Many women have an idea about how they’d like their birth to go but it’s also helpful to prepare for the unexpected. Here are some suggestions about what to consider before your due date.
Preparing for labour and birth can help parents-to-be feel more confident and less daunted as their due date approaches. And it’s good to think about what might happen in advance so you’re not making decisions when you don’t have the energy, time or a clear head.
Writing a birth plan – and outlining your preferences – can be a useful way of thinking about what you’d like to happen. The NHS has templates you can use to get started and your midwife may also have information to help you.
Antenatal courses are really beneficial as you’ll have a chance to find out more about what happens during labour, different types of birth and your options for managing pain.
Try not to be influenced too much by one person’s story – every birth is different!
Some women find it useful to make a note of anything they hear about options around birth – whether this is from a midwife, doctor, friend, book or website – and then think more about what their choice might be as they listen to others’ experiences.
Hannah Fleck, mum to Toby and Idris, and NCT branch co-ordinator for Aberconwy and Colwyn, made birth plans. ‘I used the NHS template and wrote a plan focusing on being calm, moving around and having the least medicalised birth possible.’
‘It included my husband telling me the baby’s sex, my feeding preferences and that I fancied radio 4 in the background!’
Hannah had an emergency caesarean with Idris. Although it wasn’t the experience she’d hoped for, she says it made sense to her because her birth plan had focused on being informed, being involved in the decision making process and knowing the risks and benefits.
Once you’ve listed your birth preferences, you might think it’s simply a case of following the ‘plan’.
However, it’s so important to be prepared for things changing.
There may be a deviation from your birth preferences right from the outset. That’s why it’s helpful to go through ‘what if’ scenarios with your birth partner so you both feel prepared if the situation changes [see box below].
NCT member Lorna Brooke went for a flexible approach. ‘Birth plans are good and assist a lot of people, but I think if I’d written down what I truly wanted I’d have been disappointed if it hadn’t turned out that way.’
She added: ‘In life I’m very organised and get stressed if things don’t go as arranged. After my NCT course I decided for my own sanity that no plan was actually my best plan, so I could just go with what came up.’
Location, location, location
You’ll have a choice of a home birth, a midwife-led birthing centre or a labour ward in hospital. You may also have the option of a water birth. Don’t forget that while you’ll probably start thinking about this early in your pregnancy, you can change your mind at any point, even once labour has started.
A birth partner is an invaluable source of support, so thinking through who you’d like to be with you (and you can have more than one person) and how you’d like them to support you is important.
Many women don’t anticipate being induced but it does happen in around 20% of births. Ask your midwife about the circumstances in which induction may be recommended and think about whether you’d want to agree to it. Find out what induction involves so you have a clear understanding of the process if you do go down this route.
This is an important topic to discuss prior to the birth and some women put their preferences on their plan. Discuss the options with your midwife or at your antenatal course, as the more information you have the more informed your choices will be on the day.
While thinking about your birth preferences, be aware that an assisted birth (meaning ventouse or forceps) is recommended in about one in eight births, so it’s good to be informed about them beforehand.
Once baby’s born
Some couples opt for their partner to cut the umbilical cord and announce baby’s sex and include this on their birth preferences. You can also note your preferences for skin-to-skin contact and whether you’d like your baby put straight onto your tummy, or if you’d like your newborn gently washed first.
You can include information about the third stage (when the placenta is delivered). In most cases, you’ll have a choice between a natural third stage where there’s no intervention, or an active third stage, where you’re given an injection to encourage a big contraction to deliver the placenta. Cord clamping is also something to address on your plan. You can decide how long you want to leave it before the cord is cut.
Some newborns don’t have enough vitamin K (which helps the blood clot properly) so it’s recommended they have an injection or an oral dose. It’s your decision so find out more before the birth and write your wishes on your plan.
The birth plan is your opportunity to record anything that’s important to you, so do note down your preferences. It’s good to have something for you and your partner to reference, especially as things can easily get forgotten.
And do, of course, say if you need specialist help like an interpreter, support for a physical or sensory disability, or if you have dietary needs.
Although it can seem like there’s lots to consider with your birth preferences, try to keep it short and simple. A single A4 sheet is usually enough, typed in a large font to make it easy to read.
Try to be open-minded and adaptable when it comes to your birth preferences. This will hopefully mean you’ll be less likely to feel upset or like you’ve failed if things do change.
If you feel disappointed about the way your birth went you do have the opportunity to talk through the birth afterwards with a midwife.
Hannah has the following advice: ‘Plan, be honest about what matters to you, but make sure you’re clear that plans do sometimes have to change.’ She also offers the following useful analogy:
Remember, like a wedding day to a marriage, the birth is just a tiny part of becoming a parent.