A few years ago, a couple in one of our antenatal classes asked if their course leader & I could run through their birth preferences with them – which we were delighted to do! One thing that jumped out immediately was that they started with: "All communication must go through my partner." This raised the alarm straight away. Why? Because of the legalities of consent!
Understand your rights.
Any person giving birth must consent to treatment provided by their midwife, doctor or anyone involved in their care during labour, birth and the early postnatal period. This includes everything from examining you to taking your blood pressure and giving you pain relief.
It is your body and against the law for anyone to give you medical treatment or care without your express permission. A third party cannot consent on your behalf, even if they are your husband, wife, partner, or mum. The only exception to this is if you cannot give consent. For example, if the medical team needed to provide life-saving treatment and you were unconscious.
In fact, until your baby is born, the person giving birth is the only person who can provide consent on their behalf. After they're born, anyone with parental responsibility will be involved in decision-making.
This may sound extreme, but the law is there to protect you during childbirth. No one can make or persuade you into doing something you don't want, whether it's a loved one or a medical professional.
This is why doing your research before going into labour is essential. If you know and understand the birth process you can make truly informed choices. Developing realistic and flexible birth preferences will help your maternity team support you better. Plus, you'll be less compelled into making decisions you don't feel happy about.
What do you actually want your midwife to know?
So, we sat the couple down and asked them to explain why they didn't want the midwife to talk to them during labour. It turned out that it wasn't for medical reasons but that she was an introvert and found too much chat tiring. She wanted to conserve her energy and focus on giving birth!
This was a handy piece of information her maternity team would need if they wanted to look after her effectively during labour! So, we said, "Write that, rather than telling your midwife you don't want her to talk to you! It will help your midwife personalise your care and set a more positive tone for your relationship as she looks after you."
Your birth plan communicates your preferences for labour, birth and the immediate postnatal period, to the midwives and doctors who may look after you.
It is important to remember that a birth plan is a flexible document. It is impossible to 'plan' for labour and birth. Which is why we recommend having a list of preferences which your midwife will work with you to keep to. However, it is possible you may move away from your original plan if your choices or circumstances change on the day, or for the safety of you and your baby. This is why it is a good idea to have a full understanding of all directions your labour might take, so that you can make informed choices ahead of time. This approach can help you feel more in control, for the twists and turns of labour and childbirth.
Some of the topics you should research include:
- Where you want to give birth
- Who you want to support you as a birth partner
- What pain relief options you might like to use - or not - including natural pain relief options like water and massage
- Different birth positions
- How you want your placenta delivered
- How you plan to feed your baby
- What happens if things don't go to plan and you or your baby need a little more medical attention.
There is a lot to think about, and it can be a bit of a minefield knowing where to look for good quality information that will help you make positive, informed choices that best suit your individual circumstances.
- Firstly, speak with your community midwife and any friends who have recently given birth in the local area - they will be able to help you with lots of the practical information about your chosen birth unit.
- Find quality online sources of information. Some good examples include www.tommys.org, www.babycentre.co.uk or www.emmasdiary.co.uk.
- Finally, one of the best places to get the information you need to help you plan your birth preferences is by signing up for an antenatal class. Ideally go for a class which is midwife-led and focuses on delivering evidence-based information. Check our digital courses, including both free and paid options. Alternatively, speak to your local midwife for the NHS classes available in your area, or look for local midwife-led classes.
How do you want to be spoken to?
Remember, writing your birth preferences document introduces you to the maternity team looking after you. It tells them everything you need to make your labour and birth experience as positive as possible. It's a great idea to include a little information about how you like to communicate too!
This includes whether you want a quiet space or more of a party atmosphere. Also, how do you like medical information presented? For example, "Give it to me straight, doc", or "Please be gentle in your explanations. I'm a little squeamish!"
Words matter
A lot of the language associated with labour and birth is not particularly helpful. For example, 'failed induction' often leaves people feeling like they did something wrong (they didn't!).
With this in mind, consider any language you do, or don't, want your midwife to use during labour and include it in your birth plan. For example:
- Hypnobirthing-friendly words, such as surges rather than contractions.
- Inclusive language that's appropriate to you, including the correct pronoun use.
- Avoiding negative phrases such as 'failed induction' for more positive alternatives.
- Jargon-free language only please, for example SROM stands for spontaneous rupture of membranes or in layman's terms, your waters breaking.
I recognise the NHS is a busy and often understaffed place. But the maternity teams genuinely want to support you in the best way possible. Your birth preferences document is a great tool to help get them started.