Your birth plan is the way you’d like to your baby to arrive… in an ideal world.  Writing a birth plan provides a means of helping you to identify and focus on the things you’d like to happen, and the things you’d like to avoid, a way of exploring all the options open to you: home birth or hospital, birthing pool or birthing ball, the kind of pain relief you’d prefer, and a whole host of other factors.  When the big day arrives your baby may have other ideas, but it can’t help to be prepared.  Even if you end up having a birth that bears no resemblance to your birth plan, you’ll have achieved a successful birth and will have a little bundle of joy to show for your efforts!

Do your research

Before starting on your birth plan, it’s important to understand your options.  By talking to your midwife, attending antenatal classes, speaking to friends and family who have been through labour and reading up, you’ll quickly get to grips with what’s on offer to you.

What should your birth plan include?

Where?

Are you planning to have your baby at home or in hospital?  If in hospital, there are still choices as most hospitals now offer minimal intervention birthing centres, which have a more home-from-home feel to standard labour wards.  Depending on your medical history, your risk of complications during labour and your previous (if any) birthing experiences these may or may not be an option for you.

Who?

A key element of your birthing experience will be the people supporting you.   For this reason it’s good to think about who you want to share the experience with you – your partner, your mother, your sister, your best friend?  Also are there any aspects of the labour that you don’t want them there for, during examinations for example, or if you need a caesarian?

Once you’ve decided just who will be on ‘team baby’, make sure you talk through your preferences and choices, so that even if you are a little preoccupied during labour, they will be able to make your wishes clear to the medical staff.

Birthing Equipment, Position and Monitoring

There may be certain equipment that you’d like to use whilst giving birth to help things progress, keep you relaxed and keep you as comfortable as possible.  It’s useful to indicate this in your birthing plan – wall bars, mats, birthing balls and beanbafs are all commonly used, and if you’ve requested them, your midwife will be able to let you know if they are available.

If your pregnancy is straightforward your midwife will monitor your baby’s heartbeat regularly using a handheld device. Make it clear if you are happy for intermittent monitoring or whether you’d prefer continuous electronic monitoring (EFM) during which a belt is strapped around your waist.

Keeping active will help your labour progress, but if you have strong feelings about this or have had past experience that would suggest it won’t be helpful to you, this should be on your birth plan.  Similarly you may feel that certain positions could help you, whilst others are definitely not for you.  If you try out positions that make you the most comfortable at home, it may be worth noting these – sitting, standing, kneeling, squatting, are all common positions for labour, but every woman is different so say what you think will work for you!

Pain Management?

What types of pain relief are you hoping to cope with?  Are hypnosis, relaxation and and massage things you’d like to try?  Would a TENS machine be of interest or would you rather head straight for the serious pain relief and try pethidine or an epidural?

Interventions

An episiotomy is a cut in the perineum (the area between the vagina and anus). This may be necessary if the perineum won’t stretch enough and may tear, or if the baby is short of oxygen and needs to be delivered quickly. If you have a strong view on this, make sure it’s on your birth plan.

If your labour slows down or is taking a long time, would you be happy for interventions to speed things up?

Once your baby has arrived

If you give birth in hospital it is likely that you’ll be offered an injection to speed up the delivery of the placenta, called a managed third stage.  This injection into your thigh contains the drug syntometrine or syntocinon which helps the womb contract and can prevent the heavy bleeding that some women may experience without it.  You can choose to have the injection or you may prefer to have a natural third stage without drugs.

If you have a strong preference for someone to cut the umbilical cord, maybe your birth partner, say so (although you’ll probably be asked this during labour too).

The first few hours with your little one are so precious.  If you have strong feelings about how you’d like the first bonding moments to be, include these on your birth plan.  If you’d like skin-to-skin contact immediately, that’s great.  If you’re a bit squeamish and would like the baby to be cleaned up a bit, that’s absolutely fine too.

If you’re planning to breastfeed then make sure you include that on your birth plan.  You may feel that breastfeeding isn’t for you, and change your mind when your little one arrives and that’s ok too!  You may have tried to breastfeed before and know that this time, it’s bottle feeding all the way – not a problem, but it’s a good idea to state your preference if you have one.

Some newborns need additional Vitamin K to help their blood clot properly and it may be suggested that your baby is given Vitamin K either by injection or orally soon after birth.  Make sure you’ve read up on this and made your feelings clear on your birth plan as to whether or not you’ve given consent.

If you don’t know where to start and need some additional guidance, NHS online have a birth plan writing tool, which can help guide you through all of the steps mentioned above.,  Your midwife may also have a form that you can fill in as a guide to the information to include.