Birth preferences is what most call a ‘birth plan’ – a document that outlines your preferences for things during and after childbirth such as environment, pain management, staff, sounds etc. You can choose how and where you want to give birth. Even if labour or birth doesn’t go as “planned” or “preferred”, it is still always your choice to decide for you and your baby.
That requires to know your choices! If you don’t know your choices, you don’ have any. So yes, knowledge is power. Being well informed means that you’re able to make informed decisions at each stage of your pregnancy, labour and beyond. Based on your choices you can then start writing down your birth preferences for your birth plan.
Everything that is important to you and your birth partner. Include in your birth plan also contact details and the intended birthplace. Include a description of your birth environment (dimmed lights, scents, music, perhaps not to have unnecessary people in room etc.). If you use hypnobirthing techniques, feel free to mention that in your birth preferences too and that you wish your caregivers support this too. Mention, whether you want vaginal examinations or any other type of monitoring. Consider how you would like to use equipment during labour, how to move around and whether you want to use a birthing pool or not. Outline in your birth plan how you feel about pain relief during labour: Gas and air, Pethidine, Epidural or Spinal block. Write down, what you do not want to use. Consider your options beforehand: if you want a water birth for instance, you cannot have an Epidural or most other pain killer. Also write down in your birth plan checklist, how you would like to be supported during labour: mention for example if you do not want midwife-directed (coached) pushing and rather go for mother-led breathing or whether you are happy for students/trainees to observe the birth or not etc. Include details in your birth plan about what you would like to happen after birth, who announces the sex of the baby, who cuts the cord and when (delayed cord clamping or not), if you would like skin-on-skin right away to make most of your golden hour and the very first moments with your baby including breastfeeding, if you would like your baby to be given vitamin K after birth and how you would like to birth the placenta (managed or not) and what do you want to happen to the placenta etc. There is lots to consider beforehand, so please talk with your birth partner through everything and get more information on specific topics if needed.
I prefer to call the birth plan birth preferences, as birth doesn’t always go exactly as planned. Birth is like life; it can take little unexpected turns here and there and suddenly you find yourself in a totally different scenario. A birth plan sounds final or set in stone whereas birth preferences sound more flexible, which is what you need to be when it comes to birth. Prepare your mind for change – yes, you should have birth preferences and write them down, so everyone is aware of them. But if things take a different turn, try to stay calm and make an informed decision. There is a very helpful acronym to keep in mind: BRAIN.
Benefits (what are the benefits of any suggested care for you and your baby?)
Risks (what are the risks?)
Alternatives (are there any? Do you have any other options?)
Instinct (what does your instinct tell you?)
Nothing (what happens if you do nothing for an hour or for a day, a week etc.?)
Once you can answer all these questions, you will be able to make an informed decision.
Staying positive is the number one thing to keep in mind, so please remember that your birth plan communicates your preferences rather than your set in stone plan. Be aware that your document should offer some flexibility as birth often does not go as planned – which doesn’t mean things go wrong, it just means that birth stages can take longer, or even shorter as expected or take a different turn and you then decide a change of (birth) plan. This document states your birth preferences before birth – once the labour has started you are absolutely allowed to change your mind about things! It’s your baby, your body, your birth – you’re the boss.
My advice is to think about some ideas for your NHS birth plan as your pregnancy progresses. They can then evolve over time.
TIP: Keep your birth preferences sweet and short – it is unpractical if a midwife must read a full novel before she knows what you prefer and what not. Write down short sentences in your birth plan, perhaps in bullet points and make it easy for caregivers to read.
Include everything that could occur – even the very unexpected. It is worth thinking about every detail beforehand.
Include birth preferences on:
PS: There is a birth plan template (pdf) and download option available below.
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