Thoughts from a labour ward midwife.... birth plans

Thoughts from a labour ward midwife…. Birth Plans

So your midwife has suggested you make a birth plan…. What are you thinking? People vary so much…. My clients are so different! Anything from “I’ll go with the flow” and “I’ll do whatever you think” to a laminated 10 page booklet of instructions!

So which way to go?

My advice is somewhere in the middle…. Being chilled out is great, but the likelihood is that you will never have met the midwife who cares for you in labour. As a midwife, it’s great to know some of your preferences or any fears you have, so we can help support you. By the time we meet you, you might be too focused on your contractions to convey exactly what you want.

Equally you also don’t always want you birth plan to be too complicated and specific…. Although it’s great to know what you want, labour sometimes brings some surprises, and what you thought you wanted may change. Being open with your midwife and listening to their suggestions can really help.

Things I suggest you include…

·         Who you want there – we’re great at telling those “surprise” visiting relatives a few white lies to keep them out if you don’t want them there!

·         What kind of pain relief you plan on having – but as always, keep an open mind. This can include TENs machines, water, Entonox (aka gas&air), pethidine, epidurals, massage, hypnobirthing etc.

·         How you feel about baby having the recommended vitamin K – injection or oral or none at all?

·         What your hopes and fears are for the birth? Is there anything you really do or don’t want and why? This will help your midwife to understand where she/he can help

·         How do you feel about student(s) being present? Is one fine? Or you would rather not have any? Sometimes students come into the room alongside the midwife. Asking them to refer to your birth plan can be a less awkward way of conveying that you would prefer them not to be there. Then again, don’t forget students can be amazing, and it can mean you always have someone in the room with you whilst the midwife pops in and out to get things!

·         When your baby is born, what do you want to happen? Skin-to skin? Baby dried first? Dad to cut the cord? The two of you to see what sex the baby is together?

·         How would you like to feed your baby? Breast or bottle?

·         How would you like to deliver your placenta? Do you want the injection to deliver it? Do you want to do it yourself without drugs? It’s good to know what you’d prefer, but again, being open to suggestions from your midwife is always a good idea.

·         Anything out of the ordinary! Is there anything else we need to know?

What I don’t think you need to include…

·         Forceps or ventouse assisted deliveries… what I keep seeing more and more these days is a preference for what type of instrument used in the event of an assisted delivery being required…. The fact is that the doctor needs to deliver the baby with the appropriate instrument. They will never deliver with one over the other if it is not appropriate or safe, and at that moment, only one of the instrument types will be appropriate and safe. They will discuss this with you at the time, and of course it is always your choice to accept or decline, but there is not an option to have your baby delivered by an unsafe choice of instrument.

·         Saying “only if medically required”…. More and more birth plans are stating things such as “ I will only have a c-section if medically required”… the fact is that this is always the case. We (midwives and obstetricians) would never intervene unless medically required and never without your permission.

·         Positions for birth…. Many websites say you should include this, and you’re welcome to state your preferences! However most women have no idea what positions they prefer until they are having contractions and we will always help you to do whatever is best for you at the time.

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