My initial thought about a birth plan was ‘how can I create a plan when I don’t know what is going to happen?’ I have had quite an open mind about labour throughout my pregnancy, I am not trying to think about how much it is going to hurt but rather just take the whole experience in my stride, practice my breathing techniques when I can and work on finding some comfortable positions to labour in.
When my midwife suggested making a birth plan in my 34 week checkup, I asked her why I needed to produce one because what will happen will happen. She agreed with me, and that it is important to have an open mind about labour as you don’t know what is going to happen and you don’t know how you are going to feel. However she said it is important for you to consider in an ideal world, if everything went smoothly and to plan, how you would like your labour to be. When I considered this I thought it is probably a useful tool to have in the back of your mind to focus on through contractions to try and help remain calm. Obviously there are things we don’t have control over such as the need for a C-Section or other forms of assistance such as forceps. However there are some things we can control, such as how we manage our contractions, whether we want drugs, who we want in the room with us and what kind of environment we want to labour in.
If like me you are feeling uncertain about what to include in your birth plan, here are some things to consider, which I included in my plan. I gathered these ideas from the NHS website and from speaking to ladies in my antenatal classes. Here is my top 7 things to consider when making your birth plan:
Where to give birth
There are three main places you can give birth. In the comfort of your own home, a delivery suite in a hospital or a midwife led unit/ birth centre. Each one has their own merits, and the choice is very much a personal one. Much of the advice out there is if you are having a healthy uncomplicated pregnancy then it should be safe for you to give birth unassisted at home or in a midwife led unit. If you are suffering from complications throughout your pregnancy, or you have any health concerns then you may be advised to give birth in a delivery suite in hospital, where there are professionals on hand who can provide you and your baby with tailored care. Even if your pregnancy has been healthy and there aren’t any concerns for your birth, you may feel more secure delivering in a hospital knowing there are doctors on hand who can assist you if complications arise.
To help make my decision I read a lot of information online in order to weigh up my options. I discussed each option with my midwife, friends and family who have already had children. I have chosen to give birth in a midwife led unit, the reason for this being that I didn’t feel a home birth was suitable for me especially with it being my first baby, however the mid wife led unit still provided that relaxed environment where you are free to labour in any which way you want. However the midwife led unit I am booked into is in a hospital, so if for any reason there are any complications during my labour, or I decide I would like to have an epidural, then I will be transferred down to the delivery suite where there are doctors available to assist.
This really goes hand in hand with where you would like to give birth. You may feel that giving birth at home is the most suitable for you, being in familiar surroundings with all your home comforts around you may help you relax and feel most at ease and in control. Or you may feel that being in a hospital is a much more reassuring environment for you, where there are specialists on hand just in case any complications arise.
I opted for the midwife led unit as it is almost like the middle ground between birthing at home or in hospital. The environment of a midwife led unit is much more relaxed. The lighting can be adjusted to be more relaxing, there are cushions and fairy lights and led candles to try and help create a softer relaxing environment. However there are midwives on hand, and you are within a hospital if any complications arise. Again discuss your thoughts and ideas with your midwife or GP who can provide advice and discuss your options.
Many people decide to just have the babies father in the room with them during the birth. However for some people this may not be the most desirable option, whether they feel that person won’t be able to provide the right kind of support they require during labour, or they may have someone else who they would prefer to assist them in labour.
It is important when considering who you would like with you, can the person advocate for what you want and need during labour as you will probably find it near impossible to fight for what you want, can they keep you focused and help you through each contraction and most importantly will they take everything you throw at them during labour and not hold it against you after.
Depending on where you give birth, you may be able to have more than one person with you during labour and the birth of your baby. If you are wanting more than one person with you, consider the environment that may be created by having many people with you. You may feel more reassured having all your close friends and family with you, or you may find that you feel you are on show which could make it difficult to labour.
Another thing to consider is if you would like any equipment to assist you in labour to help ease your contractions and make you feel as comfortable as possible. The sorts of equipment you can use during labour are a birthing pool, birthing ball, birthing stool or a bean bag. It is important to have some idea of what you would like to use so you can arrange for it to be available for when you are in labour, whether you are going into hospital or a midwife led unit, you will need to request for certain equipment such as the birthing pool when you call prior to going in, so they can prepare it for your arrival. It is also useful to research into what equipment will help you get into the most comfortable positions when in labour.
I will be taking my birthing ball with me as I will be using it to rock through the contractions, which will help me focus on my breathing. You can also bend over the birthing ball which helps with back pain. I will also be using the birthing pool as a form of pain relief and a method of relaxation.
You can gain further information on available equipment from your antenatal classes, your GP or midwife. YouTube is a great source to view demos and see reviews of different equipment or speak with friends and family who have had children and see what they found useful.
This is probably the most controversial topic when it comes to labour. Some people are dead against using any form of drugs and other people want as much as they can get. If you attend any antenatal classes on labour and pain relief you will receive a lot of information in order to make an informed decision on what you would like to do. The NHS website can also provide useful information to help you weigh up the pros and cons. Also discuss any of your thoughts and concerns with your midwife or GP.
I am in the mind set that I would like to try and labour using just gas and air and the birthing pool as pain relief, however I am very aware that I am naive about how it is going to feel and how I am going to cope with the contractions, especially towards the end of the first stage of established labour. So I am keeping an open mind about the use of drugs, I think if they make labour more manageable and help me birth my baby I am open to it.
Examinations and Monitoring
You will need to consider if you are happy for you and your baby to be examined and monitored throughout labour to ensure you are both safe and well. You do have an option to decline this, so you will be asked by your midwife or doctor if you are comfortable with this.
After the Birth
There are a number of aspects to consider following the birth of your baby such as:
- Would you like skin to skin contact? If so when?
- Do you want to be the first one to hold the baby or do you want your birth partner to hold them first?
- Do you want your birth partner to cut the cord?
- A friend of mine advised me you can request for your birth partner to be the one to tell you the sex of your baby if you don’t already know. I thought this was a nice personal touch.
- Are you going to be breastfeeding? If so you can request to try and feed your baby as soon as possible.
- Another thing to consider is how you would like to deliver your placenta. Would you like to do it naturally or would you like to be given a drug, syntometrine or syntocinon which will help you deliver the placenta.
I think even though you have a plan in mind, it is important to keep an open mind about what may happen. I think if you can take labour as it comes, deal with each contraction at a time and try to remain as relaxed as possible this will stand you in good stead. However I am talking from a very naive point of view as this is my first baby and I have never experienced labour, but my approach is going to be to try and remain as relaxed and focused as possible during each contraction, to try and remain at home for as long as possible to help progress labour as quickly as I can. When I am in the midwife led unit I will try to remain as relaxed as possible using the birthing ball, birthing pool and gas and air. However if I feel I can’t cope I will discuss other pain relief options with the midwife and make a decision there and then.
I hope this has been useful for people out there who are struggling to make headway with their birthing plan. Just know that it isn’t set in stone once it is written and you can always change your mind from what you have planned.