Examples include:

What type of birth you wish to have (vaginal/caesarean)

• Any specific birth practices you wish to be honoured such as hypnobirthing or water birth. Please note that if you do hypnobirthing you will need to also supply more detail on your preferred choice of words, person to communicate with and other details. Remember that hospitals generally do not offer water births and that not everyone is familiar with hypnobirthing. A lack of understanding does not mean they do not care. It might simply be unfamiliar so you can inform them. As long as you remember that in the case of medical emergencies, birth plans cannot always be honoured.
• Your choices for pain relief (none/epidural/injection/mobilisation etc.)
• Skin-to-skin time with the baby. This is always subject to the baby’s conditions and not needing medical care straight after the birth.
• Delayed cord clamping (see video at the bottom of the page). You need to discuss this with your healthcare provider BEFORE the birth so that they can talk you through it and discuss the instances where it won’t be possible so that you are up to speed.
• Your choice of birth companion. Remember that most hospitals allow only one birth companion with you. Home births are completely up to you.
• Your choice of visitors. You have full right to refuse certain visitors, especially if people want to bring their children along and you don’t want your baby exposed. Many hospitals restrict children under 12 years old, but many don’t. You still can.
• When you want your baby bathed
• How involved you want to be with bathing and changing nappies. If you don’t say or do anything, the nurses will carry on with their routine but you will lose out on learning opportunities.
• Your choice of feeding, breast or formula.
• If you are doing  newborn cloth nappies, then let them know and include a guide if you can. TIP: the first couple of days in hospital can be very overwhelming. If it is your first cloth bum, start at home where you have access to the washing machine and can keep up with the washing routine. You will get a baby bag in the private hospitals with disposables for your stay, these should be enough until you go home.
• Whether you prefer rooming in or not. It is recommended to room in with your baby. This means that baby stays with you at all times and you get used to the routine. Sometimes though, you need a break and can send the baby to the nursery.
• The list carries on – see our Birth Plan video below with some resources to birth plan templates.

NB: Keep it short and sweet. Bullet points. Very few people have time to read pages of essay-type plans. If you want your birth plan to be honoured as far as possible, keep it short and sweet.

Here are some great website for birth plan templates if you want to design your own:

• https://www.thebump.com/a/tool-birth-plan 
• https://www.whattoexpect.com/pregnancy/labor-and-delivery/birth-plan/
• Download a template here https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/how-to-make-a-birth-plan/

No problem. No one can force you to do anything. You have to consent to all procedures. As long as you keep in mind that every decision you make also has consequences so make sure you are happy with your decision and that you believe it is in the best interest of you and your baby. This might sound farfetched, but from a medical perspective I would not recommend a family member, friend or church pastor make decision on your behalf (it happens).

Consult them, pray with them and ask their advice but the decision you make at the end of the day is only yours (and your partner’s) and you will have to live with the consequences so make sure you are okay with the decisions.

You can change your birth plan until the baby is born and after as well. A birth plan is just that, a plan. It is not a rule book and you are not obliged to stick to it. If you change your mind mid-labour about pain relief even though your birth plan explicitly stated otherwise, that is okay. You can decide what works for you. Maybe you thought you wanted an epidural and find that you are managing perfectly fine without it. Or you wanted an unmedicated birth and you find it hard to cope, then opt for pain relief. No choice will make you any less of a brave woman bring a miracle into this world. 

Braxton hicks contractions are often referred to as false labour.

These are in essence practice contractions. Your uterus is practicing for labour. You will find your stomach tightening at random times, feeling hard all over your abdomen. It can last for 10 seconds or even for 2 minutes. These contractions do not get stronger or painful. 

Note here: Most sources will note that Braxton hicks contractions are not painful but only uncomfortable. Actually, many mothers do experience them as quite painful. Nothing like real labour, but ‘uncomfortable’ enough to make you sit still for a second and just wait it out. The key is that the intensity does not change i.e it does not get stronger and they are not regular. Sometimes you can have a couple of braxton hicks contractions in an hour and then nothing for another day. Or you might get 2 or 3 in a day.

If you are ever unsure, sit down and relax. Count how far they are apart, how long they last and if you give some time i.e an hour or two if they become stronger.

Sometimes a bladder infection can also feel like contractions. If you have painful urination or a constant dull crampy feeling in your lower abdomen, you might suffer from a bladder infection. It can be verified during a checkup at your doctor and treated.

NB: At all times you should feel your baby move. Regardless of contractions intensifying or not, if you do not feel your baby move like usual then you should go in to get checked out.

The key to contractions is the intensity and the time. So over time contractions get stronger or more intense/more painful and they come more regularly.

Childbirth is managed in three stages:

1. -> First Stage is the labouring period
2. -> Second stage is the birth
3. -> Third stage is the birth of the placenta (afterbirth)

The first stage consists of early labour and active labour:

1. * Early labour is when contractions come and go in the form of your stomach ‘tightening’ and feeling hard all over. IT slowly intensifies and can last anywhere from 10 – 90 seconds and can come every 5 – 10 minutes, but slowly coming closer together.
2. * Active labour is when your contractions come at regular intervals i.e every 3 – 4 minutes, last for more than 60 seconds and become stronger and more intense. A pressing feeling might be noticed in your pelvis, almost like you need to go to the loo.

So how do you time them?

When you start feeling the tightening in your stomach you start timing. Once the tightening goes away you stop the timer. Also note the time in-between contractions. You can also work on 10-minute intervals. How many contractions are you having in 10 minutes? 3-4 contractions in 10 minutes is a good sign to get to the hospital or phone your midwife. 

Sometimes a bladder infection can also feel like contractions. If you have painful urination or a constant dull cramping feeling in your lower abdomen, you might suffer from a bladder infection. It can be verified during a checkup at your doctor and treated.

NB: More than 5 contractions in 10 minutes is called hyperstimulation and is considered a high risk for complications during the birth. Make your way to the hospital ASAP.

The mucus plug, also called the ‘show’ is a sign of your body preparing for labour. It is however, not an indication that labour is starting, merely a sign that labour can start soon. Sometimes it can be a couple of hours, sometimes it can be weeks.

The show is a jelly like discharge that a pregnancy lady will notice. It does not look like normal watery or white vaginal discharge. It is sticky and can be blood-tinged so pinkish in colour. It will stay on a sanitary pad or underwear and won’t be absorbed as it is not water.

The show is basically a mucus plug in the cervix that protects the baby from organisms from the “outside” entering through the vagina and potentially causing infection. When the cervix relaxes and starts to dilate somewhat, whether before labour or in labour, the show comes loose and it can exit through the vagina. Sometimes it does not come out until the birth, it is not a given that you will see it.

If you are more than 37 weeks pregnant, you can relax and look out for any other labour signs in the days coming.

If you are earlier than 37 weeks you should notify your healthcare provider and they will advise you what to do next. High risk pregnancies such as multiples (twins or more), previous preterm labours or any infections being treated are at a higher risk of preterm labour so you should definitely notify your doctor/midwife. If you experience any contractions as well, immediately go in to the hospital.

NB: You should always feel you baby move in his/her normal patterns. At any point if you don’t feel movement you are used to, lie down and relax. Count the movement and if you still feel nothing, go and get it checked out at the hospital.

Remember that no one can force you to do anything. It is your body and baby and you get the ultimate decision. There is a fine line between advising you and forcing you. You are seeing a healthcare provider because you trust their knowledge and expertise and therefore should take note of their information and guidance if yo have important decisions to make.

But they should also respect your decision even if they would prefer you make a different choice. As long as there are no obvious harm to you or your baby they cannot force you. And even if they perceive harm to you or your baby, they have the right to withdraw care (within reason) and advise you to find a different healthcare provider to continue the journey with you. Yes, you can be ‘fired’ from you healthcare provider if they do not agree with your decisions and they perceive a risk to you, your baby or their own careers as a result of your decision. But this is ONLY in circumstances where you are not in need of emergency care, in those case they are obliged to assist you.

An example would be if you had previous caesareans and now wish to do a VBAC (vaginal birth after a caesarean section). Most of the time, healthcare providers will be comfortable after 1 caesarean but not after 2. In such cases they can withdraw care because then if there are birth complications, they cannot be implicated as it was not there choice. But they also cannot force you into another caesarean if you do not want one. You will then need to find a healthcare provider that will be willing to take over your care.

Research and research and read and read. Attend antenatal classes and ask as many questions as you need so that you have all the facts on the table. Be informed before you make a decision and then have peace with your decision.