Your birth plan is a written document to communicate to those involved in your birth, what you would like to happen during and immediately after the delivery. It can explain the type of labour you would like, anything you’d like to avoid and who you want there with you. A few things like medical history, higher risk restrictions and what local facilities are available to you may influence the contents of your plan.
It gives you a chance to think about the options and decisions that might need to be made ahead of the day.
You don’t have to have one. It is a personal preference and should be used to help and reassure you in preparing for your birth.
It’s important to remember that however much preparation you put into your plan, you’ll need to be flexible on the day if circumstances change.
From NHS Choices
How do I write a birth plan?
We have compiled a suggested birth plan template and supporting information to help. These are just a guide as the document is specific to you and your needs, so include anything you feel is important to you.
Your Midwife will also be able to provide help with writing your plan and what type of questions to consider.
It’s your right to choose where you would like to have your baby. Your midwife can discuss the local facilities with you and issues to do with your health or pregnancy that may affect your choice.
Most women choose to give birth in hospital, a birthing centre or at home. Even if you’re not yet sure, it’s worth discussing the options with your midwife. For example, some hospitals do not support a decision to switch to home birth on the day, but do allow you to switch from home birth to birthing centre or hospital.
Who you would like with you during the birth, if you want them there all the time or if there are any circumstances or procedures when you would like them to leave.
You may wish the birthing partner to have other roles, such as being the first point of contact for general questions the staff have during the birth.
The use of birthing equipment such as birthing balls, mats and wall bars can help to provide physical support and relief during labour. They are often available in birthing centres and some hospitals. If you might wish to use these it’s worth checking with your midwife what your birthing location has to offer or if you can bring your own.
If you intend to use a pool during the birth, include this in your plan. You can also speak to your midwife to understand what stages of labour it’s recommended you can be in the water, when you might not be able to and why.
If you’re planning a home birth it might be worth asking your birth partner to do a ‘practice run’ inflating the pool and checking the hose can reach from the tap to the space you plan to birth in.
If you hope to use a birth pool in the birthing centre or hospital, remember there are a limited number available, so it might not always be possible.
You may be asked if you are happy for Midwives, nurses or doctors to observe during your labour for their training. You can state on your birth plan if you consent or not for this to happen and the choice can be changed on the day.
It is worth highlighting on your plan any special requirements you have to the midwifes and doctors such as; if English isn’t your first language, you have certain religious customs to be observed, you need a sign language interpreter, you or your birth partner have special needs, or you have dietary requirements.
You are encouraged to choose positions that are comfortable for you during labour and birth. Practicing them beforehand, at home or in an antenatal class will help to give you an idea of what is comfortable. But be aware that on the day, you may prefer weight on different parts of your body, so if those you practised don’t suit, try others until you find what works for you.
Note on your plan if you would like to be standing, sitting, kneeling, leaning forward, squatting, on your side or your back. Or if there are any of these positions you do not want to be encouraged into unless absolutely necessary.
Pain relief for birth comes in many forms and you might find it useful to write in your birth plan which, if any, you hope to use. The order in which you intend to use them if necessary and any you hope you avoid is also useful to write down. You can use a number of different methods at different stages of birth for whatever suits you best and these include:
Breathing and relaxation, massage, acupuncture, water, TENS (transcutaneous electrical nerve stimulation), gas and air (Entonox), pain-relieving injections, an epidural, try to manage without pain relief.
You may also request to be informed about any medication and possible side effects before it is given to you.
Your baby’s heart rate will be monitored during labour to ensure they are not in distress. There are different ways this can be done depending on your preference such as sonar, Doppler ultrasound or with a stethoscope.
Gentle, normal movement such as standing up and walking around should help to progress the birth. You might wish to include a note in your plan if you are keen to follow an “active birth” approach.
An episiotomy is a cut in the perineum (the area between the vagina and anus) that may be performed if the perineum won’t stretch enough and you would prefer not to tear, or if the baby is short of oxygen and needs to be delivered quickly. Discuss this with your midwife and note in you plan whether or not you want this if the time comes.
Here you might like to include a few notes to;
- reiterate here what position you would like to be in, or avoid being in to push, which might be different to the positions during the first stage of labour.
- outline if there’s any information you want to be made aware of during the 2nd stage – if the baby’s head is crowing etc.
- what sort of encouragement you would like from the staff around you; strong guidance, enthusiasm, as quiet as possible.
- if you plan to photo / video the birth.
Soon after your baby is born, in hospitals you will be offered an injection of artificial oxytocin in your thigh to help the womb contract, prevent possible haemorrhaging and speed up the delivery of the placenta.
You can choose to have this injection or you may prefer to expel the placenta naturally. The choice is yours and it is worth discussing it with your midwife and doing some research beforehand if you wish, to include your decision in your birth plan.
If you wish to do some detailed research on birthing your placenta we recommend the book “Birthing your Placenta” by Aims – http://www.aims.org.uk.
The default approach is for the midwife or doctor to clamp the umbilical cord, so if you would like someone such as your birth partner to do it, you should state this in your birth plan. You may also prefer to delay the cord clamping to allow the full supply of oxygenated blood to reach the baby, which you can also highlight in your plan if so.
Assuming there are no health concerns the midwife or doctor need to immediately address, you can choose to have your baby handed to you immediately before the cord is cut, or you may prefer to have them cleaned a little, the cord clamped and/or wrapped in a blanket first. You can of course change your mind at the time on the day.
New mums are encouraged to try and breastfeed as it is the best form of nutrition for babies and has lasting health benefits, however it is the choice of the new Mum. You may wish to think about in advance and state on your birth plan if you wish to breastfeed, bottle feed or mix feed your baby. If you are planning to try and breastfeed, please know that it takes most mothers and babies a while to establish feeding so don’t worry if it doesn’t come easily.
Vitamin K is offered for babies after they are born to help the blood clot properly and prevent a rare disease called Vitamin K deficiency bleeding. It can be given orally or by injection and the choice is yours whether you wish your baby to have it.
We recommend discussing this with your midwife and doing further research if you are unsure. There is an Aims book on this topic available as well. http://www.aims.org.uk/
Useful books and sources of further information:
AIMS (Association for Improvements in the Maternity Services) publications were recommended to us through pregnancy yoga and Hypnobirthing professionals. They cover a variety of topics such as what your decisions are, induction, vitamin K, the second and third stages of labour. http://www.aims.org.uk/
The organisation Birthrights also has some interesting information about women’s rights during pregnancy and childbirth; http://www.birthrights.org.uk/