HOW TO WRITE A BIRTH PLAN – ESSENTIAL TIPS AND WHAT TO INCLUDE

Awaiting my first child, I wanted to know everything there is about giving birth, what to expect and how to picture it. Now, I think you can read as many books as you like, you will only know once you are there. However, that doesn’t mean you cannot be prepared! You should know what you want (freedom to move around, presence of a doula, etc.) and what you do not want (continued monitoring, epidural, etc.) the day of the delivery. This is why I want to share with you how to write a birth plan.

Only knowing that your wishes will be respected will help you lose your fear and change it into something positive. This is what a birth plan is for.

All things are ready, if your mind be so. – William Shakespeare, Henry V

What is a Birth Plan?

Writing a birth plan will help you outline your preferences throughout labour & delivery. You can either write it down on paper for yourself and your partner so you feel more prepared and know your choices or you can give a copy to the hospital staff that will be at your side during labour & delivery. Write down everything that you believe will make labour and birth more comfortable and aligned with you.

It can include anything from monitoring, early labour, delivery and the first hours after your baby is born. It may include your preferences about room environment, pain management and birthing positions you want to be able to try.

This does not mean your wishes are set in stone. The birth plan is to be seen as a draft of how you would wish L&D to go. Don’t forget that giving birth to a tiny human is always unpredictable and that the medical staff is there to help you and guide you all along the way. The midwives’ priority is always mommy’s and baby’s wellbeing and safety.

I was very happy that most of my birth plan was respected but many changes needed to be made as unexpected things can happen.

If you are dreaming of a physiological birth without any medicated pain relief and against all your dreams and hopes labour needs to be induced the plan will probably have to be adapted.

Who to share your Birth Plan with?

You can share your birth plan solely with your partner if you like or talk to your midwife and the medical team at the hospital about it. They can then inspect it for any conflicting delivery policies. This is also why it is important not to wait until the day of delivery before sharing it so you can still adapt and change any potential conflicts.

Bring a couple of copies with you to the hospital in case the nurses and the medical team are not aware of your birth plan because it is tucked away in your medical file.

How to write a Birth Plan?

All along your pregnancy you can write down your wishes but do not simply copy a plan from the internet. They can be a guide but your birthing project is as unique as you are.

If you want it to be respected as best as possible stick to the basics which mean the most to you. Some key points and preferences can already be enough for you to feel more at ease.

Start by writing down your wishes in form of “I would like…”, “I’d prefer not to…” explaining the reasons for your choice.

Even knowing that you will or might have a C-section, you can include some lines about it to help you digest it more easily.

What shall I include in my Birth Plan?

Delivery room & environment

• Would you like a quiet, soothing environment with dimmed lights during labour with minimal interruptions? Do you want the possibility to play music (you might need to bring your radio station or CD player)?
• Do you want to be called by your surname?
• Who will be in the room with you for labour and delivery? Would you like a midwife or doula to be present the whole time? Is it ok for you to be observed by students, interns or staff?
• Do you want to be able to eat and drink throughout labour as desired? This will only be possible if you don’t have a C-section planned. You will probably not be very hungry but it’s good to be able to have some snacks.

Labour Preferences

• Include the preferences you have for your labour
• Do you want to use a Nature Room (physiological labour rooms that they have in more and more hospitals), a birthing ball or take a shower?
• Do you want to limit the number of vaginal exams?
• Is it ok for you to have labour chemically or mechanically induced or only if the baby is in danger?
• You might prefer that foetal heart tones are monitored intermittently rather than a continued monitoring
• Do you want to be free to walk, change positions and be able to adopt any birthing position you would like? This will surely only be possible as long as you do not have an epidural.
• Do you want to be able to go to the restroom as needed or desired and not have a tube or an enema?

Pain Management

• This is one of the most important points in your birth plan. In case you do not want an epidural this is how you can avoid being asked every two hours if you think it’s time now.
• You need to be flexible since your condition might change (e.g. induced labour) or you will be so tired after a couple of hours that you need to be able to sleep for a while.
• Would you like nonmedical choices for coping like a bath, acupuncture, homoeopathy or a massage? Do you have other preferences about pain relief options?

Delivery Preferences

• Would you rather have an episiotomy than risk a tear?
• Do you want to wait until you feel the urge to push and not have guidance or coaching in this effort? In case your epidural is too strong you might need this help because you will not be able to feel the labour pain or urge to push.
• Do you refuse an artificial rupture of your membranes unless medically indicated?
• Does your partner want to cut the umbilical cord? Do you want it to stop pulsating before it is cut? This is supposed to give the rest of the good blood flow to the baby. Of course, this might not be possible in case the umbilical cord is wrapped around the baby’s head cutting off her respiration.
• If a C-section needs to be done, who would you like with you in the delivery room?
• Do you refuse an abdominal expression?
• Do you refuse a systematic exploration of the uterine cavity and only allow it in case a part of the placenta is missing?

Cesarean Section Delivery Preferences

• You probably feel very strongly that you would like to avoid a caesarean delivery, however, if necessary it is good to have your wishes covered
• Would you like the medical staff to explain the surgery to you as it happens?
• Would you prefer general anaesthesia or an epidural in order to remain conscious through the delivery?
• Do you want to have your here outlined birth plan to be followed as closely as possible after the birth (see baby care section)?

Baby Care and Feeding Preferences

• Do you want to breastfeed right after delivery or do you prefer to bottle feed?
• Do you want your baby to be placed on your chest as soon as possible after delivery to be able to hold the baby skin-to-skin to allow bonding?
• In case your baby must go to the nursery for evaluation or medical treatment, do you want the dad to be with the baby at all times?
• Are you ok with giving the baby a pacifier?
• Are you ok with the baby receiving the first medical treatment (eye drops, cleansing of the nose) or do you want to wait until you are well past the initial bonding period a couple of hours after birth?
• Do you want your baby to be weighed and measured only later once you are willing to separate yourself from her?
• Do you want the baby to be bathed only after a couple of days?

I hope this list will help you find out what you do want and do not want the day of labour & delivery. It is not exhaustive so please feel free to leave a comment in case I missed something important.

Please, do not forget that this birth might still go different than planned but at least you know that your wishes will be respected.

Now, I wish you lots of fun deciding what’s best for you!