Giving birth is a unique event in a woman’s life and in a couple’s relationship. That is why it is important that mothers take part fully in the decision-making that affects their labour: where they want to give birth, who will be with them during the process, or what support equipment the medical team will use to help them with the birth of the baby. All these preferences can be set out in the labour plan, or birth plan, a document the woman will hand in at the hospital when she goes in to give birth.
What a birth plan is:
The birth plan is, therefore, a written document that the pregnant woman uses to express her wishes and expectations about how her labour will go. Its aim is to guide the team of professionals responsible for caring for the mother-to-be during her stay in hospital.
It is advisable to draw up the birth plan at around 28 – 34 weeks of pregnancy. In it, the mother can set out her preferences specifically and clearly. Also, it is not a fixed document, so the wishes set out at first can be changed at any point during the process. It is important to make clear, therefore, that the mother can change her mind at any time.
During labour, the doctors, as well as the midwives and the team who will be with the mother, will ask for her consent for procedures such as an IV line, vaginal examinations or checking vital signs. All of this comes with detailed information to help her make informed decisions.
What can be included in the birth plan:
Birth companion: the mother can state whether or not she wants someone with her; who she wants with her during the process or whether, instead, she will decide at the time.
Environment and physical space. The obstetric unit has operating theatres and delivery rooms, as well as fully equipped multi-purpose rooms to care for the mother and baby throughout the whole process. In this way, privacy is preserved within an environment.
Dilation stage. During dilation, the mother can state, among other things, the birthing aids she would like to use, such as a birthing chair or a Pilates ball. She can also choose which options she would like to use for pain relief during labour, such as medication. The medical team will also take into account any requests the mother has about monitoring the baby.
The birth of the baby. When the time comes, the mother will feel the need to push once she is fully dilated. Most births are vaginal; however, on some occasions instruments have to be used. The medical team will tell the mother what is most suitable in her case.
Delivery of the placenta. When the placenta comes out, the usual practice is active management, that is, giving a drug to help the uterus contract and prevent postpartum haemorrhage. However, the mother can choose what type of delivery she would like for her placenta.
Caring for the baby. Immediate “skin-to-skin” contact has been shown to have many benefits for the baby’s adaptation to life outside the womb, as has starting breastfeeding early. The medical team will give the baby its first care while interfering as little as possible with the bond between mother and baby.
If she has any need or wish that the birth plan did not cover at first, the mother can get in touch with the obstetric team so that they can meet her requests as far as possible.