A Birthing Plan

The writing of a birthing plan is a somewhat new concept in South Africa and the intention of the plan is to give parents a certain degree of control over the labour stage and ultimately the birth of their child. In years gone by, the birthing process was decided solely by the medical practitioner however, with a birthing plan in place, parents are now able to give a step by step account of their hopes and their desires, and how they wish or plan to bring their newborn child into the world.

What should be written in a birthing plan?

Pain relief: This is a very important part of the birthing plan and when the plan is written, a woman (especially a first time mom) is urged to consider that labour and childbirth is painful and she must base her decision on pain relief for what is best for both herself and her baby. The types of pain relief which can be written into the birthing plan includes the choice to have an epidural, as well as various other pan relief techniques, such as water therapy, massage therapy, compresses and position change. It is also important for the couples to decide when pain relief should be offered such as in the first or second stage of labour, and if it should be offered routinely or as a last resort.


Pushing options: A lot of women find that a birthing plan allows them to be in control and maintain their dignity and when in labour, they may choose from the following pushing choices:

*         Push in a squatting position,

*         Use of foot pedals instead of stirrups;

*         Using people to aid with pushing, rather than stirrups;

*         Pushing while in the hands and knees position;

*         Spontaneous pushing which is pushing when the urge to push is great;

*         Or pushing when instructed by medical staff.


A birthing plans will contain other information such as, the mother’s wishes in the event that an episiotomy is needed or in the event that an emergency c-section is required.



Here the couple or mother can choose if she requires a mirror to see the crowning of her baby’s head or if she wants to feel the head while it is crowning. The other choices which can be written into the birthing plan are if the couples wants the delivery to be filmed or photographed. With a home birth the birthing plan should also include, if the soon-to-be parents would like, incense to be burning during the labour and delivery as well as their preference of dim lighting, or soft music playing. Other options to consider include who should be present during the delivery, whether it is birthing coach and partner or just the coach.


After delivery

This section will cover the new parents’ desires for their child and the choices include:

*         The decision to allow the partner to cut the umbilical cord;

*         The mother cradling the baby while the placenta is delivered;

*         The baby to be examined with the parents present or at least the birthing coach;

*         The baby to be placed on the mother’s stomach or breast immediately after the birth.


Many birthing plans also provide clear guidelines on the mother’s wishes in terms of sleeping arrangements for her and her baby while in hospital, such as when or if the new infant should be taken to the nursery and if she plans to breast feed or bottle feed.


In essence the plan is a step by step guide from the onset of labour right up to the delivery. It contains a full list of the parent’s desires and how they plan and hope the delivery to be.  However, there are cases when a birthing plan cannot be carried out and in such cases, the medical doctors and caregivers will rely on their medical training and experience to make the right decision for both mother and child. It is wise to write up a birthing plan and ensure that the midwife or obstetrician receives a copy during the pregnancy but it is also recommended that the parents bear in mind that the birthing plan is not cast in stone and needs to be flexible.


A lot of South African obstetricians and hospitals are new to (and often against) the concept of a birthing plan, however midwives are open to the concept and may tend to be a lot more flexible in helping the couple achieve desires. Most South African government hospitals are unfortunately unable to and not equipped to provide couples with the opportunity to write their own birthing plan and the final decision for the delivery will rest with the trained medical staff.


For more information on the writing of birthing plans and to find pre-written birthing plans templates that cover all the issues which need to be contained in a birthing plan, be sure to visit the many online website sites.


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