The birth of your baby is a very exciting time; the midwives and doctors would like to help make the birth experience special, while also making it safe. Through making a record of your preferences for labour and birth, this can make you feel more in control. This allows the midwife and doctor looking after you to know your wishes and understand your individual needs. Please remember that every birth is different and the course of labour is unpredictable. Aim to stay flexible as your plan may have to change - keep an open mind as your birth may not go exactly as planned. We would like you to have as natural an environment as possible to welcome your baby, please do bring items (e.g. pillow and special music) which will help to personalise your experience.
Your midwife will be very happy to explain in further detail any parts of the birth plan you wish to discuss.
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Where to give birth
You will have a choice about where to have your baby. Your midwife or doctor will be able to tell you what services are available locally and advise you on any issues to do with your health or pregnancy that may affect your choice.
Please tick your choice/preferences
| I would like to give birth at home | |
| I would like to give birth in a stand-alone midwifery led unit | |
| I would like to give birth in a stand-alone midwifery led unit | |
| I would like to give birth in an alongside midwifery led unit in hospital | |
| I would like to give birth in an obstetric (Doctor) Maternity Unit in hospital | |
| I am not sure yet where I would like to give birth |
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My comments on where I would like to give birth and why:
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Companions
Having a companion you can ‘lean on’ and who can support you during your labour can be helpful. It has been shown to reduce the need for pain relief.
Please tick your choice/preferences
| I would like my partner or companion(s) to be with me during labour | |
| I would not like my partner or companion(s) to be with me during vaginal examinations | |
| I am not sure yet whether I would like my partner or companion(s) to be with me during labour and examinations |
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My birth companion is:
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My birth companion will support me by:
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During the baby’s birth
Pre-labour: This is when you start to feel discomfort, perhaps back-ache, and period type pains. You may start to be aware of your tummy ‘tightening’ regularly.
1st stage of labour: This is when the contractions are starting to come more regular and stronger, so that your cervix dilates. We classify 1st stage of labour when you are contracting regularly (usually 3 contractions or more in 10 minutes) and your cervix is at least 4cms dilated.
Please tick your choice/preferences
| I would like to remain at home for as long as possible as long as I feel comfortable | |
| I would like guidance on relaxation, breathing techniques | |
| I would like to bring in personal items to support my birth experience | |
| I would like my husband / partner / doula / friend to be present | |
| I would like monitoring of the baby to be kept to a minimum unless there is cause for concern | |
| I would like any proposed intervention e.g. breaking waters, continuous monitoring and vaginal examinations to be explained and discussed first and ideally be kept to a minimum | |
| I would like to use a birthing pool if available | |
| I do not want to have midwifery and medical students involved in my care |
Additional wishes:
Keeping active during labour
Keep active for as long as you feel comfortable, this helps the progress of birth.
Please tick your choice/preferences
| I would like to move around during labour | |
| I would like help/advice in trying different positions | |
| I would like to use a birthing ball | |
| I would like to try alternative positions on the birthing bed such as chair position, supported and kneeling etc. | |
| I would like to be lying on my side rather than on my back | |
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I would also like:
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Pain relief
There are many different pain relief options. Some women use a combination of methods. You may find that you want more pain relief than you had planned to assist with your labour/ birth. You can use a number of different methods at different times
Please tick your choice/preferences
| I would like to use breathing and relaxation techniques | |
| I would like to be in water during labour and /or birth | |
| I would like for my partner to rub my back/massage | |
| I do not wish any pain relief to be offered. I will ask if I need anything | |
| I would like to use TENS (Please hire your own TENS machine) | |
| I would like to try gas and air (Entonox) | |
| I would like information about different pain relieving injections | |
| I would like an epidural | |
| I have had private classes in alternative options such as hypnobirthing, acupuncture, reflexology which I would like to try |
My preferences for pain relief
Transition and 2nd stage in labour
A change occurs from 1st stage labour to 2nd stage labour which is called the transitional phase, where the body starts to feel like you want to ‘bear down’. Once fully dilated, your contractions change to a pushing sensation which is then called 2nd stage
Please tick your choice/preferences
| I would like to find my own comfortable position for pushing | |
| I would appreciate firm advice and guidance at this time | |
| I wish to know when the head is visible | |
| I wish to feel the baby’s head / see it in a mirror | |
| I consent to an episiotomy if the midwife/doctor feels this is necessary if the baby is in distress or to prevent a tea | |
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Additional wishes
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Delivery and birth
Please tick your choice/preferences
| I wish the baby to be delivered onto my tummy / I wish to hold my baby straight away | |
| We would like to discover the sex of our baby ourselves | |
| I wish the cord to remain attached until it stops pulsating | |
| My partner would like to cut the cord | |
| I wish the baby to suckle to encourage 3rd stage | |
| I would like skin to skin contact with my baby | |
| We would like to be consulted if the baby has to go to the Special Care Baby Unit | |
| I wish to breast feed as soon as appropriate | |
| If I am unable or choose not to have skin to skin contact due to perhaps having to be stitched or go to theatre, my partner / husband would like to do skin to skin contact with the baby | |
| I consent to the baby to have the Vitamin K injection / oral Vitamin K | |
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My comments at delivery and birth
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Third stage of labour – delivery of the placenta
Please tick your choice/preferences
| I wish to have an actively managed 3rd stage (given syntocinon drug to accelerate delivery of placenta) | |
| I wish to deliver the placenta physiologically (no drugs given) | |
| If there are any signs of haemorrhage (blood loss over 500mls), I consent to drugs to control the bleeding | |
| We would like to see the placenta and have it explained to us | |
| Following the delivery of the placenta, we would like to be left alone with our baby | |
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My comments on third stage of labour and immediate care of my baby:
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Emergencies
Occasionally birth does not go as planned and there may be an emergency situation, where the maternity team are called to your room. This can be a frightening situation but be assured that your midwife will stay with you will keep you informed of what is happening.
My comments on emergency situations:
In the post-natal ward
Please tick your choice/preferences
| I do not want our baby to be given any artificial milk | |
| I intend to breast feed responsively | |
| I intend to bottle feed responsively |
My comments on the post-natal ward
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I would like:
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I would not like:
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The pregnancy care planner adapted from www.nhs.uk/pregnancy & NCT Birth planning
Confidentiality
‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.
For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302