The Importance of Writing A Birth Plan

Updated: May 29

Recently I saw a post on Instagram, by a Hypnobirthing practitioner, advising the following -

"If you are having a hospital birth, don't bother with a birth plan, because it will be ignored"

She then went on to say that the post could be used as space for people to discuss the instances where they had had their birth plans ignored in the hospital.

I'm not going to name and shame this page. In all honesty, I saw it, and I saw red straight away. I was infuriated! I lost the page, and it wasn't a page I followed, so I couldn't find it, but I did take to my stories - which I don't usually do, I rarely air my frustrations or anger on social media - to talk about why it had made me so angry, and it also inspired me to write this post.

This angered me so much! While birth plans and preferences can be ignored, this doesn't mean they will be, and they can be incredibly useful! This message is not helpful. Shouldn't we be putting more effort into educating people on how to become informed in birthing choices, in making birthing choices, knowing how to stand up for themselves, and how to make themselves feel empowered?

Moving on. I've let go of this anger. And I've found some inspiration in the incident!

First of all, I just want to make you all aware that I'm not a medical professional, and have no training in this area. I am just someone who has been pregnant and given birth twice, and who feels really passionate about calm birth, hypnobirthing, and the importance of being able to make informed birthing choices.

Secondly, this isn't me saying YOU MUST write a birth plan. I will never tell another person that they should do anything. I always say each to their own. This post is all about the reason why a birthing plan is a good idea, and why you might find it useful. If you are fully set on the idea that it won't work for you, or it's something you don't need, that's completely fine!

So what is a birth plan?

A birth plan, or a list of birth preferences, is basically what it says on the tin - it's how you want your birth to go. Or at least that's the short version. Depending on the sort of person you are, will depend on the sort of plan you write. It could be a few bullet points with a couple of preferences, or it might be pages of detailed wants and needs.

It can be as detailed as you like. I would make sure you have a copy, your birthing partners have a copy or know where to find your copy, and be sure to keep a copy in with your maternity notes. When I had my two, there was a section in my maternity notes to include my birth plan. I've spoken to a friend who is currently expecting and she's very kindly shared with me that maternity notes are all done through an app now, and in the app, there is a section for your birth plan. The sections for this are fantastic, and they cover a wide range of topics that are so important. You could certainly use just this, but you could also write a more in-depth version to go alongside it - it's all about what makes you feel confident, comfortable, and prepared.

When I had my first baby (read his birth story here) I had a good conversation about my birth plan with my midwife, and she had clearly read it. When I had my second baby (read her birth story here) my midwife didn't discuss it once, but she had not only clearly read it, but fully understood what I wanted. Both experiences were brilliant, but I would say the second birth, overall, was better.

How do they help?

Childbirth can be a daunting process, and preparation is a great way to try and reduce the stress and anxiety we might feel towards it. Anxiety can really interfere with labour, and make our bodies do the opposite of what it needs to do.

It's important to remember though that you can be the most prepared person in the world, it doesn't guarantee anything in your birth. The more prepared you are though, the more informed and confident you will feel.

By writing a birth plan, you will hopefully find yourself thinking about the different routes that your labour will take, and researching the different possible interventions, procedures, techniques, and everything in between.

Not only will it hopefully prevent you from being uninformed and making a decision on the spot that you potentially don't want, but if you are in the position where you can't make a decision about something, or you are starting to feel unfocused, or like you are starting to struggle, it can help your birth partner(s) and midwives to know and understand what your preferences are.

What goes on a birth plan?

This is completely personal preference, it can be a few bullet points of some basic ideas, or it can be really detailed. Here are some suggestions of things you might want to include -

  • Birthing environment - music, lighting, smells, personal items, location

  • What would you like to be during labour - in the pool, on the bed, on an exercise ball, walking around, eating, drinking etc

  • What sort of pain relief would like - none at all, gas and air, TENNS machine, pain killers, epidural, breathing techniques

  • Are you following hypnobirthing?

  • What position would you like to give birth in?

  • How do you feel about medical intervention - Vontuse, forceps, episiotomy

  • How do you feel about a C-section?

  • How do you feel about being induced?

  • How do you feel about fetal monitoring?

  • Are you happy to have vaginal examinations?

  • Who would like in the room during your labour? Who would you like there during the actual birth?

  • Who would you like to catch the baby?

  • If you don't know the gender, how would you like it to be announced?

  • One baby is born, would you like them placed straight on your chest?

  • Would you like to do delayed cord clamping? How long for? Who would you like to cut the cord? How would you like to deliver the placenta? What would you like to happen to the placenta?

  • Would you like the baby to have a vitamin K injection?

  • Are there any special clothes/hats/blankets you want for baby? Or perhaps you would like to leave them undressed for skin on skin as long as possible?

  • Would you like to try breastfeeding straight away?

There's a lot to think about, and there's certainly more than this list, and again, you might not want to go into this much detail. It could be as basic as positions and pain relief, or you could cover every step. Go with whatever makes you comfortable. There may well be things on here that aren't important to you at all, and that's fine.

My Birth Plans -

Here are copies of my birth plans -

A birth plan written on white lined paper, in notebook
My first labour - 2018

As you can see this one is just a list of basic bullet points. From my preferences with my first, the majority was followed. They advised against the birth pool, and I ended up delivering on my back but otherwise, it was pretty much point for point.

A birth plan written white, lined paper in a notebook
My second birth - 2020

This one was more detailed, and structured. Similarly to the first, it was pretty much stuck to point for point, but again they advised against the pool, and I did give birth on my back again but this time it was because the midwife was eagre to see the baby as soon as she came out, and then I found out that the cord was around her neck. I also did end up doing a bit of forced pushing but this wasn't something the midwife was coaching me to do, it was just me getting impatient to get her out. My husband also didn't announce her gender, instead, I heard a chorus of "look down!" as she was being brought up to my chest.

Some extra points to consider -

  • Regardless of where you are giving birth, a birth plan can still be useful, and if you are having a home birth.

  • If you aren't sure if you should write a plan, I would suggest that it's better to go with than without

  • Talk about your birth preferences openly with your partner so they fully understand what you want

  • You might be worried that it will be ignored, and I have heard stories of this happening. Remember first of all that this is your birth - ask questions! Why can't you have the things you want? If you feel like you are really not being listened to, you can request to change the midwife that you have, and if you feel totally confident in what you are doing, you can request that no one is in the room with you. It's important to remember that while they have their use, we do not need medical facilities or staff to give birth. I can't speak from experience about being ignored as this did not happen to me, but remember to speak up. It may help to talk prior to your birth to your community midwife or hypnobirthing instructor about these worries as they may be able to put your mind at ease and help you to feel empowered to ask the right questions and say no when it's needed.

  • A final important thought here is to remember that a birth plan isn't a map of how your labour should go, nor is it a list of instructions to follow to the T. It is simply a list of pretences. It is so important to be mindful of this, and not to focus on "this how it should go" but rather "these are the things I'd like where possible." One aspect of hypnobirthing that I really love is that it can give us the tools to calmly cope when things aren't able to go a certain way.

I want to leave you with one of the best bits of advice I ever heard about giving birth... from my prenatal yoga instructor, who was fantastic... if you are advised you need to have a procedure or intervention that you aren't comfortable with but they seem particularly pushy about... ask if you have time to think about it. Say around 20 minutes. If they say no, it more than likely means it's urgent and needs doing straight away, but if they say yes, there is a good chance you don't need it.

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