WRITING YOUR BIRTH PLAN

A birth plan helps prepare you for labour and delivery. Here's how to write yours.

Before we dive deeper into writing a birth plan, let's unpack what a birth plan is, and why you need to write one.

What is a Birth Plan?

Essentially, a birth plan is a written document that communicates your labour and delivery preferences to your health practitioner, concerning pain management, postpartum care and newborn procedures. It's more or less a roadmap for having your ideal birthing experience, assuming everything goes according to plan (which is not always the case!).

Why write a Birth Plan?

A well-written birth plan can help you have a better birthing experience. Besides, it helps keep your expectations realistic, prevents disappointment and misunderstanding between you and your birth attendants. It also helps to have a productive discussion with your practitioner on your labour and delivery.

What to keep in mind when you are writing your Birth Plan

Bear in mind that a birth plan should be personalised. Every expectant woman is different in what kind of birthing experience she wants and her expectations given her pregnancy profile and history. So do not jot down what your neighbour told you she wrote in her birth plan!

Before writing your birth plan, talk to your insurance provider about what options are available to you. Find out also what the hospital and the insurance plan offer. Go the extra mile to do a background check on the hospital and ask questions. Find out about their practices, procedures, and the type of equipment they have available. For instance, do they have labour and birthing equipment like a tub, shower, birthing balls or stools? How many people do they allow to be in a delivery room with you? The information you gather will inform what you write in your birth plan.

If you are racking your brains on what to write, use these pointers to guide you:

• background info
• your preferences before birth
• your preferences during labour and delivery
• your preferences for newborn care

Background Info

Start writing your birth plan providing basic details. These should include:

• Your name.
• When your baby is due.
• Contact details of your doctor, midwife, doula and pediatrician.
• Where you would have the baby. The name, address and contact details of this hospital or birthing center.
• Who your birth partner or support person is and his or her name and contact details. You need to specify that this is the person who will be with you during labour and delivery, and that the hospital or birthing center can consult with him or her if you are unresponsive.
• Your medical history or any medical issues you need to let your healthcare provider know.

 

Preferences Before Birth

You have to specify at this chapter of your birth plan the kind of atmosphere (where you would be giving birth) you prefer. You should note down:

• If you want to eat or drink during labour.
• If you want to be out of bed, walk around or sit up during labour.
• If you want to be in a tub for labour or delivery or for both.
• If you want to have some music, lighting and items from home in this atmosphere.
• If you want photos or videos to be taken.
• What birthing equipment you prefer to use during labour - a birthing stool or ball.
• What birthing position you want your practitioner to help you with.

Preferences During Labour and Delivery

Here, you need to clarify how you want to labour, how you want to manage labour pain and what labour procedures you prefer. You should detail the following:

• What type of birth you are planning.
• If you want to use an epidural or any kind of pain medication.
• What other alternatives to pain meds you prefer.
• If you want artificial rupture of the membranes or membranes to be left untouched.
• If you want external and internal electronic fetal monitoring.
• If you want to use an IV or catheter.
• If you want to use oxytocin to induce labour or increase labour contractions.
• What your practitioner's opinion is on episiotomies or natural tearing. And which of these two options you prefer given his or her opinion.
• If you want interventions like forceps or vacuum extraction to assist you with the birth of your baby. 
• If you want to be in your own clothes or clothing provided by the hospital.
• In case of an unplanned cesarean, the kind of anesthesia you want if you have to make a choice.

Preferences for Newborn Care

This is where you share your expectations and preferences for the care of your baby during recovery. You should cover issues such as:

• What your requests are concerning the suctioning of your baby, for instance, suctioning by your baby's father.
• Do you want to hold your baby right after birth? Do you want to give the baby time to move from your belly to breast?
• Plans for breastfeeding immediately.
• Do you need the assistance of a lactation consultant?
• When you want the umbilical cord to be cut.
• Do you prefer cord blood banking?
• Do you want your partner to catch the baby when you push him or her out?
• Do you want your partner to cut the umbilical cord?
• Do you want to greet your baby first before they weigh him or administer eye drops to him?
• Do you have any requests for the placenta?

 

C-section Birth Plan

If you know you are going to have a cesarean delivery, you need to specify your preferences. If you are high risk or have an emergency during labour or delivery, know that your practitioner may not approve some of your preferences. In this case, write your birth plan using some of the pointers above as a starting point, and then address some other issues like:

• Who should be with you in the operating room?
• If you want your practitioner to record the types of incisions made in your abdomen and uterus. This is very vital information for future pregnancies.
• What are your preferences for breastfeeding?
• What kind of post-surgery pain relief do you prefer?

VBAC Birth Plan

Vaginal Birth After Cesarean (VBAC) can be risky. There is always the fear that the first cesarean scar can tear even though 60% to 80% of women have a successful vaginal birth after a cesarean. However, VBAC still presents some challenges and risks, so any woman opting for a VBAC must write a separate birth plan detailing her preferences. 

When writing a VBAC birth plan, you can use the same format for a vaginal birth plan. But it must include your preferences for if you are having a C-section, just in case a vaginal birth becomes too risky for you.

For instance, you may specify which birthing equipment you prefer when you are in labour. But also state your preferred type of anesthesia if you are going to have surgery.

You also need to discuss your preferences with your practitioner and seek his or her advice before writing out your VBAC birth plan.

Here are some FAQs about writing a birth plan and their answers:

When should you write a birth plan?

Ideally, you should start thinking about what to put down in your birth plan as early as your second trimester. You can start writing it out when you are between 32 and 36 weeks pregnant. Before writing it, you should have had a discussion with your practitioner, so you are both on the same page about issues you are likely to disagree on.

How should I phrase my birth plan preferences?

Labour and delivery are unpredictable, and so your birth plan should not be cast in stone. It should make provisions for alternatives should your first choice or option or preference not work out. Here are some ways you can phrase your preferences:

If it's doable, I would like to...

I'd prefer A, only if it's necessary.

Please offer me A if it becomes an option, so I can decide on it at the time.

If everything goes well, I'd prefer...

What do you do with your birth plan when you are done writing it?

You have to give a copy of it to your health practitioner, who will schedule a discussion with you to review it. Don't be surprised if you are asked to make changes based on your practitioner's advice. Do also give a copy to your midwife, doula, birth partner and keep a few copies in your hospital bag.

What if I get second thoughts concerning some of my preferences?

If you do, inform your practitioner, he or she will tell you what your options are and advise you on which is best and safe for you and your baby.

Click on our four (4) printable cheat sheets to download. They will help jog your memory on what to write about in your birth plan.

Happy writing!

 

 

By Nana Ama Afoa Osae I Writer I GreatWonderful Team

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