Birthplans have been the topic of much debate over the past few years. I’ve seen so many reasons given for why we shouldn’t write them: they set you up, they give you false expectations, they are rarely read anyway and mean nothing to medical staff, just to name a few. But I honestly believe in writing a birth plan, and I think every expectant mother should write one.
Okay, SHOULD is perhaps a little more prescriptive than I intended, but I think birth plans are important if only for one reason: They make you think about birth, and make you take some responsibility and an active role in your birth rather than birth being something that happens to you.
I’ve heard it said that people will spend more time researching what car radio to buy than how to give birth, and I find that pitifully sad. I’ve seen it even – a woman coming in to labour ward in labour, spots a poster on the wall and says to her partner, “Oh wow, you can give birth in any of these positions?’
So, I believe that your birth plan is there to help you consider your options, and to help you decide and prepare. It’s also there to give your birth attendants an idea of what you are hoping for. It is not a script, however, and for everything to fall into place, a lot of preparation, planning, research and a little bit of luck are needed too.
Some thoughts on birth plans
Some people recommend having two birth plans – one with your ideal scenario, another with alternatives. For example, say you’re planning a home birth, but end up with an emergency c-section, having an alternative birth plan can allow you to research the alternatives too. For example you can request to have your baby with you while you’re being stitched up ( assuming s/he’s okay) and so on. I’ve heard many transferred homebirth mothers say that the reason it’s been so hard for them is that they simply had no idea what to expect when they went in for their operation. I know that would have been the case for me. Knowledge, true knowledge, and true preparation, means knowing your rights and alternatives even when things don’t go to plan.
Also, be sure to discuss your birth plan with your care provider before you go into labour. If your midwife arrives at your house when you’re already trying to push, she may not have the chance to read it. Make sure your birth partner who will be assisting you at the hospital is very familiar with your wishes too, so that they can be your advocate and speak up for your choices when you might not be able to.
With all of that now established, I’ve used as my foundation a birth plan that our local drugstore-parenting-club gives out, and with my last pregnancy I adapted it to suit my needs. I’ve done the same again this time.
Over the coming weeks and possibly months, I will be ‘writing up’ my birth plan by looking at each of the following questions in no particular order, and really examining what they mean.
1)The name you’d like to be called?
2)My preferred birth partner would be… Who is my…
3)I’m happy to be photographed/video taped during labour, yes or no?
4)During labour I would like the following pain relief:
5)I would like to use the following during labour:
6)My preferred positions in labour are
7)Am I happy to have students present?
8) I am happy to have my baby’s heartbeat continually monitored, yes or no?
9) I would like to be in the following position to give birth
10) My thoughts on having my waters broken artificially
11) I would like to be told when to push or push when it feels right?
12) My thoughts on having an episiotomy
13) I would like my birth partner to cut the umbilical cord, yes or no?
14) My thoughts on being given an injection to contract my womb before the delivery of the placenta
15) I would like my baby to be delivered straight into my arms or wiped first
16) Would like my baby to be given Vitamin K, yes or no.
17) I want to feed my baby by…
18) My special requests…
So… what am I missing? What should be included here? What should I still ask?
How To Write A Birth Plan And Why You Should
Happy, halhtey babies, achieved! Birth plans went out the window, massage, essential oils did bugger all to help with the pain it just bloody hurt! So in went the Epidural. With the second one no time, just pain and a very quick delivery it felt good to be in control and to feel it all, but if it had been any longer than the 2-3 hours I laboured (mostly in the car on the way to hospital) drugs would have been required .Love your stuff, Emma .
I reckon that when you walk into the hospital your Birth Plan needs to be handed to the midwife to read. I have come across the Birth Plan accidently AFTER the event. If you have done your research then you SHOULD/OUGHT to be calm enough to wait while the midwife reads it. For MANY woman the birth plan falls apart when the intensity of the pain surprises her and the “prepared” partner suddenly finds himself no longer focused on the process but on his partner.
ALSO what is stated above re being set up and then dropped is so true if the hospital you are intending to use says on thing but practises another.I have seen few that ACTUALLY will take your wishes into consideration..therefore consider community birthing units if home birthing is not acceptable!!!!!!
I am a registered midwife 3 countries 2 continents
I think that it’s really important to prepare yourself because once you’re prepared it’s like half the work is done already 🙂 so great post on creating a birth plan. I never did write anything out with my first child but i will with the next one for sure
I would suggest putting pain relief options as the first part of the plan…from experience and friends experience (although doesnt seem to count if you dont ‘book’ yourself in at the time you are ‘due’) as otherwise they dont have the right medical professional to give you that care.Maybe im thinking more along the lines of late stage labour but it can come quickly so….maybe advice could be given to 1. preplanned labour (inducction)and 2. first time…hope youve got a plan cus its happening NOW
I’m always really surprised by the negative comments about birth plans. Presented in the right way, I think they can be a wonderful tool for keeping everyone on the same page. I can’t say enough how happy I am that I wrote one. I *know* it had a great deal to do with the success of my birth.
I wanted no pain medication to be given at all, and on other thing I noted was that I did not want to be offered any during my birth either. I didn’t want a well meaning nurse’s persistent offers of an epidural to introduce self-doubt. No one mentioned meds once and it was a wonderful thing. Other things I included that I don’t see discussed here were: I asked that no IV be administered, unless in the case of an emergency. I opted not wear a hospital gown, and chose to eat and drink throughout my labor. I requested dim lights and soft voices in my room.
I’m not sure about the standard of care there, but newborns are routinely given the Hepatitis B vaccine here, so I noted my feelings on that as well. Then there’s the rest of the baby care issues: antibiotic ointment in the eyes, the first bath, swaddling, etc. Plenty to think about there!
You may want to add something about “In the case of an emergency…” One thing I had written was that I want to be notified of my options (if there was time.) I think mine was something like: “I would like to be informed of all options in the case of an emergency and the possible results of each choice.” So, if my Dr. had decided I needed a C-section, I wanted him to tell me the possible consequences of waiting until the last possible moment to head to the OR and what could happen if I didn’t consent to one.
Another thing to include would be some of the other things you’d like to happen (or not happen) right after birth – cord clamping/cutting, mom & baby bonding immediately after birth or do the baby evaluation first, breastfeeding/bottle feeding… Right after having babies, my body went into shock and I couldn’t think straight. It was good to have these things written down!
I write down three things for my midwives: Please do not speak to me during contractions unless it is a genuine emergency. I do not welcome commentary or instruction when pushing. We plan to lotus birth and will at the least be leaving the cord until it stops pulsing. Those are the only things that are not assumed, either at home or hospital, that I would not wish to have to tell them myself.
I have written birth plans in the past, and with my second birth I wrote a long one – then tore it up and threw it away. If I can’t trust the midwife attending me, I’d insist that they leave. If I did trust them, why would I assume they’d go against their stated policies (which are in line with what I want ie not to be offered pain relief, to be offered skin to skin immediately, etc?)
For me, the debate is already over. The research is important. Knowing your birth partner and having them be informed of your wishes is important. A piece of paper to hand to care providers simply doesn’t work.
@Sarah, I agree with you in almost all circumstances – with the exception that midwives differ even in the same NHS Trust and that it can and does happen that you have never even met the person who arrives on your door step. I was ‘lucky’ because my labour was so long, the midwife I really wanted ended up being the one I got – she was on leave the day I actually went into labour and the person I was supposed to have I’d never met. To me, having something with your thoughts, reasons and research written down shows the ‘new person’ where you’re at. Assuming they don’t arrive after it’s all over! 😉
Yes – thanks for those. Will be adding when to cut the cord and what’s to become of the placenta to my list!!