Many women choose to draw up a ‘wish list’ for labour and birth, called a birth plan, and there is a page for this in your maternity notes. You don’t have to have a birth plan – plenty of women give birth successfully without one: they simply use their voice (as does their birth partner) to express a preference or to seek clarification for why a procedure might need to take place.
However, making a birth plan can be useful for getting you to consider why certain preferences are important to you and for helping your healthcare professionals to make the birth as close as possible to what you would like. Specifically, writing one in advance can:
- Give you the opportunity to discuss your wishes with your healthcare professionals, so that you can discover if any of your choices are incompatible with hospital policy, are unsafe or simply unrealistic
- Help you to feel more relaxed on the day, because you know that you, your birth partner and the hospital are clear about what sort of labour you would like.
However, there are a number of disadvantages to having a birth plan, too:
- It may raise your expectations as to what should happen in labour, even though, in reality, you have no idea what circumstances will occur.
- You may end up more stressed, due to the level of detail in the document.
- If things don’t go to plan, you may feel very disappointed, if not distressed.
- You may have feelings of inadequacy after the delivery, because you may think you have ‘failed’ or ‘lost control’ of your labour.
The key thing is to expect the unexpected in childbirth and it is much better to be prepared for all eventualities. Furthermore, there is no ‘right’ way to give birth, other than aiming for the safe delivery of a healthy baby.
Remember also that every birth is different: what works for one woman may not work for you and, even if you have given birth before, what happened to you last time may not happen this time. So, rather than thinking of your document as a ‘plan’, consider it an openminded and flexible list of what you would prefer to happen.
Before writing your birth plan, read as much as possible about labour and birth. If you can, watch a documentary-style delivery on TV. (There is even a great episode of ER – Season 1, Episode 19 – that includes nearly all the major labour complications and which doctors now use for training!)
You should also find out about Caesarean sections (which make up around 25–30 per cent of births in Australia), so that you can understand why they are necessary and what the procedure entails. This will help you to remain calm if a decision to perform one needs to be made quickly. Equally, it will be reassuring to know that the expression ‘emergency Caesarean’ does not always mean a life-or-death situation, but rather an operation that is not planned and does not have a pre-designated start time (see Chapter 6, p. 204). Even if youhave chosen to have a home birth, you still need to inform yourself about this in case you develop any complications.
You can start to discuss your birth preferences with your healthcare professionals from about the 30th week of your pregnancy. The list can cover anything you like, but remember: the longer the plan, the less likely it is that your expectations will be met (as staff will simply get lost in the detail), so try to limit yourself to a page of bullet points at most. Elements you could consider for your birth plan include:
- outlining who your birth partner(s) is and what they will be doing to support you
- what you like to be called
- what atmosphere you want in the room (e.g. quiet with minimal disturbances, background music, dim lighting)
- pain relief preferences (e.g. you want to try to labour without pharmacalogical methods but have not ruled out an epidural)
- if you are happy for your obstetrician or midwife to suggest artificial rupture of the membranes if your labour is taking a while to progress (see Chapter 6, p. 193)
- whether you have strong feelings about an episiotomy or a tear (see Chapter 6, p. 174)
- whether your partner wants to cut the umbilical cord (many partners change their mind when they see blood!)
- whether you want to receive an oxytocin injection to speedup the delivery of the placenta.
Depending on what else you decide to include in your birth plan, you may also need to find out hospital policy on, for example, breech birth, birthing pools (specifically, whether the midwives prefer you to get out of the pool to deliver), permitted or preferred positions for delivery, pain relief (e.g. whether there is a 24-hour epidural service), eating and drinking during labour and wearing your own clothes.
See also Chapter 1, p. 19 for questions to ask when choosing your hospital. Your birth partner should also familiarise themselves with your birth plan, or even help you draft it, so that they are aware of what it contains and can try to ensure that it is followed whenever possible.
The role of your healthcare professionals in the birth
Sometimes, in planning the perfect birth – just as in planning the perfect party or wedding – the reason behind your preparations can get forgotten or lost among the detail.
It is important to remember that the aim of the medical professionals is to ensure that you and your baby are safe and healthy throughout the labour, delivery and afterwards. So, although your midwife and obstetrician will try to adhere to your birth plan as much as possible, sometimes a medical situation arises that needs a quick decision to be made. While this could lead you to feel that you have no control over what is happening, bear in mind that they are acting with your and your baby’s best interests at heart.
Nonetheless, it is your right to seek and to receive an explanation – even after the event – for why a certain decision was taken and medical staff will always try to offer this before you even need to ask. When time allows you to be involved in decisions, you should listen to professional advice, even if this goes against the preferences listed in your birth plan.
DID YOU KNOW?
Other mothers who have recently given birth can give you helpful tips on birth plans and on which elements of their own one they felt were important to include.
Top five songs played at the birth (as compiled by obstetricians!)
The following songs are the most popular ones to be played as a woman is giving birth, according to obstetricians:
1. Happy Birthday – Stevie Wonder
2. Beautiful Day – U2
3. Make You Feel My Love – Adele
4. One Day Like This – Elbow
5. Greatest Day – Take That
The books are published by Hardie Grant and available through good bookstores or online.