What is a birth plan?
A birth plan is a record of what you want to happen during your labour and birth. Of course, the best-laid plans of mice and men (and pregnant women) may often go awry, but it never hurts to be prepared. A birth plan may contain information about what sort of birth you'd like (such as a water birth) and any instructions about pain medication and forceps that will help your midwife and doctors to provide care when the big day comes. Really it's just a fancy name for a document that has all the important information in one place.
The problem with a birth plan is that the baby hasn't read it.
Birth plans are not legal documents, but any good healthcare team will do their best to accommodate your wishes – as long as you're realistic and not screaming the place down because your partner forgot the Vangelis CD. Do keep in mind that your birth plan may have to change – we're sure we don't need to tell you that labour can be unpredictable.
Making a birth plan
Why should I write a birth plan?
Birth plans are totally optional, and some women do prefer to wing it – the decision is totally up to you. However, you may wish to make one if you have specific thoughts on how or where you would like to give birth. It is also a useful document if you have any medical conditions, or if you have strong feelings about assisted labour via intervention or instruments (forceps or ventouse). If you are worried about labour and childbirth, a birth plan might help you feel calmer about what's ahead.
I wrote clear birth plans for the different options; I decided what I wanted in the event of non-progression, EMCS, ELCS, ventouse, tears etc. I think it's important to be realistic and know that stuff might not go according to plan. If you have thought about those things beforehand you aren't caught on the hop.
How to write a birth plan
Before you write a birth plan, it's worth speaking to your friends and family about their experiences for a bit of inspiration or having a chat with other mothers about their birth plans on Mumsnet Talk. You may also find it helpful to talk to other women at your antenatal classes, but do remember that a birth plan is a very personal thing, and what works for one mother-to-be won't be right for another. Also, talk to your birthing partner or doula if you have one so they understand your wishes and can help on the day.
If you have a chat with your midwife they should be able to help you write a birth plan together, and talk through the resources that are available to you. Your birth plan may form part of your patient record or it could be a separate document. You might like to keep a copy on you and/or in your hospital bag, so it's there when if you have to dash off to the hospital. Some midwives will provide you with a template, but you can just as easily write or type out a birth plan yourself.
Things to consider
Who will be present during labour
Whether you have a birth partner or doula or you'd prefer to be alone during labour, you can specify your wishes for support in your birth plan. You may also consider if you want your birth partner to stay with you in the event of a caesarean or assisted delivery. If you intend to have a complementary therapist with you during labour (such as a reflexologist or aromatherapist) this is a good place to specify this as well – do check with the staff at your chosen birth site that this is OK first. It's also worth remembering that it's fine to change your mind, even during labour.
I planned a lovely calm home birth, no drugs, just hypnobirthing and a water pool. In reality, I was induced and went with the flow. A birth plan can be useful if you can't communicate for whatever reason, but I don't think I'll bother making one next time.
Where and how to give birth
Would you prefer to give birth at home, in a maternity unit or in a hospital? If you have a strong preference you can specify this, as well as your reasoning in order to make arrangements easier for everyone involved. Similarly, if you would like to bring your own equipment or use hospital equipment such as a birthing pool or LDRP room (labour, delivery, recovery, postnatal room) where available, this is a good place to note it down.
If you have a preference for a birthing position you might also like to include this information, but you may well find when push comes to shove (so to speak) it's easier to just go with the flow.
Pain relief and speeding up labour
It's not just about epidurals – there are a vast range of natural pain relief options that may be available to you during labour, including breathing techniques, massage, acupuncture, TENS and gas and air. The availability of different types of pain relief will depend on your healthcare provider, so do discuss your options with your midwife or doctor ahead of time in order to decide what's best for you and your baby.
Similarly, you may wish to include instructions in your birth plan for speeding up your labour – but don't feel like you have to. It's completely fine to just see what happens on the day. You are likely to be offered an injection to speed up the delivery of your placenta (third stage delivery) if you give birth in a hospital – this is called a managed third stage. You can mention whether or not you want a managed third stage in your birth plan if you like, or just play it by ear.
Forceps, ventouse and caesarean section deliveries
If you have a preference about assisted delivery or do not want to have an episiotomy, you may wish to state this in your birth plan, so that doctors are aware of your wishes. However you may find that on the day you change your mind based on your doctor's advice, which is completely fine, or that an episiotomy is essential for the safe delivery of your baby.
Your baby after birth
This section can contain information about cutting your baby's umbilical cord and the expulsion of your placenta, as well as skin-to-skin contact postpartum, breastfeeding or bottle feeding and Vitamin K injections. It is helpful for doctors and midwives, especially if you choose to not have a birth partner, or are having pain relief which may mean you cannot express your wishes immediately after giving birth.
If English is not your first language or you have special dietary requirements, you may wish to note this in your birth plan. Similarly if you would like religious customs to be observed or have special needs, you may also like to make a record of these.
I had a birth plan. The bits that were really important to me (like my husband being there to support me throughout, having skin-to-skin contact ASAP and breastfeeding shortly after birth) happened and I was delighted about that.
If you have specific preferences for lighting and music you might also jot them down – but remember, the most important thing is making sure that you and your baby get through the process safely, so be prepared to throw the plan out of the window.
Include your hospital number and the names and telephone numbers of your labour ward and/or midwifery team. It's also worth writing down the name and number of your birth partner, particularly if it's different from your partner. Finally – print off a few copies. You'll need one for your midwife, one for your birth partner, one for your hospital bag, and one for a complimentary therapist if you have decided you want one present.
What do I do when I've written my birth plan?
Show your birth plan to your midwife and arrange an antenatal appointment to go through it together, ideally before your 36th week of pregnancy. Your midwife will make sure your birth plan is kept with your records.
However, do remember that a plan is just a plan – labour is annoyingly unpredictable, and you may find your darling bundle of joy refuses to play by any of the rules.