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Preparing a Waterbirth Plan


The template Birth Plans for hospital and home water births include a wide range of preferences for the birth of your baby. Some may not be relevant to your circumstances and there may be other areas which you don’t wish to include.

Alternatively, there will probably be some aspects not covered which you wish to add. It is important to create your personal birth plan. Use this page or the downloadable documents for ideas, make as many changes as you wish, and share your birth plan with the people who will be present when you give birth.

The very act of writing your birth plan is often the main benefit of having a plan: it forces you to picture your birth and think through what your want to happen.

Discuss your plans with your birth partner(s), so s/he can support you in achieving the birth you want.
Some of the terminology may be unfamiliar. Ask your midwife, other health professional or antenatal teacher to provide you with more information as required. The following sample birth plans should be adjusted to your needs.
You might also want to plan contingencies if your baby needs special care.
The birthing plans below were originally created by Anne McCabe (August 2000) and have been edited by Amy Maclean (2005).
 
Home Water Birth Plan
Dear Midwife or Health Care Provider,

The following is our plan for our baby’s birth, preferably in water at home.

Before Our Baby’s Birth

If there is any research you would like me to participate in, please provide details as far as possible in advance of the birth OR I prefer not to be involved in research.
I am planning a vaginal home water birth without intervention, but, should circumstances dictate, I am willing to consider other options so long as I am fully informed of the advantages and disadvantages. 

During Our Baby’s Birth


1st Stage
I would like to remain at home for my birth.
I would like to be attended by the community midwife at home.
I would like my husband / partner / doula / friend / children to be present.
I would like my privacy and dignity to be respected at all times.
I would like my partner to be able to join me in the pool if I choose at the time OR I wish to remain on my own in the pool with my birth supporters outside the pool.
I wish to have music of my choice playing
I wish to have no non-essential talk by health care providers
I would like to have the lighting dimmed to suit my needs
I would like to remain as active as possible, finding the best positions for myself and changing these as I wish.
I would like to try and rest between contractions where possible.
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, acceleration, ventouse to be explained and discussed first and ideally to be kept to a minimum.
I would like information about any proposed medication before receiving it, including the purpose, potential side effects on me / the baby and options on timing e.g. before or after the baby is born.

Pain Relief

I would like to cope without pain relief OR I would like to use entonox AND/OR TENS machine AND/OR homeopathic pain relief AND/OR pethidine
I would like to use massage AND/OR move around AND/OR bathe and be given lots of support to help with this.
I would like to use the water birth pool for 1st / 2nd stage
I plan to use an "all fours" position OR squatting OR other position to help with pain relief.
Advice will be welcome, and I am open to considering other pain relief options if necessary.

Transition

I wish to be very centred on myself at this stage and to have no intrusion.
Gentle support and firm guidance will be appreciated.
Information on progress and caring support will be helpful.
I will probably be in an "all fours" OR upright OR semi reclining position. 

2nd Stage

I would like to deliver my baby in water OR I wish to exit the pool and deliver my baby on land.
I would like to find my own comfortable position for pushing. This is likely to be an "all fours" OR upright OR leaning over the edge of the pool.
I wish to know when the head is crowning although I may be able to know this myself.
I wish to feel the baby’s head AND/OR see it in a mirror.
I will appreciate advice and guidance at this time to guard against too quick a delivery giving the perineum time to fan out thus (hopefully) preventing a tear.
We plan to take photographs AND/OR video the birth.
I do not wish to have an episiotomy unless vital and I or my partner agree OR I prefer an episiotomy to a tear.
I wish the baby to be delivered onto my belly OR I wish to hold my baby straight away OR I wish for the baby to be washed and then given to me.
We would like to discover the sex of our baby ourselves. 
 
3rd Stage
I wish the baby to suckle to encourage 3rd Stage.
I wish to deliver the placenta naturally OR I wish to have an actively managed 3rd stage.
I wish to exit the pool to deliver the placenta OR I wish to stay in the pool to deliver the placenta. 
I only wish cord traction to be used if syntometrine has been administered.
If there are signs of haemorrhage, I will have IV ergometrine as necessary.
I wish the cord to remain attached until it stops pulsating.
My partner would like to cut the cord.
We would like our baby to stay with one of us at all times.
We would like to be left alone with our baby.
We would like to see the placenta and have it explained to us.
We would like to be consulted if our baby needs to go to special care.

Return to the top

Multiple Births

If one baby needs special care and the other(s) don’t we would like the well baby(ies) to stay with us until we go.
I wish to breastfeed as soon as is appropriate.
We do OR do not consent to Vitamin K injection.
Tears
I hope to avoid this and will appreciate support to adopt positions to minimise tears.
If one occurs I would prefer not to be stitched unless it is essential to healing OR I prefer to be stitched
If stitching is necessary I do want a local anaesthetic to be well administered prior to stitching OR I want Gas and Air on hand for when I am being stitched. 

Return to the top

Emergencies

I or my husband / partner 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 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?
We will be guided by balanced, informative advice.
If we go to hospital I would like my husband / partner and you to be with me in the ambulance.
In the event that assisted delivery is necessary I prefer ventouse to forceps.
In the event that a caesarean section is necessary I would like to have a spinal OR general anaesthetic. 
Birth Room(s)

I intend to use the xyz room(s).
The birthing pool will be in the xyz room.
There will be special lighting AND/OR music AND/OR scents.
There will be a bright, angle poise lamp available for midwives use.
My child(ren) will have their own supporter and may pop in and out at appropriate times.
My child(ren) may want to watch the delivery - their supporter will be responsible for them.
It would help if midwives and supporters helped themselves to food and drink as required without asking. This will be available in the xyz room.

After the Birth
We do not want our baby to be given any artificial milk.
I intend to breastfeed on demand OR I intend to bottle feed on demand.
We would like our other children to visit as soon as possible after the birth 
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Hospital Water Birth Plan

Dear Midwife or Health Care Provider,

The following is our plan for our baby’s birth, preferably in water in hospital.


Before Our Baby’s Birth

If there is any research you would like me to participate in, please provide details as far as possible in advance of the birth OR I prefer not to be involved in research.

I am planning a vaginal hospital water birth without intervention, but, should circumstances dictate, I am willing to consider other options so long as I am fully informed of the advantages and disadvantages.


During Our Baby’s Birth


1st Stage

I would like to remain at home for as long as I feel comfortable.

I would like to be attended by the community midwife at home.

When I go into labour, I would like to be able to arrange with the hospital an appropriate time for me to arrive and use water upon my arrival in hospital.

If a birthing pool is not available in hospital, I would like to be able to bring my own or use a back-up pool the hospital will provide.

My partner can be involved in setting this up, but I’d prefer if hospital staff could take charge of allocating space and ensuring the erection and filling of the pool goes as smoothly as possible.

I am happy to discuss these plans with the delivery suite manager prior to my labour.

In hospital I would like my husband / partner / doula / friend / children to be present. I would like my privacy and dignity to be respected at all times.

I would like my partner to be able to join me in the pool if I choose at the time OR I wish to remain on my own in the pool with my birth supporters outside the pool.

I wish to have music of my choice playing.

I wish to have no non-essential talk by health care providers.

I would like to have the lighting dimmed to suit my needs.

I would like to remain as active as possible, finding the best positions for myself and changing these as I wish.

I would like to try and rest between contractions where possible.

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, acceleration, ventouse to be explained and discussed first and ideally to be kept to a minimum.

I would like information about any proposed medication before receiving it, including the purpose, potential side effects on me / the baby and options on timing e.g. before or after the baby is born.

Return to top


Pain Relief

I would like to cope without pain relief OR I would like to use entonox / gas and air AND/OR a TENS machine AND/OR homeopathic pain relief AND/OR pethidine.

I would like to use massage AND/OR move around AND/OR bathe and be given lots of support to help with this.

I would like to use the water birth pool. I wish to use for 1st / 2nd stage.

I plan to use an "all fours" position OR squatting OR other position to help with pain relief.

Advice will be welcome, and I am open to considering other pain relief options if necessary.


Transition

I wish to be very centred on myself at this stage and to have no intrusion.

Gentle support and firm guidance will be appreciated.

Information on progress and caring support will be helpful.

I will probably be in an "all fours" OR upright OR semi reclining position.


2nd Stage

I would like to deliver my baby in water OR I wish to exit the pool and deliver my baby on land.

I would like to find my own comfortable position for pushing. This is likely to be an all fours OR upright OR leaning over the edge of the pool.

I wish to know when the head is crowning although I may be able to know this myself.

I wish to feel the baby’s head AND/OR see it in a mirror.

I will appreciate advice and guidance at this time to guard against too quick a delivery giving the perineum time to fan out thus (hopefully) preventing a tear.

We plan to take photographs / video the birth.

I do not wish to have an episiotomy unless vital and I or my partner agree OR I prefer an episiotomy to a tear.

I wish the baby to be delivered onto my belly OR I wish to hold my baby straight away OR I wish for the baby to be washed and then given to me.

We would like to discover the sex of our baby ourselves.

Return to top


3rd Stage

I wish to deliver the placenta naturally OR I wish to have an actively managed 3rd stage.

I wish the baby to suckle to encourage 3rd Stage. 

I wish to exit the pool to deliver the placenta OR I wish to stay in the pool to deliver the placenta

I wish the cord to remain attached until it stops pulsating.

I only wish cord traction to be used if syntometrine has been administered.

If there are signs of haemorrhage, I will have IV ergometrine as necessary.

My partner would like to cut the cord.

We would like our baby to stay with one of us at all times.

We would like to be left alone with our baby.

We would like to see the placenta and have it explained to us.

We would like to be consulted if our baby needs to go to special care.


Multiple birth

We would like both / all of the babies to be taken to special care together.

If one baby needs special care and the other(s) don’t we would like the well baby(ies) to stay with us until we go.

I wish to breast feed as soon as is appropriate.

We do OR do not consent to a Vitamin K injection.


Tears

I hope to avoid this and will appreciate support to adopt positions to minimise tears.

If one occurs I would prefer not to be stitched unless it is essential to healing OR I prefer to be stitched

If stitching is necessary I do want a local anaesthetic to be well administered prior to stitching OR I want Gas and Air on hand for when I am being stitched.


Emergencies

I and/or my husband / partner 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 possible outcomes with and without this intervention be?

4.How much time do we have to make a decision?

5.Are there any other courses of action open to us?

We will be guided by balanced, informative advice.

In the event that assisted delivery is necessary I prefer ventouse to forceps.

In the event that a caesarean section is necessary I would like to have a spinal OR general anaesthetic.

Return to top


In The Post-Natal Ward

We do not want our baby to be given any artificial milk.

I intend to breastfeed on demand OR I intend to bottle feed on demand.

I would like our baby with me at all times unless I request otherwise.

I would like to be present when our baby has a nappy change or bath.

We would like our other children to visit as soon as possible after the birth.

I would like to be consulted as to when I should be discharged from hospital.

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