Your Birth Plan

An ideal childbirth experience can mean very different things to different people. Every woman has a different idea of how they want their labour and birth to go. For example; some women want to experience every contraction and feel every sensation of their baby’s birth, some women want to be as pain free as early as possible and some just want to see how they feel once they are actually in labour. All of these choices are equally valid – no-one is right or wrong. These are the things which are important to them. These choices can help women feel like they have some control in their birth experience and for me as a midwife, they then become important to me too.

The majority of women in the UK meet the midwife who cares for them in labour and during birth when they are already in labour. We will not have had the opportunity to discuss these wishes for your birth beforehand. As a midwife, knowing what is important to you from as soon as we meet means I can do my best to support your choices for birth and strive to facilitate the best birth experience possible. Learning and considering your birth choices is essential before you write your birth plan.

Be prepared

Not just the scout’s moto! To make an informed choice and plan your wishes for birth, it is essential that you learn about what options are available.

Most units and hospitals will provide antenatal or parent education and tours of the facilities they offer. You will also receive many leaflets and booklets throughout your pregnancy and many units are providing these online on their websites. These are a great resource to understand the options available to you at your chosen birthplace and they will include information regarding their benefits and risks. NHS choices is an excellent resource.

We would always advise you to be cautious of reading unaccredited or unofficial maternity information as they may be inaccurate or in some cases, quite dangerous. Although pregnancy forums and groups can be a wonderful way to meet other new mums and mums-to-be, these often contain inaccurate information so choose your reading resources wisely.

Sharing your birth plan

Having your birth plan prepared by your 34 week appointment will give your community midwife the opportunity to discuss this with you. If your birth wishes are complex or if they fall outside of your hospital or unit’s guidelines, your midwife may refer you to the Head Of Midwifery (HOM) or consultant midwife who can discuss this with you in more detail at a longer appointment. They will likely ask for the opinion of one of the senior doctors too. You can also self-refer to the Head of Midwifery if you wish to, you can usually contact the HOM via your hospital’s antenatal clinic. This doesn’t mean you cannot birth in the way you wish to, it simply gives you all an opportunity to collaborate together, with you at the centre of the decision making, to ensure care is provided safely and that you understand your care options.

That said, like many things in life, sometimes things don’t go according to plan. You may decide on the day that you want to change your mind and choose another option and sometimes plans need to evolve with the clinical situation. Even if additional resources have been used to facilitate your birth wishes, this does not mean you can’t change your mind. If the clinical situation changes, i.e. you or your baby have signs of becoming unwell, your midwife (and likely your doctor) will discuss any proposed changes to your plan with you and explain the reasons, benefits and possible risks involved. Your maternity team should strive to give you a chance to digest this information to enable you to make an informed decision. However, in an emergency situation, this process will be done quite rapidly. Ultimately, as long as you understand the choices which are available to you, including the risks and benefits, you have the final say in what care is provided.

Things to consider

  • Would you like to give birth at home, in a midwifery-led unit or consultant-led hospital? Visit our Place of Birth page.
  • Who would you like your birth partners to be? (Most units recommend 2 birth partners only)
  • Would you prefer not to have students present?
  • What are your preferences for pain relief?
    • Simple methods (such as TENS, keeping active, using a birthing ball etc.)
    • Gas and air
    • Using the birthing pool
    • Injections
    • Epidural
  • How would you prefer your baby’s heartbeat to be monitored?
  • Most hospitals assess your progress 4 hourly by performing a vaginal exam, is this acceptable to you?
  • What positions are you keen to try during labour and birth?
  • Would you like your baby born onto your chest/tummy or dried first?
  • Would you like to delay clamping the cord?
  • Do you or one of your birthing partners want to cut the cord?
  • The delivery of your placenta.
  • Would you like to keep your baby skin-to-skin for at least the first hour following birth?
  • Would you like Vitamin K for your baby?
  • Do you have any spiritual or religious practices you would like observed during your labour and birth?

Be Empowered:

MAMA Academy have found a few different links for creating your own birth plan, which can be discussed with your midwife during pregnancy.

http://www.nhs.uk/conditions/pregnancy-and-baby/pages/how-to-make-birth-plan.aspx

http://aimsireland.ie/birth-preferences-template/