A birth plan or birth preference?
Every woman wants a birth that feels right for them, so it’s important to let your health professionals know what you want. The traditional way is to write a birth plan – a kind of road map for your wishes when it comes to labour and birth, as well as what happens immediately after. But as many new mums and wise midwives will tell you, in life all the best laid plans don’t always go the way we would like, and in childbirth that is definitely the case! You may feel strongly about a certain type of labour, but your baby may have other ideas. The best advice is to explore the possibilities and make a plan of your preferences instead of a plan that is set in stone. Think of it as a flexible birth plan that lets the midwife know your ideal choices.
There’s no special way to write a list of preferences – you can download a form to fill in, or you can just write it on a piece of paper. It is completely personal to you and your medical history. You can find examples online and on the NHS’s website.
When to start writing your birth preferences
Start thinking about your flexible birth plan as you enter your third trimester. Once it is complete, keep it with your pregnancy notes that you take to each appointment. From 36 weeks, keep your birth preferences, notes, and your hospital bag together for when you go into labour.
What decisions must be made before this point?
You may have already made the choice for where to give birth, whether that’s a hospital, birthing centre or at home. You may also have specific health concerns that make certain choices necessary – for example, if you need a planned Caesarean. These need to be considered when writing your birth preferences, as you may have access to certain facilities and equipment depending on where you are going to be.
What to include in your birth preferences
Don’t worry if the list below sounds daunting – your midwife will explain all of this, so you have time to consider all options!
What types of equipment you would like to use – birthing ball, water birthing pool, stool, cushions etc
Who do you wish to have with you as your birth partner?
Your preferred birthing position(s)
What types of pain relief you’d like, and at what point you want to progress to each
If you have any special needs or disabilities
How you would like your baby to be given to you – straight onto your tummy after birth, for example
What checks and tests you would like for your baby after the birth
Whether you would like to delay checks and tests after birth so you can have uninterrupted skin-to-skin time with your baby
If you would like delayed cord clamping
If you wish to store your baby’s cord blood, you’ll need to let the birth team know
How you wish to feed your baby after the birth
Whether you want your baby to have the Vitamin K injection
If you have a Caesarean section, whether you’d like the lights dimmed and the screen lowered when your baby is delivered
What you should not include in your birth preferences
There are some things that aren’t necessary to include...
How you would like the room to be set up
Dim lights, music, essential oils and so on – you and your partner can sort that out on the day
What you should wear
You can wear whatever you want to. Whether you’re more fully clothed until near the end, in night wear or totally naked, it’s up to you
Pain relief items you bring with you such as, aromatherapy, hot water bottles, massage and so on. That’s also completely up to you
Eating and drinking
It’s best to pack some snacks and drinks for you and your partner, as labour can be long and tiring. Some hospitals and medical conditions may mean you can’t eat or drink, but you can discuss that with your midwife at the time
What if your birth preferences get disrupted?
Sometimes, with the best will in the world, things don’t go as you expect. If your baby needs to be delivered quickly, you may find that even your flexible birth plan needs to change. Rest assured that your medical team will discuss all aspects of this with you and help you make these choices as you need to. They are responsible for the best possible care for you and your baby.
Tips for writing your flexible birth plan
Keep it short. Your team doesn’t need a life history and it’s best to stick to the important points. Use it as a point for starting a conversation with your midwife about what you want. It often helps you truly understand what your body’s about to go through - and knowledge is power. Make sure your partner knows your birth preferences off-by heart, or at least has a copy of your flexible birth plan. They'll need to be familiar with your birth preferences, as they may have to speak for you if you are in the middle of an intense contraction!
Are birth preferences important?
Yes, choosing your birth preferences is important in as much as it helps you to focus on what you want when the time comes to go into labour. It also helps your birth team get to know your needs and wants quickly, as you may not see the same midwife twice. It also helps you to open up a conversation with your partner, so they know what to expect during labour and birth and can be your advocate when you need some help speaking up.
If this isn’t your first baby and you feel confident to discuss your preferences with your midwife when the time comes, or you don’t want to write everything down, that’s fine too!
Where can I find a flexible birth plan to follow?
There are plenty of examples online or you may be given a template by your midwife or antenatal class. You can download one here that we have put together. Alternatively, you can also create your own. This is a very individual note of your wishes, hopes and preferences, just remember to stay open minded in case your little one decides to make another kind of entrance! The end game is the same: a beautiful healthy baby.