Birth Plans

A birth plan is a document that communicates prospective parents’ wishes and goals for before, during and after labour and delivery. It outlines how they'd ideally like labour and delivery to play out if all goes to plan.

Women using this template should not worry about not knowing all the answers. A birth plan is not meant to present a rigid set of expectations, as this is a set-up for disappointment when things don’t go according to plan. In fact, birth plans are not mandatory, and only a small percentage of women complete them. Some prospective parents will find the exercise of preparing a birth plan useful, as it may lead them to reflect on aspects of the labour they had not considered, and then discuss them with their OB.

Women who are in special circumstances (eg. history of trauma) and have concerns or requests that are out of the ordinary may wish to formally outline these in a written birth plan, in order to avoid having to bring these up repeatedly with their care providers when in labour.

Women delivering at BC Women’s can rest assured that they will be cared for by a very experienced team of providers and that when decisions are required, various options, including their pros and cons, will be presented. There are very few ‘routine’ procedures at BC Women’s, and every effort will be made to respect prospective parents’ wishes, when feasible.

CORD BLOOD BANKING

Currently, banked stems cells from umbilical cord blood are mainly being used to treat cancerous blood disorders, such as leukemia and lymphoma. There are many potential future uses for these stem cells, but they remain largely experimental.

There are two options for umbilical cord blood banking: public and private. If neither is chosen, the cord blood is simply discarded as medical waste.

The public option is an altruistic donation to the stem cell bank at Canadian Blood Services. BC Women’s is one of four collection sites in Canada. To donate, women can simply register online.

In the private option, the stems cells are stored for the exclusive use of the child/family. Prospective parents contact a company to purchase a cord blood collection kit that will be taken to the hospital for the medical team to collect the stem cells at the time of delivery. There is a one-time collection fee (approx. $1,000) and a yearly storage fee ($200-250), with pre-paid packages available. Cord tissue can also be stored. There are two main providers in the Vancouver area: Healthcord and Insception Lifebank.

Our OBs are strong advocates for the public cord blood bank.

Private cord banking is very expensive, and has one major limitation:

It’s extremely unlikely the stem cells will ever be used.
Studies estimate the probability of using one's own cord blood for autologous transplantation to be between 1 in 20,000 and 1 in 250,000.

Why?

1. The diseases currently being treated with stem cell transplants are rare.

2. If a child requires stem cell transplantation, cells from a healthy donor are often preferred, as the child’s cells may carry the same genetic or congenital disorder that caused the disease.

3. A typical unit of cord blood has enough stem cells for transplantation in a child of up to about 80lbs. For larger children or adults, additional units stored in public use banks are still needed.

Doulas

Doulas are labour support people. Their main duty is to provide a continuous source of comfort, encouragement and support (both emotional and physical) during labor. Unlike OBs or midwives, doulas do not have medical training — they are there to soothe, help with relaxation techniques and breathing exercises, offer advice on labor positions and more. Postpartum doulas can assist with newborn care and breastfeeding.

Any woman can hire a doula, but women hoping for an un-medicated labour, and women who may not have effective support from a partner in their labour, can particularly benefit from doula services.

Birth is a very intimate experience and finding a doula whose personality and philosophy is in harmony with those of a woman and her partner is critical. Word of mouth is a great place to start, and interviewing a few prospective doulas during pregnancy is recommended. Services are generally provided on a private-pay basis, and can be in the range of $700 to $2000.

You can search for a doula through the Doula Services Association of BC.

IMMUNIZATIONS

Women will be informed of advised immunizations. Vaccinations that are safe and recommended during pregnancy include the flu shot (recommended during flu season) and pertussis (whooping cough) vaccine, also known as Tdap (given at 27-32 weeks).

Boosters of the MMR (measles, mumps and rubella) and varicella (chickenpox) vaccines are given postpartum, if required.

It is recommended for pregnant women to be up-to-date on immunizations for Covid-19 and COVID-19 vaccination is recommended during pregnancy in any trimester and while breastfeeding per the SOGC.

Prenatal Classes

Prenatal classes are a great idea for couples expecting their first child. There are many options in the Greater Vancouver area. Most women will opt for a comprehensive program covering pregnancy, childbirth, and breastfeeding/early newborn care. The classes often take place over several weeks, and many providers will offer single-day courses as well. Courses usually start at around 30 weeks, but women should book early as popular classes will fill up. There are also niche programs (eg. hypnobirthing), for women seeking an alternative birth experience. It should be noted that women under the care of the OB Group are not eligible for home birth or water birth.

Baby Prep is a very popular outfit running out of the Kitsilano Neighbourhood House. They have a multitude of offerings including in-person group and private classes, online classes, and specialized twin and C-section classes.

Down to Birth is run by Alison and Marlene, two of our most experienced labour and delivery nurses at BC Women’s. They offer prenatal-in-a-day classes.

Dancing Star Birth is run by a professional doula and birth photographer. They have online offerings and in-person classes on the east side.

St. Paul’s Hospital offers online and in-person prenatal classes, which are aimed at women delivering at St-Paul’s, but open to all-comers.

Douglas College offers basic online and in-person prenatal classes in the following communities: Burnaby, New Westminster, Coquitlam, Chilliwack, North Delta, North Surrey, Langley and Abbotsford.

Dodo Childbirth is run by Sylvia Chang, who is one of our best and most-experienced labour and delivery nurses at BC Women’s. She specializes in mandarin and cantonese-language classes.

For women interested in hypnobirthing, Hypnomammas is run by a doula who offers the Hypnobabies Program online and in-person from locations on the east side or downtown.

Tummy Talks is a free 2-part virtual prenatal series sponsored by Insception Lifebank and run by registered nurses from Markham Prenatal & Newborn Educators. They consist of two 2-hour live and interactive webinars.