A birth plan is a document written by yourself that informs your care providers about how you wish your birth to be handled. It will let them know how you wish to be cared for during your labour and birth, and will help them to assist you in having the kind of birth you want.
Most women write some kind of birth plan, even if it is just a few notes to be kept within your maternity notes. Here in the UK there is a section within the handheld maternity notes that covers important points, such as what kind of pain relief (if any) you wish to have, and whether you want the baby to be placed immediately onto your tummy following the birth (or cleaned up first). This may be adequate for you, or you may wish to write something more detailed – especially if having a natural birth is important to you and you are planning on delivering in a hospital.
What your birth plan includes will depend largely on where you choose to give birth. If you are having a home birth, your birth plan won’t need to be quite as detailed as it would be if you were birthing at a hospital. Depending on who will be caring for you at a home birth, you may not even need to write one. Here in the UK home births are attended by NHS midwives, and the midwife who cares for you antenatally will probably not be the midwife who attends you at home, unless she happens to be on shift when you make the call.
Your birth plan should be concise – try to resist the urge to write reams and reams – there is no need to explain your choices on your birth plan. Simply state what’s important to you. Your providers will pay more attention that way. The language you choose is important too; try to be assertive without sounding bossy. Most importantly, be sure to go through your birth plan with your care provider prior to your baby being born. If you are planning a home birth in the UK, ask your midwife to put a copy of your birth plan in each office that could possibly dispatch your midwives to you – that way, it will be seen before D-Day, allowing the midwives to get a feel for how you want your labour and birth to be. Ensure there is a copy of it in your notes, and have a spare too.
Remember, your birth plan isn’t a contract. There may have to be compromises to ensure you or your baby’s safety. A good example of this would be something that happened at my home birth – I had stated in my birth plan that I absolutely did not want the cord clamped and cut until after it had stopped pulsing, ideally not until after the placenta was born. However, it became apparent when my son was halfway out that the cord was wrapped so tightly around his neck that the midwives were unable to unhook it. So, it simply had to be clamped and cut at that point. It is important to remember that your birth plan is as much for you as it is for your care providers – it’s a way of figuring out what you want from your birth (apart from the baby, of course) and deciding what points are most important to you.
Things may spring up during your birth that force you to compromise, or you may need to make compromises in the lead-up to your baby being born should certain issues present themselves. However, you shouldn’t ever be pushed to compromise with things that are very important to you if there is no medical reason to do so. If you have a good doctor that you can trust fully, you won’t need to second-guess them (and it’s never too late to find a new one, if you can). It can become a sticking point when Hospital Policy infringes on what you want for your birth – for example, if the hospital insist on continuous monitoring, placing an IV or withholding food from every labouring mother. In these situations it’s best to talk to your doctor to see if there is some kind of waiver you can sign in order to decline any standard procedures that you do not wish to have.
Following is a sample birth plan to help you put yours together. It is exhaustive, because I have tried to cover every point that I possibly could. You will almost certainly want to scrub at least a few of these from your list and add some of your own. This plan is written from the perspective of somebody birthing in a hospital who is seeking a totally natural, intervention-free birth – this may not be your prerogative, and I respect that. This is simply a guide to help you structure your own birth plan.
Mother: *your name goes here *
Father/Partner: *their name goes here *
Doula: (if applicable)
Other support person(s): *you get the idea… *
- Please help us create a peaceful environment for our birth – we would appreciate minimal interruptions by doctors, midwives and other staff.
- I do not wish to have my cervix checked for dilation during my labour after my initial check on admission.
- I wish to take food and drink freely during my labour. I will provide my own snacks and drinks if this is permitted, otherwise I will purchase them on site.
- I wish to allow my labour to progress at its own pace providing that myself and baby are doing well – I would strongly prefer to avoid AROM, cervical stretch/sweep, artificial hormone drips to augment labour or any other form of augmentation.
- I wish to be able to move around freely during my labour.
- I wish to labour and birth without pain medication. Please do not offer me any kind of pain relieving medication. I am aware of my options and I will inform you should I change my mind.
- I would like to labour in the birthing pool, if available.
- I would prefer for my baby’s heartbeat to me monitored intermittently with a Pinard stethoscope or doppler, unless continuous monitoring proves necessary.
- I do not wish to have an IV placed during my labour. I am happy to have a heparin lock placed instead as a compromise.
- I decline any non-emergency episiotomy.
- I do not wish to give birth laying on my back. Please allow me to assume the position that is most comfortable and effective.
- If possible, I would like for the room to be dimly-lit and quiet at the time of birth, with as few staff present as possible, although I appreciate that this may be difficult in a busy hospital.
- I would like to deliver in the birthing pool if it is available.
- I would like to deliver the baby into my own hands, or my partners.
- Please refrain from coaching the pushing stage – I wish to listen to my body’s cues and ‘breathe the baby down’.
Immediately Following Birth
- Please do not clamp/cut the umbilical cord before it has stopped pulsing, unless in absolute medical emergency. My partner would like to cut the cord when the time comes.
- I would like the 3rd stage of labour to be physiological – I do not consent to any drug to assist with delivering the placenta, or to any traction of the umbilical cord.
- I wish to keep my placenta, and I will provide a container for it. Please do not dispose of it.
- If I am unable to catch the baby myself, please put the baby on my tummy immediately following delivery.
- I do not wish to be separated from my baby at all following delivery. Please carry out immediate newborn checks whilst the baby is with me, and postpone any weighing/washing/dressing until we have bonded.
- If baby must be separated from me due to medical emergency, my partner will accompany the baby at all times.
- We do not know the sex of the baby and would like to discover it for ourselves.
- I decline the vitamin K injection and antibiotic eye ointment for my baby.
- I plan on breastfeeding the baby and wish to start as soon as possible following the birth.
- Please support us to have skin-to-skin contact with the baby after delivery for as long as possible.
- I do not wish to be separated from my baby at any point unless absolutely necessary.
- Breastfeeding is important to me – please do not offer my baby any artificial teats or formula at any point without my consent. I would like to see a certified Lactation Consultant during my stay if possible.
- If c-section is necessary, I would like my partner to accompany me in the operating room.
- If at all possible I wish to avoid general anaesthetic.
- Please lower the screen at the point of delivery so that I may witness my baby being born.
- If at all possible, I would like to avoid any type of incision that is not conducive to VBAC.
- When repairing the incision, please use a suturing method that is conducive to VBAC.
You may also wish to underline or bold particular parts of your birth plan that are especially important to you.
I hope this has been helpful! As always, I love to hear your feedback (constructive or otherwise). Please feel free to comment below!