Writing your birth plan

When writing your birth plan it helps to think of it more as outline of preferences and concerns rather than an instruction sheet for your doctors. You may really want a waterbirth, but if the only birthing pool at your hospital is in use by someone else when your baby decides to make an entrance then you'll have no choice but to be flexible. No-one can guarantee you your ideal birth, but a clear and well-written birth plan will help midwives and hospital staff understand what is important to you.

When to write your birth plan
You'll probably start thinking about what kind of birth you'd like in your second trimester. As you come across ideas that appeal to you it's a good idea to jot them down, likewise with procedures or medications that you'd rather avoid. You'll want to write several drafts of your birth plan, changing it as you learn more about labour and birth at your antenatal classes or from reading up on the topic.

Talk through draft versions of your plan with your birthing partner to make sure they know how you'd like them to be involved and gain a good understanding of your preferences and concerns. It's also a good idea to talk through your plan with your midwife or doctor.

As you move into the last month of pregnancy make sure you take a look at your birth plan and are still happy with it.

What to put in the plan
There's no need to account for every eventuality in your plan - and in any case that would be impossible! - but the plan should give health workers a good idea of the kind of labour you would prefer and include the points you feel most strongly about.

Here are some key sections you might want to include:

• Place of birth - Would you prefer a home, hospital or a special maternity unit birth?
• Birth partner - Say who you would like to be present
• Medical staff - Is there anyone you would like in particular to look after you? Would you object to student staff being present?
• Labour - Do you want to be able to walk around during labour? Are there any particular accessories you'd like to use to help cope, like music, cushions etc?
• Pain relief - What kind of pain relief would you prefer to use eg: a birthing pool, massage techniques, gas and air - What kind of pain relief are you open to trying if need be? eg: Gas and air, a tens machine, an epidural
  - What kind of pain relief do you feel strongly against using? eg: an epidural
• Birthing position - What position would you prefer to give birth in? eg: In a birthing pool, using a birthing stool, squatting, on all fours, sitting up
  - Would you like your birthing assistant(s) to be involved in supporting you? - Are there any positions that you would prefer to avoid? eg: Lying flat
• Medical intervention - If there are any complications and doctors recommend medical intervention do you have any particular concerns or requests?
  - Are there any procedures that you would like to avoid unless absolutely necessary? Eg: induction, caesarian, episiotomy
  - Are there common procedures that you wouldn't object to? Eg: induction, syntometrine injection to speed up delivery of the placenta
• Birthing moment - Do you have any particular requests for the actual birth and moments immediately afterwards? For example touching the baby's head as it emerges, having the baby placed on your tummy straight after birth, having your partner cut the umbilical chord.
• Feeding - Do you plan to breastfeed and if so would you prefer to get breastfeeding underway as soon as possible / express milk if necessary?