Your birth preferences and plans

Pregnant woman sitting up on a bed with a note book and pen

Completing a birth preferences plan can help you and your birth partner to think about your choices and preferences during labour and the birth of your baby. During your pregnancy you will have the opportunity to meet with your midwife/doctor and discuss the plan – try and do this around the time of your 34 or 36 week appointment. This will help your team understand the kind of birth you would like. Read the in app content about labour and birth, then using the birth preferences plan in the Personal care and support plans section write down your thoughts and preferences. See below for what options to consider.

Your birth preferences and plan

Options to consider

13th August 20184th April 2023

Options to consider

Smiling health professional hold the arm of a pregnant woman in a reassuring gesture

who will be your birth partner(s)
how you feel about having a student present during labour/birth
different pain relief options for labour and birth
different positions for labour/birth
coping strategies and pain relief
how you feel about vaginal examinations
whether you would like continuous or intermittent monitoring of the baby’s heart during labour
any preferences you have if an assisted birth is recommended.
who will cut the cord/optimal cord clamping
skin-to-skin contact
your thoughts about infant feeding
how you would birth your placenta (afterbirth)
vitamin K for your baby.

It is useful to think about how you would like your baby’s birth to be in the event of having an induction of labour or a caesarean birth – planned or unplanned, and to ask your midwife or doctor what things you might need to consider for your own personal circumstances. Your midwife will discuss your preferences with you again when you are in labour and any reasons to consider changing the plan. You can share your birth plan with your midwife when you meet at the maternity unit (or at home if you are planning a homebirth). Complete your Personalised birth preferences plan in this app which can be printed out to share with your maternity team.

How to make a birth plan Which? Your birth plan

13th August 201826th July 2021

Would you like to talk with somebody about your options for place of birth?

Mother to be and birth partner attend maternity appointment

Some women may find it helpful to talk to someone about their birth options. This is especially true if they have had a pregnancy, labour or birth that was difficult previously, or if something unexpected happened. It is not unusual to be unsure about your options or what effect any choices may have on this pregnancy and birth. You can speak to your midwife, and if needs be she will refer you to a birth options clinic, which is normally run by the consultant midwife at your chosen maternity unit. If you are considering requesting a planned caesarean birth, this decision would be made with you and the specialist midwifery and obstetric teams. Ask your midwife to refer you to the appropriate clinic, where you will be able to discuss your options.

Contact my maternity unit

13th August 201826th July 2021

Which option is safest for me and my baby?

Safety is always the priority, so if you have certain needs or complications with your health and/or pregnancy it may mean that giving birth on a labour ward is the safest option. Your midwife or doctor will discuss this with you if it is their recommendation. If this is your first baby, and your pregnancy is considered low-risk, it is just as safe to have your baby in a midwife-led birthing centre as it is to have your baby in a labour ward. Research shows the risk to the baby is slightly increased when planning to give birth at home. If this is your second or subsequent baby, it is just as safe to have your baby at home as it is to have your baby in a midwife-led unit or in a labour ward. Women who give birth at home, or in a midwife-led birthing centre are much less likely to require medical assistance including caesarean section, instrumental delivery, blood transfusion and episiotomy.

Which? birth choice Birthplace study Is home birth safe?

13th August 20184th April 2023

Choosing place of birth

This is a decision you will make following discussion with your midwife or doctor at around 34-36 weeks of pregnancy, but it is helpful to start thinking about your preferences before this time. You can change your mind about where to have your baby at any point. If you choose to have your baby at home or in a midwifery led unit (birth centre), some events or complications before or during labour may mean transfer to the labour ward is advised.

Home

At home – in the comfort of your own home with the support of two midwives and whoever you choose to have with you. You can hire a birthing pool and your midwife can provide gas and air (entonox) if you want to use it.

Midwife-led unit (MLU)/birth centre

This is a ward within the maternity unit. It is a homely and calm environment that supports normal birth with minimal assistance. Midwives and chosen birth partners are on hand to support you. You will have the choice of a birthing pool, gas and air (entonox), aromatherapy and opiate based pain relief, depending on your maternity unit of choice.

Obstetric-led unit (OLU)/Labour ward/Delivery suite

This is a ward in a maternity unit where your care will be provided by a team of doctors and midwives. Normal birth with minimal intervention is always the goal, if it is safe to do so. Access to more specialised medical facilities and equipment is available for those women who need it.

Options for place of birth

Options for place of birth Which option is safest for me and my baby? Would you like to talk with somebody about your options for place of birth?

Choosing place of birth Which? Birth choice Homebirth Planning a home water birth

13th August 201815th November 2022

Your baby’s movements

Pregnant woman with a happy surprised expression looking down at her bump

From 16-24 weeks on you should feel the baby move more and more up until 32 weeks, then stay roughly the same until you give birth. Take time to become familiar with your baby’s normal pattern of movements. You should continue to feel your baby move regularly right up until you give birth to him or her. The movements your baby makes offer reassurance that he or she is well, and therefore if you notice these movements change or reduce from what you are used to, it is important to call your midwife or attend the maternity unit urgently.

The importance of monitoring fetal movements

This video is available in many languages. Click on this link and scroll down to view the videos in English and other languages: The importance of monitoring fetal movements in 20 languages including sign language

Portal: Your baby’s movements

Contact my maternity unit

Baby movements in pregnancy Your baby’s movements Why movements matter? Feeling your baby move is a sign that they are well Babies’ movements – MAMA Academy

13th August 201827th February 2024

Getting to know your baby during pregnancy

Pregnant woman smiling and holding a pair of baby shoes

Taking time as part of your daily routine to think about and bond with your unborn baby is known to release oxytocin, a hormone which can help your baby’s brain to develop. Babies need adults to nurture and support their development during pregnancy and their speech, language and communication beyond birth. There is lots of helpful information to support you with chatting to your bump during pregnancy and talking, singing, playing and reading with your baby after birth. You can try:

talking, singing, playing and looking at books with your baby, and encouraging your partner/family/other children to do the same
gently massaging your bump
having a bath
trying pregnancy yoga
practising hypnobirthing
playing music to your baby
writing a letter to your baby
using an app to help you understand how your baby is growing and developing, such as the Baby Buddy App.

Building a relationship with your baby

UNICEF UK Baby Friendly Initiate, Building a happy baby leaflet Baby buddy app Talking to your baby (Hungry Little Minds) I CAN’s Talking Point for parents

13th August 201815th April 2022

Work, maternity/paternity leave and money

Woman holding a mobile phone to her ear with one hand and carrying a clip board in her other hand

After your 20 week ultrasound scan, you can ask your midwife or GP for a MATB1 form. This form entitles you to statutory maternity pay from your employer or maternity allowance from Jobcentre Plus. During pregnancy/after birth you are entitled to:

paid time off for your antenatal appointments
maternity pay or maternity allowance
maternity leave
protection against unfair treatment, discrimination or dismissal.

Working partners are entitled to one or two weeks paternity leave and together you may be able to take shared parental leave. If you are not working, or you/your household is on a low income you may be entitled to maternity benefits and allowances. If you are employed, you must inform your employer that you are pregnant at least 15 weeks before your baby’s due date. When you tell your employer they must perform a risk assessment, which ensures any necessary adjustments can be made to your working environment or pattern. It is worthwhile speaking to your company’s human resource department and accessing the policy on pregnancy and maternity leave. More information on maternity/paternity leave, work, child or other benefits and money can be found in these related links:

Government advice Advice on your maternity rights The Money Advice Service Pregnancy, breastfeeding and health and safety

13th August 201823rd June 2022

Antenatal classes

Mothers-to-be and their birth partners attending a antenatal class

Antenatal education (also known as birth preparation or parent craft classes) can help you to prepare for your baby’s birth, giving you confidence and information. You can attend these classes with your birthing partner so you can prepare together for the arrival of your baby. Antenatal education is also a good way to make friends with other parents who are expecting babies around the same time as you. These friendships can help parents through the first few months with their new baby. There are two types of class available to choose from:

free NHS antenatal classes available at your local maternity unit or children’s centre. Ask your midwife about these classes
private/independent antenatal classes.

Most antenatal classes can be started when you are around 28-32 weeks pregnant, but they can often get booked up in advance so it’s good to arrange your place early on. There are specialised antenatal classes for women expecting twins/triplets and your midwife or doctor will give you the information you need about these. Topics covered by antenatal classes include:

health in pregnancy, including a healthy diet
exercises to keep you fit and active during pregnancy
what happens during labour and birth
coping techniques for labour and information about pain relief
relaxation technique
information about the different modes of birth (vaginal, assisted with ventouse or forceps, caesarean)
caring for and feeding your baby
your health after giving birth
emotions and feelings during pregnancy, birth and after.

Classes can be attended by anyone – it doesn’t matter if it is your first baby or your fifth! A series of short videos have been created for those unable to attend classes in person:

Antenatal classes: Videos

Portal: Antenatal classes

Antenatal classes Find an NCT antenatal course Find an independent antenatal class near you

13th August 201820th July 2023

Stillbirth

Close up of woman's hand being enclosed by the hands of another woman to comfort her

When a baby passes away after 24 weeks of pregnancy, either before or during birth, this is known as a stillbirth. Stillbirth is one of the most devastating things a family can experience, and a range of support is given through a specialist team (including midwives, obstetricians, counsellors and charities) to parents who are affected by it. This period of time may seem a complete blur, and it may seem like you have no control over the things that are happening to you and around you. You may have received the tragic news of your baby’s death and now been sent home for some time before coming into the hospital to give birth. You can talk to your midwives about what to expect to help you prepare yourself for the coming days, but here are a few things to consider.

Choices

You still have choices about many things to do with your birthing experience – these can be discussed with your midwives. If you have made a birth plan and wish to retain elements of it, your midwives will work with you to help you achieve that wherever possible – from water birth, to pain relief, to skin-to-skin, to partner cutting the umbilical cord. You may be offered a tablet to stop your milk coming in – it is your choice whether to accept it. Many mums do want this, some do not. You should be given the chance to discuss options relating to this including the opportunity to express and donate your milk – different things will be right for different parents, and this is still your journey, and you can do what is right for you.

Memory-making

Your midwives will help you have the opportunity to make memories with your baby. What memories you may choose to make are entirely your choice. There is no ‘right’ or ‘wrong’ way to go through this experience. You do not have to do everything – or anything – that you’re offered, or you can choose to do everything. You do not have to do everything at once, and you can change your mind. Your midwives will support you in any way they can. Your hospital should have a “Cuddle Cot” or “cold cot” that can help you be able to spend more time with your baby. You should be offered a memory box by your midwives. Memory boxes are like a starter kit for memory-making, with items inside that can help you capture these moments. If you choose to have one, you may continue to add to it over time or keep items from your pregnancy such as scan photos and your baby’s hospital band.

Here are some of the things you may wish to consider:

A pair of small teddies. Many parents like their baby to keep one, and the other to come home with them in the memory box. You may wish to give your baby one, and then switch them over before you leave so that you keep that one.
Inkless prints – prints of your baby’s hands and feet are often a treasured memory, and one that can be used by parents to get other memories made in the future, such as necklaces, cufflinks, or other jewellery. If you want these, you may want to take part in doing them yourselves, or you may want your midwives to do them for you.
Clay imprints – like the inkless prints, clay imprints are another memory that you should have the chance to participate in making if you wish, or you may wish for your midwives to do them for you. These are imprints that many parents like as it means they can trace the shape of their baby’s hands and feet with their finger, or put them in a frame – there may be a kit for this in your memory box.
3D casts of hands and feet may also be offered to you. Your midwives can take moulds and then connect with charities or casting companies to enable you to have beautiful casts made from the moulds that you can keep.
Photographs – it can often seem strange at the time to want to have photos taken of or with your baby that has died, but many parents are so incredibly grateful to have these photos to look back on later. You may also wish to have photos taken with siblings or other family members who you choose to have meet your baby. Make sure you have a phone charger with you when you go into hospital. There are photography charities offering free services that your midwives may be able to get in touch with for you.
A lock of your baby’s hair – your midwives may be able to help you take a lock of your baby’s hair to keep. Your memory box may have a little box in to store this.
Reading your baby a story – some memory boxes may have a story book in to read to your baby, but if you have a favourite story that you want to read your baby, bring it with you.
Clothing – if you have favourite outfits that you have got for your baby, pack them and bring them with you. If your baby is being born premature and is going to be too small for any clothes you may have, speak to your midwives – there are charities that provide specialist clothing for premature babies.
Bathing your baby – if this is something you would like to do, speak to your midwives and get their help.
Heart in their Hand keyrings – your memory box may contain one of these keyrings – a keyring with a heart cut out to leave in your baby’s hand so that you will be able to remain connected to them. These hearts can also contribute to beautiful photos with your baby. Ask your midwives for more information.
You may wish to remember to bring personal effects for yourself/yourselves while you’re in hospital too, such as toothbrushes and toothpaste, sanitary ware, shampoo, changes of clothes, phone chargers, and snacks.
These are just a few things you may wish to consider, but this is absolutely your journey and the decisions are yours.

Sands: Coronavirus and impact on bereaved families

Stillbirth Stillbirth support Sands charity Sands Bereavement Support app More on stillbirth Stillbirth counselling service Pregnant after a stillbirth Terminating a pregnancy for medical reasons (TFMR) Commonly asked questions about lactation after loss Dad Still Standing: Baby loss support for fathers Beyond Bea Charity Bereavement support after the death of a baby or child