Today I’m talking all about birth plans…
- Why they’re important
- What’s the point of writing one when they ‘never’ get used?
- What was my birth plan (and did we actually follow it)
- How you can write your own birth plan
To get started, in this episode of Lizzie Sophia TV I explain why birth plans are important (even though lots of people will tell you they aren’t!) and the 3 simple steps to writing a birth plan that you’ll actually use!
Watch that episode now:
https://youtu.be/jfwa-B44mww
TL;DW: A birth plan is not a script for how your labour will go! The purpose of a birth plan is to educate yourself on the drugs and interventions available to your throughout labour, so that you can make informed decisions along the way.
What Was My Birth Plan?
I thought I’d share my exact birth plan, with commentary about why these things mattered to me, and share what did and did not ‘go to plan’.
An Introduction…
I began my birth plan with a candid and honest paragraph addressing my medical team. To be honest, I knew this would probably be unnecessary.
I was in a case-load model of care, which means that one midwife saw me throughout my entire pregnancy, and was present at my home birth.
However, it was (of course) possible that I would give birth on her day off.
In that case, another one of the midwives would be sent my way, and since I hadn’t met the rest of the team or discussed my wishes with them, I wanted to have this on hand so that I could quickly and easily communicate where I was coming from.
What I Did & Didn’t Want During Labour…
Next, I addressed things I did and did not want to happen during labour.
YES
Things I Wanted To Happen During Labour
- People allowed to be present
I was lucky not to have anyone pressuring me, wanting to be at my birth. However, I wanted to clearly list who I was happy to have there, so the midwives could easily turn anyone else away.
- Use of shower as desired
This was a non-issue, most hospitals (and certainly home births!) will allow you to shower during labour, so I probably won’t include this in future birth plans.
In the end, I decided not to shower at all because I was using the TENS machine as a primary pain-management tool, and it’s most effective if you don’t take it off.
(And I knew I wanted to birth baby in the water, and I didn’t want to run us out of hot water!)
- Freedom to film and take photos
Being at home, this wasn’t an issue. But if you are planning on filming or photographing you definitely need to discuss it with your hospital.
Some flat out refuse, others will only let you film labour and post-birth, but not during the actual delivery. And others are totally fine with it.
- Suggest different positions that might help me, and help me to ‘pace myself’
I planned to have a very active labour. I wanted to be moving. However, I knew I could easily wear myself out.
I also knew that my midwife would have a much more accurate view of where I was up to. So I wanted her to guide me.
In the end, I was really happy with her recommendations. You see, I’d been in labour for over 17 hours, and was convinced I was progressing and baby was close.
But my midwife checked me, and I had not progressed at all in 8 hours! She ended up suggesting different positions along the way that helped kick me into established labour (I had been side-lying to rest, but that can slow things down).
- Encourage me to wait as long as possible before getting in the birth pool
Oh my goodness! I both hated and loved my midwife for actually doing this! In the end, I was glad with this decision.
Once I was in transition, labouring on the bed again, I was begging for the birth pool.
I was barely coherent, and my midwife kept saying we had plenty of time, but I could feel that baby really was coming now, and I wanted in!
It was probably only about an hour before I actually got in the pool, but it felt like an eternity! And I was glad she had delayed me.
She didn’t actually say no during this time, she just told me we had plenty of time, and suggested we quarter fill it with cold water to prepare (because I was worried about the speed of our water flow).
- Use of gentle, controlled pushing
Ironically, nothing about my pushing felt ‘controlled’. It was like my body took over and demanded that the baby get out! I definitely had an involuntary pushing urge.
During the pushing stage, I actually focused on not pushing. I wanted to relax my body as much as possible and ease baby out.
- Massage and support of the perineum to avoid tearing
This was something I had read about, and to be honest wasn’t even 100% comfortable with the idea. But, I really didn’t want to tear, so I figured if it would help then I’d do it.
I discussed it with my midwife, and she said we’d just play it by ear and that usually the water softens the area in the same way. (I ended up tearing, but no stitches).
NO
Things I Wanted Not To Happen During Labour
- Vaginal exams, unless medically necessary (or requested by myself at the time)
This ended up being exactly what happened… I requested them.
When I’d already been labouring for 9 hours, I was convinced I was progressing and wanted to know my dilation. 4cm.
It was good to know, because it told me that even though I was progressing, I was still only early in the labour.
After another 8 hours, I requested a second check. Still 4cm.
(Little did we know she would be born just 4 hours later!)
There was one stage, as I was about to enter the birth pool, that my midwife asked to check me and I said no.
- Enemas
This was a non-issue. Apparently in a lot of American hospitals this is standard procedure, but my midwife said she rarely did them.
- Episiotomy
I really wanted to tear naturally (okay, I really, really wanted not to tear at all!).
I heard from quite a few women that they were given episiotomies without even asking for consent, so this one was important to me.
- Offering transfer for pain relief
One of the reasons I loved the idea of birthing at home is the fact that I didn’t have any pain-relief drugs available to me.
I know myself well enough that if the drugs were easily accessible, I’d be far more likely to take them. So I was very clear with my birth team: do not offer me pain relief.
And further than that, if I’m asking for drugs, encourage me to keep going!
- Stripping of membranes or breaking of bag of waters
I discussed this with my midwife, and I was happy to play it by ear. For the most part, I know that the less I interfere, the more likely my body is to just get on with the job!
However, I was aware that labour can stall and it can make sense to break the waters and speed things along. So even though I wanted as little intervention as possible, I trusted my midwife and was happy to take her recommendations on board.
- Supine (laying down) position for pushing stage
This is another point that is probably more relevant for hospital births, where it’s quite common for doctors to instruct the mother how to push. I didn’t want to be told I had to be lying down.
Ironically, I ended up giving birth in a reclined position!
I wanted to be squatting, but my legs cramped and laying back was the only position that was comfortable.
What I Did & Didn’t Want Post-Birth
YES
What I Wanted Once Baby Was Born
- Immediate skin-to-skin on mother’s chest
This was a no brainer. Unless something was wrong with baby, then she was to come to me immediately.
- Wait for cord to stop pulsating before cutting
I wanted baby to get all the nutrients she needed from my placenta, just the way God designed it! Also, this had the added benefit of giving her more time to actually breath (since she was still receiving oxygen through the umbilical cord).
Emelia still had quite a lot of ‘gunk’ in her throat, and took ages to actually cry. But I knew she was fine because the cord hadn’t been cut. (In the end, she hardly cried at all! Just went straight for the boob and she was happy).
- Offer for Stephen to cut the cord
My husband wasn’t sure whether he wanted to cut the cord, so we were leaving it up to him.
In the end, he did cut it 🙂
- Please allow baby ample time to naturally ‘crawl’ and begin breastfeeding of their own accord
Basically, I wanted baby to do her own thing and get to my breast using all her newborn instincts. I didn’t want my midwife putting her into position or anything like that.
So I took my top off and let her feed.
(The first feed was amazing. Everything ‘worked’ perfectly, I didn’t have any pain – in fact I kept asking my midwife if I was doing it ‘right’ because I wasn’t in pain… little did I know the struggles I would face! But at least that first feed was magical)
- Delay any tests and checks that are not medically necessary
Throughout all my decision making, I tried to imagine things from my baby’s perspective…
She’s just been born, all she’s ever known is my womb. Suddenly, she’s in a room full of people and being taken away from me to be put on some scales and having a tape wrapped around her head?
I had seen birth videos where they whisk baby away to measure and weigh them. I didn’t want that. I wanted time with my baby, bonding and loving on her.
So after about an hour and a half of feeding, we got around to weighing and measuring her.
The best part? She didn’t cry! She was so content, she just lay on the scales sleeping.
- We would like an extended period of time (perhaps an hour or so) for mother and father to bond privately with baby immediately after delivery (midwives excepted)
This is another one of those things that we sort of followed, but sort of didn’t!
The room was still full of people, but I was completely off in my own little world. My precious little baby consumed all of my focus!
We ended up feeding for an hour and a half, but we were all on such a high that we invited the whole family around!! My dad, his mum, and my husband’s parents all came around just an hour after the birth.
People ask me how I coped with all those people around, and just like them, I thought I wanted a private time. But this is a perfect example of how a birth plan should work…
It’s not a script. And I didn’t come away thinking, “oh no, I forgot I wanted that!”. I knew my options, and I chose what was right for me at the time.
NO
What I Wanted To Avoid After The Birth
- Active third stage
I know the value of the injection: it can avoid haemorrhaging.
However, throughout my entire labour I was very conscious of the fact that I didn’t want baby to be getting any drugs in her system.
So, I simply asked that if I was going to have the injection, that it be after baby is born.
- Cleaning of baby
All the birth fluids are really good for baby’s skin, so I didn’t want them scrubbed away.
Obviously, when you wrap baby in a towel or blanket, a lot of it comes off anyway. But I didn’t want her intentionally cleaned.
What I Did & Didn’t Want For Baby
YES
What I Wanted For Baby
- Vitamin K injection
When I discussed my birth plan with my midwife, she actually suggested that we give the Vitamin K orally (because I was very uncomfortable with the idea of giving my newborn baby any injections!)
I was thankful for the recommendation, and glad that we didn’t jab her on her first day of life!
Again, this came down to trying to see things from my baby’s perspective. And being given two needles on her very first day of life sounded awful!
- Newborn blood screening
I was totally fine with the heel prick, and they didn’t do it until the day three visit, so that was nice.
- Hearing screen
I wasn’t just fine with all this testing, I was glad that it was available to us!
I have friends who have picked up deafness through this screening. I even know of babies with extremely rare blood disorders, but with the newborn screening it gave their parents the best possible chance, from the very beginning, to treat the condition.
- All baby examinations done with the permission, and in the presence, of a parent
One of my friends had her baby wheeled into an adjacent room to get his newborn tests and injections done.
I think the idea is that it’s distressing for mum to see. But it’s even more distressing when you can hear your baby’s blood curdling screams and you’re not right there with them!
I knew that if I got to birth at home, this wouldn’t be an issue. But if we transferred for any reason, I knew that it is quite common for the midwives to take baby into another room and I didn’t want that.
NO
What I Didn’t Want For Baby
- Hepatitis B vaccination
Like I said before, I did not want my baby getting needles when she was just born!
Aside from that, this vaccination was completely unnecessary for my baby because…
>> I am not infected myself
>> I am not in a high-risk social circle (meaning that certain demographics are more likely to be exposed to Hep B)
>> She was going to be fully breastfed
>> And last, but certainly not least, she would be getting vaccinated at six weeks old. Hep B is one of the vaccines included in the 2, 4 and 6 month vaccines.
So, Did I Actually Use My Birth Plan?
Yes. I used it to inform myself of my options.
I thought through what I wanted, and I wrote that out clearly. (And changed my mind on the day!)
I talked it through with my midwife, and she suggested other ways we could do things.
We both went into the birth on the same page, and both willing to be flexible and make decisions as the labour unfolded.
Did I pull it out on the actual day? No.
Maybe I would have if another midwife came. I certainly would have if I was in hospital. But it wasn’t necessary on the day.
Thanks for reading!
I hope this has been helpful for you.
I hope it encourages you to think through each of your options, and that you can go into your own birth feeling empowered to make the right decisions for you and your baby while you labour!
What Now?
Are you busy planning and preparing for birth?
First of all, congratulations on the little bundle of joy growing in your belly!
Second, I recommend you download my FREE ‘Complete Guide to Writing a Birth Plan That You’ll Actually Use’
In it you’ll find…
- All the terms you might hear throughout your labour. What are the different drugs on offer? What benefits and side-effects do they have?
- What interventions might be offered throughout your labour
- A template for writing your own birth plan
- Both my home birth plan & hospital transfer plan
- As well as advice on how to talk to your doctor about your wishes
What do you need to do?
Simply enter your details below and you’ll receive your free guide after confirming your subscription 🙂
Good luck as you plan and prepare for your own birth!
Blessings,
Lizzie x