Please feel free to use the birth plan below.
Copy and paste it into a new word processing file, alter it as you
see fit and fill in the blank spaces.
Birth plans can help to reduce conflicts and misunderstandings during
labor and delivery. They include the parents' ideas and expectations
about the birth of their child but they should be considered as a
guide only with the understanding that if a medical emergency arises
then it may be necessary to deviate from the plan.
_______________ and _____________'s Birth Plan.
(Baby due: ________________).
As this is a planned VBAC birth, we are looking forward to an active,
positive and natural birth.
Our desire is to give birth vaginally, with as little medical intervention
as possible. We want to participate in this birth to the fullest,
with the wonderful support and encouragement of our birthing team.
This is assuming my birth goes normally - if it does not, we are
flexible about deviating from the plan if it is medically necessary,
but we wish to be informed of the risks, benefits and necessity of
intervention and to participate in these decisions.
We have listed our preferences below, these decisions have been made
after much research, consultation and thought. Therefore, your help
in attaining these goals is very much appreciated.
__________ would appreciate, at all times, being encouraged in a
patient and supportive manner.
As I have a longer than normal menstrual cycle (5 weeks) could this
please be taken into account, and an extension granted to my due date.
No enema or shave please. ___________ will bring her own clothing
____________ and our Midwife will be providing support and physical
help during the labour, as well as the midwife supplied by the hospital.
We do not wish to have medical students present during our labour,
or student midwives, unless they are in their final year of midwifery.
Care During the First Stage:
I would like to have an active labour/positions. So could you please
- as mobile as possible.
- use of different positions.
- use of beanbags, cushions, etc.
- frequent drinks and snacks.
- regular use of the toilet.
- human fetal monitoring using a fetoscope or a Doptone. If this
is not suitable then using a Telemetry unit or if really needed, intermittent
EFM along with fetoscope evaluations. ________ must still be able
to assume mobile positions even if being monitored, and the EFM volume
should be turned down, or even off if possible.
- Please do not set time limits. We do not want to be hurried with
time constraints, as long as the baby and mother are tolerating labour
please assess their progress rather than looking at the clock.
- Because we worry about their effects on the baby, could drugs not
be administered unless they are requested by ________. This will only
be if, at the time, ________ feels strongly that she cannot manage
without, and all other options have been tried.
- We would like to use the water bath, showers, breathing, relaxation,
massage, mobility, heat and cold, plus any other suggestions.
- If we decide to use drugs, we would prefer gas initially, and other
drugs only after discussion.
We want to avoid:
- Induction, or acceleration, of labour with Oxytocin. Though I would
prefer even this than contemplating another caesarean.
- Artificial rupture of membranes, unless _________ and partner can
both be convinced that it will be helpful in their particular labour.
Such as if there was a reason to be concerned about the condition
of the baby, but definitely not to put an electrode scalp monitor
on the baby.
- Frequent vaginal examinations - as few and as gently as possible.
- Internal electronic monitoring, as infection could be passed to
the baby via the puncture site of an electrode clip on the scalp.
Care During Second Stage:
- Unhurried second stage, so long as baby and __________ okay, that
is waiting to push until _________ feels ready.
- Choice of positions for birthing.
- No episiotomy, please give the perineum every chance to stretch.
To an extent _________ would rather tear naturally than be cut.
- If assistance in delivery is necessary, please use suction rather
At the Birth:
- A mirror available.
- A quiet and intimate environment. Dimmed lights with no unnecessary
- Allow baby to take first breaths unassisted, if possible.
- Allow _________ to discover the sex of the baby.
- Allow _________ the freedom to touch the baby during delivery and
to feel the head as it is crowning.
- Baby to be put immediately on to _________'s abdomen and put to
the breast, as long as medically stable.
- Cord left intact until pulsing has ceased, and then to be cut by
_________, (if he wants to).
- I would like to deliver the placenta naturally. No pulling on the
cord, no Ergometrine or Oxytocin. I realise these drugs and procedures
can be lifesaving if there is heavy bleeding, but if everything is
going well I'd rather have a natural third stage possibly in an upright
position (eg, kneeling or semi-squatting).
- Baby to remain with us in first few hours after birth- waiting
until later for weighing, tests or washing, etc.
- If there is a problem with the baby, _________ is to stay with
him/her at all times, and _________ wishes to join them as soon as
- Please perform all physical examinations and procedures in the
room with the parents present.
As we mentioned before, we realise there may be problems (some we
may not have taken into consideration here) and we are willing to
co-operate, all that we ask is that our informed consent be sought
before any procedure or medication is used.
We also realise there is a chance that ________ may require a caesarean,
and all the points mentioned above then become mostly invalid. If
_________ does need a caesarean the important points are mentioned
In case of caesarean:
- If we do need a caesarean, then we would appreciate it if _________
could receive a spinal epidural and remain conscious during the operation.
- _________ to remain with _________ at all times.
- If emergency caesarean necessary, under general anaesthetic, then
we wish for the baby to be given to _________ straight after birth
and held by him until _________ is awake and can be told of the baby's
sex and well-being (by _________).
- If an elective caesarean is necessary, then _________ would like
to begin labour naturally before the caesarean is done. That is, we
do not want a date and time preset, we wish our baby to decide the
day on which it is ready to be born to avoid any problems with prematurity
and for both of us to reap the benefits of our hormones.
- If we are convinced that a scheduled caesarean must be performed,
then we would appreciate preoperative blood work and tests to be done
on an out-patient basis, and hospital admission on the day of the
birth (not the night before).
- _________ and _________ would both like the option of viewing the
birth, either by lowering the screen or by positioning a mirror. _________
has had a previous caesarean and it is still a bit unreal, as she
has never actually seen a baby leave her body - they tend to just
appear from behind the green screen and be held up for a quick look
before they disappear to be wrapped up and tested.
- _________ and _________ would appreciate a verbal description of
the birth as it occurs. _________ especially has felt left out of
her previous caesarean as her body and labour have been discussed
as though she wasn't there.
- _________ would love to meet her new baby in his/her unclothed,
naked newborn state. Could the baby please be placed on her chest
with a warm blanket over them both. It would do a lot to make this
surgical delivery a bit more natural for mother, father and baby.
And it may even resolve a few inner conflicts that are faced after
- _________ would like to feed her baby while she is being sutured,
if she feels up to it, and we would like the baby to stay with her
throughout the surgery and even during the recovery. _________ would
be delighted to hold his child within _________'s view throughout
these procedures if she feels unable to participate in the bonding
(at least she would be able to witness it this time).
- It is very important for _________ and _________ to view the placenta.
Please do not just discard a part of _________ that she has carried
for nine months as insignificant. We will be taking the placenta home,
so please be sure to make suitable arrangements with us to see that
Thank you very much for taking the time to read our Birth Plan, and
I hope we can discuss any problems you see with it.
We thank you in advance for your support and kind attention to our
choices, as we look forward to a wonderful birth. Your support and
co-operation is really appreciated.
For many women the thought of having a caesarean is terrifying, the
knowledge that after viewing your newborn child, you may be unable
to hold or even see your baby for at least an hour (sometimes longer),
can be devastating. Paula Beckton experienced a ground breaking caesarean,
where she helped assist in the birth of her second child Oliver (during
an elective caesarean) and not only was he not whisked away immediately,
but was placed on her chest for cuddles and mother/baby bonding.
*Click here to read her story.
* Oliver's Birth Plan - Click here
to download a copy of it.