How to Write your Birth Plan

Before we get started here, let me acknowledge that the term “Birth Plan” is probably a little outdated and I actually prefer the term “Birth Preferences”.

Birth rarely goes to ‘plan’ so let’s be realistic about that first and foremost. But you are still 1000% entitled to have an idea of how you would prefer your birth experience to go. After all this is your body and you are in control of birthing your baby. It makes sense that you would have at least imagined how you would like this to go doesn’t it?!

When looking at the labour and birth experience in a hospital setting, I like to break it in to 4 parts. First I’ll provide a brief outline of these for you then we can delve in to the types of questions you might like to think about for each stage in order to formulate your birth preference sheet.

1. Prior to Hospital Admission 
   This may be considered as the latter stages of labour where you may be having more in-depth discussions with your care provider in relation to labour and delivery.
2. Hospital Admission 
   You’ve been admitted to hospital because you’ve either a) gone in to spontaneous labour or b) are being monitored and/or induced.
3. During Labour 
   During labour refers to the first stage of labour, so everything leading up to the pushing stage (or caesarean if you require an emergency caesar). For any mamas having a planned Caesar, you may like to consider preferences for everything that happens in the hospital between being admitted and entering theatre.
4. During Birth 
   This is the second stage of labour or the period in which you are trying to get the baby out. During birth may refer to pushing or caesarean delivery

So let’s take a closer look at some of the questions you might like to ask your self for each stage. Remember, that you are formulating your ideal preferences. This is not a solid plan and there may be genuine medical reasons for many things on this list to become unachievable and that’s ok.

So always be guided by your Dr. But even just putting your preferences together means that you and your health care provider team have a loose run sheet of how your labour and birth will go. Think of it more like a flow chart.

1. Questions to Consider Prior to your Hospital Admission:
• Are you open to having a stretch and sweep?
• Do you wish to be induced (in the instance that it is not considered a medical emergency to do so)?
• If Induction is required do you have a preferred methodology i.e. gel, syntocinon drip etc. Is there any type of induction that you would not consider?
2. Questions to Consider for your Hospital Admission:
• If this is an option at your hospital, do you want to be admitted in early labour (4cm or less) or do you want to return home to progress (if safe to do so)? Do you even want to have a cervical examination?
• Do the Staff have access to or are they already familiar with your preference sheet?
• If you are hypnobirthing, are staff familiar with this technique and accomodating of this?
3. Questions to Consider for During Labour
• What do you want the atmosphere of your birth space to be like?Number of people? Essential oil diffuser? Music?
• Are people allowed to talk to you? If so when (e.g. not during contractions)?
• Do you want to be offered pain relief by staff or will you ask for it yourself if and when you require?
• Do you want cervical examinations and do you want to receive ‘progress updates’?
• How do you want your birth partner to support you?
• Do you want to labour in water? Is this a possibility at your birthing hospital?
• Is it possible for baby to be monitored intermittently so that you have freedom of movement in labour?
• If you require more than 1 support person, is this a possibility at your hospital (e.g. spouse and doula)?
• If you are trying for a physiological birth at what point might you consider epidural and/or caesarean?
• For Caesar Mums you might like to consider, how you want the atmosphere of the room while you are having your epidural / How many people in the room / Music / Lighting
4. Questions to Consider During Birth:
• Do you want to avoid laying on your back to deliver baby (if you have not had an epidural)?
• Do you want to be guided in relation to breathing baby out?
• Is talking allowed?
• Do you wish to have a water birth?
• Where do you want your birth partner located? How can they best support you here? Do you want them to receive (catch) the baby and/or cut the cord?
• Do you want to have an oxytocin injection to deliver your placenta? Or do you wish to try and breastfeed first to help stimulate natural oxytocin?
• For Caesar Mums You might like to consider the environment of the room. Can you have music playing? Can your birth partner be in the room? Can you have skin to skin straight away and begin breastfeeding? Do you want to have an assisted birth where you help pull your baby out?
• How long do you want to delay cord clamping?
• Do you plan on keeping your placenta for encapsulation etc?

Key Tips for Birth Preferences:

If you are planning to have a physiological birth, always include preferences for Caesarean delivery too. You never know how things will go on the day so it just makes sense to know that if you end up having the Caesar you’ve already thought it through and can make it your own experience regardless. This helps pave the way for a more positive birth experience.

Always Share your birth preferences with your health care provider team in advance and have an open discussion with them about what is and is not achievable. At the end of the day you want to feel comfortable and confident that your team of health providers to be on your side and fully across how you want this experience to be. You definitely do not want to be having any heated or uncomfortable discussions mid contraction.

Always share and discuss your birth preferences with your birth partner/doula. Whoever is there as your support person. Ensure they understand the document so that if required they can advocate for you, if something on the plan is missed or disregarded.. For example you may not want to have a cervical examination and your OB has requested one.