Pregnancy, birth and arrival: 22 decisions to make together
Care provider, birth setting, pain plan, visitors and the postpartum weeks.
1. Prenatal genetic and carrier screening
Prenatal screening uses blood tests and ultrasound to estimate the chance of conditions such as Down syndrome; carrier screening checks whether you carry genes for inherited conditions; diagnostic tests (CVS and amniocentesis) take a sample for a definite answer.
5 options · Your call · During pregnancy
2. Vaccines in pregnancy and the RSV route
Vaccines in pregnancy (flu, COVID-19, whooping cough) pass protection to the baby.
4 options · Well established · During pregnancy
3. Care provider and labor support
Who will look after you in pregnancy and birth (an obstetrician or a midwife) and whether you will add a doula, a trained person who gives continuous support during labor.
4 options · Well established · During pregnancy
4. Birth setting
Where you want to give birth: a hospital, a birth center attached to a hospital, a freestanding birth center, or at home.
4 options · Experts disagree · During pregnancy
5. Midwife or doctor
Who will be in charge of your care in pregnancy and birth: an obstetrician (a surgeon who handles complications), a midwife (a specialist in normal birth, in a hospital, birth center or at home), a family doctor who delivers babies, or a team that shares the care.
5 options · Evidence leans one way · During pregnancy
6. Choosing a hospital and what to ask
Which hospital you plan to give birth in, and what to compare: how close it is, how advanced its newborn intensive-care unit is, its cesarean rate, and its policies on visitors, doulas and rooming-in.
4 options · Evidence leans one way · During pregnancy
7. Planning a home birth
Whether you would plan to give birth at home with a trained attendant.
4 options · Experts disagree · During pregnancy
8. Water birth
Whether you would use a tub or pool in labor, and whether you would plan to actually deliver the baby underwater.
3 options · Experts disagree · During pregnancy
9. Pain management and preparation method
How you plan to handle labor pain, from a planned epidural to preparing for an unmedicated birth with a method such as Lamaze, Bradley or hypnobirthing.
4 options · Your call · During pregnancy
10. Elective induction at 39 weeks
Induction means using medication or other methods to start labor rather than waiting for it to begin.
4 options · Experts disagree · During pregnancy
11. Cesarean on request
A cesarean is a surgical birth through the abdomen.
3 options · Your call · During pregnancy
12. Delayed cord clamping
Whether to wait a short time after birth before the umbilical cord is clamped, so more blood passes from the placenta to the baby.
3 options · Well established · During pregnancy
13. Cord blood
Whether to collect blood from the umbilical cord at birth for possible future medical use: do nothing, donate to a public bank, or pay a private bank to store it.
3 options · Well established · During pregnancy
14. Placenta
What happens to the placenta after birth: disposed of by the hospital, kept (for burial or as a keepsake), or prepared for consumption.
3 options · Your call · During pregnancy
15. Finding out the sex
Whether to learn your baby's sex before birth, and if so when and whom you tell.
4 options · Your call · During pregnancy
16. Birth plan philosophy
How much you want to spell out in advance about your birth: a detailed written plan, a short list of priorities, trusting the care team, or no plan.
4 options · Evidence leans one way · During pregnancy
17. Who is in the room
Who will be with you during labor and birth: just the two of you, a doula, a family member, or more people.
4 options · Evidence leans one way · During pregnancy
18. Announcing the pregnancy and the birth
When and how you tell people about the pregnancy and the baby, and whether you share on social media.
4 options · Your call · During pregnancy
19. Naming and surname
How you will choose your baby's name and last name: one parent's surname, hyphenated, both, or a new one, and whether the given name honors someone.
6 options · Your call · During pregnancy
20. Visitors and the first weeks
Who comes to see the baby in the first weeks and on what terms, from an open door to no visitors for a set period, and any ground rules such as hand-washing.
4 options · Your call · During pregnancy
21. Postpartum support model
What help you will have after the birth: just the two of you, family, or paid help during the day or overnight.
4 options · Your call · During pregnancy
22. Postpartum mental-health plan for both parents
Knowing the signs of postpartum depression and anxiety (in either of you) and agreeing in advance who will speak up and what support you will arrange.
3 options · Well established · During pregnancy