A birth plan is a list of instructions or preferences that you would like to be considered when you’re in labour. It should be written by you and your partner, with support from your midwife.
why do I need one?
Making a birth plan will help you to feel more prepared for labour and birth. It will encourage you to find out more about all the options available and consider which would be best for you.
when should I make one?
The earlier you start, the longer you’ll have to consider your options. You can change or rewrite your birth plan at any time right up until the birth – as long as what you want it safe and available. Your midwife will usually introduce you to birth plans at your first meeting so you can start to think about yours.
can I have what I want?
To a certain extent yes. When it comes to pain relief (drugs) or any medical procedure then you will usually get what you’ve asked for. Some facilities may not be available at your hospital or even in your area. You may find that you have no local birthing pool facilities or maybe your hospital doesn’t allow father’s to stay overnight with their partners and babies.
If you can’t get what you want you may need to try another hospital or think about having your baby at home. Check with your GP or Midwife as soon as you can and they will be able to advise you.
When you’re writing your plan it’s important to remember that there’s no such thing as a textbook labour. It may be longer (or more sudden) than you expected, you may need more pain relief than you anticipated and occasionally there will be complications. Try to cover all your options so that you feel comfortable and confident, whatever happens.
For example: – `I would like to give birth without any drugs but if the pain gets too much I would like to try Gas and Air`
how do I write it?
The best birth plans are fairly short and to the point. You may find it easier to make it in the form of a ‘wish list’ under headings. For example: –
Birth Partner My husband John will stay with me throughout labour and the birth
Pain Relief If I need pain relief I would like a low dose epidural so that I can still feel my legs and push the baby out myself
Episiotomy I do not want to be cut unless it’s absolutely necessary.
who should I give my birth plan to?
When you’ve finished your plan, give copies of it to your midwife, GP and your birth partner. Ask for a copy to be kept with your hospital records and keep another in your personal pregnancy record wallet. This should be carried with you at all times in case of emergencies.
Having a birth plan will help you to achieve the kind of labour you want and makes sure that everyone who attends you knows exactly what you want.
suggestions & headings
hospital or home birth
Where do you want to have your baby? You may think that a hospital is the safest place to have your baby. If you have certain pre-existing medical conditions or have experienced complications during your pregnancy, this may be true. However, if you are fit and well and your pregnancy has progressed without any problems it should be just as safe to give birth at home as it would be in hospital.
Read our special Home Birth article by midwife Lesley Hobbs for more information and a guide to arranging a home birth.
birth partner
Who will be supporting you during labour? Your birth partner can be anyone you like – your partner, your mum or a friend. Most dads will jump at the chance to see their baby born and others will be extremely reluctant. Maybe they hate the sight of blood, needles etc, can’t bear to see you in pain or just really, really don’t want to be there. If they feel very strongly about it may not be a good idea to pressure them into it. You are going to need someone you can rely on to be supportive and reassuring. If dad doesn’t feel that he can do this it will be better for you to find someone else who can.
When you’ve decided on a birth partner think about the following questions: – will they be attending antenatal classes with you? Do you want them to stay overnight with you and the baby? If you need a caesarean, would you like them to stay with you if at all possible?
pain relief
Think about how you will manage your pain. Do you want to try and give birth naturally – without drugs, using breathing or relaxation techniques? If you would like drugs to help with the pain then which one, or combination would suit you best. If you want to use a birthing pool check the availability as early as possible.
We have a detailed section on methods of pain relief.
positions
Have a think about the position you would find most comfortable to give birth in. Some women find it helps them to move around as much as possible during labour and others may want to stay in bed. Perhaps you will choose to have your baby in a semi-upright or squatting position. You may not know what works best for you until you’re actually in labour.
assisted delivery
If you want to avoid the use of a ventouse, forceps or having a caesarean then you should specify this on your birth plan. Of course you can change your mind when the time comes. Another quite important point to consider is whether you are happy to be cut to help your baby out (episiotomy). If you are, it may make delivery quicker but you will have to have stitches, which can be very uncomfortable.
If you don’t want an episiotomy then tell your midwife early on and ask for advice – there are things you can do to make the area between your vagina and anus stretchier and reduce the chances of being cut.
touching your baby
If you want to feel your baby’s head as it crowns it’s a good idea to note it on your birth plan. You’ll be amazed at how quickly some babies shoot out at this stage and you don’t want to miss it. When the baby crowns you will get a strong stinging sensation and you may find that you’re too busy wincing to remember what you wanted. Your midwife will remind you if you jot it down. Remember to take a small hand mirror if you want to get a good look!
It’s also worth noting whether you would like your baby lifted straight into your arms when it’s delivered, or if you would prefer for your midwife to clean baby and wrap him up before he’s handed to you.
breaking your waters
Some women find that their waters break before they start to feel any contractions. Yours may not. If you are slow to dilate then artificially breaking your waters will let the baby’s head press firmly against your cervix and this should speed things up. Are you happy for your midwife to rupture the amniotic sac or would you prefer for nature to take its course? Unless you feel very strongly one way or another this is something you can leave out of your birth plan.
fetal monitoring
There are three main ways of monitoring your baby’s heart rate during labour: –
A Pinnard Stethoscope is basically a traditional ear trumpet that your midwife will place against your bump and listen to hear the heartbeat. It has been used effectively for years.
Continuous Electronic Monitoring is used routinely in many hospitals. Whilst it is effective, you will normally have sensors strapped around your abdomen that take the readings so you won’t be able to move around. It can also be quite uncomfortable having something strapped firmly around you.
A Sonicaid is a small portable monitor that uses ultrasound to listen to your baby’s heartbeat. With this, you will be able to hear your baby’s heartbeat too.
induction
If you are overdue or your labour is progressing slowly you may be advised to consider an induction. Would you be happy with an induction to speed things up or would you only ever consider it if you or your baby were at risk without it?
shaving & enemas/suppositories
Ask whether your hospital performs these routinely and if you don’t want them then say so. Some women get really worried that they will poo on the delivery table. Yes, it’s possible, but your midwife will have seen it all before. Quite frankly, if it happens (and the chances are it won’t) you’ll be far too busy to be embarrassed. If it really worries you then ask your midwife for advice on what you can do to avoid it.
breastfeeding
If you intend to breastfeed your baby it is worth noting on your birth plan. If you are worried about feeding or feel that you would like extra encouragement and support then say so.