Designing a birth plan
A birth plan is a way of communicating your wishes to those who will care for you during labour. It helps you to think about the kind of labour and birth you would like to have, and what you particularly want to avoid. A birth plan most importantly, enables you to communicate your wishes clearly to your care providers. But like a lot of things in life, birth doesn’t always go to plan. There is a lot you are in control of, but some things are definitely out of your control. Always keep this in mind when writing your birth plan, as it saves a lot of disappointment and regret later on.
Birth plans should be guides and not set in stone–they should enhance your birth experience, not be a means of conflict. This is why it is best to write a birth plan in conjunction with your care provider. It is also a good idea to get as much information as you can before writing it. This includes reading pregnancy and birth books and going to antenatal classes. Talk to other women about what worked for them, and try not to listen to the inevitable horror stories.
Make sure you include your partner in formulating the birth plan, as they need to be happy with it and be able to advocate for you during the labour. Your support person should also be aware of your birth plan. Birth plans can come in handy when quick decisions need to be made and you might not want to be disturbed during labour. On the other hand they may stop an unnecessary procedure, like an episiotomy, being done without talking to you about it.
There is no formal structure to a birth plan. Write your ideas down on a piece of paper and then you can group them into headings, if you feel it will be easier to read. Dot points can be easier to read than an essay style. If you have a midwife you know who will be at the birth, then less detail is needed as you will have discussed all your plans beforehand and she will be aware of them. However, even in this case she may not be able to be there for all or some of the labour, so you want to have a plan for others who may care for you.
There are some common things women tend to include in their birth plan but remember, you need to make a plan that works for you. Your birth plan is confidential and for you to show to whom ever you want, so you can be as honest as you like.
What to include in a birth plan
Who do you want (and not want) to be with you in labour? Do you want the support person in all the time or to go out for certain procedures or stages?
What kinds of pain relief do you, or do you not want?
Positions for labour and birth
Which type of birth positions would you like to use for the labour and birth.
If you have a midwife caring for you in an environment that has a birthing pool, then you may be able to request a water birth, or to just labour in the water for pain relief.
Some doctors have very high episiotomy rates (surgical cut to the perineum), and you may want to ask that this not be done unless absolutely necessary. If you need to have assistance during the birth, you may want to ask a vacuum extractor is used rather than a forceps, as it leads to fewer traumas for you and the baby. You may also not want your membranes broken artificially, unless absolutely necessary.
You may choose not to have an injection in order to deliver the placenta faster after the baby is born. Discuss this with your care provider, as women experience less bleeding when they do have the injection.
Feeding the baby
Be clear about how you will feed your baby. Asking to have the baby put on your skin straight after the birth and to encourage early breastfeeding in the first hour is best and leads to more successful breastfeeding. If you don’t want your baby to have any bottles, then let the midwives know. They should ask your permission anyway if this is required.
Some women ask that their partners can stay with them in hospital, or their children be with them for the birth. There may be certain religious and cultural traditions you would like to adhere to.
Birth plans should be like birth, written joyfully and positively, but with a sense of acceptance of the great unknown. When birth plans turn into report cards of women’s’ success or failure, then they are not being used appropriately.