| 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?
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
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?
The three essentials things are:
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?
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 Who do I give my birth plan to?
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?
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.
Should an anterior placenta affect my birth plan?
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. Find out how other women fared in the labour ward on our Birth Stories message board. Take a look at the live discussions happening there right now: |