Do You Really Need a Birth Plan? Here's What You Should Know

While much of what happens during delivery is way beyond your (or anyone’s!) control, creating a birth plan will at least make your wishes clear. Definitely talk the plan over with your partner, support people, LMC and health care provider —it’s important to make sure you’re all on the same page.

The day you give birth will be one of the most important of your life (yes!). Creating a birth plan ahead of time helps you make decisions about how you may want your labour and delivery to be, and lets others know your wishes. While you don't have to actually 'write' your birth plan if you don't want to, having a clear conversation to discuss eventualities if and when they arise is super important. It is essential to know that your options and the pros and cons, will be explained to you and your consent will be sought for all matters during your labour and birth. The key is ensuring that you understand those explanations – hence it is a fantastic idea to attend antenatal classes and obtain information from your LMC prior to your labour and birth.

A birth plan is usually an outline of your ideas and preferences during your labour and delivery. You can include anything you think will make your labour and birth more comfortable for you, so take some time thinking about what these things may be. Keep in mind, though, that your birth plan is not 'set in stone' it needs to be fluid, because you cannot predict everything that may occur during your labour and birth. You or your LMC may need to make changes to the plan once your labour begins.

Although it's tempting to include many details in a birth plan, try to keep it short and clear, so it's easy for everyone to read and understand.

Place of birth, this is a vital choice to make and it may be affected by geographical location, local services, personal preferences, previous births and/or medical conditions. Options in New Zealand include home birth, birthing centres and hospital maternity units.

Who you would like to have with you at the birth, this is essential to how you will feel about the experience. In order to birth with ease we all need to feel safe and secure – consider whether your partner will be able to support you through a long or short labour, easy or complicated. Perhaps you may wish to have a member of your family or friend on standby if needed.

How and when to contact your LMC (and if necessary, their backup LMC). Ensure that you discuss this with your LMC later in the pregnancy. Some LMC's like to know as soon as you think you are in labour, as they have arrangements they need to make.

Part of feeling safe is being able to relax and simple measures such as low lighting and gentle music (or ACDC if you prefer!) may help you relax your muscles and help you to cope with the awesome journey you are undertaking. These may be especially important to some people early on in labour, while the contractions are getting established.

Have you considered the use of water? Water is a well-known relaxant and also creates buoyancy and pain relief. Pools for water birth are offered in many maternity units and can be hired for home births too. Discuss water birth with your LMC if this is something you would like to try if possible.

A huge topic for many people is the use of pain relief. There are many options for pain relief, natural and medical, and many people feel that it is the length of labour that is often difficult to cope with and no-one ever knows how long their labour will last – and your LMC and Birth Educator will only be able to give you estimates based on ‘the average woman’. It’s really important to carefully consider medication use during labour. Not only are there risks for you and your baby, but your baby can have a hard time eliminating some drugs from their system. There is no 'perfect' pain relief, it is very much a decision to make at the time, based upon knowledge and experience.

It's super important to stay well hydrated in labour (water, water, water!!). Include frequent sips of water or sucking on ice chips, whatever you are doing-especially, if you are in a birthing pool or birthing during the summer months. If your body is short of fluids the contractions will become less effective, slowing the labour and we don't want this. Some people will vomit during their labour, this can be hard, but it is vital to continue sipping water nonetheless. You may or may not want to eat while you are labouring, but if you do feel hungry then eat something easily digestible, such as toast, crackers or plain sandwiches. Check with your LMC, as people who are at risk of a problem in labour are sometimes advised not to eat in case they need an anaesthetic.

There is no perfect position for labour – movement, being upright and frequent changes in position will help you to be more flexible and aid your baby’s journey through your pelvis. Great ideas include hands and knees, all fours, lying on your side, standing, squatting (if you have strong legs!). Avoid lying on your back for extended periods as this creates an uphill journey for the baby-making your labour longer and birth harder.

Once your baby is here there are other considerations to make. There are options around clamping the umbilical cord and the delivery of the placenta and membranes Generally, you have two options for how you do the third stage, active management and physiological management, while there are pros and cons for both and circumstances that would sway the best course of action but generally, active management is recommended for people that have an increased risk of severe hemorrhage, have had an intervention during labour or if you have a pre-existing medical condition. Discuss this with your LMC if you are unsure.

Review your birth plan with your partner and anyone else who will be with you in the delivery room. Reviewing your birth plan ahead of time gives you time to help resolve any potential issues that may arise.

The very best advice that I can give is to remain flexible throughout your labour and birth and ensure that you understand the explanations and options that your LMC and health professionals are giving you.