Making a birth plan before you go to hospital is a great way to prepare yourself mentally for labour.
Going through your key decisions point by point can help to prepare you for all of the stages of labour.
Although there are no guarantees what type of birth you will have, by writing down your key wishes and preferences, you can communicate with your midwife about what you need.
They will appreciate seeing key decisions written down, so that they know right away any particular wishes you have.
This can be really helpful if you are right in the thick of labour, when contractions can be so painful it’s difficult to speak and focus on getting all of the right information across.
Do you need a birth plan
A birth plan is a list of needs and decisions you have made regarding your birth.
It may be written in the form of a checklist you have downloaded and ticked your preferred options, or you may write it completely yourself from scratch.
However you write it, it’s best to stick to short, simple sentences so that your midwife can scan the document quickly if she’s in a hurry.
The birth plan can be as specific or as simple as you like. It may go into great detail about the conditions in which you want your baby born, for example lighting and music, or it may just be simple things about the medical treatment you want.
You can start thinking about your birth plan at any time in your pregnancy, but it’s a good idea to have it ready at around week 37 of your pregnancy.
I did not write a birth plan for my first baby. I just didn’t see the point in specifying anything when ultimately it was out of my control. If I needed a C-section to save me or the baby, I was going to have it, so ruling it out on a bit of paper seemed silly.
However with my second I did write down a few vague bits of guidance, because I didn’t want to have to answer loads of questions during labour like I did with my first.
Having done both, I recommend writing a birth plan, however brief, and popping it into your folder with the rest of your hospital notes. It may come in handy if you are rushed into hospital and there’s not time to discuss all of your needs with the midwife before the crucial moment arrives.
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What to include in your birth plan
Your birth plan should include everything your midwife or doctor needs to know in order to care for you during your labour.
Think about your birth from beginning to end, including who is going to be there with you, where you will be, as well as the specific health treatment you would like to receive.
Remember that although you may want a natural birth, this might not be possible.
Sometimes you have to roll with the punches and just go with what your midwife says is best. Of course you can specific that you do not want induction, or you prefer not to have a C-section.
However if your health or the baby’s health is compromised, your midwife may strongly suggest you have these options. Having a healthy baby is the most important thing, so remember not to pin your hopes on your birth plan being set in stone.
If it helps, here’s a very simple birth plan template you could try using.
The key things you really need to include in your birth plan are:
Who will be at the birth and what should they be called
Start simple with your name and the name of your birthing partner. You should also note what you would both like to be called during labour.
Your hospital notes will include important details like any health issues you may have.
Do you want an epidural, or would you rather use gas and air? Would you like any other form of pain relief, such as diamorphine or another type of painkiller that would be injected.
There are of course some risks associated with having an epidural, but I have friends who insist it saved their sanity during labour.
The choice is completely yours, however it’s worth noting that opioids such as diamorphine can pass to the baby and make them drowsy when they’re born. This can hamper breastfeeding in the early days.
Be sure to read up on the pain relief options ahead of your due date and decide if there are any options you would like to rule out unless circumstances change significantly.
Where do you want to give birth
Do you fancy a home birth, or would you prefer a midwife-led unit? In the UK, some NHS trusts have midwife-led units in a larger hospital, so if there are complications that require a doctor, transfers to a labour ward are easier.
However others are some distance from a hospital, so this may be something you want to think about. Discuss your options with your community midwife before making a final decision.
Your midwife will examine you vaginally every four hours during labour.
This will be carried out to assess how dilated your cervix is, which is an indicator of when you might be able to start pushing. Your midwife will be looking for you to reach 10cm dilation before it is safe to start pushing.
The midwife can also tell if your waters need to be broken manually, and the position of your baby, by conducting a vaginal exam.
Whether or not these are painful depends on the lady. Some women only find them uncomfortable, while others find vaginal examinations painful.
You can say you would prefer not to have vaginal exams during your labour. Your midwife can use other assessment techniques to see how far along in the process you are.
Hypnobirthing or other techniques
If you are using hypnobirthing, it will be useful to let your midwife know in your birth plan so that she can be supportive of this technique.
Hypnobirthing involves self-hypnosis and breathing exercises to help you deal with the pain of labour. It can mean using music and visualisation exercises to keep your mind occupied and relaxed.
You could also note any other birthing techniques you would like to use, such as specific music, a type of massage your partner will be doing to help with pain or breathing techniques.
Some mamas like to use essential oils (aromatherapy) and massage to help with pain.
Do you have any preferred birthing positions? Some ladies like to spend the first part of labour on a birthing ball.
You can even break this right down to your preferred positions for when your are in the first stage of labour (when you will be contracting and waiting to push) and the second stage of labour (when you will push your baby out).
Some ladies want to be on their knees for the pushing, as gravity can really help. Others prefer to be on their back or side for the entire thing.
During your final trimester, you could try different positions to see what works best for you.
If you would like a birthing ball, most maternity wards will have them available for you to use while in hospital.
Do you want to see/touch the head
As your baby crowns, you can touch the head or ask for a mirror to be angled so that you can see your baby arriving.
Some ladies like to see that they are finally getting to the end point of the birth, and to see their baby’s arrival into the world.
Others feel squeamish at the thought of seeing it happen. It’s entirely your choice what you do! Some ladies find it motivating, others find it a bit too much.
Do you want a oxytocin injection?
This speeds up delivery of the placenta after your baby is born. I had it both times, it’s worth it. I hardly even noticed the placenta coming out. It is injected into the thigh as you give birth.
Cutting the cord
Does your partner want to cut the cord, do you want to do it together? Have a conversation with your partner before your due date. Once the baby is born, the cord will be clamped in two places and your partner can cut it in-between of these clamps. It feels quite spongey and tough, so a certain degree of force is needed to snip it.
Vitamin K for your baby
Vitamin K helps the blood to clot and prevents serious bleeding. In newborns, vitamin K injections can prevent a now rare, but potentially fatal, bleeding disorder called Haemorrhagic Disease of the Newborn (HDN), also known as Vitamin K Deficiency Bleeding (VKDB).
It can be administered with an injection or orally. Injection is a more efficient way of administering it. The baby will hardly notice it happening.
Most midwives will be sure to initiate skin-to-skin contact between mama and baby as soon as possible.
But you may want to note in the birth plan that this is your wish to do skin-to-skin as soon as the baby is out. If your partner would also like to do skin-to-skin with the baby, you can also note this down in your birth plan.
Do you want to breastfeed
Statistics show that most new mums do breastfeed their baby to begin with. However there are of course circumstances when you may not wish to do this or cannot breastfeed.
Whatever your feeding method will be, note it down in the birth plan so your midwife is aware if you need help with the first breastfeed.
Some babies may latch on and feed right away with no problems. Other babies may need a little help with the first feed.
If you do want to breastfeed, it’s a good idea to get that first feed done in the first hour after birth, sometimes known as the “golden hour”.
In addition to the printable birth plan template closer to the top of this article, you could also check out this one by the NCT.
Consider all of these things when writing out your birth plan, and any additional requests you might have.
Always have in the back of your mind that things may not go to plan. No two births are the same, so be prepared with go with whatever this labour throws at you.
Go in there with an open mind, and you will be absolutely fine!