Birth plans can be very useful, both in the planning stage, when you are thinking about what sort of birth you would like and what information you need to give to the people caring for you, and while you are in labour, to give information to the team caring for you. The plans can take any form, but are most easily read when they are clearly written, specific, and not too long.
You can put a copy in your handheld notes as well as the hospital notes, and take some extra copies in your hospital bag to give to anyone who comes into contact with you who needs to know about your PGP.
What to write
Make sure you discuss your birth preferences with the team looking after you. It is particularly important to discuss any strong views with the team when you meet them.
Explain how PGP affects you, and what you can/cannot do (e.g. lie on your back, walk without crutches etc).
Measure your pain-free gap before your due date and write it in your birth plan (you can always update it if it changes). Your pain-free gap is measured if you lie on your back with your knees bent, and measure how far apart you can move your knees without pain. This distance should not be exceeded during birth. This is particularly important if you have an epidural or an instrumental delivery where you cannot control your legs.
Write down your wishes for the birth of your baby.
Write about what you will need after birth, e.g. any special equipment on the wards - you may not be thinking about this clearly when you arrive at hospital in labour!
Describe the pain relief you would like, both in labour and postnatally. As an example, here are extracts from the birth plans of some of our members: “I have Symphysis Pubis Dysfunction, which means that the joints in my pelvis are unstable and painful. There are two main things that are important to me about my baby’s birth: Firstly, it is important that I have a healthy baby. Secondly, it is important that I too am healthy and able to care for my new baby and my toddler, which I was not able to do after my first birth. This means avoiding anything that may cause further damage to my pelvic joints.”
I wish my labour to be a positive experience and would welcome support and encouragement to achieve this.
I would like my partner to be present at all times, whatever is happening to me, including if a caesarean becomes necessary.
I wish to be fully informed about any decisions or discussions about me or my care.
I do not wish to have continuous foetal monitoring on admission or at any other stage unless there is a strong clinical indication to do so. I would like to labour in the birthing pool, and probably deliver in the water.
I would like to use gas and air and massage for pain relief.
I wish to remain as active as possible during labour.
I have a pain-free gap (abduction in crook lying) of xxxx cm or xxx inches (correct as of (date)). This should not be exceeded in any procedure during or after labour and birth.
I need to avoid opening my legs very far (sometimes referred to as abduction of the legs). Therefore I would like to deliver my baby on all fours in the pool. If this is not possible, I wish to give birth on all fours or lying on my side with my legs fully supported.
The positions I am able to get into are: – Kneeling/all fours (but I am unable to crawl). – Side lying, using a monkey pole to turn over. – I can get on/off a bed most easily through left side lying. – I cannot get into any asymmetrical position (e.g. standing on one leg, half kneeling, lying with one knee bent up etc). – When lying, I need a pillow between my knees.
I cannot lie flat, or sit with my legs extended or cross-legged, as these positions cause pain in my pelvic joints.
I find it painful to lie on my back. Therefore I would like to use another position for internal examinations, such as all fours or side lying.
If stitching is required, please could it be done by somebody who can work while I am lying on my side.
I would prefer to avoid a forceps delivery or any intervention which involves the lithotomy position. Having given this a great deal of thought, I have decided that I would prefer a caesarean section if intervention becomes necessary.
I am very concerned about care in the few days after the birth. I may need help with mobility, self-care and caring for my baby, and would welcome any assistance with these.