inform the medical staff of her decision in advance and again once she is admitted for delivery. If she is in considerable pain and seems to want to change her decision about medication, ask whether she would like to consider it or if she would like to continue with her goal of a medication-free birth. Ultimately, she always has the final say. Support her decision either way. Medical staff often asks repeatedly about pain management and are willing to accommodate requests at many points during delivery. There is often a point during delivery after which staff cannot perform an epidural, however. This may be the appropriate time to convey a single offer of pain medication during delivery if the mother previously decided against it; otherwise do not bother her with repeated offers. There are a variety of positions that can work for the different phases of labor, and it’s worth looking into what would be the most comfortable for the mother. You can even practice some of these positions with her beforehand to get a sense of what she likes. Some examples include being on her hands and knees, sitting, lying on her side, or squatting. The hospital or birthing center staff will need to be able to monitor the baby’s heartbeat to make sure that it’s normal and healthy. However, sometimes there are different ways to go about this, and it’s good to know what the mother would prefer. Typically, the baby’s heartbeat will be monitored externally using a belt tied around the mother’s belly for the first 20-30 minutes after the mother is admitted to a hospital. There are alternatives to external monitoring:  Internal monitoring involves placing an electrode on the part of the fetus closest to the cervix. Wireless external monitoring: Instead of a belt, some hospitals have technology that will monitor the fetus wirelessly and allow the mother to move around during labor. Many recent health findings suggest that immediate cord clamping isn’t recommended unless the baby is having trouble breathing. Delayed cord clamping allows more blood to transfer from the placenta to the baby, which can be especially helpful for early preterm infants. Even during deliveries that a mother intended to be entirely natural, certain circumstances may require medical intervention or surgery. Cesarean birth (sometimes called a C-section) is the most common form of surgical delivery, and it comes with its own set of risks and complications.  If the mother has expressed in advance a decision to avoid intervention if possible, inform medical staff of this choice upon admission to the birth unit and ask that they discuss potential interventions with you prior to mentioning it to her, particularly if the intervention is purely optional. If an intervention becomes necessary for the health or life of the mother or her baby, it is your responsibility to convey the severity of the situation to the mother and allow her to make a decision in line with her values. Once she has decided, defend her choice to the medical staff and offer continual support and encouragement to the mother, especially if she had to accept intervention when she had not desired or anticipated it. Ask if the mother wants to hold her baby right away after birth so you can communicate this wish to health care providers. Immediate skin-to-skin contact between mother and baby after birth has been shown to have a number of physiological benefits, including easing breastfeeding and decreasing stress hormones in the baby.  If the baby is healthy and does not need immediate medical attention, hospital procedures can delay measuring and weighing of the baby for up to an hour after birth. If the mother will be delivering in an institutional setting but would like to breastfeed her baby, part of your role as a birth advocate is to inform nursing staff of the mother’s decision and request that the baby be allowed to stay with the mother as much as possible to facilitate breastfeeding. Childbirth is a highly personal experience and every woman may have unique expectations, desires, and opinions surrounding her upcoming labor. Do your best to understand and support her decisions. For example, if the mother wants to try to have a completely natural birth, you can ask her about her reasons for wanting to do this, but ultimately be supportive of her decision.

Summary:
Schedule a meeting with the mother to talk about her birth plan. Ask about her preferences for your role. Discuss her opinion on medication. Talk to her about different positions for giving birth. Get a sense of her preferences for fetal monitoring. Ask if she wants to delay clamping of the umbilical cord. Get her opinion on medical or surgical intervention. Talk to her about immediate skin-to-skin contact with her baby. Ask the mother about her breastfeeding decisions. Listen carefully and non-judgmentally.