When we were trying to conceive, and through the early months of pregnancy, the thought of a birth plan scared me. I used to think there was so much pressure to make the right decisions on how to give birth, what pain relief to use (if any), where to give birth and so on. What if I make the wrong decision with my birth preferences?
Once I was 26 weeks pregnant however, I had a complete shift in mindset towards creating a birth plan. I’d go as far to say that I started to look forward to the day I’d map this out with my midwife. That’s all thanks to the reading I did on hypnobirthing, and a bigger thanks to Siobhan Miller’s book, Hypnobirthing: Practical Ways to Make Your Birth Better. I wrote a post all about my decision to make hypnobirthing my priority in my birth plan and what I learned, so feel free to give that a read.
The reality is, you have no idea how or where you will give birth, or what intervention (if any) will be needed once the big day arrives. Whether it’s as simple as not making it to your location of choice because your labour progressed so quickly that you unexpectedly gave birth in the car; or medical reasons or your baby’s well-being meant a c-section was necessary in the end, you simply do not know how your baby will eventually enter the world. Despite that, your birth plan is designed for you to inform the midwives of your ideal labour and birth, so that even if some intervention is required, they can ensure your birth plan is still respected and see how it can be aligned with, even with some changes being put in place.
My birth plan
Now, you don’t need to provide a full-blown essay or even provide as much as the below, or anything at all in fact. However, in your antenatal appointment when you go through your birth plan (in my experience when 31 weeks pregnant) the midwife simply ticks a few boxes on a computer and types in a few details i.e. your birth partner’s name, and that’s pretty much it. There’s no opportunity on that screen to expand on your preferences, or even go further as to say what your second preference would be if the first was not possible. So, if you’re like me and want to ensure your preferences are in writing for all to see, then providing a pre-written birth plan which can also sit in your maternity notes is ideal.
So, here’s my birth plan I shared with my midwife using a template I mapped out based on further reading of all the main topics to cover.
Where to give birth
I would like to be in the Midwife Led Unit and with dimmed lights to help me stay relaxed.
My Birth Partner
My husband, James.
I would like James with me at all times throughout labour and birth, including if I was to be induced, have an instrumental delivery, or a c-section.
Unless it is medically necessary for me and/or the baby’s health, then I do not wish to be induced. If induction is recommended, I want to be talked through the reasons why this is and be able to make the decision as to whether I believe, based on the information I’ve been given, it’s right for me. I would prefer to explore natural ways of inducing labour first i.e. exercises, aromatherapy, reflexology, foods/drinks etc.
Positions for Labour & Birth
I’d like to have the freedom to move around and stay active as much as possible. I’d like to try giving birth on all fours, or standing partly squatted holding either a wall bar or on to my birth partner. I do not wish to be on my back or restricted to the bed.
I wish to use, or at least have available to me, a birthing ball, bed bar to support squatting positions if on the bed, and mats.
Keeping me informed throughout labour and birth
I prefer to hear positive comments on how my labour is progressing. If progression slows for example, I don’t want to be reminded of or have an emphasis on this, it’ll only set me back mentally. Any comments like that instead can be mentioned to my birth partner and not myself if I don’t need to know about it, to ensure I’m remaining positive.
1st Choice: I’d like to try and cope with hypnobirthing relaxation techniques, but with gas and air (Entonox) to be available for immediate use. Encourage me to stick with up-breathing in the first stage of labour (count 4 in and 8 out for me when I’m struggling to keep the rhythm), and down-breathing for the second stage of labour. Do not encourage me to push, I want my body to push on its own.
2nd Choice: I’d like to have a Pethidine or Diamorphine injection (whichever is available). If I’m asking for this option and it’s not advised due to my stage of labour at that time, then please inform me in a positive way i.e. “It’s not possible because you’re so close to the final stage and you’re progressing really well. Let’s try XYZ instead and get you more comfortable, you’re doing great”. Please always keep things positive for me.
3rd Choice: I do not like the idea of an epidural due to fearing having no control of my body. If a mobile epidural is available/possible, I would consider this more. However, I will not rule out epidural altogether if it gets to a point where I’m not coping, or of course is medically required.
Despite the above preferences, if I honestly feel I cannot continue without some form of additional pain relief, then please respect my decision to change my order of preference.
Baby’s Heart Monitoring
I’m happy for my baby’s heartbeat to be monitored as much as necessary throughout my labour and birth.
If I’m at severe risk of tearing as my baby is born or my baby is in distress and needs to be born quickly, please discuss my options with me first. I’d like to avoid an episiotomy if possible, but if the tear could be worse without it, then I’m happy to reconsider.
I would like immediate skin-to-skin, or if not possible for me, I would like my husband/birth partner to have skin-to-skin.
Delayed Cord Clamping
I’d like to delay cord clamping if possible. My birth partner (husband) would also like to be asked if he wishes to cut the cord.
I would like an active delivery where I am injected with Oxytocin to encourage the delivery of the placenta.
I will be combination feeding; starting with the colostrum I will be bringing with me, and ready-to-drink formula.
Vitamin K for Baby
I’m happy for my baby to be injected with Vitamin K.
Medical Professional Training
I’m happy for student workers to be involved throughout my labour and birth.
First photo source here.