Short on time? Then the key things to know are:
- You should have an appointment to discuss your birth plan with a midwife at around 36 weeks
- It is important to remain flexible if any complications arise - it is not a failure if things don’t go to plan
- A birth plan appointment is a chance to discuss labour and birth and ask any unanswered questions with a midwife, at the same time it gives your midwife a good opportunity to get to know you better and understand your feelings and preferences
- You can change your mind at any time - you don’t have to stick to the plan at all times
- It is more important to be aware of your choices and preferences rather than trying to adhere to a strict plan
A birth plan is a written account of your birth preferences. Whilst it is always nice to have a plan to follow, it is worth bearing in mind that not all births will go to ‘plan’ and that it is more important to become aware of your options rather than trying to stick to a rigid plan.
In this article we share the top things to consider for your birth plan.
Why is it important to have a birth plan?
Having a discussion with a midwife about your birth plan can give you the opportunity to ask plenty of questions around the birth and to find out more about what happens during labour.
A birth plan discussion gives your midwife the chance to get to know you better and understand your feelings and priorities. It also allows you to think through and discuss your preferences with your birth partner.
Like we said, it’s more about discussing your preferences rather than a strict plan and you are perfectly within your rights to change your mind at any time.
When should I do a birth plan with my midwife?
You should have an appointment to discuss your birth plan with your midwife at around 36 weeks of pregnancy.
How to write a birth plan
Below are 11 important things to have on your birth plan.
Birth plans should include…
Who do you want with you as a birth partner?
Current restrictions across the UK state that only one birth partner is allowed in a hospital setting. Usually most birthing units will allow two birthing partners to accompany you.
Where do you want to give birth?
Choosing where to give birth is your first key decision. Throughout the UK you have the following options:
- At home
- At a stand alone birth centre
- Midwifery led unit (often in hospitals and alongside an obstetric led unit)
- Obstetric led unit - where you will be cared for by midwives but there are obstetricians (Doctors specialised in birth) available should you need any intervention
Find out more about birth place decision making.
What forms of pain relief are you considering?
It’s a good idea to think about labour pain relief in advance. In the UK you have two options:
Non intervention forms of pain relief, such as:
- TENS machine (Trans Electronic Nerve Stimulator)
- Water therapy (bath/shower/birthing pool)
- Entonox (gas and air)
Medical forms of pain relief:
Would you prefer an active labour?
An active labour is where you are able to mobilise and move around as much as possible, allowing your body to be in the position that it feels most comfortable during labour. Being upright allows gravity to work with your body, enabling a quicker more natural labour.
Consider ‘UFO’ - Upright, Forward, Open positions to encourage a more natural labour.
How would you like your baby to be monitored?
During a low risk labour, midwives will recommend that they listen to your baby’s heartbeat every 15 minutes during the first stage of labour and every 5 minutes (or after every contraction) during the second stage of labour, this is called intermittent auscultation.
If for whatever reason your baby needs to be monitored more closely, the following methods will be offered:
- Continuous monitoring via CTG (cardiotocograph) This is when your baby’s heart beat is monitored continuously using an external doppler that is strapped to your abdomen. There will also be another sensor which monitors your contractions.
- STAN monitoring, continuous monitoring of baby’s heartbeat with more accurate ST analysis, this is via a fetal scalp electrode (an electrode which is placed on your baby’s scalp.
Vaginal birth or caesarean section?
All women have the right to choose a caesarean section for the delivery of their baby.
Vaginal birth is always considered the safest method for the health of both mothers and babies unless a caesarean section is medically indicated.
Find out more about elective c-sections.
Ventouse or Forceps
Consider assisted births (Ventouse or Forceps delivery) and think about your preferences regarding these types of birth. Both these types of delivery are only considered when absolutely necessary, under these circumstances it is best to take the advice of your obstetric team at the time as to which method of delivery would be the best. Some women would prefer to opt for a Caesarean section than a forceps delivery so it is worth considering both these options and making your carers aware of your preferences.
Who wants to cut the umbilical cord?
Cutting the umbilical cord is quite often a right of passage for birth partners, when they step up to their big part in the whole birthing procedure. However some may be a little squeamish and not want to partake in this particular moment of glory, so this is definitely something to discuss.
Physiological or active 3rd stage for placenta delivery?
Many women don’t even know that they have an option for the delivery of the placenta, but indeed they do. If there has been no medical intervention whatsoever during the birth, it is thought that there should be no need for any intervention to deliver the placenta and women can allow the placenta to be delivered naturally. This usually happens after a couple of contractions and a few little pushes. This is a physiological 3rd stage.
Some women opt to have an injection of a bolus dose of Oxytocin following birth, which causes the uterus to contract quickly and expel the placenta. If you have been induced or have had any medical intervention during the labour of birth it is recommended that you have this injection to prevent any excessive bleeding following the birth.
There are no serious side effects from having an active 3rd stage of labour, although some women may experience some nausea. When having an active 3rd stage, the midwife will help you to deliver the placenta by applying a small amount of traction on the cord (by this time the cord will be clamped and cut and no longer attached to your baby!)
Consider how you want to feed your baby; breast or bottle?
If you wish to breastfeed you will be given help with the first few feeds from the midwives. If you wish to bottle feed, most hospitals throughout the UK will have formula milk available for your baby.
This is also a good time to think about colostrum harvesting; the collection of your first drops of breast milk.
Vitamin K after birth?
Vitamin K is a vitamin that all babies are offered following birth and is highly recommended. It helps with blood clotting and reduces the chance of any blood clotting issues following birth.
Babies can have this either via injection (this is usually carried out when the babies are being checked over and weighed) or via oral syringe. If they have an oral dose they will be given 3 doses over the course of the first month.
Your birth plan is your choice
It is important to remember to be flexible and be prepared to do things differently if any complications arise or if facilities such as a birthing pool aren’t available.
Need support with creating your birth plan? Book a midwife appointment online at a time that suits you to get specialist advice.
Kate, Naytal Midwife
Kate has been a Midwife within the NHS for more than 15 years and supports women to work harmoniously with their bodies and tune into their intuitions.