What’s the point of writing a ’Birth Plan’ when you are told “Nothing ever goes to plan“?
At around 36 weeks of pregnancy your midwife will finally turn to that long awaited page ’Preferences for Birth’ and start to read down through a whole list of what to expect during labour and birth and what may be offered as a result. This page used to be called ’Birth Plan’. Its at this very moment that it finally dawns on you that you are about to birth a baby! “Of course, I need a list, plenty of lists…but what should be on my list of birth preferences? Can I plan my birth?” You realise that this is definitely a chocolate biscuit moment especially as by now you have already lost sight of your feet so one more biscuit is not going to make a difference! Anyway, this baby likes biscuits especially ones with a chocolate centre…
Firstly let me tell you that it is ALWAYS worth writing out your preferences. In fact my advice would be to start to consider and research these early in your pregnancy. Once the morning sickness subsides and a little bump starts to rise towards your tummy button, you would benefit in beginning to direct your thoughts towards a ’perfect’ birth. I use the word perfect as what is the point in planning a less than perfect birth? I would also however urge you to look at the ’What If’s’ in that you consider what you would like to happen if things do steer away from the ’plan’ as of course birth can not and will not be planned! Our bodies and our babies are unique and each birth journey will consequently be unique to you as an individual. So what should you consider?
The first section on the page directs you towards considering where are you planning to birth. I am sure that by now you have an idea of where you would most like to birth? Whether at home, in a birth centre, hospital, in a birth pool, or up a tree; you will need to pop this on the top of your list. This is your first ’Wish’ on your ’Wish List’.
You must then begin to consider how you feel about the routine care that will be offered to you during labour, for e.g. Do you feel comfortable having a V.E (Vaginal Exam) and would you be happy if these were offered to you every 4 hours? You will be offered some routine examinations during your labour such as having your blood pressure, temperature, pulse rate and your respiration rate measured. These routine exams help guide your midwife in best care for you. Your baby will also be ’listened to’ fairly frequently and your abdomen palpated, to try to determine how your little passenger is doing in there. These routine examinations are recorded alongside how you are feeling and help to determine the course of your care. All examinations are to be carried out only with your full consent.
Next I encourage you to consider your coping strategies for labour and birth. There are many ways to try to relax and let labour flow, releasing the oxytocin as the natural physiological event of labour and birth progresses. You may consider; Hypnosis for birth, water birth, visualisation, breathing techniques, massage, aromatherapy, Active Birth, homeopathy…the list continues. All of these techniques have fantastic evidence to support there uses, it all depends on what appeals to you. There are no major ’top tips’ here, as individuals we need to explore what we feel suits us best and we all have the right to change our minds at the 11th hour!
The next section revolves around your decisions once your baby is born and in you arms. After you birth your baby, this section considers what you would like to do about birthing the placenta, (Yes, there is more to come out)! This amazing life support system was snuggled up in there against your growing baby and is no longer needed. You will be offered two options, either to leave this as a completely physiological event and allow you body to naturally expel this fascinating organ, or you may opt for or need a more managed event in which a drug is given to you via an injection to help to expel the placenta with the help of your midwife within a few minutes of birth. I urge you to go forth and research, ask questions of other mums and midwives to begin to consider what you would like to happen as the decision is yours.
Before the placenta is to be born, I do urge you to consider a pause prior to the cord being clamped and cut or to consider leaving this little cord alone altogether to stay attached to your baby for as long as you want. You may even consider a Lotus Birth. Please research Optimal Cord Clamping and the benefits of leaving the cord to pulsate before it is clamped and cut. If you would like to consider the injection to hurry the placenta along, then a delay in clamping the cord can still apply if all remains safe.
Lastly, you will be pointed in the direction of the ’What If’s’, what if birth does not appear to be going as well as you had hoped and visualised? You may be asked to consider to transfer in to hospital if at home or you may be offered some extra help with birthing your baby. This extra help may come in the form of a ventouse (suction cup placed on baby’s head to help birth), forceps (large metal tongs used to bring your baby down and out into the world), or a c-section may be discussed as best option. I would urge you all to go and research these a little, not to worry yourselves but just so you are aware of what they are at least. As midwives it is our job to help to normalise any situation that arises for you and your baby. We are there to help you to make your informed care decisions and gain you the best care available. Trust in your caregivers to help to guide you and your baby in your journey.
So you have lots of researching to do, lots of homework, and I expect you all to get a A! Birth itself is a normal, natural, physiological event that should not be feared but embraced. Go forwards from this blog and begin your lists, start to consider your options and your wishes, wants and what if’s. You will have 101 questions that will raise themselves but by talking, listening, and being heard, you will be able to write your birth preferences and enjoy the perfect birth for you and your baby.