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Here’s my step-by-step guide to writing a birth plan, including a checklist of all the different things to consider when you are putting your birth plan together.
IS IT WORTH WRITING A BIRTH PLAN?
Should you write a birth plan?
No birth goes as perfectly planned.
And no birth is perfect.
You can’t predict or control what will happen in labour and what help you will need.
Or how you will feel about it.
The decisions you make in labor may be the very opposite to those you thought you’d make.
There will be things you regret. And may be great distress.
So surely it is a total waste of time to write a birth plan?
I don’t think so..
WHY IT IS WORTH WRITING A BIRTH PLAN
Writing a birth plan won’t ensure the perfect birth.
But it can help us make big choices during pregnancy and understand the possible realities of labor and decisions we may have to make quickly when we’re exhausted and scared.
I wanted as natural a birth as I could, so my plan didn’t include an extra two weeks of pregnancy followed by an induction! But having prepared myself for all eventualities I was able to take the birth more in my stride.
A birth plan for your birthing experience
So no a a birthing plan won’t give a perfect birth but it can give us the courage to influence & change what we can during labour and the serenity to accept what must just be …
In this post I am sharing the birthing plan I wish I had written and a heap of stuff I wish I had known that would have made the birth I did have and mine and baby’s recovery much easier.
The Big Decisions in Your Birth Plan
These are the big decisions to cover in your birthing plan … if it looks scarily overwhelming, don’t worry, I’ll take you through everything involved in each of these decisions …
- Where would you like to give birth?
- Who would you like to be at the birth?
- What birthing positions would you like to try?
- What natural birthing equipment would you like to use?
- What natural pain relief would you like to try?
- What chemical pain relief would you like to be available and in what circumstances would you like chemical pain relief?
- What do you want to happen immediately after the birth?
- How would you like to be cared for after the birth?
- In what circumstances are you willing to be induced and how?
- In what circumstances are you willing to have manual intervention?
And remember you’re not trying to make decisions cast in stone.
You’re just using them to help you understand and influence what can happen.
10 Point Step-By-Step Birth Plan
1. Where Would You Like to Give Birth?
Would you like:
- A home birth?
- To labour at home as long as possible?
- To deliver in a mid-wife led unit?
- Siblings in the delivery room?
Many mums find it easier to have the natural birth they yearn for in the comfort of their own home … I was a home birth and my mum raves about how much better it was than hospital.
But if you’re considering a home birth, you need to think about …
- How easily could you get to the hospital in an emergency?
- Will you be comfortable with your baby being monitored less than in hospital?
- Midwifes can give gas+air and pethidine/demerol as pain relief but not epidurals
- Whether you have space for e.g a water birth, if you think you might want one?
If you think you might want a home birth, say so at your first ante-natal appointments. You can change your mind later but it may be hard to arrange if you don’t say from the start.
Unfortunately, a home birth is not usually an option if you are classified as high risk.
Labouring at Home
Even if you want to deliver your baby in hospital, your health provider may support you labouring at home with a midwife until very close to the delivery time.
Labouring at home with a midwife can be much easier and quicker than in hospital but may only be a viable option if you can get easily to the hospital in later stages of labour.
As with a home birth pain relief options are more limited.
Mid Wife Led Unit
Mid-wife led units are committed to actively promoting as natural labour as possible. As the units are almost always attached to a hospital, you still have the option to transfer to a doctor led unit if you want or need to.
Mid wife led units at hospitals can be good options for high risk mums who can’t home birth.
Local Hospital or Somewhere Else
There are lots of benefits to your closest hospital. It’s easier to get to in an emergency & may let you labour for much longer at home. BUT it’s worth doing your research ….
- Does it have the facilities you want?
- What do other mother’s think about it? Check out forums + ask friends.
- If you’re concerned, check out stats on levels of patient complaints
2. Who Would You Like at the Birth?
- Would you like an experienced mum as well as your partner?
- Would you like a doula?
- Who would you like as back-up if partner can’t make it?
- Who would you like to visit you and when?
Experienced Mum as Birth Partner
The birth of a child is obviously uniquely special to the child’s parents.
But stretched midwives who can’t be with you the whole time … particularly in public hospitals … and completely inexperienced fathers to be is NOT necessarily a great combination!!
An experienced mum … a sister, mother, aunt or friend … who can support both mum and dad … particularly when the midwife is not there … can be absolutely worth her weight in gold!
A doula is an experienced birthing partner … many have been midwifes … who stay with you throughout labour to help you have as natural a birth as possible.
They help you establish most comfortable positions at different points of labour, manage your breathing and may provide massage AND they can help to calm you and your partner.
Doulas are very valuable if you won’t have a dedicated midwife throughout labour. And they can be a massive help establishing breastfeeding.
On the downsides ..
- a doula may not be something covered by your insurance or that you can afford.
- you need to find one as early as possible in your pregnancy.
- there may be tensions between the doula and the midwife and other hospital staff.
If you go into labour early or labour is very quick, it’s possible your partner might not make it, so it’s arrange back-up partners very close by who will definitely be there for you.
Which Visitors & When
Obviously, you want to show baby off but you need rest and quiet skin to skin time with baby to help establish breastfeeding. If you don’t want everyone to visit let them them
But if you think you’re going to be super hurt if you don’t have a long line of friends & family arriving with gifts … let them know they ARE expected 🙂
Student Doctors & Nurses
Some hospitals may give you the option to say you don’t want student doctors and nurses observing your birth. If you feel this would be intrusive say actively that you don’t want them in the labour room.
3. Birthing Positions
There are all sorts of different birthing positions you can try which can really help at different stages of labour. There is no right birthing position but lying on your back is never great!
It’s impossible to know what will work best in advance but it’s a really good idea to try out different positions … e.g. kneeling on all fours, raised supported kneeling, squatting, hand holding squat … in advance as it will be so much easier to adopt them under pressure.
Antenatal classes … do sign up if you haven’t already … usually cover birthing positions and give you a chance to try them out. If you go to a class & they’re not covered ask for a demo.
4. Natural Birthing Equipment
Birthing Balls, Stools & Rails
I found a birthing ball … a big yoga ball …. really helpful during labour … it was the only position in which I could really relax. Birthing stools and rails can also help you when you’re tired maintain comfortable birthing positions that really get baby moving.
Find out what your health care provider will have available, and if they don’t have what you want post on forums and ask friends to see if you can borrow one or get second hand.
Birthing Pools, Showers & Baths
Many mums find water births helpful, if you’re interested, make sure you find out at which delivery units they are offered and how frequently they are used. You can have a birthing pool at home … hiring the equipment … but you do need plenty of space and you need to practice putting it up before the actual delivery.
A shower or bath can really help throughout labour so find out whether you’ll have access to a bathroom throughout labour … if not you might want to labour at home for as long as you can.
Typically it should only be necessary to monitor contractions and baby’s heart rate intermittantly during labour so you can still move around, use birthing equipment you want to and adopt the most comfortable position you can find.
Delivery teams sometimes want to monitor baby continuously, which traditionally limited you to your bed and restricted birthing positions you could try. But some healthcare providers now have wireless monitoring which will let you move around.
Find out what’s available in advance and talk to your delivery team about how you can stay as mobile as possible and avoid lying on your back if frequent or continuous monitoring is needed.
5. Natural Pain Relief
If you want a natural birth you do have to invest time during pregnancy to make it effective.
Breathing & Hypnobirthing
Good breathing really, really helps during labour.
And I found hypnobirthing techniques … a combination of breathing, mantras & visualisation … great in early labour but you need to practice throughout the third trimester.
There’s some good CDs & videos you can get but it’s worth signing up for an ante-natal class who can coach you through it.
TENS machines give off electrical pulses through pads attached to you during labour. Lots of mums swear by them but they may not be offered by your healthcare provider.
If not you can buy them from about $45/£30 or you can hire them.
The great advantage of having your own is that you can use it at home in early labour.
Good massage is amazing, particularly when you’re beyond exhaustion.
But nervous prodding from a fumbling partner is beyond rubbish!!
If your partner is willing and able it is worth getting them trained up in some basic techniques or having an experienced mum as an extra birthing partner who knows what she’s doing.
Lots of midwives are brilliant at it but not all. It’s worth finding out whether your healthcare provider trains all its midwives in massage and expects them to use it … some hospitals pay lip service to it but the midwives, through no fault of their own, haven’t a clue.
Acupuncture & Acupressure
There is evidence that both acupuncture and acupressure can reduce the need for a c-section and both mums and midwives report “better births” for those who use it.
Most health care providers don’t offer it so if you want it to be available you may need to find a doula who is qualified to practice it.
6. Chemical Pain Relief
I wrote on my birth plan that I absolutely didn’t want pethidine.
36 hours through an induction and stuck in early labour my midwife advised me that more than anything I needed sleep and that pethidine was probably the only thing that would let me.
So I took it and mercifully I slept a little.
From experience, I would say that even if you want the most natural birth you can, don’t rule anything out. You just don’t know what’s going to happen.
I think the important thing is to understand the consequences of the pain relief both during labour and for your baby … I didn’t! … so that you can prepare yourselves for these.
I’ve outlined possible side effects of the three forms of pain relief typically available.
Gas & Air (Entonox)
You can have gas & air at home as well as in hospital.
It can make you drowsy and nauseous and your mouth & lips very dry but shouldn’t have any other effect on you and none on baby. Not all mums find it helpful.
It can make you very drowsy and nauseous so you may feel you have less control over labour.
The real biggie to be aware of is that it can make baby very drowsy and delay breastfeeding.
That doesn’t mean that it might not be the right thing for you in labour but if you have it, you are going to need to really help baby with breastfeeding … loads of skin to skin, hold them as much as you possibly can and whenever they make little fish movements with their mouth even if they are asleep, get them onto your breast.
You can only have an epidural in hospital.
You will be stuck in bed after the classic epidural and although there is a walking epidural not all healthcare providers offer it … it’s another question to ask when you’re selecting a hospital.
It can slow down labour so you can end up being given syntocinon the drug used to induce labour. And you are more likely to end up with manual interventions such as forceps and ventouse and to having a c-Section.
Epidurals particularly combined with syntocinon can make baby very very sleepy so as with pethidine you will need to really help baby establish breastfeeding and you may get into a cycle of low milk supply as baby doesn’t demand enough milk.
7. After the Birth
Natural Placenta Delivery
You can be given an injection to speed delivery of the placenta after birth … this is known as a managed third stage. There are various reasons why delivery teams may think you need this … e.g. twins, polyhydramnios … but some hospitals will inject you by default.
You should ask your healthcare provider what their practice is in advance and state clearly if you only want a managed third stage if medically necessary.
Although, a natural third stage in which you push the placenta out can take longer and involve more bleeding there can be complications of a managed third stage with parts of the placenta left behind. And some people think it interferes with breastfeeding.
Vitamin K is needed for blood to clot. Babies are offered Vitamin K shots as a small % don’t have enough when they are born. In the UK it is recommended that all babies receive it.
Some parents are unhappy with their baby being injected immediately after birth. One study in the 90s appeared to show a connection to childhood leukaemia but this has never been replicated.
What is certain is that babies at risk who don’t receive the shot can suffer from bleeding on the brain which causes brain damage and in some cases death. Unfortunately, it is not possible to identify the babies at risk and so default injection for all seems to be best protection.
Would you like your partner to cut the umbilical cord?
This can be incredibly moving but not if dad is squeamish … dads need the space to say no.
You need to advise the delivery team in advance and recognise in some circumstances it’s just not going to be possible without putting baby at risk.
Will you bank the cord blood?
Blood cord cells can be used in the treatment of a wide range of diseases.
Many hospitals will offer you the chance to donate the cord blood to a cord blood bank.
It is important to recognise that cord blood cells are NOT embryonic stem cells, the use of which in medical research you may be opposed to.
Would you like to have a son circumcised?
Boys can be circumcised at most North American hospitals in the days after delivery. You need to advise your healthcare provider if you want this to happen.
It’s not usually an option outside North America so you will need to make other arrangements.
8. After Birth Care
Do You Want Your Partner to Stay Overnight?
Some hospitals … particularly in the UK … do not allow partners or other family members to stay over night at the hospital after delivery. Personally, I found this an incredibly lonely experience.
Night shift midwives in a post-natal ward can in no way make up for having your family around you caring for you and your baby.
If you find your partner and family won’t be able to stay plan ahead so someone can stay with you right up until kicking out time and someone can be there first thing as soon as the ward opens.
Also, try to get some sleep during the day when partners and family are there and can watch baby … I found it impossible to sleep over night without someone watching my new born. It may have been crazy but more sleep in the day would have helped.
Do You Want Baby to Stay By Your Bed?
Many US hospitals offer nurseries in which baby can sleep so mum can get some sleep over night. This is now very uncommon in the UK.
Keeping baby close to you will help breastfeeding and bonding. But sleep also helps breastfeeding. If you have had a particularly long labour sleep may be the most important thing.
How Quickly Will You Leave Hospital?
After a natural birth you can typically leave hospital within 24 hours. After a straightforward C-Section it is usually 2 or 3 days. And can be longer if there are complications for mum and baby.
As a new mum you may feel nervous about leaving the support of the hospital particularly if you have had a c-section. But hospitals … particularly public post-natal wards … are noisy places. Most mums find they get more rest and sleep at home.
Believe me inductions aren’t great!
They often involve very long, slow labours and are more likely to result in the use of forceps or ventouse and a c-section, as the induction drugs can cause the baby distress.
Some mums will tell you to avoid one at all costs but if baby is overdue or there are complications in late stage pregnancy they may be necessary … I was induced at 37 weeks for polyhydramnios.
So although, you almost certainly don’t want to be induced, it’s worth understanding what the options are and asking your delivery team in advance what their usual practice is.
Find out from your healthcare provider …
- How long after due date they are happy for you to go before induction?
- How long after waters breaking they will want to induce?
- Whether they will want to try stripping or sweeping the membrane … this involves a midwife or doctor inserting their finger into the cervix and separating the sac from the uterus
- If you will be able to go home after being induced or will need to stay at the hospital
Initially induction usually involves a prostaglandin tablet or pessary and if this doesn’t work a syntocinon drip after waters have been manually broken.
Induced babies may take longer to breastfeed effectively due to delays in milk coming in and the baby being sleepy after a long labour.
10. Manual Intervention
Forceps or Ventouse
Your delivery team may want to use forceps or ventouse if your baby is in a difficult position or making very slow progress in late labour.
There are risks of bruising to the baby’s face and head and of mum having tears that require sewing, which can be associated with incontinence.
Some mothers prefer to have a c-section than to have forceps or ventouse. Find out from your healthcare provider what their policy is regarding this.
I do regret having had to have a c-section. I felt robbed of a natural birth.
BUT … big BUT I know it was the right thing for my baby who was in distress.
Most mums won’t put “have a c-section” on their birth plan, but there are all sorts of reasons why it may be neccessary to have a c-section or you may end up feeling you want one.
The most valuable advice I can share is to read in advance about some of the consequences of having a c-section so you can prepare yourself if it is needed and make it the best experience possible for you and your baby.
More pregnancy and baby related posts:
- ALL THE NEW MOM AND BABY POSTS IN ONE PLACE
- FIRST TRIMESTER PREGNANCY TIPS
- 5 FIRST TRIMESTER PREGNANCY MUST-HAVES
- WHAT TO PUT IN A MORNING SICKNESS SURVIVAL KIT
- 30 NATURAL REMEDIES FOR MORNING SICKNESS
- WHAT TO PUT IN A FIRST TRIMESTER CARE PACKAGE
- HOSPITAL BAG ESSENTIALS CHECKLIST: AKA THE THINGS YOU ACTUALLY NEED FOR YOU AND YOUR NEWBORN BABY
- FREE HOSPITAL BAG CHECKLIST PDF PRINTABLE
- STEP BY STEP GUIDE TO WRITING A BIRTH PLAN
- COPING WITH POLYHYDRAMNIOS
- THE ULTIMATE BABY REGISTRY CHECKLIST AND BEST REGISTRIES GUIDE
- IS IT RUDE TO PUT EXPENSIVE ITEMS ON BABY REGISTRY?
- WHAT DO YOU NEED AFTER GIVING BIRTH?
- NEWBORN BABY ESSENTIALS CHECKLIST LIST. PLUS FREE PRINTABLE CHECKLIST
- BUILDING TOYS FOR BABIES
- BEST BEDSIDE CO-SLEEPER CRIBS AND BASSINETS 2020
- ESSENTIAL BABY TOYS FOR BABY’S FIRST YEAR
- BABY SLEEP TIPS
- BREASTFEEDING TIPS
- SIMPLE TIPS TO INCREASE BREASTMILK SUPPLY
- TOP TIPS – CRADLE CAP
- INTRODUCING SOLIDS WITH BABY LED WEANING
- HOW TO RELIEVE BABY REFLUX
- TOP TIPS TO REDUCE COLIC
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