Birth Plan
PREGNANCY
Evidence
Haward, M.F., Lantos, J., & Janvier, A. (2020). Helping parents cope in the NICU. Pediatrics,145(6), Article e20193567. https://doi.org/10.1542/peds.2019-3567.
Blackburn, C., & Harvey, M. (2019). ‘We weren’t prepared for this’. Parents’ experiences of information and support following the premature birth of their infant. Infants and young Children, 32(3), 172-185. https://doi.org/10.1097/IYC.0000000000000142
Homson, G., Nowland, R., & Irving, M. (2023). Psychosocial needs of parents of infants admitted to neonatal care: A qualitative study. Journal of Neonatal Nursing, 29(2), 326-329. https://doi.org/10.1016/j.jnn.2022.07.006
Education
What is a birth plan?
A birth plan is a way for you to tell your healthcare team what kind of labour you’d like, what you want to happen and what you want to avoid. Your birth plan can cover anything about labour and birth that is important to you.
Your plan is personal to you. It will depend on what you want, your medical history, your circumstances and what is available at your maternity service.
In some cases, pre-term labour is planned because it's safer for the baby to be born sooner rather than later. This could be because of a health condition in the mother (such as pre-eclampsia) or in the baby (such as fetal growth restriction).
You might be in hospital or on bed rest for pregnancy complications that make a premature or complicated birth likely. You might be having twins or higher multiples. Or antenatal scans and tests have shown that your baby has a condition that will affect their health or development.
If your healthcare team know you need to give birth early, you may be offered an induction or caesarean section.
If this is the case, you may have some time to prepare for your birth experience.
You may want to think about things like:
- if you would like any music playing while you give birth
- how you would like to deliver the placenta
- how you would like to feed your baby after birth
- who you want as your birth partner.
- what positions you’d like to use during labour
- what type of pain relief you want to use during labour.
You’ll be busy with your new baby after the birth. And if your baby is in the neonatal intensive care unit (NICU), where many premature and sick babies are first cared for, you’ll want to be there as much as possible.
It can be difficult to fit in everyday chores like shopping and cooking, so planning can help.
Stock up
If you can, stock your freezer and cupboards with essentials well in advance. Frozen home-cooked meals are a good idea.
Also, if you make school lunches for your other children, you can make sandwiches ahead of time and freeze them. The older children can have frozen sandwiches some days, and fresh one's other days.
Leave some space in your freezer, though – you might need it for expressed breastmilk.
Organise care for other children
It can be a big help if friends or relatives can look after your other children sometimes or pick them up after childcare or school.
For example, there might be times when you want to stay at the hospital with your baby for longer than you planned, or you might want to visit together with your partner, if you have one.
You’ll also want to introduce your other children to their new sibling, but it can be hard for children to be still and quiet in the NICU. Some NICUs don’t let siblings visit because of the risk of spreading coughs and colds. You could organise for grandparents or friends to visit at the same time, so there are other adults to look after your children when they visit the NICU.
Note that visitors are often limited to 2 at a time in the NICU. Please ask the staff for their current rules on visitors and children.
Organise help at home
If you have a caesarean, driving isn’t recommended for about 6 weeks until your wound is well healed. Friends and family might be happy to help by taking you to the hospital.
If you can get someone to help you with the cleaning, putting out washing, ironing, grocery shopping and so on – do!
You’ll feel more in control and less stressed and tired if things run as normally as possible. And sticking to your usual routines will help your other children cope with what’s going on.
Have contact people
Keeping everyone up to date with news about your baby can be exhausting. So it can help to have 1-2 people who are contacts for everyone else.
You can let these people know what’s going on, and they can pass it on. For example, a grandparent might send group updates every couple of days and also be the telephone contact for other family members.
Let well-wishers know that the contact people will pass their names onto you, so you know that people are thinking of you.
When the baby is coming and you’ve gone to hospital, you can ask your contact people to let others know. You might even have a list of people for them to get in touch with.
Getting ready for hospital and the NICU
Think about who’ll take you to the hospital, stay with you and support you.
You’ll also need to get your hospital bag ready. Even if you haven’t packed it, it’s a good idea to have a list of what you want to go into it. If you don’t have time to pack the bag, leave the list so your partner or other support person can bring what you need later.
You might want to take photos or videos in the NICU. This is usually OK if your phone is set to airplane mode. Or you might prefer to take a camera. Ask your nurse what is suitable.
If your baby is staying in a private hospital, you’ll probably need to bring your own baby clothes.
If your baby is staying in a public hospital, you probably won’t need baby clothes – the hospital will have what your baby needs. But once your baby is medically stable and can handle being dressed, you might like to use your own baby clothes.
There are baby clothes designed for premmies. These are easy to put on and take off and are made with very soft fabrics.
Tours of the NICU/SCN - You might find it useful to visit the neonatal care unit in advance to familiarise yourself with it and get to know the neonatal team that will take care of you and your baby. Some units even offer virtual tours on their website. Contact your nearest NICU/SCN and ask them about a tour.
After your baby is born
After your premature or sick baby is born, the healthcare team will immediately assess your baby's health and start treating them if necessary. What level of care they need will depend on how prematurely they were born and their health.
If your baby needs immediate care, you may not be able to hold them straightaway after they are born. This can be a very difficult time, but you will be given precious time to bond with your baby as soon as it is safe and possible.
Find out more about skin-to-skin contact with your premature baby – known as kangaroo care.
You might like to keep a diary to record your baby’s progress, daily changes and questions for doctors and nurses. You should receive a NICU Survival pack on admission to the NICU/SCN which will contain a NICU Journal, this unique and beautiful journal has been developed to help families document their baby’s progress and hospital journey and create a memento of their baby’s early life, including a pen and stickers.
More about the resources available can be found here.
Empowerment
Sometimes things don’t go according to plan during pregnancy or labour. You need to be flexible and be prepared to do things differently from what you wanted.
You might feel confused or overwhelmed in the lead-up to the birth. These strategies that can help you manage strong emotions and stay calm:
- Do breathing exercises, muscle relaxation exercises or mindfulness exercises.
- Do activities and hobbies that relax you. For example, listen to relaxing music, go for a walk, paint, read or take a warm bath.
- Take things one step at a time. For example, focus on what you need to do today, and try not to worry about what might happen tomorrow.
- Focus on positive thoughts. For example, try thinking about your baby in a calm, loving and positive way.
- Ask for help if you need it. You can talk to your partner, a family member or a trusted friend. You can also talk to your doctor or midwife or call Miracle Babies Foundation’s NurtureLine on 1300 522 243.
Useful Links
Raising Children
Queensland Health Clinical Guidelines – Preterm Birth
https://www.health.qld.gov.au/__data/assets/pdf_file/0013/140143/c-ptl.pdf
COPE – Centre for Perinatal Excellence
https://www.cope.org.au/getting-help/e-cope-directory/
Panda - Perinatal Mental Health
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Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances. To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].
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