Having a baby like Meghan? How - and why - to write a birth plan

22nd Mar 19 | Lifestyle

Getting ready for labour like the Duchess of Sussex? Jenny Stallard asks an expert what you need to know about birth plans.

Royal visit to Birkenhead

With the royal baby due this spring, Meghan and Harry probably have all the details meticulously planned about where their baby’s arrival will be (the Lindo Wing of St Mary’s Hospital, London, like many royals before) and who’ll be arriving to do her hair and make-up afterwards.

And even if you won’t have the world’s media waiting outside desperate for a glace of your new baby, the seventh person in line to the throne, it’s important to think about how you want the birth to go – even if it ends up not quite going the way you expected.

Royal visit to Birkenhead
The Duchess of Sussex (left) presents Angela Midgley with a Moses basket (Anthony Devlin/PA)

Writing a birth plan is a key part of that, but according to the NCT, just 33% of women currently draw up birth plans.

So what exactly are they, and why might you need one? We asked an expert.

Why make a birth plan?

Val Willcox, practice manager with the NCT, explains: “When I’m teaching antenatal classes I have a bit of a discussion about this, about what extent can you actually plan something you’ve had no prior experience of.

“You may not know exactly when it’s going to happen and you have no idea how you’re going to respond to that experience. So I tend to talk about the usefulness of thinking about discussing with your partner and writing down any strong preferences that you have.

“I take a two-pronged approach, particularly about the discussion with your birth partner. Because if the birth partner has sat down with the woman and they’ve gone through some of the things the woman feel strongly about (so anything she does want to do, or avoid) the birth partner is then in a good place to advocate for the woman and re-enforce her decision making and her thinking, and have discussions with health professionals and midwives if the woman is busy concentrating on labouring and doesn’t want to have those in-depth conversations.”

What is a birth plan?

In short, it’s how you’d like the birth to go. While many joke that it’s simply ‘have a baby’, there are lots of things to think about that might happen during the birth. Things that, in the heat of the moment, you might not know what you’d want.

“It’s different for everyone, and what might be right for one couple might not be right for someone else,” says Willcox. “It gives the midwives a starting point.”

Your specific medical needs would be in your notes – the birth plan is more where there is an element of choice, from where to give birth to pain relief or being examined by doctors. “Part of it is about being able to facilitate that conversation with whoever is looking after you, so they get a sense of ‘what’s important to this woman?’ and really help her feel they’re looking after her and thinking about what she wants.”

How do you start one?

Birthplan
(Thinkstock/PA)

Pen and paper – that’s it.  You can download a template via the NHS or the NCT – you don’t have to follow this to the letter, but it can give you an idea of where to start with your own.

“It can be written down carefully on several bits of paper, or literally the back of an envelope,” says Willcox. Consider making a few copies and ensure your birth partner has one of them, as well as you.

Why write it early?

“They’re not compulsory, you don’t have to do one,” says Willcox. But one of the main reasons is that you can deal with anything contentious in advance, says Willcox. There will be some things you might want that they can’t accommodate, for example.

This is your chance to really consider how you want the birth to be, and make notes to reflect on and perfect before you go into labour.

What kind of things to consider

“Language is incredibly important,” says Willcox. That could be what name you go by, or whether you’re ‘Mum’, ‘Mummy’, ‘Mama’ or your first name (and what your partner is called). “If you have personal circumstances that are important the staff know about, that’s important to put into the birth plan,” she adds.

These can be even more personal things, such as if you’re not able to breastfeed because of previous illness. Willcox adds: “If there’s learning disabilities or deafness, or if there’s anything contentious. For a woman who is a survivor of abuse, vaginal examinations can be triggering. So that can be something that could be put into a birth plan and gives midwives the opportunity to say they know that.”

Don’t expect it to go to plan

Writing a birth plan
(Thinkstock/PA)

WHAT?! We hear you cry. Yes, you write the plan and then, well, birth happens and often all those best-laid plans can go awry. In fact, a 2017 survey by the Care Quality Commission (CQC) found that four in ten women ended up using a different type of pain relief in labour than they had planned to beforehand.

But no planning at all can leave you in tricky emergency situations with no backup. From knowing what you’d both prefer if, say, your baby is rushed to the ICU, to whether you want the doctor to cry, ‘It’s a boy!’ in the delivery suite, these things are worth planning.

“Some people will plan as far as going to the operating theatre,” says Willcox. “People’s faces drop when I say this, but it’s worth having what can be a difficult conversation with your partner in the case of the  baby going to special care. What do you want to do if the baby isn’t well? Do you want your birth partner to go with the baby, or to stay with you and leave the medical staff with the baby?”

Think through your plan B and C

Royals attends Christmas Day Church service
The Duke and Duchess of Sussex will be welcoming a new baby into the family soon (Joe Giddens/PA)

For your birth plan, you should thinking through and discussing with your partner how you would like things to be if everything is straightforward, and then thinking, ‘This is my next option,’ Willcox says.

“Some women will say, ‘Please don’t offer me pain relief,’ because if you’re offered pain relief and you’re feeling tired and achy and vulnerable it’s often impossible to resist it.

“Think about after the birth – for example, if you want to do immediate skin to skin contact. There’s so many aspects of having a baby where women can think about what it is they’d like to do.”

© Press Association 2019

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