Making a birth plan

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Many women in NZ make a birth plan for their labour and birth. A birth plan can help to guide your midwives and doctors and make them aware of your wishes.

What is a birth plan?

A birth plan is an individual plan of your wishes and expectations for your labour and birth. It may be a discussion between yourself and your lead maternity carer (LMC) or may be written, so that all maternity professionals involved in your care can be made aware of your wishes.

Birth plans vary greatly – from an expression of desire to cut the cord, to a lengthy and involved plan of what you would prefer to happen during each stage of labour.

Does everybody have a birth plan?

Many people do not have a birth plan, preferring to discuss eventualities if and when they arise. It is important to know that your options will be explained to you and your birth partner and your consent will be sought for all matters during your labour and birth. Only in the case of a rare emergency would anything be done without prior explanation. The key is ensuring that you understand those explanations – hence it is a great idea to attend childbirth education classes or obtain information from your LMC prior to your labour and birth.

Many women do have a birth plan, which is beneficial as it enables those who do not have a prior relationship with you to know about your wishes. It also focuses your attention on possible outcomes prior to the birth.

But remember, all those who care for you are on your side – hoping to enable you to have the very best labour and birth possible.

What should I include in my birth plan?

Here is an information list to consider for your birth plan with possible options and choices (you can download a birth plan checklist / form /sample to use by Birth Plan):

Place of birth

This is a vital choice to make and it may be affected by geographical location, local services, personal preferences, previous childbirths or medical conditions. Options in New Zealand include home birth (for women without previous complications), birth centres and hospital maternity units.

Support people

Who you have with you at the birth of your child is vital to how you will feel about the experience. In order to birth with ease we all need to feel safe and secure – consider whether your chosen birth partner will be able to support you through a long or short labour, easy or complicated. Perhaps you may wish to have another member of your whanau on standby.

Contacting your midwife

Ensure that you discuss this with your LMC midwife later in the pregnancy. Some midwives like to know as soon as you think you are in labour, as they have their own childcare to arrange.

Music and lighting

Part of feeling safe is being able to relax and simple measures such as low lighting and gentle music (or ACDC if you prefer!) may help you relax your muscles and help you to cope with the awesome journey you are undertaking. These may be especially important to some women early on in labour, while the contractions are getting established, hence why many women prefer to stay at home initially.

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The use of water

Water is a well known relaxant and also creates buoyancy and pain relief. Pools for water birth are offered in many maternity units and can be hired for home births too. Discuss water birth with your midwife if this is something you would like to try – not all maternity professionals are proficient with water births.

Pain relief

There are many options for pain relief – for more information, visit our Kiwi Families article from the link below. Many women feel that it is the length of labour that is so difficult to cope with and no-one ever knows how long their labour will last – your midwife and doctor will only be able to give you estimates based on ‘the average woman’. Therefore keep an open mind about pain relief and try not to right off any type of pain relief before your labour even begins. There is no perfect pain relief, it is very much a decision to make at the time at the time, based upon previous knowledge and experience.

Food and drink in labour

It is vital to stay well hydrated in labour! Include frequent sips of water, whatever you are doing – especially, if you are in a birthing pool or birthing during the summer months. If the body is short of fluids the contractions will become less effective, slowing the labour. Many women vomit in labour so this can be hard, but it is vital to continue sipping water none the less.

Usually women will not want to eat while they are labouring, but if you do feel hungry then eat something easily digestible, such as toast. Check with your midwife, as women who are at risk of a problem in labour are sometimes advised not to eat in case they need an anaesthetic.

Positions in labour

There is no perfect position for labour – movement and changes in position will help you to be more flexible and aid the baby’s journey through the pelvis.

Great ideas include hands and knees, all fours, lying on your side, standing, squatting (if you have strong legs!). Avoid sitting and lying on your back as this creates an uphill journey for the baby!

Baby at birth 

A few ideas that you may wish to consider are –

  • Position for birth
  • Who will cut the cord?
  • Do I want the baby passed straight to me at the birth?

Third stage of labour

There are options around the delivery of the placenta and membranes – an injection is available to reduce the risk of haemorrhage, but many women prefer to remain ‘drug free’ during a normal birth. Discuss this with your LMC if you are unsure.

What special considerations should I be aware of when I am writing my birth plan?

For some women many of the above choices are limited by pre-existing condition, such as diabetes, or a previous birth, for example a Caesarean section.

Many individual wishes can still be taken into account, but your safety and that of your baby are paramount and therefore you may sometimes be advised against certain pathways. Do remember to discuss your wishes with your midwives and doctors – they may not be able to give you the choices you want, but they may be able to help you understand the option they are advising for you and your whanau.

How can a birth plan help me?

The very best advice that I can give is to remain flexible throughout your labour and birth and to ensure that you understand the explanations that health professionals are giving you.

Useful articles

There are many types of Pain Relief available for women in labour – to find out more, click here

For more information on Promoting Natural Birth visit our Kiwi Families article

It’s a great idea to know about different types of labour and birth – click on these links for information on Normal Birth, Caesarean Section and Assisted Birth

 

Paula Skelton

Paula Skelton is a qualified NZ nurse and midwife, a midwifery & childbirth educator and the mum of three lovely girls.

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Please note that Kiwi Families is not intended to replace individualised, specialist advice that you receive from your doctor and other health professionals.

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