Birth Plan

The idea of a birth plan is to help you achieve the birthing that you and your companion want as far as possible. It should not be a set in stone list of instructions to your caregivers, but a set of ideas about how you feel about your birthing and how you would like it to be managed. This will probably be one of the most emotionally moving experiences in your life and it is only right that you should maintain informed control over it. You will, however, want to work with your obstetric team not against them. If your approach to the medical team is collaborative rather than dictatorial, you are far more likely to get their support and you will be in far better position to enjoy the relaxed natural birthing that you want.

Some of the issues you may wish to consider in your birth plan are the following:

1. State the name of your birth companion and that they will be assisting you with your relaxation and you therefore want them with you during labour.
   
   
2. Inform you care team that you are using The Second Nature Birth Program and explain briefly what this entails. You may wish to ask that all birth attendants respect your wish for peace and quite in the birthing suite.
   
   
3. If you choose a hospital birth, state whether or not you would be happy to have medical or midwifery students attending your birthing.
   
   
4. State that you might want to move around and use different postures during labour. It is worth chatting to the midwife well in advance if you have any special requests. If you are having a water birth ask whether the labour ward or delivery suite has a birthing pool or whether you need to hire one.
   
   
5. State whether or not you are happy to have constant foetal monitoring. Remember that if you choose to agree to constant monitoring your movement is likely to be restricted. Your midwife will be able to monitor your baby’s heart intermittently if you want to be free to walk around and change position.
   
   
6. You may want to limit vaginal examinations during labour. Discuss your concerns with your midwife if you have strong feelings on the matter, but make your feelings clear from the outset.
   
   
7. Make sure you visit the hospital prior to going there for the birthing. Check out the environment and ask about facilities for reduced lighting and music should you choose to have it.
   
   
8. Make sure you prepare you bag of items that you want with you, before your due date. If you should get surprised by your baby coming early you won’t want the hassle and stress of having to rush to get all your things together.
   
   
9. Make sure your feelings on episiotomy are included in your plan and make sure your obstetrician and his/her team, including your midwife know about your views. The relaxation techniques, perineal massage and exercises that you have practised will give you the best chance of avoiding an episiotomy. If the second stage of labour is not rushed and there are no signs of foetal distress it is better to be patient. There is also evidence that tears heal faster than episiotomies and that episiotomies lead to more postnatal pain than tears.
   
   
10. Make your feelings about induction of labour with Syntocinon (artificial oxytocin), or the artificial rupturing of your membranes known. Some maternity units will not want labour to last more than 12 hours before inducing, and some don’t like waiting more than 48 hours between the your waters breaking and the start of labour. However, these are arbitrary time limits which your body may not comply with. If you decide to accept artificial induction with Syntocin, request the minimum dose possible, as induced births with Syntocin can be very painful. When you follow the Second Nature Birth Program, you will be more relaxed and calm throughout, so this may not be an issue. Remember to ask if the safety of yourself or your baby is at stake when medical interventions are suggested. These interventions certainly have their place but only when medically necessary and there is wide variance between hospitals on caesarean section rates and the use of artificial induction. For example Northern Ireland has an induction rate as high as 35% whereas in the West Midlands it is only 15%.
    
    
11. Include your feelings about cord clamping in your plan and note who you want to cut the cord. You may want your partner or companion to cut the cord or you may wish to do this yourself. It is important not to cut the cord too soon so request that this is not done until it has stopped pulsating.

Discuss your feelings with you obstetrician and your midwife at your antenatal appointments. They will be used to seeing birth plans as they are recommended by the National Childbirth Trust in the UK.