How to write a birth plan: A guide for mums to be

As an expecting mum, there are many decisions to make about birth. Some women decide to write a birth plan to communicate their preferences and desires for their birth experience to their healthcare providers. Others prefer to go with the flow and follow the instructions of their medical team. Both approaches are alright. And it is important to do what feels right for you.

As someone who likes to have things under control, I decided to do quite a lot of research and write my birth plan. However, when I shared my birth plan with family and friends, I faced comments that it was useless and that things wouldn't go as planned. While many things were out of my control, I still feel happy that I wrote down my plan. After all, the hospital team tried to fulfil my wishes as much as possible. And I learned that while a birth plan may not guarantee that everything goes according to plan, it can still be a helpful tool for communicating your preferences and desires.

It's important to remember that giving birth is not a competition. There's no prize for having unmedicated labor or delivering vaginally. Every woman's experience and preferences are unique, and there's no one-size-fits-all approach to giving birth. Some women may choose to go without pain medication, while others may opt for an epidural or a planned C-section. It's important to make choices based on what feels right for you, rather than trying to meet someone else's expectations. Remember, the goal of childbirth is a healthy baby and a healthy mother, and there's no shame in choosing the path that works best for you.

In this article, we'll explore some tips for writing a birth plan that meets your needs, and I'll share what my birth plan looked like to give you an idea of how to structure your own.

Start with a template

Writing a birth plan can seem overwhelming at first, but starting with a template can make the process much easier. There are plenty of templates available online that you can use as a starting point. Look for one that resonates with you and meets your needs. Some templates may be more detailed than others, so choose one that feels comprehensive but not overwhelming. This was my birth plan:

Did it go according to the plan? Well, not really. But in the end, it was a very positive experience. I will talk about it in the next post dedicated to my birth story.

Discuss your options with your healthcare provider

When you have a draft of your birth plan or before writing it, it's important to discuss your options with your healthcare provider. This will help you understand what's available and what's realistic given your health and the health of your baby. Your healthcare provider can explain your options for pain management, delivery, and the immediate postpartum period. They can also help you understand the risks and benefits of each option.

Consider your preferences for pain management

Many women choose to include their preferences for pain management in their birth plans. This can include options like epidurals, nitrous oxide, and natural pain management techniques. You may have a strong preference for one option over another, or you may want to keep your options open. Whatever your preferences are, be sure to communicate them clearly in your birth plan. It's important to note that no decisions are final, and you can always change your mind if you find that you can't cope with the pain as you had hoped. Be open to discussing your pain management options with your healthcare team, and remember that the most important thing is the safety and well-being of you and your baby.

Here's an overview of some of the pain relief options that may be available during labor:

1. Epidural: An epidural is a regional anaesthesia that can help relieve pain in the lower half of your body. A needle is inserted into your lower back, and a catheter is then inserted through the needle to provide continuous pain relief. Epidurals are a common form of pain relief during labor and can provide effective relief for many women.

2. Nitrous oxide: Nitrous oxide, also known as laughing gas, is a gas that you breathe in through a mask. It can help you relax and reduce your perception of pain. Nitrous oxide is a safe option for pain relief during labor, and it wears off quickly once you stop breathing it in.

3. IV pain medication: Intravenous pain medication is a type of medication that is given through a vein. It can help relieve pain and make you more comfortable during labor. However, it may cause drowsiness, and it can affect your ability to push effectively during delivery.

4. Natural pain management techniques. These techniques may not completely eliminate pain, but they can help you cope with it more effectively.

   • Breathing techniques: Focused breathing can help you relax and cope with pain during labor. You may want to try slow, deep breathing, or quick, shallow breathing, depending on what feels most comfortable for you.

   • Massage: Gentle massage from a partner or a trained massage therapist can help relieve tension and ease pain during labor.

   • Water immersion: Some women find that being in a warm bath or shower during labor can help them relax and cope with pain.

   • Movement and positioning: Changing positions frequently during labor can help you find a comfortable position and relieve pain. You may want to try walking, rocking, or using a birthing ball.

   • Acupuncture or acupressure: These techniques involve the use of needles or pressure on specific points on the body to relieve pain.

   • Relaxation techniques: Techniques such as visualisation, guided imagery, or hypnosis can help you relax and cope with pain during labor.

It's important to discuss your options with your healthcare provider and birthing team, and to choose the option that is best for you and your baby. Remember, there is no one "right" way to manage labor pain, and what works for one woman may not work for another.

Think about your preferences for delivery

There are many options for delivery, and it's important to consider your preferences when writing your birth plan. Do you want to give birth in a hospital, birth centre, or at home? Do you want to have a vaginal delivery or a C-section? Here is more information on some of the preferences you may want to consider when it comes to your delivery:

1. Monitoring baby's heart rate: During labor, your healthcare provider will likely monitor your baby's heart rate to make sure they are tolerating labor well. You may have a preference for how this is done, such as with an external fetal monitor or an internal monitor.

2. Vaginal examinations: Vaginal exams are often performed during labor to check your progress and the baby's position. You may have a preference for how often these exams are performed or whether you want to decline them altogether.

3. Episiotomy: An episiotomy is a surgical cut made in the perineum to widen the vaginal opening during childbirth. Some women have a preference for whether they want an episiotomy or not, and may prefer to try other techniques to avoid tearing or the need for an episiotomy.

4. Perineal massage and compress when crowning: Perineal massage and compress during crowning can help reduce the risk of tearing or the need for an episiotomy.

5. Pushing preferences: Some women prefer to be led by the midwife in terms of when and how to push, while others prefer to follow their body's natural cues.

6. Use of tools: Forceps, vacuum extraction, and other tools may be used during delivery to help facilitate the birth. You may have a preference for when and how these tools are used, or you may prefer to avoid their use altogether.

7. Pushing positions: Different pushing positions can be more comfortable and effective for different women. You may want to discuss options such as squatting, using a birthing stool, or leaning forward with your healthcare provider.

8. Labouring aides: There are various tools and aids available to help you manage your labor pain and discomfort. These include a squat bar to help you maintain an upright position, a birthing ball to help you stay active and find comfortable positions, a peanut ball to help open up your pelvis and encourage the baby to move down, and a stool or chair to help you find a comfortable position for pushing. You may want to discuss these options with your healthcare provider or birth team to determine which ones may be right for you.

These are all important considerations to include in your birth plan. You may also want to consider who you want to be present during the delivery, such as a partner, family member, or doula.

Include your preferences for the immediate postpartum period

After your baby is born, what do you want to happen? Do you want to hold your baby skin-to-skin right away? Do you want to delay cord clamping? Do you want to breastfeed immediately? These are all important preferences to include in your birth plan. The immediate postpartum period is a critical time for bonding with your baby, so be sure to communicate your desires clearly. Some preferences that you may want to consider for the immediate postpartum period:

1. Delayed cord clamping: Delaying the clamping and cutting of the umbilical cord can allow more blood and nutrients to pass from the placenta to the baby. This can have potential benefits for the baby's health and wellbeing.

2. Who cuts the cord: Some parents prefer to have the partner or another designated person cut the cord, while others prefer the healthcare provider to do so.

3. Skin-to-skin contact: Skin-to-skin contact between the mother and baby immediately after birth can help regulate the baby's temperature, heart rate, and breathing, and can promote bonding and breastfeeding. You may want to request skin-to-skin contact as soon as possible after delivery.

4. Breastfeeding: If you plan to breastfeed, you may want to request help with breastfeeding as soon as possible after delivery. This can include support from a lactation consultant or healthcare provider, and ensuring that the baby has a good latch.

5. Delayed exams: You may want to delay routine exams, such as weighing the baby and measuring their length, to allow for more uninterrupted bonding time between you and your baby.

6. Golden hour: The first hour after birth is sometimes referred to as the "golden hour," and can be a special time for bonding and breastfeeding. You may want to request that any routine procedures, such as giving the baby a bath or administering vitamin K, be delayed until after this hour.

7. Vitamin K: Vitamin K is often given to newborns to help prevent bleeding disorders. You may want to discuss your preference for giving vitamin K with your healthcare provider.

8. Delivering the placenta: Some women prefer to deliver the placenta naturally, while others prefer to have it manually removed by the healthcare provider. One common practice is the administration of an oxytocin injection to help prevent excessive bleeding. You may have a preference for how this injection is given or whether you would prefer not to receive it. Additionally, some women may be interested in the practice of placenta encapsulation, which involves processing the placenta into capsules to be taken as a supplement in the weeks following childbirth. Others may prefer to have the placenta buried or planted, often under a special tree, as a symbolic gesture.

9. Keeping vernix on baby: Vernix, the white substance that covers a newborn's skin, has moisturising and antibacterial properties. Some parents prefer to leave the vernix on the baby's skin instead of wiping it off immediately after birth.

10. First bath: Some parents prefer to delay the first bath to allow for more bonding time.

11. Dummy (pacifier): Some parents choose to offer a dummy to their newborn for comfort, while others prefer not to. Discuss your preference with your healthcare provider.

Keep it concise and easy to read

Your healthcare providers will be busy, so keep your birth plan concise and easy to read. Use bullet points and avoid lengthy explanations. You want your healthcare providers to be able to quickly reference your birth plan and understand your preferences. You can also download this template and just tick your preferences.

Be flexible

Remember that birth can be unpredictable, and your plan may need to change based on your health or your baby's health. Be open to changes and be willing to communicate with your healthcare provider about any adjustments that need to be made. Your healthcare provider is there to support you and help you achieve the best possible birth experience.

Make sure your birthing partner knows the plan

It's a good idea to discuss your birth plan with your partner beforehand and make sure they understand your wishes and preferences. They can then act as your advocate during the birth and help communicate your preferences to the medical team. In addition to being knowledgeable about your preferences, your partner can also provide emotional support and reassurance during labor and delivery.

By following these tips, you can write a birth plan that meets your needs and helps you achieve the birth experience you desire. I wish you all the best as you work on your birth plan and congratulate you on your upcoming arrival!