Your birth plan

2. My birth partner will be

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5. During labour I would like to use

A birthing pool

A birthing ball

A birthing mat

A birthing stool

Wall bars to lean on

standing up

I am not sure

1. I am planning to give birth…

At home

In hospital

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In a MLU/birthing centre

Other

3. Please call me

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9. I am happy for the baby’s heartbeat to be monitored:

Intermittently by a hand held Stethoscope/Doppler if

the labour is trouble free

Continually using a CTG machine taped to my

abdomen

I do not wish my baby’s heart rate to be monitored,

so please discuss with me

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10. My thoughts on having my waters artificially

broken are:

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. I plan to stay active during labour and move around:

Yes No

6. I am happy to have training doctors/midwives

present:

YesNo

4. We would like my birth partner to take photos/

videos during labour:

Yes No

8. I may wish to use the following pain relief options

in the order I’ve numbered:

A bath/shower

Massage

Breathing techniques

Being in the water

Acupuncture

TENS machine

Gas and air

Pain relieving injections

An epidural

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7. I plan to use the following positions during labour:

Standing

Sitting

Kneeling

On all fours

Leaning forward

Squatting

On my side

On my back

Other

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13. My thoughts on having an episiotomy:

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15. If the birth results in a forceps, vacuum or caesarean

section delivery

I would like my partner to remain

I would like my partner to leave

I am not sure yet

14. I would like to have the following happen during the

2nd stage of labour:

Be told how the baby is progressing – e.g. when the

head is crowning

Be given strong encouragement

Everyone to be as quiet as possible

Be told when I should push

Push when it feels right to me

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16. I want to be told the sex immediately after birth

Yes No

19. If there are no complications, I would like:

My baby cleaned a little then handed straight to me

My baby handed straight to me with cord still attached

My baby cleaned, wrapped in a blanket and handed to

me

I do not mind

I am not sure yet

20. I plan to feed my baby:

Breastmilk from birth

Bottled milk from birth

Mixed feed from birth

I am not sure yet

22. My special requirements

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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17. My thoughts on an injection to contract the womb

and speed up the delivery of the placenta:

I am happy to have the injection after birth

I would like to wait and expel the placenta naturally if

possible

I am planning a lotus birth and wish to expel the

placenta naturally and remain attached to the umbili-

cal cord

I am not sure yet

18. I would like the umbilical cord to be handled as

follows:

The doctor/midwife to cut the cord

My birth partner to cut the cord

The cord to be cut immediately

Delay the cord cutting

I am planning a lotus birth and wish the cord to

remain attached

I am not sure yet

21. My feelings on giving my baby vitamin K are:

I am happy for my baby to have a vitamin K injection

I am happy for my baby to have vitamin K orally

I do not wish my baby to have vitamin K

I am not sure yet

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12. I hope to give birth in the following position:

Kneeling on all fours

Leaning forward

On my side

On my back

Squatting

I’d like to decide at the time

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MyBirthBox

Where to give birthIt’s your right to choose where you would like to have your

baby. Your midwife can discuss the local facilities with you and

issues to do with your health or pregnancy that may affect your

choice.

Most women choose to give birth in hospital, a birthing centre

or at home. Even if you’re not yet sure, it’s worth discussing

the options with your midwife. For example, some hospitals do

not support a decision to switch to home birth on the day, but

do allow you to switch from home birth to birthing centre or

hospital.

Birth PartnerWho you would like with you during the

birth, if you want them there all the time

or if there are any circumstances or

procedures when you would like them to

leave. You may wish the birthing partner

to have other roles, such as being the first

point of contact for general questions the

staff have during the birth.

Birth Plan tips

Birthing equipmentThe use of birthing equipment such as birthing balls,

mats and wall bars can help to provide physical support

and relief during labour. They are often available in

birthing centres and some hospitals. If you might wish to

use these it’s worth checking with your midwife what

your birthing location has to offer or if you can bring

your own.

Birth poolIf you intend to use a pool during the birth, include this in

your plan. You can also speak to your midwife to under-

stand what stages of labour it’s recommended you can be

in the water, when you might not be able to and why.

If you’re planning a home birth it might be worth asking

your birth partner to do a ‘practice run’ inflating the pool

and checking the hose can reach from the tap to the space

you plan to birth in.

If you hope to use a birth pool in the birthing centre or

hospital, remember there are a limited number available, so

it might not always be possible.

Special requirementsIt is worth highlighting on your plan any special require-

ments you have to the midwifes and doctors such as; if

English isn’t your first language, you have certain

religious customs to be observed, you need a sign

language interpreter, you or your birth partner have

special needs, or you have dietary requirements.

Midwives, nurses and doctors in trainingYou may be asked if you are happy for midwives, nurses or

doctors to observe during your labour for their training.

You can state on your birth plan if you consent or not for

this to happen and the choice can be changed on the day.

1st Stage

Pain relief optionsPain relief for birth comes in many forms and you might

find it useful to write in your birth plan which, if any, you

hope to use. The order in which you intend to use them

if necessary and any you hope you avoid is also useful to

write down. You can use a number of different methods

at different stages of birth for whatever suits you best

and these include:

Breathing and relaxation, massage, acupuncture, water,

TENS (transcutaneous electrical nerve stimulation), gas

and air (Entonox), pain-relieving injections, an epidural,

try to manage without pain relief.

You may also request to be informed about any medica-

tion and possible side effects before it is given to you.

Positions for labour and birthYou are encouraged to choose positions that are comfort-

able for you during labour and birth. Practicing them

beforehand, at home or in an antenatal class will help to give

you an idea of what is comfortable. But be aware that on

the day, your body may prefer weight on different parts of

you, so if those you practised don’t suit, try others until you

find what works for you.

Note on your plan if you would like to be standing, sitting,

kneeling, leaning forward, squatting, on your side or your

back. Or if there are any of these positions you do not want

to be encouraged into unless absolutely necessary.

Keeping active during labourGentle, normal movement such as standing up and walking

around should help to progress the birth. You might wish

to include a note in your plan if you are keen to follow an

“active birth” approach.

InterventionAs your labour progresses, the doctor or midwife may feel it is

necessary to intervene in some way for safety reasons e.g.

breaking waters, acceleration, ventouse. You might wish to

highlight in your plan if you are happy for them to proceed as

necessary or if you want them to be explained and discussed

first, and ideally to be kept to a minimum. Sometimes at this

stage of labour there may be some variation from your ideal

birth plan as delivering the baby safely will be your highest

priority.

Having an episiotomyAn episiotomy is a cut in the perineum (the area between

the vagina and anus) that may be performed if the perineum

won’t stretch enough and you would prefer not to tear, or if

the baby is short of oxygen and needs to be delivered

quickly. Discuss this with your midwife and note in you plan

whether or not you want this if the time comes.

“Obstetrics and Gynaecology Department:

Monitoring in Labour”

Monitoring during labourYour baby’s heart rate will be monitored during labour to

ensure they are not in distress. There are different ways this

can be done depending on your preference such as sonar,

ultrasound or with a stethoscope. A good article on this is:

http://www.uhcw.nhs.uk/clientfiles/File/Monitoring_in_la-

bour_UHCW_patient_information.pdf

http://www.uh-

cw.nhs.uk/clientfiles/-

File/Monitoring_in_la-

bour_UHCW_patient_

information.pdf

http://www.uh-

cw.nhs.uk/clientfiles/-

Here you might like to include a few notes around;

• reiterate here what position you would like to be in, or avoid

being in to push, which might be different to the positions

during the first stage of labour.

• outline if there’s any information you want to be made aware

of during the 2nd stage – if the baby’s head is crowing etc.

• what sort of encouragement you would like from the

staff around you; strong guidance, enthusiasm, as quiet as

possible.

• if you want to be told the sex immediately or find out

yourselves.

The final push

2nd Stage

Clamping the cordThe default approach is for the midwife or doctor to clamp the

umbilical cord, so if you would like someone such as your birth

partner to do it, you should state this in your birth plan. You

may also prefer to delay the cord clamping to allow the full

supply of oxygenated blood to reach the baby, which you can

also highlight in your plan if so.

Skin-to-skin contact with your

babyAssuming there are no health concerns the midwife or

doctor need to immediately address, you can choose to

have your baby handed to you immediately before the

cord is cut, or you may prefer to have them cleaned a litt

le,

the cord clamped and/or wrapped in a blanket firs

t. You

can of course change your mind at the time on the day.

Feeding your babyNew mums are encouraged to try and breastfeed as it

is the best form of nutrition for babies and has lasting

health benefits, however it is the choice of the new

Mum. You may wish to think about in advance and

state on your birth plan if you wish to breastfeed,

bottle feed or mix feed your baby. If you are planning

to try and breastfeed, please know that it takes most

mothers and babies a while to establish feeding so

don’t worry if it doesn’t come easily.

Soon after your baby is born, in hospitals you will be offered an

injection of artificial oxytocin in your thigh to help the womb

contract, prevent possible haemorrhaging and speed up the

delivery of the placenta.

You can choose to have this injection or you may prefer to expel

the placenta naturally. The choice is yours and it is worth

discussing it with your midwife and doing some research before-

hand if you wish, to include your decision in your birth plan.

http://www.aims.org.uk.

http://www.aims.org.uk.

http://www.aims.org.uk.

http://www.aims.org.uk.

http://www.aims.org.uk.

http://www.aims.org.uk.

http://www.aims.org.uk.

Delivering the placenta If you wish to do some detailed research on birthing your

placenta we recommend the book “Birthing your Placen-

ta” by Aims - http://www.aims.org.uk.

After Birth

Vitamin K for your babyVitamin K is offered for babies after they are born to help the

blood clot properly and prevent a rare disease called Vitamin

K deficiency bleeding. It can be given orally or by injection

and the choice is yours whether you wish your baby to have

it.

We recommend discussing this with your midwife and doing

further research if you are unsure. There is an Aims book on

this topic available as well. http://www.aims.org.uk/

http://www.aims.org.uk/

http://www.aims.org.uk/

http://www.aims.org.uk/

http://www.aims.org.uk/

http://www.aims.org.uk/

http://www.aims.org.uk/

http://www.aims.org.uk/

http://www.aims.org.uk/

3rd Stage