How to Write a Good Birth Plan

What is a birth plan?
A birth plan is YOUR plan for giving birth. It includes everything from who you would like to be in the room with you during labour, to what name you would like to be called (some people have nicknames they hate, and, trust me, the last thing you want when you’re giving birth is to be called something you hate), to the types of pain relief you are happy to be given.

Although a birth plan is not required to give birth, it is recommended on the grounds that it will provide the medical team who assist you during labour with an idea of what you would and would not like to happen. Of course, like all the best plans, some aspects of your birth plan will change when you go into labour. For example, I stated in my birth plan that I wanted a water birth, but when my contractions started, my baby’s heart rate hit 160 beats per minute (which is at the upper end of normal) so I was put on a constinous fetal heart rate monitor and told I wouldn’t be able to have a water birth.

You should think about writing a birth plan when you are between 30 and 34 weeks’ pregnant if you are having a multiple birth (twins or triplets), and between 32 and 36 weeks’ pregnant if you are expecting just one baby.

What should I include in my birth plan?
Below, we have provided a list of all the things you could include in your birth plan. We have added an asterisk (*) against the things you definitely should include.

#1 – People in the Room

Obviously, you will be in the room when you give birth, but you should also think about:

• What you want to be called (your name, a nickname) and what you definitely do NOT want to be called;
• Who you would like to be in the room with you (your husband, your mother, your sister). Most hospitals allow a maximum of two people (other than you) to be present.

#2 – Capturing the Moment

Giving birth is an amazing experience, but it is also intimate, painful and extremely messy. It’s best to decide in advance whether you are happy to have all or any of your labour immortalised in photos or videos.

Also think about whether you are happy for students to be present – your doctor or midwife may ask you if you are happy for work experience students to witness the birth. It will definitely help your stress levels if you have an answer prepared.

#3 – Birthing Aids

Some women like to keep “busy” during the early stages of labour – walking, talking, updating their Snapchat story – and they use this busy-ness as a birthing aid. Some women just want to concentrate on the task at hand. You won’t know which type of woman you are until you go into labour.

If you discover that you fall into the “task at hand” category, here are some birthing aids that you can control to help you get through the contractions:

• A birthing ball
• A birthing pool
• A birthing stool
• Beanbags and cushions
• Music
• Audiobooks

#4 – Pain Relief *

The first thing you should know is that pain relief in the form of medication is not obligatory during labour. Your doctor cannot make you take medication if you don’t want it. Some women prefer to give birth naturally with no pain relief at all.

If you are happy to use medication, these are the most commonly offered options:

• Co-codamol
• Entonox (Gas and air)
• Pethidine
• Epidural

Alternative forms of pain relief include:

• A bath or shower
• Breathing techniques
• Massage
• TENS

Check out our article on pain relief for more information.

#5 – Positions During Labour

The position most people think about automatically if you say “giving birth” is lying down on a bed with your knees up and your feet apart. This is actually not the best position to give birth in as it restricts the lower back and prevents the birth canal from opening fully.

Alternative positions include:

• Lying on your side with your knees drawn up
• Squatting
• On all fours
• Leaning forwards against a wall or other hard surface
• A combination of all of the above

However, if you have an epidural, you may find that numbness in your lower body means that lying down is the ONLY position you can safely be in. If this happens, don’t worry – the most important thing is that you’re comfortable, and that you realise there are other positions you can be in, either when you are dilating or once you are ready to push.

#6 – Monitoring your Baby

Some hospitals will give you the option of wearing a fetal heart monitor for the duration of your labour. This means you will be able to hear your baby’s heartbeat continuously.

There are different schools of thought regarding whether this is a good idea or not – some say it is good because you can immediately tell if the baby is becoming distressed, others say it is bad because it can cause you to perceive problems that aren’t actually there.

Either way, it’s worth thinking about it in advance and trying to work out whether “ignorance is bliss” or whether you would like to know what’s going on, even if it’s not good news.

#7 – Assisted Labour *

Of course, we all hope for a smooth labour without complications. But in the event that things don’t go as smoothly as planned, here are the types of assistance that may be offered to you at different points both before and during labour:

• A sweep*
• Artificially inducing labour
• Artificially regulating contractions
• Episiotomy
• Forceps delivery
• Ventouse delivery
• C-section
• Injection to help the delivery of the placenta

*used if your baby is overdue; your doctor will insert a finger into your cervix and rub the area around the base of the amniotic sac in an attempt to trigger the release of hormones that cause labour to start.

#8 – Meeting Your Baby

Finally, the moment you have been waiting for! You get to meet the little person you have been nurturing in your womb for the past 9 months. Your baby. Your. Baby.

It’s an important moment, so here are some equally important things to think about:

• Would you like the baby delivered straight into your arms / onto your stomach, or would you like them to be cleaned first?
• How are you planning on feeding your baby? Will you be breastfeeding, giving formula, or doing a combination of the two? Would you like to breastfeed straight away?
• Would you like your husband or birthing partner to cut the umbilical cord?
• Would you like to keep the umbilical cord? Some women choose to freeze the umbilical cord or umbilical cord blood so that it can be used for stem cell extraction later on.
• Would you like your baby to be given Vitamin K? Vitamin K helps the blood to clot and can prevent serious bleeding. It is recommended for all babies, either in injection or drop form (although if it is administered as drops your baby will need top-up doses at 3-5 days old and again at 4 weeks old).

And that’s it! Of course, you may have a list of “extras” you would like to discuss with your doctor, such as the type of room that you’d like (private, suite), the layout of the room, whether you’d like additional forms of entertainment, special meals, etc. But we’ll leave those finer details to you.

Good luck!