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Your birth plan questions answered

Giving birth is frightening but writing a birth plan in advance can help you feel calmer and more in control. Lesley Regan, Professor of Obstetrics and Gynaecology at St Mary's Hospital, London, answers the questions of expectant iVillage mums

Do I really need a birth plan?
I'm a bit confused as to whether I actually need a birth plan.

My midwife seems to think that my hubby and I should just discuss what I want and don't want, and what are my boundaries. We need to talk about if I'd be willing to push them when the time comes or if he's to make sure I don't when the drugs kick in! She says I'll be asked on arrival for a rough idea of what I want, and other than that I just ask for things as and when I want them. cl-parasol15

What your midwife is asking for is some guidance as to the type of birth you want. So think about

  • Who you hope will be with you at the delivery
  • Pain relief - epidural, gas and air, pethidine injections, absolutely no drugs whatsoever - these are all valid options
  • Birth positions - some women are very disturbed by being asked to lie flat on their backs and want to deliver on all-fours. Others just want to remain mobile for as long as possible before moving onto a bed.
  • Think about whether you would be happy to have your waters broken, or syntocinon augmentation to speed up contractions - if they were advised.
  • Also the third stage - some women prefer not to have syntometrine because it makes them feel nauseous, albeit briefly. However, it reduces blood loss significantly so I would advise you to have this.

The very best advice is to remain flexible in your attitude at all times. Don't decide on a rigid policy and then feel let down when it doesn't pan out. Listen to what people are saying to you and make sure that you let them know how you are feeling and what you would like to happen if at all possible. - prof_regan

What are the key points I need to think about for my birth plan?
What are the three most important things to consider when sitting down to a write a plan from scratch? - stinny

The three essentials things are:
Flexible attitude,
Flexible attitude and
Flexible attitude!

Do have a good look at pages 245-247 in my pregnancy book, which includes lists of topics you may want to think about and develop viewpoints about.

There are advantages and disadvantages to birth preference lists but all of the problems can be prevented by not being rigid in your approach or aggressive about your requests.

Listen to your midwife and doctor and make sure that you communicate your views, hopes and fears to them. They actually want to help women have good birth experiences - and there are many different ways of achieving this ranging from a completely non-interventional approach to high tech. There is no right or wrong and it is a very individual thing. - prof_regan

When should I start writing my birth plan?
When do I need to start thinking about making a birth plan and what information do I need to gather before I do? Classes/books/talking to others etc.

I'm not due for another four months but I am freaking out about the whole giving birth thing. I think this is mainly due to feeling unprepared and not knowing all my options. - joneschick

It is never too early to start thinking about birth preferences. However, it is very important that you keep an open mind since events that you cannot predict at say 36 or 40 weeks may greatly change how the labour and delivery turns out.

If you are feeling anxious about the delivery then this is an important fact to acknowledge and I advise you to book some time with your midwife sooner rather than later. In this way you can get to know her and she you, in order to help answer your concerns and queries. You could also ask her to help you write a birth preference list after she has established your viewpoints.

Talk to other mums and reading books will help too. - prof_regan

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