Step 1: Home Birth vs Hospital?
Free birth plan template download with 10-step guide to writing your own birth plan
Firstly, mamas, let’s make one thing clear: your birth plan is not the be-all-end-all of your birth experience. On the day you are gonna live each minute as it comes and only cross a bridge if and when you get to it.
Some people will tell you to not to even bother with a birth plan “because things never turn out the way you plan them”. While there is some truth in that, the girl scout in me strongly poo-poo’s such negativity and favours this sort of proactive attitude:
“A clear vision, backed by definite plans, gives you a tremendous feeling of confidence and personal power.” ― Brian Tracy, The Gift of Self-Confidence
Especially if you’re a bit of a control freak like me, taking the time to do this properly is a hugely beneficial exercise in itself. The more you learn about your options, the better educated and relaxed your decision making becomes.
On the big day, you know, your birth partner knows and your whole birthing team knows what your first, second and even third choices are for practically any eventuality.
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Where should I give birth?
Initially, the thought of home birth totally freaked me out and hospital seemed to be the obvious, logical place to have a baby...
“In case something bad happens…” - Once-upon-a-time Lynn
But what if I told you that in the UK, there is virtually no time difference between that “something bad” being professionally identified and you actually getting the required intervention in hospital, whether you were are at home, in a birth centre or in hospital?
How can this be? Well, consider these factors::
- The preparation time it takes to call out and set up for an emergency medical team and
- The fact that problems are identified much faster when you have one-to-one attention from your midwife (which you get at home).
The midwife, doula or your birth partner will call ahead for an ambulance and to notify the hospital of your situation.
This triggers immediate preparation so they are already getting ready for you as you are still on the line and then while you are transferring so that there’s no waiting around when you get there.
Because you have 1-2-1 attention, things get picked up much faster, transport is arranged faster and then everything is ready to receive you.
If you were already in hospital, the medical team might only check on you every 15-20 minutes or so because you are not under 1-2-1.
Then they still have to call the team on the phone and they still need to prepare the theatre so whether you are waiting on the ward to be transferred or you are transferring in your car, it will probably take the around the same amount of time to get treatment. Ask your practitioner how long it would take you to transfer to your designated hospital to see how applicable this is to you.
When would I need to go to hospital?
If you and baby do not have a medical condition and you decide to stay at home to labour and birth, there are only two scenarios where you would have to transfer to hospital:
- “Failure to progress”. This is a medical term meaning that there are no signs that baby is coming despite your efforts. Be mindful to note that THIS IS NOT AN EMERGENCY. So stay calm and go with the flow. The more you stress about it the more your labour will regress and your cervix can even close back up… what I call “sphincter rules”, but that’s another story.
- Meconium in discovered in the amniotic fluid (usually spotted in your knickers or when you go to the toilet). Meconium is a black sticky substance that babies poo in the first days of life after birth before it becomes real food-based poo. This means the baby passed a bowel movement which is a sign that it could be distressed.
AGAIN I STRESS THE “COULD” (not “is”) so relax and remember that only 1 in 1000 with meconium are actually distressed - the other 999 babies are fine. Expect your midwife to monitor baby’s heart rate, which is only distressed if it goes over >160 bpm or dips under <110bpm.
THE NHS GUIDELINES:
- If the amniotic fluid is clear = all good
- If it’s slightly brownish but no lumps = still okay
- If there are lumps = this means that meconium lumps could block baby’s air passage.
Don't panic because lumps are not an immediate health threat as oxygen continues to be delivered through the cord until baby is born and starts breathing on land.
That’s when you don’t want a respiratory obstruction and should transfer to hospital with better equipment to clear baby's airway with that if it does happen.
Even then it doesn’t mean that any of it will be needed. Channel Mum vlogger, Emily Norris, birthed her third baby at home beautifully. They found meconium and so went to hospital after the birth to check that everything was fine. And guess what? Everything was fine.
What are the benefits of a home birth?
Firstly, you have all your creature comforts to hand, soft fluffy things to lie on, a guaranteed birthing pool (instead of first-come-first served), decent food and drink, Netflix, candles and music instead of bright lights, waiting rooms and bleeping machines.
Secondly, a midwife is sent out to you and usually a second one comes to assist at the birth so you'd get the same equipment as if you were in the midwife-led birth centre:
- Gas and air
- Pethidine provided by MW or that you have pre-prescribed from GP in advance
- Baby resuscitation equipment
- Injection for the rare event of a haemorrhage
- Baby heart rate monitor
Moreover, if you’ve been nesting just half as much I did, your home is probably spotless and mostly germ-free, unlike hospitals that are full of sick people and have to fight superbugs.
There’s always a story about hospital-contracted infections. There’s even a word for it: iatrogenic, "caused by medical intervention". Which leads me this this head melter:
“On the basis of what we have heard, this Committee must draw the conclusion that the policy of encouraging all women to give birth in hospitals cannot be justified on the grounds of safety.” - House of Commons, 1992 Investigation.
Birthing at home or labouring at home for as long as possible before going to hospital is recommended on the grounds of reduced risk of infection but equally so that you can remain in a familiar and comfortable sanctuary of calm, which helps the labour progress more rapidly and efficiently.
You never know though... Be open-minded and remember that although you ordered in your birth plan your first, second and third choices, you should prepare yourself to birth ANYWHERE. Women give birth in stuck elevators, in taxis, a barn.
My plan didn't go to plan but the flexible planning was what made it okay. I dreamed that my first birth would in a pool in a midwife-led centre but I actually gave birth in the hallway of my then one-bed flat and it was still the best day of my life - thanks to my hypnobirthing training.
A home birth wasn't my first choice but it was an option listed on my birth plan. The Plan is not just a wish list - it's a tick list of every eventuality you need to prepare for.
Wherever you start or end up, know that you can remain in the same portable bubble of calm confidence and positive energy. Block out the noise of the outside world with headphones and focus on your breathing with hypnobirthing meditations.
If you’re put off by the instrumental music that comes with many relaxation audios then try one of my voice-only MP3 meditations:
This was Part #1 of a comprehensive 10-part guide to writing a practical birth plan that you’ll actually use. You can read and watch the specific youtube videos for each sections and fill in your birth plan as you learn.
Download the exact same template that I used here for free. It’s word document so you can type directly into it or print it out to make notes as you read and watch the next videos.
HERE ARE THE NEXT STEPS FOR COMPLETING YOUR BIRTH PLAN:
- Where should I give birth? The pros and cons of home vs hospital vs midwife-led birth centre.
- Birth partners: What do they do and who do I want with me during birth and interventions?
- What equipment should I bring with me and what can I borrow from hospital and midwife-led birth centre?
- PAIN RELIEF: what are my options?
- Birth position, birth pools, labour activity and monitoring baby during labour.
- How do I deal with invasive interventions (episiotomy, forceps, ventouse etc…)?
- What’s so important about immediate skin to skin and the APGAR test?
- Cord clamping and cutting: when - who - how?
- Birthing the placenta (after-birth)
- Feeding a newborn baby and the first medical decisions you make for them.
Disclaimer: This birth plan template and guide is based on publically available NHS information, the professional and personal experiences of Lynn JT, lead coach of the online hypnobirthing school, Achieve The Birth You Want™. Every pregnancy needs to be monitored in person by professional medical staff who will provide personal medical advice specific to your pregnancy circumstances, especially if you or baby have a medical condition(s). A birth plan only displays preferences but by no means or form does it guarantee a specific labour and birth outcome. All birth plans should be reviewed and discussed fully with your professional birthing team and modified according to individual needs.