Birth choices: how to write a birth plan
Emily Cater
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Before you reach your due date it's a good idea to write a birth plan. From how you'd like to give birth and which pain relief you want to use, to who cuts the umbilical cord, it's a handy source of information for you, your birth partner and your midwife team.
What is a birth plan?
During your second or third trimester, your midwife will probably talk to you about writing a birth plan. It may seem like the birth is way off, but the truth is, it'll come around quicker than you know!
If you're wondering what exactly a birth plan is, it's literally a piece of paper that records your wishes for how your labour and delivery go, including anything special you need to flag up.
It's useful because it gets you thinking about all the choices that are ahead of you. These include:
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- Using the NHS or going private
- Where will you have the baby (labour ward, birthing centre, home)?
- How you'll have the baby (natural birth, C-section, VBAC)
- Who'll be present during the birth (your birth partner)?
- Your pain relief options (epidural, pethidine, gas and air, none)
- Will you be using hypnobirthing?
- Birth positions
- Whether you want a water birth
- When you want the cord clamped
- Who will cut the umbilical cord?
- Whether you'll give the baby a vitamin K injection at birth
- Getting help to birth the placenta
- Skin-on-skin contact (straight away or do you want the baby to be cleaned before being put on you?)
- Are you planning to breastfeed?
There's a lot to think about – and that's not even everything!
Once you've had a think and made some decisions (see below for more help on these), you should write or type up your birth plan.
Your antenatal notes may even include a birth plan that you can fill in directly. Or, you can download one from the NHS here.
Make sure you also include:
- your hospital number and the name(s) and telephone number(s) of your labour ward and/or midwifery team
- the phone number of whoever has volunteered to look after any older children when the time comes (it's good to have a backup option, too)
- your birth partner's name and telephone number (if different from your partner)
When it's ready, print off several copies of your birth plan and give one to:
- your midwifery team
- your obstetrician
- your birth partner
If you make changes to it, get rid of any old versions to avoid confusion.
What to think about for your birth plan
As mentioned above, when it comes to childbirth, there's a lot to think about and decide upon. But being pregnant can make it hard to form a decision – blame those pesky pregnancy hormones or tiredness (or both!)
To help, here are some of the topics and questions to ask yourself ...
Where to have the baby
Will you use the NHS or go private? If you choose to go private, make sure you know what's included in the cost, for example: are antenatal appointments included, is pain relief extra?
Whatever you decide, you'll also need to pick whether to give birth:
- In a hospital labour ward, where you can have all types of pain relief
- In a birth centre (midwifery unit), which is a more homely environment, but doesn't usually offer all types of pain relief
- At home (did you know, if you're having a healthy pregnancy and you've given birth before, it's just as safe to give birth at home as a hospital or birth centre?)
If you want to give birth at home, have you checked that your midwives are happy to attend you and that you are considered a suitable candidate? And do you have everything you need for a home birth?
Could you be flexible if things don't go as planned? Would you want gas and air (which is usually the only pain relief available for a home birth)?
How to have the baby
How do you want to have the baby? Are you planning on having a natural birth, an elective C-section or perhaps you're trying for a VBAC (vaginal birth after caesarean)?
Who's at the birth
Who'll be present during the birth? Are you using a doula, a birth partner or will it just be your partner there? Do you mind male midwives or even student midwives attending?
Pain relief
What pain relief do you want to use? Whether you want that epidural or not, make sure you know your pain relief options and write them down. Have you thought about hypnobirthing? Some women swear by it.
Birth positions
Do you want to remain mobile during labour? Do you plan to use a birthing ball or other aid? If so, do you need to take your own? If you want an active birth, does your medical team support this?
What if they decide you need continuous monitoring? Are you willing to go along with this, even if it restricts your movement?
Water birth
Do you want a water birth? If your birthing centre has a pool, what are your chances of it being available? What does it entail?
If you're having a home birth, where will you rent a birth pool from?
Intervention
How do you feel about the possibility of induction if you go overdue? And if labour doesn't progress smoothly, what are your thoughts on using forceps, ventouse or episiotomy to help your baby be born?
Cord clamping
When do you want the umbilical cord clamped? And who will cut it? Do you want your partner to cut the cord? And do you want delayed cord clamping?
Latest guidance from the National Institute for Health and Care Excellence (NICE) recommends waiting 1-5 minutes before clamping if it's right for the mother and baby. You can ask to wait longer than this if you want.
Vitamin K
Do you want your baby to be given vitamin K at birth? This is given routinely – either by single injection or as three separate oral doses – because newborns have low levels and vitamin K is needed to help the blood clot. Your midwife can discuss this in more detail.
Skin-to-skin
Do you want your baby placed straight on to your chest at birth for skin-to-skin contact? Do you want your midwife to clean your baby up before you hold them?
The third stage of labour
Do you want an injection for the afterbirth? Once you've given birth, you'll be offered an injection to speed up stage three of labour, birthing the placenta. Do you want to have this or would you rather have a natural afterbirth?
Breastfeeding
Do you want to breastfeed? If so, ask for help with the baby latching on as soon as you can.
If you're still not sure where you stand on certain topics, that's totally normal if you've never done this before. To help you can always talk to:
- your midwife
- mums in our chat forum
- experts at your NCT or antenatal classes
- fellow mum friends
- your partner
What to do if you have specific needs
If you have particular health needs or concerns then make sure these are written in your birth plan (and discussed with your midwife, too).
These could include:
- Being GBS positive (having group B strep) – flag this up as you may need IV antibiotics during labour.
- Needing to be induced – if your pregnancy is high-risk or you've had complications that require you to be induced, this will be in your notes but there's no harm in making it clear in your birth plan, too.
- Knowing your child will be born with a birth defect – again, your antenatal midwife will be aware of this but flag this up for your labour and birth midwife team, too.
- Religious requirements – make sure your birth plan includes anything that needs abiding by for religious reasons.
- Your own disability – use your birth plan to record what assistance or additional help you may need during labour.
- Language assistance – if English isn't your first language or if you're deaf and use sign language to communicate, make a note of this and ask about having an interpreter present or someone who can understand sign language.
What if my birth plan gets ignored?
When you arrive at triage or on the labour ward, make sure you (or your birthing partner) show the midwife where it is and tell her what's really important to you.
If you or partner feel that your preferences have been ignored, make sure you flag up anything key, such as if you're GBS positive or have a disability or pregnancy complication.
On the flipside, if you've written that you don't want pain relief and then realise it's too much to handle, don't worry – you're more than entitled to ignore your birth plan.
Although you may have strong views about how you want your baby to be born, things don't always go smoothly, and it isn't always possible to retain that control.
For instance, you may have wished to give birth naturally, but if your medical team recommends an emergency C-section to get the baby out quickly, it's a good idea to forget your birth plan and listen.
The healthcare team are there to care for you and your baby's health, and have the experience to know what is best to do in any given situation.
You may prefer to think of your birth plan as more of a 'birth wishlist'; you can lay out your hopes for different situations, and your maternity team should try to honour those wishes as best they can, but you may need to be a little flexible on the day.
So, what are you waiting for? Grab your pen and paper or laptop and enjoy writing your birth plan.
We love this beautiful book, specially designed for writing a birth plan in – see more details at Amazon.
We also like these birth plan cards by birthing guru Milli Hill (author of the Positive Birth Book) which help you to explore your birthing choices – see more details here at Amazon.
Need more inspiration? Chat to other parents about what they put in their birth plans, in our chat thread below ...
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