Getting ready to give birth

Your birth plan

13 min read

Writing a birth plan gives midwives, doctors and your birth partner a clear idea of what’s important to you during labour, birth and in the first few hours with your baby.

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We provide everything you need to get your birth plan ready.

What is a birth plan?

A birth plan outlines what you want to happen during the early stages of labour, through to the first hours with your newborn. The aim is to let the team taking care of you know what your ideal birth looks like, so they can work towards it while giving you the care you need. In a recent study, NCT suggested birth plans help midwives to quickly establish rapport with the women they are caring for in a very short period of time.

Whether it’s a written guide, or a few principles that you have discussed with your midwife, a birth plan is about feeling prepared for what’s to come.

While it might not be the case that everything will go as planned, it’s your right to express your preferences and to discuss them with the team taking care of you.

Think of your birth plan as a rough guide that provides an overview of what you would prefer to happen. It’s a good idea to include details of what you want to happen if circumstances change. If you plan for a home birth, for example, you might need to be transferred to a labour ward, or if you plan for a vaginal birth you might end up needing a caesarean section.

If you’ve already considered these outcomes you’re likely to feel more prepared as things happen, even if you don’t get the birth you had imagined.

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Tips for writing your birth plan

Research is the key to a good birth plan. Taking on new information and making important decisions during labour can make things more stressful, so it’s better to familiarise yourself with the situations you may be confronted with so that you feel prepared and well informed on the day.

Putting a birth plan together can be as simple as writing up a few key points by hand, or you might want to use an existing birth plan template which can be found online. We’ve collected a few useful templates for you to take a look at when you’re ready to write yours.

The earlier you write your birth plan, the more time you’ll have to find out about local services and to speak to midwives about what’s important to you, so it’s recommended that you think about it throughout your pregnancy.

Some women prefer to go into a lot of detail and others decide to give guidance on a few key aspects that are particularly important to them. It’s entirely up to you how detailed your birth plan is.

As a rough guide, aim to fit it onto a sheet of A4 paper, if possible. Remember, your midwife may not have a lot of time to read it.

The most important thing is to communicate all of your preferences clearly, so don’t fret if it does span out over a few pages.

What information should a birth plan include?

The list below is by no means exhaustive. Cherry-pick what’s most important to you, or include other ideas to get everything down that matters to you.

Key people

To start with, list the names of the people who are going to be involved in the birth, and the roles you want them to play. Make sure you include:

  • Your name
  • Your partner’s name and their role in the birth
  • The name of the person overseeing your medical care
  • The name of your doula or your other children (if they will be around).

Consider whether you want birth partners, friends and family members to stay with you in the event that a forceps or ventouse delivery is needed, or if you need to have a caesarean section, and include this in your birth plan.

If you need to stay overnight once you’ve had your baby you might want your partner to be able to stay with you. It’s worth knowing that not all units allow partners to stay overnight, so if this would be important to you, look up your local unit in our search to see what its policy is so that you’re not disappointed if you have to stay without them.

Where you want to give birth

Choosing where you want to give birth is an important decision. You’re likely to have a choice of planning to give birth in a hospital labour ward or at home, and in many areas there’s also the option of a birth centre.

Which is best for you will depend on how likely you are to experience complications during labour and on your personal preferences and circumstances.

If you haven’t made your decision yet, use our award-winning Birth Choice tool, which takes your birth preferences and clinical circumstances into account to recommend the best place for you to give birth.

You can then check out the individual pages for your local units. These contain useful information and birth statistics to help you make an informed decision.

If you decide to plan a home birth or birth in a freestanding birth centre, keep in mind that during labour you may need to be transferred to a labour ward. As a precaution, it’s good to make a note of the kind of birth you’d like to have there in case the situation changes on the day.

Watch videos of mums describing what it’s like giving birth in different environments to hear how birth at home, in a birth centre and in a labour ward differs.

Pain relief

What pain relief you would like access to, and what you want to avoid, can sometimes determine whether a home birth, birth centre or labour ward is the best fit for you.

It’s worth doing some research into which forms of pain relief are available where you have decided to give birth. Gas and air, for example, is always available as it can be brought to a home birth by your midwife, whereas epidurals are only available in a labour ward.

You can find out more about the availability of pain-relief options in our comparison of giving birth in a labour ward, birth centre and at home.

Even if you know which kind of pain relief you want to use, it’s good to read up on other options too, as a 2017 survey by the Care Quality Commission (CQC) found that four in ten women ended up using a different type of pain relief in labour than they had planned to beforehand.

Creating the right atmosphere

You’re likely to have ideas about the kind of atmosphere you want to create in the room you’re going to give birth in. Below is a list of things you can often change to get the atmosphere that feels right for you, so look out for these things when researching local units.

  • Using a birth pool
  • Ability to control music and noise in the room
  • Ability to adjust lighting
  • Number of guests in the room
  • Availability of aromatherapy
  • Flexibility for freedom of movement
  • Preferred furniture (including mats and birthing balls)

You may have other ideas about ways you can make the environment as comfortable as possible. Be sure to contact the unit in advance to run what you want by them so you aren’t disappointed when you arrive. Look up your local unit in the search to see what they offer to help you feel comfortable.

Keeping active during labour

Some people prefer to have the freedom to continue moving around the room during labour. This can help speed up the process and provide some relief from pain.

You can use a birthing ball or chair to stay sitting upright. Swaying or rocking from side to side can be comforting and reassuring and can also help move your baby into the best position for birth. If you feel up to it, standing up and leaning on your partner, or even leaning over the side of the bed can help things move along naturally too.

The types of pain relief you have will impact whether or not you’re able to move around during labour. For example, you can’t usually move around by yourself if you’ve had an epidural. How you want your baby to be monitored during labour will also affect the positions available to you.

The 2017 survey by the QCQ found that seven-out-of-ten of women who didn’t have a planned c-section were able to move around and get into comfortable positions during labour most of the time.

Foetal monitoring

Foetal monitoring is the process of checking a baby’s heart rate during labour.

Your midwife will check your baby’s heartbeat for one minute, every quarter of an hour, using a Sonicaid or Pinard stethoscope. This intermittent monitoring is the recommended practice for women with uncomplicated pregnancies.

If health problems are spotted in the run-up to the birth or if your midwife is concerned about your baby’s heart rate during labour, they may recommend continuous foetal monitoring. Also known as CTG, continuous foetal monitoring is only available in labour wards (obstetric units) so if you’re in a birth centre or at home you will need to be transferred.

You can request continuous monitoring but this isn’t usually recommended if you’re having a straightforward pregnancy. Discuss it with your midwife and note any specific preferences in your birth plan.

Position during delivery

After considering movement and your preferred positions during labour, think about what kind of position you want to be in when you give birth. Here’s a handful of positions to consider:

  • Squatting
  • Kneeling
  • On all fours
  • Leaning on a birthing stool/bed
  • Lying on your side
  • Sitting up.

Practice getting into these positions with the help of your birth partner beforehand to find one that feels right for you.

If your baby is being monitored continuously, or if you have an epidural, this can limit the positions you can get into. If you feel like you need to move, discuss it with your midwife so that they can help you.

While thinking about how you’d like to give birth, also try to prepare yourself mentally for if things don’t go quite to plan. In the 2017 CQC survey, one in three women reported gaving birth with their legs in stirrups.

Episiotomy

An episiotomy is the process of making a surgical cut in the area between the vagina and your bottom to widen the opening and allow the baby to be born more quickly.

Usually this is done to prevent extensive tearing, though it’s worth keeping in mind that the majority of women do tear to some extent when giving birth, and that routine episiotomies are no longer recommended. Sometimes an episiotomy will need to be performed if the baby is in an abnormal position, or in order to speed up delivery if the baby’s health is at risk.

It’s a good idea to state a general preference such as ‘I would prefer to tear naturally unless circumstances dictate otherwise’, or ‘I would prefer to have an episiotomy if required’.

Placenta delivery

Let the midwives or doctors know whether you have a preference for how you want your placenta (afterbirth) to be delivered.

Choosing a ‘physiological third stage’ means that the placenta will be delivered naturally, without any assistance or pulling on the cord. The other option is an ‘active third stage’, where your doctor or midwife will give you an injection of the oxytocin hormone and then pull on the cord to help speed up the process.

Most hospitals are likely to opt for active management if you don’t give them a preference, as it can help to reduce the loss of blood.

Cutting the umbilical cord

The World Health Organization (WHO) recommends clamping the umbilical cord one to three minutes after the birth, which is referred to as delayed clamping.

If you have a preference, describe how long you want to wait before the umbilical cord is clamped and then cut. Many people prefer to wait until it stops pulsing to ensure that their baby receives the maximum amount of oxygen and nutrient rich blood from the placenta.

Another thing to consider and add to your plan is whether you want your partner to be the person to cut the umbilical cord.

Skin-to-skin contact

Having your baby on your bare skin straight after birth can help you and your baby bond. It can also help to naturally encourage breastfeeding.

It can be more difficult to have uninterrupted skin-to-skin contact immediately after birth in certain situations – for example if the baby is delivered by c-section. If you feel very strongly about this, include it in your plan so that those caring for you can make sure you have skin-to-skin contact as soon as possible.

Breastfeeding

Breastfeeding sometimes occurs quite quickly and naturally after birth, but for many women it’s not as easy or straightforward. One thing you can include in your birth plan is whether you intend to breastfeed as soon as possible after birth.

You can also specify requirements around how your baby should be fed, for example whether you’re happy for them to receive supplementary formula, bottled water or glucose water. Also think about whether or not you want them to be able to use a pacifier immediately after birth.

Hospitals can receive ‘baby friendly’ accreditation if they provide a high standard of support with breastfeeding. You can see whether a hospital has received this accreditation by looking the hospital up through our Birth Choice tool.

Vitamin K

Doctors recommend that as a precaution vitamin K should be given to babies shortly after birth to reduce the likelihood of a rare bleeding disorder.

If you don’t want your baby to have an injection so soon after birth, vitamin K can be provided as an oral supplement. Taking it orally is known to be slightly less effective, so your baby will need additional doses. If you have strong feelings about the use of vitamin K, or how it’s administered, discuss this with your doctor or midwife and include your preference in your birth plan.

Having a c-section

It’s always good to consider what might happen if things don’t go to plan. If you’re planning for a vaginal birth, it’s still a good idea to write about what you would like to happen if circumstances change and you need to have a caesarean section.

Things to consider include whether you would like your birth partner to stay with you during the surgery, whether you want to be able to see the birth happen, and whether you feel you want to have skin-to-skin contact and breastfeeding as soon as possible in the operating room after the birth.

Who can I talk to for help with my birth plan?

If you have concerns or questions when you’re putting your birth plan together, talk to your midwife. They’ll be able to explain what you need to include and provide information on any aspects of labour and birth you’re interested in or concerned about.

Antenatal classes are another great opportunity to discuss your birth plan. Teachers will often set aside time to discuss it and it can be really useful to ask questions and share ideas with other mums-to-be.

If you have a friend or family member who has given birth recently, ask them about what they included in their plan and whether there was anything they’d have been keen to include in hindsight.

It’s good to involve your partner when you’re thinking about your birth. Not only is it useful for them to understand your wishes so they can support your decisions confidently during labour and childbirth, but it can also help to get another person’s support with research when you’re making decisions about what you do and don’t want to happen.

Birth plan templates and examples

There are many different templates and sample birth plans you can use, so we’ve listed a couple below to help you get started:

Visit NHS Choices UK and answer questions in an online form to generate your birth plan before printing it out.

Download a blank version of the detailed NHS birth plan document, ready to be printed out and filled in by hand.

More from Which?


References

These are the sources of information used in this article:

Care Quality Commission, Maternity services survey 2017 (2017)

Plotkin, L, Support Overdue: Women’s experiences of maternity services, National Federation of Women’s Institutes/NCT: London (2017)

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