Here are three sample Birth Preferences cribbed from my clients:
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Birth Preferences for a single baby:
Please do not offer me pain relief. I know what is available and will ask for it if I need it.
My husband and my doula will be present. I would like as much privacy as possible. If my eyes are closed, please do not interrupt me.
I would like the lights to be dimmed.
Please remind me to go to the loo to empty my bladder every hour.
I would like to remain as active as possible, finding the best positions for me and changing these as I wish.
I would like to try to rest between contractions where possible.
I would like monitoring of the baby to be kept to a minimum unless there is cause for concern. Please use a hand-held sonic aid and not continual monitoring.
I would prefer no interventions (e.g. breaking waters) unless a medical emergency precipitates them.
I would like information about any proposed medication before receiving it: the purpose, potential side effects on me/the baby and options on timing e.g. before or after the baby is born.
I would like to use hypnosis/TENS/water/massage/gas and air during my labour. I do not want anyone to offer me any pain relief.
I would like to use the birthing pool, staying in the pool for as long as possible.
I would like to find an upright, comfortable position for pushing. Advice will be welcome.
I wish to know when the head is crowning. I would appreciate firm advice and guidance at this time to guard against tearing.
I do not wish to have an episiotomy unless medically vital or I agree to it.
I would like to pick up the baby and discover the sex myself. I would like skin to skin contact and to put our baby to my breast as soon as possible, ideally to find the breast itself. I would like any help in positioning the baby for breast feeding you can offer.
I wish the cord to remain attached until it stops pulsating.
My husband would like to cut the cord.
If I have had a natural birth, I would like a physiological third stage.
If a tear occurs I want to be advised whether or not I need to be stitched and I will then choose whether or not I need a local anaesthetic. I wish to be stitched by an experienced midwife or doctor.
Emergencies
My husband and I will discuss all eventualities as they arise. Please share any concerns with us as soon as they arise. It will help us to know the answers to these questions:
1. What is wrong?
2. What do you suggest and why?
3. What would be the best possible outcomes with and without this intervention?
4 How much time do we have to make a decision?
5. Are there any other courses of action open to us?
In the unlikely event that a caesarean section is necessary I would like my husband to be present if possible. If I am unable to hold the baby, please let my husband have skin to skin contact as soon as possible and for him to stay with the baby if we are separated.
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Birth preferences for vaginal twin birth
Overview
My husband and I are very keen that the birth of our twins should be midwifery-led with as little medical intervention during labour and delivery as possible. Recognising the possible requirement of medical back-up, we would respectfully request they remain outside of the birthing room unless absolutely required.
The birth of our babies is a very special time for our family and we would like to thank you in advance for your professional support in helping make the birth of our babies a very poignant and meaningful family occasion.
Natural birth preferences
Birth supporters
§ husband
§ independent midwife team or doula
Position and mobility
§ To use hand-held sonicaid to monitor the babies’ heartbeats during labour to enable an active birth (if CTG is required due to complications, I would request to be in either a standing or a kneeling position).
§ To be free to move around and be active during labour and birth to enable me to find the most comfortable position at any point in time.
Pain relief
§ To labour in a pool at the beginning of active labour
§ Preferred method to be breathing and relaxation techniques including self-hypnosis.
§ I am aware of the pain relief available to me; please do not proactively offer anything.
Birthing the babies
§ Baby 1
o My husband and I to discover the gender of our baby for ourselves
o Baby born directly into my arms
o Immediate and sustained skin-to-skin contact with either myself or my husband
o If possible we would request that the baby is not removed for routine inspection unless it is considered absolutely necessary.
§ Baby 2
o I wish to naturally aid the progress of our second baby by cuddling/nursing our first baby thereby allowing the birth of the second baby to be allowed to progress with no rush provided the baby’s heartbeat is normal.
o I am very keen for a vaginal delivery (all fours) if our second baby is in a breech position.
o My husband and I to discover the gender of our baby for ourselves.
o Baby born directly into my arms
o Immediate and sustained skin-to-skin contact with either myself or my husband
o If possible we would request that the baby is not removed for routine inspection unless it is considered absolutely necessary.
Birthing the placentas
§ Natural physiological third stage of labour without the aid of injection.
§ Each baby’s cord to finish pulsating before clamping and husband to separate the cord.
§ Both placentas to be kept for us to take away with us.
After the birth
§ Babies to remain with me at all times
§ After a normal, vaginal birth I would like my babies not to automatically receive Vitamin K. Please discuss with us in advance of it being administered.
Feeding the babies
§ I am planning to exclusively breast-feed both my babies and would request the appropriate support to allow this to happen.
Many thanks for taking the time to review our considered requests.
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Birth preferences for twin birth
In the event of complication during labour and delivery
Overview
We would be most grateful if the obstetrician would attempt to meet the previous birth preferences if medically feasible.
The birth of our babies, however they choose to arrive, is a very special time for our family and we would like to thank you in advance for your professional support in helping make the birth of our babies a very poignant and meaningful family occasion.
C-section
Birth supporters:
o my husband to be present to hold each baby as soon as possible and to initiate family bonding
o independent midwife team/doula to be present to provide continuity of emotional support for both myself and my husband
Birthing the babies:
o We request each baby to be born into a peaceful and quiet theatre and that my voice is the first the babies hear.
o We request that the theatre lights are dimmed as each baby is born and that my face is the first that the babies see.
o The screen to be lowered to enable me to see the birth of both my babies
o Each baby to be turned to face me as s/he is born
o My husband to announce the gender of each of the babies as they are born
o Me or my husband to hold each of the babies immediately after birth
o Both placentas to be kept for us to take home.
After the birth
o Babies to be wrapped in our own blankets (which I have slept with, so smell of me) and placed on me whilst I am sewn up.
o We would request that the paediatric unit, resuscitation unit and weighing scales are within the theatre to enable me to maintain visual contact with the babies.
o Babies to remain unwashed/unbathed/undressed until we are back on the ward and I have fed them.
In the event of a GA, my husband to be the first person to introduce me to our babies.
Special Care
§ If one or both babies require special care we would request that I am allowed to hold or at least touch them before they are appropriately cared for.
§ My husband to accompany the baby/babies to Special Care whilst I am supported by my midwife/doula.
§ My husband to stay with the babies until I am able to.
§ We strongly request that both babies receive my expressed breast milk; no water or artificial baby milk to be given without my permission.
§ We would be grateful if you would allow me to breast-feed my babies as soon as is possible; I would request that I be woken if required.
After the birth
§ Vitamin K to be discussed with us prior to being administered to the babies
Many thanks for taking the time to review our considered requests.
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It would be perfect if you could contain your birth plan on a single page. Try not to laminate it. Midwives take exception...
I would also suggest that you become familiar with the following which is jolly handy if you are faced with a difficult choice during pregnancy labour or birth:
Remember BRAIN:
What are the Benefits?
What are the Risks?
What Alternatives are there?
What does my Instinct say?
What if we do Nothing, at least for now?
Take snacks (including boiled sweets) and drinks and a towel, comfy clothes, a dressing gown, slippers, pjs you can breast feed in, nappies and clothes for your baby. Your mobile phone, change, any phone numbers you may need. Toiletries, maternity pads, disposable pants. A book, ear plugs, camera, lip spooge, hair elastic.