Be Prepared with a Comprehensive Birth Plan

Even though we often refer to pregnancy as “expecting”, the fact is that nothing can ever be completely planned or expected when it comes to childbirth. Nevertheless, there are certain things that you can take care of well before your baby is born to make sure that everything runs as smoothly as it possibly can, without any unforeseen hiccups. A birth plan will also ensure that your labour is managed in the way that you would prefer.

Once you have created your plan, it should be given to whoever is caring for you during the labour, and they should do their best to keep to it where possible.

Maintain control with your birth plan

The decisions that you need to make during labour are uniquely yours. You should never feel that giving birth is an overwhelming experience that is beyond your control. By writing a birth plan, you are empowering yourself and allowing the maternity care system to work according to your specifications.

In order to tailor your birth plan to your specific needs, there are various issues that you should consider well before you are ready to go into labour. The advantage of thinking about them is that not only will you and your husband be physically ready for the experience of labour, your hospital stay, and your homecoming before they happen, but you will also be more emotionally prepared. Childbirth is not just a physical event, it is also an amazing emotional experience that you will always remember.

Decide where you would prefer to give birth

One of the first questions to ask yourself is where you would like to have your baby. Some women prefer to give birth at home because they would prefer to be in their own surroundings, with their husband and children in the vicinity. By being in this nurturing, familiar environment, they feel more relaxed and less under pressure from the more clinical hospital ward.

If you are giving birth at home, it goes without saying that you would write a clear birth plan for the midwife delivering you, taking into account many of the issues mentioned in the other sections below.

On the other hand, other women would be afraid to give birth outside a hospital. The main advantage of giving birth in hospital is that there are professional doctors, nurses, and midwives on hand, and if anything were to go wrong unexpectedly there is the technology to handle it. What if you needed an emergency caesarean section or the baby needed oxygen?

Once you have decided where your baby will be born, pencil it into your birth plan. Then you must make sure to take care of any advance paperwork in good time. If you are going to a hospital or baby centre, make sure you are booked in. Once you have registered, put any forms or documentation that you need to take with you when you actually check in to give birth in the same folder as your birth plan. That way, you will not have any annoying bureaucratic problems when you arrive there already in labour.

Vaginal or caesarean?

What you plan next depends on the kind of birth that you are expecting to have. Speak to your doctor and find out whether he or she recommends a vaginal or caesarean birth. If you have never had a caesarean before and everything is fine with the pregnancy and baby, chances are that you will deliver in the regular way. However, if you have had a caesarean before, depending on the reason for it and the situation of your current pregnancy, you may find that your doctor will recommend a caesarean again. This is a very individual decision, and you are best advised to consult with your doctor to find out if this is the case.

Caesarean birth plan

If it looks like you are going to have a caesarean, there are various things that you could include on your plan.

Ask yourself if you want:

• A spinal epidural, so that you can remain conscious and feel a part of the experience, or do you feel overwhelmed and would prefer not to be aware of what’s going on if that is possible?
• Do you want your husband, mother, best friend, or professional doula to be present at the operation? If so, then write this down on your birth plan.
• Would you like relaxing music in the background during the surgery, or would you prefer silence? Do you want a step by step account of what is being done, to make you feel a part of the process?
• Would you like to stroke and touch your baby in their immediate unwashed, postnatal state, or would you prefer the hospital staff to hand the baby to you after the newborn has been cleaned up and weighed? Or should the baby be passed to your labouring partner?

Natural birth plan

If you are having a regular, natural birth, some of the above questions will also apply to you. However, when giving birth vaginally, there are other things that you might want to include in your plan.

• Pain relief – you would probably want to specify beforehand that you do not want to be offered an epidural, pethidine, or any other kind of drug treatment. The types of pain relief that you may want to stipulate instead (depending on where you are having the baby, what is available there, and what you are allowed to bring with you) are: use of a shower, a TENS machine, a water birth in a pool if the hospital or birthing centre allow it, or natural herbs that take the edge off the contractions.
• You can also stipulate on your labour plan that you would prefer not to use pitocin or any other type of drug to induce your labour. Instead, you would want to use more natural methods – unless of course the baby goes into foetal distress and emergency steps need to be taken.
• Similar to what is written in the caesarean strategy above, you should say whether you want to be handed your baby before they are cleaned and weighed and given the chance to nurse. And who should cut the cord? If you want it to be your husband, you should write this down.
• Does the hospital have a rooming-in policy? If so, you should state clearly in your childbirth plan that this is what you want, and if you are only interested in exclusive breastfeeding, you should also write this in your birthing plan.

Intervention

Of course, if you are not terribly interested in natural birth and would prefer a policy of more intervention, you would be well advised to read the points above and state your preferences (which are probably the opposite!). For example, if you have decided that you want an epidural and feel that you cannot give birth without one, you should state it very clearly in your plan. And if you would prefer that your baby is fed formula in the hospital nursery and to sleep there overnight, you should include these points in your birthing plans.