When your pregnancy is heading towards that elusive due date that you've had marked on the calendar for months, your thoughts will turn more towards birth. Whilst writing a birth plan won't guarantee anything, it's very worthwhile to know what you ideally do and don't want and to convey these wishes to your birthing partner and care team. So what do you need to consider?
Who would you like present at the birth? Many hospitals and birth centres allow two birthing partners, so will your partner be there? Your mum, your best friend? Have a chat with the person/people you would like to have by your side and make sure they're happy to be with you and arrange how to contact them should you go into labour when you're not with them.
There is also the option of hiring a private doula or a photographer to be at your birth. A doula will be a supportive presence, their role is not to assist or intervene medically as they are not part of your medical care team. They will aim to help you remain calm, to encourage you as you go through the process of labour and support you and your partner to make informed decisions. Birth photography is becoming very popular with many couple wanting to capture the moment that they meet their child as well as the birth itself and special moments such as first cuddles, first feed and meeting any older siblings or family members.
If you are having a fairly straightforward midwife led pregnancy then you have various options about where you can give birth. There is the labour ward of your hospital, midwife led birthing centres, private hospitals or home birth. Your midwife will be able to explain the options available to you and help you to make a decision.
If you are under consultant care then you may or may not have as many options so again, speak to your care team about your individual situation.
It might be a good idea to write a list of pros and cons for each available option once you've spoken to your midwife to help you make a decision. Nothing is guaranteed and a planned home birth may end up as a hospital birth, while you could be sure you want to go to hospital but your baby decides to arrive quickly at home! It's a good idea to carry your notes with you at all times towards the end of your pregnancy and to have the phone numbers of your midwife and your birthing centre or ward to hand.
What would you like to use as pain relief during labour? Some women swear by TENS machines whereas others find gas and air invaluable and some go straight for an epidural. Speak to your midwife about the various medical and non medical pain relief options available and then write your wish list with your favoured to least favoured options. There is no right or wrong, everyone experiences labour and copes with the pain differently. So from a birthing ball to walking around, a pool to a TENS machine, gas and air to an epidural, have a think about what tends to help you when you're in pain generally and use that as a starting point. As with everything though, be prepared to change the plan if necessary as your labour progresses.
Sometimes it is in yours or your baby's best interests to have some medical intervention in order to make sure that you're both healthy. This could be inducing labour medically, an episiotomy where a small cut is made to the perineum to enlarge the vaginal opening for baby to birth, ventouse or forceps to assist your baby in travelling down the birth canal or a Caesarean section.
The important thing here is for you to understand each type of intervention and to feel confident in knowing when they may each be necessary and why. In the heat of the moment it can feel very overwhelming to hear the words 'intervention' or 'procedure' being mentioned so if you know what each thing means and in what sort of circumstances they may be used, then you and your birth partner will hopefully feel better about making an informed decision should your care team speak about assisting the delivery. Don't forget that this is your body and your baby, so knowledge is key here for you to be secure about what happens.
Making a birth plan is a great way to help organise your mind and feel more ready for the birth. It's true that they don't always go the way you hoped, but rather than a concrete plan, try to think about these things as your list of ideals and also your wishes for all eventualities. If you feel comfortable with the options available to you and the 'back up' options should things deviate at all, then you have a lot less to be thinking about when your most important job is to give birth and meet your baby. Make sure that your care team and birth partner(s) are fully aware of your wishes so that they can be your advocates when you're in labour.
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