OK first things first …
I hate to disappoint you but the chances of our baby and mother nature sticking to our birth plan are pretty slim. Giving birth rarely goes to plan.
Surprisingly that doesn’t mean it isn’t worth writing a birth plan. Using this simple birth plan checklist to write your plan will help get you away from the idea too many birthing “experts” push there there is one “right” way to give birth. Our birthing stories follow very different paths and on our personal journey we will have changing choices to make along the way.
This simple birth plan checklist will help you understand the different paths delivery may take and how your choices may change on those paths.
Your birth plan won’t guarantee you have the perfect simple, natural home birth you’ve always dreamed of. Or that a c-section won’t turn about to be the right choice for you and your baby even though you really didn’t want one. Or that there won’t be aspects of your delivery that are distressing.
It is called labour for good reason.
But the questions on this simple birth plan checklist will help you be prepared for the changing choices you may need to make, so you do actually feel that it is you making the choices rather than being steam rolled into a delivery that isn’t the best possible for your baby and you.
I do help the simple checklist helps you to write your birth plan. It it based both on the tips that helped me most plus all those things I really wish I’d known before I went into labour.
10 Simple Birth Plan Questions
1. Where To Give Birth
We can choose between home births, home labour, mid wife led units and hospitals. All of these options have different pros and cons depending upon our pregnancy risk profile and the services available in our area. But our choice of where to give birth will impact our choices of birthing partners, birthing equipment, baby monitoring, pain relief and more so it does need lots of thought. One key consideration will be how easy it will be to change our choice if delivery isn’t going as planned; if we plan a home birth will we be able to get to hospital quickly if more intervention is required?
2. Birthing Partners
In today’s world we have come to accept the presence of partners when we’re giving birth as natural but this has been at the expense of someone we know who has any experience at all of giving birth. This can put an incredible burden on inexperienced partners!!
Our mothers or an experienced relative, friend or doula may be able to provide more support for us and our partner and for our baby in those first hours after giving birth, so it really is worth thinking outside the box on this one and having discussions early with partners and family about wether you’d like someone else you know to support you in addition to the medical team.
3. Active Birthing Positions
We all know now that labouring on our back for hours is not ideal. It helps to switch easily between different active positions including squatting, kneeling, semi-sitting, kneeling over something, going down on hands & knees, lying curled on one side, single knee kneeling. But it’s not enough to just write “active birthing positions” on our plan. Gently practicing these positions with a partner in the final trimester can make them much easier to adopt in labour, so go check out lots of diagrams and videos and have a giggle and a go. Sometimes however in a long labour the urge to lie down from exhaustion will be overwhelming and we shouldn’t feel we’ve failed if we can’t sustain active labour positions.
4. Birthing Equipment
Birthing balls, birthing stools and birthing bars can all make it easier to adopt active birthing positions during labour. Birthing pools are obviously essential during a water birth. If you would like to make use of them check out what’s practical or available at wherever it is you’re planning to give birth, e.g. is there space for a pool at home? Does your chosen hospital offer them? This might impact where you choose to give birth so it is worth thinking about early.
If you’re hoping for a home birth or to start labouring at home, don’t think that you have to fork out for lots of equipment. Ask around on local parenting groups for birthing balls and make use of what you’ve got: a big pile of old pillows or bed linen or towels and a kitchen chair or stool can help to support lots of difference active birthing positions.
5. Baby Monitoring
Baby monitoring during labour is much more flexible than it used to be but it is worth asking potential health care providers whether they offer flexible monitoring that will allow you to keep moving around whilst being monitored so you can adopt the active birthing positions you find most comfortable or whether you will need to lie on your back.
Traditionally little or no baby monitoring was available for home births or in some midwife led units but this is changing and it is worth asking what is available in your area. Different midwife teams may offer different services that give you more flexibility so do ask.
6. Natural Pain Relief
There are all sorts of natural pain relief options from breathing exercises, hypno-birthing and TENS machines to massage, acupuncture and acupressure but again we can’t just plonk these on our birth plan and hope they’ll happen.
Breathing exercises and hypnobirthing truly can, in my experience, help with pain relief but we have to practice using them during our third trimester for them to make any difference.
If you’d like to chose TENS machine or acupuncture or acupressure, you’ll need to do you homework to find out what’s actually available in your area. Good TENS machines can be hired easily for home births. And even if you’re planning to give birth in hospital it may be worth having your own in case you hit a very busy day on the maternity ward and you can’t get your hands on one for love nor money.
If you’re hoping to having massage during labour for natural pain relief it’s worth thinking carefully about your birthing partner. Unless you’re paying a lot of money in a private ward or hospital it’s unlikely to be available from your delivery team. This is where a good doula or experienced birthing partner who really knows what they’re doing with massage can come into their own.
7. Pain Relief
Lots of birthing writers and ante-natal charities are big advocates of natural pain relief. It certainly can give us the freedom to take on more active birthing positions that make labour easier and help us feel more in control. And there are certainly disadvantages to potent chemical pain relief.
But the reality is, none of us know what kind of labour we’re going to have or our own capacity to cope with pain unlike anything we have ever experienced. Sometimes very rapid changes in stages of labour, for example after an induction, or a very long labour can take us to levels of pain we personally can’t handle. Pain we can’t manage can be incredibly traumatic.
So even if we plan to start with natural pain relief and do the work to prepare for that – practicing techniques and making sure equipment and birthing partners are available – I truly believe we need to use birth planning to understand what our pain relief options will be if we need something more and what the implications of that will be for us and our baby.
Then if we do need to choose more pain relief we are not going to be surprised by how that changes our labour journey and that in itself will help us prepare for the side effects.
So even if you’re certain you want a natural birth with natural pain relief do some background reading on pain relief in labour so you understand the consequences of needing gas and air (entonox), opioids like pethidine, remifentanil drips or an epidural. I didn’t do that research – being adamant I wanted a natural birth – and so then when I did need more pain relief following an induction I had no understanding of the consequences.
I was also convinced before I went into labour that I didn’t want interventions if I could possibly avoid them so when I was induced at 37 weeks and laboured for three days before having an emergency c-section I hadn’t a clue what was going on!!
So again spend a bit of your birth planning time finding positive, practical tips about how to make the best of an induction or what to expect after a c-section. You don’t have to devour every detail just get the general picture and have it filed for quick reference if you do need it. And avoid the horror stories and rants about how bad these interventions are; they do have downsides but sometimes are the best possible choice for mother and baby.
9. Placenta Delivery & Cord Cutting
After our baby is born the placenta also has to delivered. This is often known as the third stage of delivery. In many hospitals “active management” of placenta delivery is the default. This involves an injection of oxytocin, early cutting of the umbilical cord and the manual removal of the placenta by the midwife as this can reduce the risk of significant blood loss but can cause nausea, vomiting and raised blood pressure.
Advocates of a natural approach to third stage labour maintain that active management and early cord cutting reduces the transfer of blood from the placenta to the baby and interferes with the natural release of oxytocin from skin to skin contact which is so important for successful breastfeeding. As with so many questions on our birth plan checklist, it can feel like a mine field. And again it takes us back to our first question. If you do feel strongly about trying a natural approach to third stage labour you need to be asking about it when you’re first choosing where to give birth. Surprisingly, you may find it is more available in some hospitals than in home births as hospitals better placed to handle the risk of heavy blood loss.
10. After Birth Care
But you are going to be exhausted, overwhelmed, surprisingly cold and in need of support not just from your partner – also exhausted and overwhelmed – but from someone with plenty of experience of new babies.
You would expect this would be the par for the course in maternity wards. Sadly – I learned from bitter experience – it is not. In one of London’s big name hospitals I was left on my own overnight with a baby who wasn’t feeding. It was unbearably lonely and scary.
So do find out what the options are for after birth care. Can a partner – and again someone who actually know something about babies – stay over night? If they can’t, how early can they come in? And find out how quickly you can go home if you and your baby are well?
Then when we get home, it all needs to be about rest. We’re exhausted. Our baby’s exhausted. Some of us have a surgery. It’s all new. And we’re none stop anxious in a way we never knew it was possible to be anxious. Rest truly is nature’s best remedy. It is the secret to getting our energy back after labour and to successful breastfeeding for beginners and is the single best natural remedy for babies with all sorts of conditions.
So when you’re writing your birth plan forget about all those fancy things you don’t need for a baby registry and absolutely make sure you have answers to these questions for the first fortnight when you get home:
- Who will produce meals?
- Who will clean the house?
- Who will do the laundry?
- Who will do the shopping?
And ideally the answer to none of them is you!!!
Our family and friends do all want to help and share their love for our new baby and them committing to deliver dinner on Tuesday or change the beds and wash the sheets is so much more powerful than yet more soft toys and baby products. Two weeks of real rest at home getting to know our baby whilst we are both looked after is the real after care we need.
Do put it on your birth plan.
I really hope this simple birth plan checklist will help you ask the questions you need to enjoy the best possible birth experience for you and your baby.
For more simple pregnancy & baby tips do check out my other posts: