Sample Birth Plan Letter

Dear Dr. Caring,

We were so thrown by the news about our baby that we are still a little confused and dazed. I know you talked about a pregnancy plan, but I have to be honest that I was not absorbing much. I hope that by writing down some of my questions I can take good notes at our next visit and get a better idea of what to expect.

The following are my questions/concerns:

Is my birthing facility an appropriate hospital at which to give birth, i.e. high level NICU if needed, etc.? If they can not meet emergency medical needs, what is the procedure for getting my baby proper care?
What are the specific risks to the baby in terms of causes of miscarriage, stillbirth, or other problems? What can we do prenatally or at birth to help protect my child?
Is there a higher risk of problems at birth that may not be predictable by ultrasound? What steps should be taken in the hospital after birth to detect and treat these issues? Will a cardiologist come in to do an echocardiogram?
Is there a greater chance of premature or early labor? How should this risk alter pregnancy treatment or birth plans?

I also would like to put on paper my desires for the birth experience and get your opinions about whether or not these are realistic expectations:

I understand many prenatally diagnosed moms have an early, induced birth. Is this something we will be doing? What are the medical reasons for early delivery/ induction for a DS pregnancy?
I would like to try to have the baby via natural vaginal birth and hopefully without an epidural. Is there anything that may interfere with those desires (specifically with regard to Down syndrome)?
I would like to have skin-to-skin contact and try to begin nursing the baby as soon as she is born. We would like to avoid any separation from the baby. I know there is a possibility of intervention after the baby’s birth, but I would like all medical personnel to be aware of my wishes so that they will make every effort to meet them short of endangering the baby. Is it absolutely necessary for the baby to go to the NICU?

I would like a warm, supportive atmosphere for the birth of my baby. Please advise all medical personnel that I am well aware that my child has Down syndrome. Please instruct them not to say “I’m sorry” or “bad news” or any other negative phrases that could potentially tarnish this experience. I can feel myself moving from a point of emotional turmoil to excited anticipation of my baby’s arrival. I do not want anyone to ruin my first few days with my child by making comments that seem pitying or by stepping on eggshells around us. Let us know of any complications kindly and gently, but please remember to congratulate us on the birth of our beautiful baby.

Thank you so much for your time, expertise and especially your patience with this concerned patient!


Expectant Mom