Understanding and creating your birth plan

Creating a birth plan is ultimately about the process of exploring your birth options and clarifying what is important for you in your birth experience.  It leads you to feeling more confident that you have done all you can to communicate your wishes and desire for woman centred collaboration with your birth team. 

It needs both your head and heart in the process and it’s well worth you effort.  It’s not setting you up for failure, it’s setting up you to be aware of your rights, your choices, your feelings, your thoughts and help you work with your birth team to create your best birth possible. 

Although you don’t know what exactly will unfold on the day you give birth, you will have a better sense of control and power because of your engagement in the process of asking for what you want.  This can feel uncomfortable for many because we are not used to being respectfully assertive, or even for asking for what we want.    But remember this birth is happening with your body, your baby and you live with the experience!  You have a right to decide what is best for you and your family. 

The birth plan process aims to equalise power by reminding us that with respectful  communication the birthing mother and their partner can consider the pros and cons of the different skills, beliefs, practices and attitudes of their different birth team members – self, partner, midwife, doula, doctor etc.  We are relating human to human not just doctor to patient. 

So use your pregnancy time to read up and research about evidence based care and common obstetric interventions. Talk to your partner in depth about what you both want, what your expectations of each other are are and how you might navigate your birth experience together in care and consideration of your similarities and differences.   

Use your antenatal visits to discuss your birth plan with your care provider (use the checklist as a guide). Find out what happens in the hospital you’re birthing at and how your care provider practices.  Aim to understand their perspective on your health care and weigh up what is evidence based and specific to your individual care as opposed to policies and habituated practices.

Going through the process of researching, communicating about and writing your birth plan helps you feel into the emotions that may come up for you when you respectfully assert yourself. During labour this can be hard to do if you don’t already have a sense of your right and power to birth your way.  It may be helpful to seek quality emotional support to process, practice and integrate positive emotions into your sense of self during your pregnancy in preparation for birthing your way. 

Use the check list to prompt you about common practices in maternity care today.  Write up a simple end document that you can give to all the people who are a part of your care during your labour.  Give a copy to your primary care provider.  Take a few copies with you to the hospital.  Politely ask any new staff to read your birth plan before discussing your care.  Naturally an emergency situation compromises this process but do what you can to communicate what is important to you. 

If you have other support people with you in labour, such as a doula or friend, the birth plan offers them a point of reference to advocate on your behalf if need be. 

Creating a birth plan by doing the preparation during pregnancy means you are more likely to be able navigate your options more calmly and with more confidence.  You are more likely to have a team that understands how to best support you and take into considerations your individual needs.  It’s an empowering practice.  It’s a life skill that helps you become the mama and papa bear that will help you care for your baby and strengthen your family bonds. 

Realise your potential to creating the birth you want!   

Below you will find a birth plan checklist and a birth plan template. You can use these to work your way through common birth options you may encounter.  Then share this with your care provider and start shaping it in action.

Birth plan check list

Name  and due date

* State your philosophy of care regarding birth

* Birth team: midwife, doctor, doula, other health professionals

* Involvement of family, friends, children

* Address of hospital/homebirth

* Diet needs and allergies

* Spiritual, religious, cultural considerations

* Health insurance

Going past the expected due date

* Kick charts * Electronic foetal monitoring

* Placental function test  * Ultra sound examination

* Natural options to stimulate labour * Medical induction options

Labour, first and second stage

* Massage * Homeopathy / Aromatherapy

* Music * Meditation/spiritual practices

* Water – bath/tub, shower, wet cloths * Food, fluids

* Photography, video * Monitoring Baby

* Artificial rupture of membranes * Vaginal exams

* Choice of active birth positions *  Gas / opioids / epidural

* Perineal support/massage/oil/heat * Use of mirror

* Atmosphere of room and Set up * Partner assisting with birth

* Who is to discover the sex of the baby * Episiotomy

* Forceps or vacuum extraction

Labour third stage

* Baby to breast * Squatting / nipple stimulation

* When to clamp and cut cord or * Lotus birth

  • Natural or managed 3rd stage * Disposal of placenta
Baby care

* Bonding with baby / skin on skin * Breastfeeding / breast crawl

* Timing of weighing, measuring, bathing * Vaccinations: Vit K / Hep B

* Resuscitation and Intensive Care  factors * Rooming in

* If baby is deformed, injured or dies

In case of caesarean section

* Full explanation and informed choice * Time alone to process

* Atmosphere in theatre (calm/respectful) * People allowed into surgery

* Keeping mother and baby together * Photographs/video

Other ideas

* Visitors * Post-natal support arranged

* Attach your hospital’s code of ethics

 

Birth plan template

Our Birth Preferences: Place your names here

We are aiming for normal physiological birth and would like our birth teams skill and support to help achieve this.  We are aware that it is our human right to determine what is best for us.

If intervention becomes necessary for medical reasons, we wish to have the benefits and risks explained, as well as available alternatives, including doing nothing. Please encourage us to have some time alone to consider this information before making a decision.

We know that as a team we are working toward a safe and satisfying birth experience for both mother, baby and partner, now, and in the long term memory of this very special day. 

The things that are most important to us are:

  • That the natural process is not disturbed unless there is a medical need and we have agreed.  Please keep our environment calm and quiet with dim lights, low voices and minimal interruptions.
  • To labour and birth in any position that feels right. 
  • To work with the intensity of the contractions and to be supported emotionally and physically if I feel challenged.  Do not offer me drugs, I know what my options are.
  • To work with our doula who is giving us emotional support, physical comfort and helping us to understand our options. 
  • Access to a bath and shower for labour and or birth.  To birth in any position and support to use natural expulsive efforts. Please allow for longer time to birth if my baby and I are safe. 
  • Skin to skin contact immediately after birth, with minimal cleaning unless needed to stimulate the baby’s breathing.
  • A natural third stage if the birth has been normal, with the cord to stop pulsing before cutting. My partner to cut the cord if possible.
  • My baby to have time to initiate breastfeeding without assistance.
  • In case of an emergency or a caesarean please do all you can to preserve our birthing intentions.