How do you write a birth plan? There’s absolutely no set formula, but we’ve created an easy-to-understand (free) birth plan template for you to download and complete (take a look at our birth plan template).
And, while it’s important to remember that you can’t know for certain what will happen during your labour and birth, writing a birth plan gives you a greater chance of having the birth experience you want.
One of the mums from our Facebook community, Claire H, used our template and seriously liked it – she tells us: “I used your downloadable MFM birth plan and I loved the format it came in – broke it down into sections and made it so much easier to fill out.”
What needs to be included in my birth plan?
On our forum, mum Sharmy tells us she was keen to write her own birth plan but wasn’t sure what to put in or how to get going:
“Today’s task is writing my birth plan but I’m not sure where to start. I have some pointers in my notes but I’m still struggling and looking at a blank page in Word..!!
“Can anyone advise this blank pregnant woman what pointers to start with or better still share your birth plans to help me get in the zone?”
Your birth plan can be as brief or as detailed as you like. But it probably needs to cover:
- what will happen before, during and after birth
- who will be there
- what pain relief you might want to use
- what you want to happen straight after the birth (eg, would you like your partner to cut the cord? Do you want to be the first to hold your baby? etc)
To kick things off, you might want to mention any important pregnancy health and background information, like:
- any conditions your carers should know about
- if you’ve been tested for Group B Strep
- if you’re Rhesus negative.
Writing a birth plan encourages you to think about what you really want for your labour and birth and to find out about the options available. It puts your birth partner in the picture so she or he can respond appropriately to you or speak up for you during the labour and birth.
Whether you’re using a template or writing your birth plan from scratch, Gillian Fletcher, Former President of the NCT (National Childbirth Trust) says a birth plan is well worth doing – though do remember, things might not always go exactly as you’d hoped.
“A birth plan helps you and your partner decide what you do and don’t want during labour. It will also help you communicate better with the medical team,” she says.
“But plan for the unexpected and keep your options open. Birth is unpredictable and may not be straightforward, and if your birth plan is too rigid you’re more likely to be disappointed.”
Tips for writing a birth plan
As well as thinking about what goes in your birth plan, you’ll need to think about things like when to write it, who to show it to etc. So here are some more tips for writing your birth plan:
- Write your birth plan 6 to 8 weeks before your due date.
- Keep it short – your midwife won’t have time to read pages and pages.
- List any specific things you really want to happen, such as birth positions and holding your baby straight away.
- List any specific things you don’t want to happen.
- Mention any special needs you have, such as a disability or a medical condition.
- Show a draft to your partner, friends and relatives for feedback.
- Make sure your birth partner is familiar with your plan.
- Give one copy to your midwife a few weeks before your due date and take a few others into hospital with you to hand over once your labour begins.
- Remember, it’s fine to change your mind. You won’t know until your labour begins how you are going to feel. Nothing is set in stone.
Birth plan ideas for labour
A birth plan helps to set the ‘tone’ for the sort of labour and birth you’re hoping for. It focuses your midwife on your needs, so she can help you make the right decisions if you’re unable to communicate well during labour.
It gives you confidence that your personal needs are being considered, which helps you to relax and can in turn make labour better.
Some things to thing about regarding what happens during the birth are:
- Who will be with you during labour? Do you want a special birthing partner or partners? Do you only want female midwives to care for you? Would you be happy to have a student midwife?
- Positions – Do you want an active birth where you are free to move around? Try out different positions, such as a supported stranding squat, rocking on all fours, or leaning against a beanbag in advance during your antenatal classes and find out what’s most comfortable. Of course, you can lie down if you don’t want an active labour.
- Pushing – Do you want to push on demand or spontaneously when you feel the urge?
- Partner to help cut the cord – Do you want him ‘up top’ with you, or down where the action is when your baby comes out?
- Baby delivered on to your stomach – Do you want your baby placed on to your stomach straight away, or do you want him cleaned up before you see him?
- Episiotomy – If your baby is stuck, in distress, or if your midwife is worried you might tear badly, you’ll be offered an episiotomy – a surgical cut to the perineum, the muscular area between the vagina and the back passage. The area is numbed so it won’t hurt, but healing can be a painful process. If you really don’t want one, discuss this with your midwife.
- Use of ventouse or forceps – Between 5 and 20 per cent of all births require the help of forceps or the ventouse cap (suction cap). An instrumental delivery is performed by an obstetrician if your baby is in distress, you’re exhausted and can no longer push, nothing is happening or the baby’s head is an unusual position. If your baby is in distress, you may not have a choice about an instrumental delivery, but if you feel you want to be given sufficient chance to push your baby out on your own, discuss this with your midwife. If you have a preference for one instrument or the other, write this down on your plan.
- Syntometrine injection to speed delivery of placenta – Your midwife will ask if you want an injection to allow for a quicker delivery of the placenta, or if you want to deliver it naturally.
- Possible side effects of syntometrine are that it can make you sick, raise your blood pressure or give you a headache. Without the injection, it can take up to an hour to deliver the placenta and you’re likely to lose more blood.
For the majority of pregnant women, anxiety about how much the birth will hurt and whether they will cope is the biggest worry as the due date approaches.
Informing yourself about the options for pain relief should help allay these fears. Until you’ve been through it, you probably have little idea about how high your pain threshold is. So, what are your preferences? Would you consider an epidural? This requires an anaesthetist, so advanced notice is needed.
Do you want to be mobile during labour? Is there anything you’re particularly frightened of and want to avoid, such as needles?
Which medical routines do and don’t you want?
- Internal examinations – As well as feeling your stomach to find out which way round your baby is, your midwife will ask your permission to do an internal (vaginal examination). If you don’t want this, say so. This will mean you won’t know how many centimetres your cervix has dilated, but a skilled midwife will still be able to tell you roughly how far advanced your labour is.
- Induction of labour – One in 5 labours are induced, or started artificially. Labour can be induced by your midwife sweeping the membranes surrounding your baby with her finger, inserting a prostaglandins gel or tablet into the vagina to soften the cervix, or use of the drug syntocinon via a drug to speed up labour. If you’ve already had prostaglandins, syntocinon should not usually be given for at least six hours. If you’re given syntocinon, you’re more likely to have an epidural to help with pain. Your baby’s heartbeat will be monitored throughout the rest of your labour.
- Foetal heart monitoring – This allows early detection of possible complications. Your midwife can monitor your baby’s heartbeat with a hand-held Sonicaid, or by continuous monitoring where two sensors are held in place by straps around your stomach. You will be able to move around more if your midwife uses a Sonicaid.
- Foetal scalp monitor – If your baby’s heart rate suddenly dips, or if there are other signs of foetal distress, a small electrode will be attached to your baby’s scalp via your vagina. Your baby may have a small bruise or scratch where the electrode was attached but this will heal soon. This will help a doctor to get an accurate picture of how your baby is coping with the labour.
- Breaking your waters – If you’ve been induced and your waters haven’t broken, your midwife or doctor may make a hole in your membrane to release (break) the waters. This procedure is done through your vagina and cervix using an instrument that looks alarmingly like a knitting needle. This won’t harm your baby, but may cause you some discomfort.
Birth plan ideas for what happens once you’re baby’s arrived
The fact of having had a birth plan can help you feel more at ease with how things went, even if they didn’t turn out just the way you hoped.
If you don’t feel your labour and birth were handled well and you want to make a complaint, you have a document to refer to.
Other things to think about and include in your birth plan regarding what happens once your baby arrives are:
- Do you want to see the sex of your baby for yourselves rather than be told?
- Does your partner want to cut the cord?
- Do you want your baby put straight to your breast?
- Do you want to deliver the placenta naturally (known as a physiological third stage)?
- Have you arranged for your baby’s cord blood to be collected?
- Do you and your partner want to be left alone straight after the birth?
Think about all these things well in advance. You’ll then discover what you don’t know and you’ll have time to find out, either through the hospital, your antenatal teacher, other mums or your midwife.
What if I change my mind about what I want at my birth?
If you change your mind about what you want as your due date approaches, don’t worry, birth plans aren’t set in stone.
You can still express different preferences as your labour progresses – and your midwife or obstetrician will use their judgment, too.