Making a birth plan

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What is a birth plan?

A birth plan tells health professionals (mainly midwives and obstetricians) about the type of labour and birth you’d like to have, what you want to happen, and what you want to avoid. It is a plan that is personal to you. It is best to be flexible about your choices because labour may not progress according to plan and how you respond to labour may be different from your expectations, particularly if you are having your first baby.

Are you required to write a birth plan?

No, you do not have to write a birth plan, but it may help you communicate your wishes when you are in labour and particularly if your experience of labour is making communication challenging. Your midwife can help you write your birth plan and will be able to discuss options and procedures with you. If you prefer, you can include a person who is important to you in these discussions, which might be your partner or the person you have chosen to support you when you have your baby.

What information should be included in a birth plan?

You can include whatever information you feel is important to you, your labour and birth. It is a good idea to talk with your midwife and doctor before you write your birth plan to find out if there is anything about your health, the health of your baby or the facilities available that may affect your choices. For example, if you have had a caesarean section previously, your doctor will advise you that the safest place to have your baby is in an obstetric led unit rather than having your baby at home or in a midwifery-led unit.

If you have needs that are specific to you such as physical disabilities, this means you may benefit from special equipment. If you have fears or anxieties such as a needle phobia, this may influence your choices of pain relief because you may wish to avoid pethidine (it is given as an injection) or an epidural. If you have special dietary requirements, you may need to pre-prepare food to take to hospital with you. If English is not your first language, you may need an interpreter, or if you are deaf, you may need a sign language interpreter.

For most women there are quite a few things to consider, as a start here are a few worth thinking about:

• Where would you prefer to give birth – at home or hospital?
• Who would you prefer to support you: your partner, your friend your relative?
• What position would you prefer to adopt when giving birth: standing, sitting, all fours, semi-recumbent, on your side?
• Would you want to give birth in water, a bed, the floor?
• What pain relief would you prefer – none, gas and air, pethidine, alternative or complementary methods such as aromatherapy or acupuncture, epidural?
• Do you have any particular preferences regarding birth procedures such as instrumental birth, caesarean section or episiotomy?
• Would you prefer a physiological or active third stage?
• Would you prefer immediate or deferred cord clamping?
• Do you want to try to breastfeed or would you prefer to use formula milk to feed your baby?
• Do you want to leave hospital (if you are planning to give birth in hospital, that is) as soon as you can (this is usually six or so hours after you’ve given birth) or would you prefer to stay in hospital at least one night?

Is there a certain format to follow when writing a birth plan?

There is no set format, you can write your birth plan however you want, but it is worth remembering that your birth plan is there to communicate your wishes to the midwives and doctors who will be caring for you, so it is a good idea to keep your wishes clear and concise. It may be useful to think of labour and birth as a journey, so you could order your wishes/choices as they would present themselves when you are in labour.

To whom do you need to show your birth plan?

It is best to discuss your birth plan with the midwife caring for you during your pregnancy and the person who will support you in labour (your partner, friend or relative) and when you give birth. When you come into the hospital or birth centre to give birth, you should show your birth plan to the midwife caring for you.

Can your choices and options on a birth plan be changed?

Yes they can, it is best to be flexible in your choices and options if you can because your labour and birth may not progress as you expect. If your birth does not go according to plan, your midwife or doctor will explain what is happening and what your options are. Nothing will happen to you unless you understand these options fully and give consent to any procedures.

Is it likely that your labour will go according to your birth plan?

Most women remain healthy throughout their pregnancies, most have normal vaginal births and most women give birth to normal healthy babies. It is difficult to say what the likelihood of labour and birth going according to plan though, that depends on your plan, your expectations and your beliefs and how flexible you are willing to be, because every birth is different.

Main Points

• A birth plan tells health professionals (mainly midwives and obstetricians) about the type of labour and birth you’d like to have.
• It’s important to remember to be flexible about your choices because your labour may not progress as expected and alternative options may need to be considered.
• A birth plan is not required, but it is very useful for communicating your wishes to your maternity team and is a good idea since it may become difficult to communicate during labour.
• Your midwife can help you write your birth plan and discuss the different options available to you.
• You can include whatever information you feel is important, which can include whether you have a disability and require special equipment or whether you have special dietary requirements.
• Some of the most common points to consider are whether you’d like to give birth at home or in hospital, what position you’d like to give birth in, your preference for pain relief, and how soon you would like to leave the hospital after giving birth.
• When writing your birth plan, it’s good to keep your wishes clear and concise.
• When you go into the hospital to give birth, you should give your birth plan to the midwife caring for you.
• If your birth does not go according to plan, your midwife and doctor will explain what is happening and what your options are. Nothing will happen to you unless you understand these options fully and give consent to any procedures.