A Birth Plan

By half way into your pregnancy, you'll probably start giving some thought into how you want to give birth. Do you want an epidural or a water birth? At home or in hospital? Would you like your baby delivered straight onto your tummy, even if he's bloody, or would you like him cleaned up first?

• When should I write my birth plan?
• Where do I start?
• What should I and shouldn't I include?
• Where can I get more information?
• What should I do now?
• Who should I give it to?
• Birth plan ideas for an elective caesarean

When the big day comes and your baby is on its way, though, it's easy to be so preoccupied with the labour that crucial points get forgotten. Many women go into another space mentally so you could find that you just don't want to have to communicate with anyone while you're busy giving birth to your baby. This is where a birth plan comes in. It's a document that you write - in any format you feel comfortable with, which sets down your preferences for the way you'd like the birth to go.
Sue Allen-Mills, once babyworld's antenatal advisor, says, "Writing a birth plan doesn't of course make your plans happen and shouldn't, I would say, be set in stone. But, having a birth plan does help the midwife who's attending you to know what your preferences are, so that she can help you to achieve them insofar as it's possible."

 

When should I write my birth plan?

It's a good idea to start thinking about writing your birth plan when you're around 28 weeks pregnant - this may well be the time you start any antenatal classes you may be doing, and it's also a time when the reality of having a baby is beginning to sink in. Sue Allen-Mills suggests you have it finished by the time you're 36 or 37 weeks - wise suggestion, as you're technically full term by 37 weeks. She continues, "I usually suggest keeping a list of things as you find out about them, then you don't forget things when you come to write the plan."

Where do I start?

There's one fact of labour you can't avoid: it's going to hurt. So it's a good idea to start by thinking about what sort of pain relief you might like, and also when. Here are some of the options you might want to consider:

• TENS
• gas and air
• massage
• keeping mobile
• a bath
• breathing
• epidural
• pethidine (or meptid or diamorphine)
• water pool
• massage
• alternative therapies (homeopathy, acupuncture etc)
• breathing
• Who are your birth partners? Do you want them there at all times?
• Do you mind having your waters broken?
• Do you want your baby monitored continuously or just every now and then?
• Do you want to be able to eat and drink as you want during the labour?
• Do you want to be told when to push or let your body guide you?
• Would you rather have an episiotomy, or tear?
• Do you want to watch or feel the baby come out?
• How would you like to have the placenta delivered: with the aid of drugs, or let it come naturally?
• Do you want the baby cleaned up first or do you want to cuddle him straight away?
• Are you planning to breastfeed, and would you like help getting it right?
• Do you think you might want to stay in hospital for a couple of nights or do you want to get out as soon as you can?
• If you have any special needs, whether they're related to your religion, your diet, or any disability, note them as well.

 

What should and shouldn't I include?

Whatever's important to you! babyworld midwife Hannah Hulme-Hunter explains, "I don't think that anything written on a birth plan is ever unnecessary. If something is important to you, we need to know about it. How do you feel about using a bed pan, for example - or having regular vaginal examinations or bright lights in the delivery room? What about your choice of companion? Do you mind what you wear for labour? If something really matters to you, please tell us!"

Where can I get more information?

If your midwife doesn't bring up the subject of birth plans in one of your antenatal appointments, do ask her about it. Once you've started putting something together, it can be helpful if you talk through it together. That way you can find out about hospital policy as well as getting an expert's input.
Some hospitals supply a tick-box style birth plan as a template, which will cover the questions above. Ask your midwife whether they have one. And don't forget to pick the brains of your fellow babyworld antenatal club members!
Once you're close to your finishing your plan, bear in mind these points from our midwife Hannah, "It really helps if you can be reasonably concise; busy midwives love bullet points! And don't feel your birth plan has to be detailed and finite in every respect. Most midwives use birth plans as a basis for discussion and planning together with you and your partner, so do feel free to write things like "I would really like to talk with you about natural delivery of my placenta" or "the way we greet our baby is very important to us; please can we discuss this?"

 

What should I do now?

• Start to make notes (keep them all in one place - maybe with your antenatal notes?) about things that you'd like or wouldn't like when it's birth day.
• Talk to your partner about what his hopes are for the birth.
• Discuss it all with a midwife.
• Make sure you attend NHS Parentcraft or any other antenatal classes to get you thinking about your options for labour and birth.
• Ask your midwife if the hospital supplies a tick-box variety of birth plan which should get you started.

 

Who should I give it to?

You may not want to give your birth plan to anybody. Many couples find that simply making a birth plan is the important part of the process. Having talked through the options and possibilities, you may feel that you are both much clearer in your own minds and can simply talk things through with your carers once you are in labour.
On the other hand, you may decide to give it to your midwife when you have an antenatal check, or your obstetrician if you are receiving specialist care. It can be helpful to talk over your wishes with them, as well as giving them the written plan. Arrange for a copy to be put in your notes, so that the midwife on duty will read it when she knows you are coming into hospital in labour.