How to Write a Good Birth Plan

Mind­ful Mum explains the ben­e­fits, research required, mid­wife reac­tion and a down­load­able birth plan for a nor­mal birth with min­i­mal inter­ven­tion used suc­cess­fully by a Mind­ful Mum to deliver her first baby.

What is a birth plan?
What are the ben­e­fits?
What hap­pens if some­thing unex­pected hap­pens?
What do mid­wives think of birth plans?
What should I include?
Where can I down­load a real birth plan?
When should I start?
Where can I find out more about birth plans?

What is a birth plan?

A birth plan pro­vides the mid­wives and med­ical staff with an easy to read doc­u­ment that sum­marises your pref­er­ences for labour and the imme­di­ate after care of your new born baby.

What are the ben­e­fits of a birth plan?

“The plan was ‘my voice’ when I was too pre­oc­cu­pied with surges to speak. The mid­wife reviewed every bul­let point with me, stop­ping dur­ing con­trac­tions. I was able to nod in agree­ment con­fi­dent in the knowl­edge that my plan was being fol­lowed.” First time Mum (nor­mal 6 hour birth)

It is a good idea to cre­ate a birth plan because it:

• pre­pares you for the birth by think­ing through ‘what if’ sce­nar­ios in advance of labour, e.g. if I go beyond my due date I would pre­fer ‘to be’ or ‘not be’ induced
• helps you focus atten­tion on birthing dur­ing labour because you have a doc­u­ment stat­ing your wishes
• com­mu­ni­cates your wishes clearly to med­ical staff when you may not be able to do so verbally
• allows you to explore options with your mid­wife and ask for more infor­ma­tion dur­ing your ante­na­tal appointments
• pro­vides a focus for preg­nancy book research,  ante-natal classes and  when talk­ing to other Mums
• cre­ates a real­is­tic plan of pref­er­ences based on real­ity; avail­able hos­pi­tal facil­i­ties, your health, home birth suit­abil­ity, hos­pi­tal prac­tices and procedures
• increases con­fi­dence because you are informed,  pre­pared and have included a num­ber of com­fort strate­gies that work for you
• helps build a sup­port­ive rela­tion­ship with med­ical staff by intro­duc­ing you and your birthing part­ner to mid­wives, reg­is­trars and anaesthetists
• is unique to your spe­cific cir­cum­stances, med­ical his­tory and per­sonal preferences

“I can’t imag­ine going into labour with­out a birth plan. It would be like turn­ing up at the air­port with­out your board­ing tick­ets and pass­port. You might still get there but it’s not going to be quite so smooth” Birthing Partner

What hap­pens if my birth takes a dif­fer­ent course from what I was expecting?

Your birth plan is not set in stone; it is a list of your ‘ideal’ pref­er­ences. Once you are in the labour, you may change your mind about cer­tain things (e.g. pain relief) or the mid wife may sug­gest a dif­fer­ent course of action depend­ing on the well being of you and your baby.

Write the birth plan in the knowl­edge that your options are flex­i­ble and it will help you to remain calm and con­fi­dent should the birthing of your baby take a dif­fer­ent turn from what you were hoping.

What do mid­wives think of birth plans?

Mid­wives are in favour of birth plans because it famil­iarises you with the stages of labour, pain relief and dif­fer­ent forms of med­ical intervention. If you and your birthing part­ner are well informed you are less likely to feel intim­i­dated by med­ical equip­ment or jar­gon. Con­se­quently you are more con­fi­dent, relaxed and pos­i­tive about going into labour.

Your mid­wife will be famil­iar with read­ing birth plans. Some mid­wives in the UK are trained as Hyp­no­birthing prac­ti­tion­ers which places empha­sis on the cre­ation of a birth plan.

Although med­ical care is para­mount to mid­wives, they also pro­vide tremen­dous phys­i­cal com­fort, emo­tional sup­port and encour­age­ment — they are most def­i­nitely on your side!

What sec­tions should I include in my birth plan?

The best birth plans are short and use bul­let points which allow car­ers to quickly under­stand pref­er­ences with­out have to flick through reams of pages.

The key sec­tions in your birth plan include:

• Per­sonal Infor­ma­tion (details you and your part­ner or sup­port­ers name)
• Envi­ron­ment (sub­dued light­ing, pref­er­ence for gen­der of med­ical staff, water birth)
• First Stage Pref­er­ences (pain relief, mon­i­tor­ing eval­u­a­tions, labour posi­tions, eat­ing / drinking)
• Sec­ond Stage Pref­er­ences (push­ing / breath­ing, per­ineum epi­siotomy, the birth, hold­ing the baby before checks)
• Third Stage Pref­er­ences (how the pla­centa is deliv­ered nat­u­rally or med­ically where the med­ical staff admin­is­ter drugs)
• Care of Our Baby (han­dling of baby by staff, wish to breast feed baby)
• In Case of Cesarean (pain relief, bot­tle feed or breast feed, sup­port required)
• Other Con­sid­er­a­tions (sum­mary of above, recog­ni­tion that birth may not go accord­ing to plan and that well being of baby and mother is paramount)

Where can I down­load a real Mum’s birth plan?

You can down­load an exam­ple of a Mind­ful Mum’s birth plan stat­ing pref­er­ences for her first baby’s birth to be a nor­mal water birth with min­i­mal intervention.

Down load the Mind­ful Mum Birth Plan (Word Doc­u­ment For Edit­ing) (235) It describes pref­er­ences for a nor­mal, nat­ural water birth with no med­ical intervention.

This birth plan was fol­lowed by the mid­wives in the labour ward in Feb­ru­ary 2009. During the labour the ‘mater­nity notes’ went miss­ing and the ‘birth plan’ was used exclu­sively. The lead mid­wife described it as a model birth plan and con­se­quently fol­lowed the detail to the let­ter.  The labour lasted six hours in total (three hours at home and three hours in the labour ward birthing pool.)

Per­son­alise the plan based on your research and pref­er­ences. Famil­iarise your part­ner with the plan so they can act as your advo­cate. Remem­ber to include it in your mater­nity notes and take a copy to the hos­pi­tal with you.

When should I start writ­ing my birth plan?

Start think­ing about your birth plan at around 28 weeks so that it coin­cides with any ante­na­tal classes you may be tak­ing. You are tech­ni­cally at full term at 37 weeks, so it is a good idea to have com­pleted it by 36 or 37 weeks.

Research­ing options for my birth plan?

• Ante­na­tal classes (local  hos­pi­tal, pri­vate classes, Hyp­no­birthing or National Child­birth Trust)
• Preg­nancy and birth books (e.g. ‘Stand And Deliver’ includes var­i­ous birthing stories)
• Check out hos­pi­tal facil­i­ties (e.g. birthing pool,  birth balls, policies)
• Talk to other Mums (aim to talk to Mums with pos­i­tive birthing experiences)
• Read real birth plans

Where can I find more infor­ma­tion on birth plans online?

• Birth­Choices and the guide on How to Write A Good Birth Plan is use­ful for demon­strat­ing var­i­ous styles of birth plan.
• What is a Birth Plan NHS Choices
• If you are con­sid­er­ing a Home Birth check out the Home­Birth website

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