Your birth plan questions answered

Who do I give my birth plan to?
Who do you hand your birth plan to when you go into labour? Is it your midwife or whoever is on duty? - karent

There is no need to hand it in formally to anyone. You can place it in your hand-held medical notes or you can take it your next antenatal clinic appointment and arrange to find a time to sit down with your midwife and discuss it. Some women just like to keep it as a reminder for themselves and their partner during labour - which can be an exciting time when trying to remember a list of requests written two months ago is sometimes impossible!

The key to all of this is a flexible approach and good communication with your carers. - prof_regan

Do I need a birth plan if I'm having a c-section?
If I'm having a planned c-section because of complications from my first pregnancy do I still need a birth plan? I like the idea of mentally preparing myself but my 'role' feels a bit diminished as the doctors will be doing all the actual work in bringing the baby out. I'd like to feel more a part of the process. - london_ny

Firstly let me reassure you that you have a very important role to play in this delivery. After all you are the clever person who has nurtured this baby through pregnancy. All the doctors are going to do is perform the actual surgery!

I understand that you may feel that there is no role for a birth plan or as I always like to call it a birth preference list, since this gets away from the idea that it is a rigid set of instructions. However, there are several issues you could usefully think about and decide how you would like them to be if all goes according to plan.

• Who would you like to accompany you in operating theatre?
• Do you want music? Most maternity units can provide simple equipment for you to play music of your choice. Check with your midwife whether it is a cassette or CD player or take in an iPOD.
• Prepare yourself for the likelihood of the theatre being quite crowded with people. They all have an important part to play but if this is likely to distress you, talk it through with your midwife.
• You are likely to have an epidural or spinal anaesthetic and be fully awake. Remember that if you do have to be given a general anaesthetic that it is likely that the person accompanying you will be asked to leave the theatre while you are unconscious.
• Decide whether you want the baby to be passed to you straight away on the operating table or dried off and wrapped up by the nurses or doctors and then handed to you. Neither are a problem, but let the team know early.
• Some couples like to arrange for the partner to cut the umbilical cord, is this something you want?

Should an anterior placenta affect my birth plan?
This is my second baby and I have an anterior placenta. Is there anything I need to take into account for my birth plan for this?

At my last midwife check-up the baby was lying back to back and my first baby was a back to back birth. Is it likely my baby will stay back to back this time with my anterior placenta?

At my 20 week scan my baby was in the 95th centile. My first baby was two weeks overdue. Can I ask to be induced this time to prevent reaching 42 weeks again? - mmouse2004

Unless the placenta is low-lying and likely to cause a problem at delivery, it should not affect any birth preferences that you have.

You don't mention the birth weight of your first baby but I am assuming it was high which is why you have noted that the 20-week scan has plotted your second baby's growth on the 95th centile and are wondering about the advisability of an induction if you don't deliver at or before 40 weeks.

First thing to say is that the next growth scan may show a different trend and you cannot use the growth curve at 20 weeks as a firm guide. Second is that it is always best to let labour start spontaneously if you want to achieve a normal vaginal delivery.

Of course there may be occasions when an induction is helpful or advisable but this is usually because the mother or baby's condition dictates it or the pregnancy is so post-mature at 42 weeks that it is thought best to induce. - prof_regan

Professor Regan is the author of Your Pregnancy Week By Week. See pages 245-247 for details of things you should consider when writing your birth plan.

Read more about birth plans

• How to write a birth plan
• When a birth plan doesn't work
• Will your wishes be taken into account

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