What is a birth plan?
A birth plan is a means of communication, in writing, that connects the mother-to-be and her obstetrician, midwives and caregivers. It outlines the type of labour you would like, what you want to happen and what you would prefer to avoid. It highlights your preferences of decisions such as birthing positions, pain relief, and postnatal care. A birth plan is essentially designed to bridge the gap between you and your medical care providers at a time when you probably won’t be feeling too chatty or up for diplomatic discussion!
It is important to acknowledge, however, that not everything always goes to plan and it can be difficult to predict a birth. As such, birth plans are not written in stone and are often referred to by some as more of a set of ‘birth wishes’ or ‘intentions’. Your birth plan should not be drafted in a way that your providers feel restricted in delivering the best care for you medically should anything unexpected occur. A birth plan can provide a sense of control and strength, particularly to first time mothers, about what to expect and prepare for. In addition, it can minimise the possibility of any last minute, unresearched decisions. It can also help you discuss with your partner the ways and means to make the birth of your child memorable.
If you have a draft birth plan early in your pregnancy it is a good idea to begin talking through your ideas with your health providers early so you can find out in advance if your carer has any objections or needs to make preparations to ensure your wishes are met. Then you can discuss your wishes and have time to find solutions.
Preparing to write your birth plan:
Before you begin drafting your birth plan it is important to get as much information as you can to ensure you are aware of all your options. You may wish to use some of the below avenues for advice and then begin jotting down your ‘birth wishes’ as they come to mind so you can sort though them all once things start coming together for you.
- Speak with your partner or the person who will be your birth partner about how they see their role and if they have any desires for your labour and birth
- Attend antenatal classes. Your health care provider or other parents may be able to recommend a class in your area.
- Talk to other women who have given birth at your desired hospital or birth centre, or those who delivered at home if you are hoping for a home birth. Discuss their experiences with them, what they recommend and the level of care they received.
- Read our labour and birth related articles and become informed about the options and decisions available to you.
- Your healthcare provider is likely to have provided you with maternity notes, which may include suggestions for writing a birth plans.
What to include in your birth plan
Below we outline the details and preferences you may wish to include in your birth plan. This is not an exhaustive list of options that are available to you, you may not wish to include all of these if they are not important to you, or there may be others you can think of that are not outlined below. For more information speak with your healthcare provider.
You may have very special needs that you want to mention in your birth plan. Do you have a disability and require help in labour? Do you have particular religious needs? Do you require a special diet during your hospital stay?
Who do you want to be with you in labour? Do you want them to be with you through the duration of your birth or are there certain procedures or stages of labour where you would prefer them to leave the room?
Positions for labour and birth
Which positions would you like to use during labour and delivery? Do you want to be active – would you like to remain mobile or upright for as long as possible or would you prefer to lie down in bed?
What types of pain relief would you like to use, if any, and in what order? Would you prefer a natural labour or birth, alternative methods or medications?
If your hospital or midwife-led unit has a birthing pool, or if you are hiring one to use at home, do you want to use it for pain relief and/or to give birth in?
How do you want your baby to be monitored during labour? Do you want your midwife to listen to your baby's heart intermittently using a hand-held device or electronic monitoring using a belt strapped round your waist?
Do you want to give birth lying on the bed, or kneeling, standing or squatting? You may also want to indicate a preference for low-lighting or particular equipment such as a birthing stool.
If you need some help to deliver your baby, do you have a preference for forceps or ventouse?
Third stage (delivery of the placenta)
Would you like an injection to speed up the delivery of the placenta, or would you prefer a natural third stage without drugs?
Postnatal care of baby
Check your carer's policy on how your baby will be cared for after birth, and record your preferences. In most Australian hospitals most babies are routinely given an injection of Vitamin K and their first immunisation for Hepititis B. If you don't want your baby to receive these treatments you will need to make this clear before the birth.
Feeding your baby
Do you want to breastfeed or bottlefeed? Is your breastfed baby allowed to have any bottles or formula, if you don’t wish for this to happen you need to be clear about your preferences.
In the unexpected event that your baby needs to go to the special care baby unit (NICU) you may wish to include your wishes on the care they receive.