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Expert Advice

How to write a birth plan

Take the time to think about the details of labour and how you’d like it to go...

By Fiona Wright
You may already be in labour when you first meet the midwife who'll support you during the birth, so having a birth plan ready to go will let her know how you would prefer your labour to be managed.
Your plan can be as detailed or as brief as you like, but do remember that not all of your preferences may turn out to be possible. When the time comes, you need to stay flexible and listen to your midwife's or doctor's suggestions. For the best chance of turning your plan into reality, discuss it with your antenatal midwife first.
Here are our suggestions for what you might like to include.
Pain relief
This is your chance to specify what pain relief you'd like and what order you'd like to try the options in. For example, if you think you want an epidural you may like to try pethidine first. If you'd like to
try to manage by staying active, you may want to also try Entonox (gas and air) or use a TENS machine.
Birthing pool
If your preference is for a water birth in hospital, check the likelihood of a birth pool being available. (There may be one, but it could be in use when you need it.)
If you can't get a birth pool, do you want to use a bath for pain relief? Establish the best time to get into the water and how long you'd like to stay in it.
Your plan can be as detailed or as brief as you like but remember your preferences may not always be possible. (Image: Getty Images)
Monitoring the baby's heart rate
Would you like the midwife to listen to the heartbeat intermittently using a hand-held device, or use constant electronic monitoring with a belt strapped around your bump? Depending on how you're progressing, your midwife may make the choice for you.
Intervention
Having a caesarean is normally planned in advance if you have a medical problem such as a low-lying placenta. However, if you have had a traumatic vaginal birth before or have an extreme fear of pain, discuss the option of a planned caesarean with your antenatal carer. If you need an assisted delivery, you may want to state a preference for ventouse or forceps.
Breastfeeding
The midwife will want to know whether or not you plan to breastfeed. Midwives and breastfeeding counsellors will encourage you to try breastfeeding.
Cutting the cord
The midwife may automatically do this unless you stipulate that your partner wants to. Also, think about whether or not you want the midwife to clean up your baby straight after birth, and who holds her first – should she be handed to your partner or do you get the first cuddle? Skin-to-skin contact after birth is a great way to bond with your baby.
Placenta
If you have a caesarean, the placenta will be removed at the same time as your baby. Otherwise, decide how you'd prefer to deliver it. You may opt for an injection of Syntometrine so you'll deliver it five to 20 minutes after the baby, but this can give you a headache or make you feel sick. Natural delivery can take 30 minutes to an hour, but breastfeeding will help speed it up.
Special needs
Discuss any religious or dietary requirements. If you have a disability, talk to your midwife about the kind of help or special equipment you might need.
Position
Lying on a bed, squatting or crouched on all fours? Discuss the positions you'd prefer to be in during labour with your midwife. She will often encourage you to stay in an upright position to help your labour progress. Being mobile will also help your baby get into the right position for birth. Lying down is usually discouraged unless you become very tired, or if you have an epidural and have no feeling from the waist down.
Birth partner
Make it clear who you'd like to be with you during labour, and indicate if you want them to be there all the time or if you'd prefer them to leave during certain procedures or stages.
Vitamin K and hepatitis B
You will be asked if and how you would like your baby to receive a vitamin K supplement – an essential vitamin for helping the blood to clot and reduce the risk of internal bleeding. You can choose whether to give your baby one injection of vitamin K straight after birth or two doses in the mouth in the first week. You will also be asked if you would like your baby to receive a first immunisation injection for hepatitis B.

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