WHAT IS A BIRTH PLAN?
A birth plan is a way for you to communicate your wishes to the midwives and doctors who care for you in labour. It tells them about the type of labour and birth you'd like to have, what you want to happen, and what you want to avoid.
A birth plan is not set in stone. It needs to be flexible and acknowledge that things may not go according to plan. Write a plan which means your midwife doesn't feel she has her hands tied if complications arise during your labour.
what research can I do before writing my birth plan?
Gather as much information as you can before you start:
Once you've spoken to a few people and researched your choices, jot your birth wishes down on a piece of paper, as they come to mind. You can tidy them up later.
Your midwife may give you a special form for your birth plan, or there may be room in your notes. Keep a copy of your birth plan in your maternity notes so it's easy to find when you go into labour.
What to include.
If you've had a baby before and have had any past experiences that may
affect this labour and birth, make sure you include them in your plan.
Your birth partner
Say who you want to have with you in labour. Do you want this person to stay with you all the time, or are there certain procedures or stages when you'd prefer them to leave the room? Would you like to talk to your birth partner in private about any interventions that are suggested? And would you like your birth partner to stay with you if you need an assisted birth or a caesarean?
Positions for labour and birth
Mention which positions you would like to use during labour and for your baby's birth. Also say how active you would like to be. Would you like to remain upright and mobile for as long as possible? Or perhaps you'd prefer to be upright in bed with your back propped up with pillows? Or you could specify that you want to lie on your side, be kneeling on all fours or standing or squatting.
Say what kinds of pain relief you would like to use, if any, and in what order. For example, you may prefer to try pethidine before an epidural.
You could mention breathing, relaxation, water, massage or a TENS machine as well as medical pain relief. And if there are any types of pain relief you wish to avoid using, make sure you write them down.
Speeding up labour
If your labour slows down, or is proving to be very long, do you want your midwife to use interventions to speed it up? Or would you prefer to wait and see what happens naturally?
If your hospital or midwife-led unit has a birth pool, or if you are hiring one for home use, write down whether you want to use it for pain relief or to give birth in, or both. Also let your midwife know if you want to have a managed or physiological third stage when you deliver the placenta.
Your hospital or birth centre may have wall bars, birth balls, mats or beanbags for use during labour. Or you may need to bring equipment in from home. Make a note of the type of equipment you would like to use in your plan.
Monitoring your baby's heart rate
If your pregnancy is straightforward your midwife will monitor your baby's heartbeat intermittently, about every 15 minutes, using a handheld device. Write down if you would like intermittent monitoring or continuous electronic monitoring (EFM) during which a belt is strapped around your waist.
You might want to express a preference for forceps or ventouse if, at the end of labour, you need some help to give birth. Or you may be happy to see what your midwife or doctor recommends when the time comes.
Third stage (delivery of the placenta)
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. 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. You could also mention if you would prefer delayed cord clamping. Delayed clamping usually happens if you are having a physiological third stage, but may also be possible with a managed third stage.
You may wish for your baby to be placed directly onto your tummy straight after birth, or you may prefer for your baby to be cleaned up before she is handed to you.
Feeding your baby
Be clear about whether you want to breastfeed or bottle feed. Also be clear about whether your breastfed baby is allowed to have any bottles of formula. If you definitely don't want her to have formula, say so.
You may want to write down what you want to happen if your baby has to go to the special care baby unit (SCBU). Do you wish to care for him yourself as much as possible, and be transferred with him to another hospital if a transfer is necessary.
Keep in mind that since not all labors and deliveries go as planned, you might not be able to call all the shots in advance — and also remember that sometimes hospital or birthing center policy dictates which shots you can call at all. Print out that first version of your birth plan and take it to your next practitioner visit as a means for opening up discussion. After you talk about your preferences for your childbirth experience with your practitioner, listen to what he or she has to say about your labor options. If there are any changes you need to make, use the worksheet again (and again, if necessary) to create a birth plan that's updated. When you're done, print out several copies so you can give one to your practitioner, one to the nurse in charge (and another for when the shifts change), and so on.