How to write your birth plan in the UAE
Use of epidural, water birth, hypnotherapy – there are plenty of choices to be made
Congratulations on your pregnancy. Now it’s time to make plans for the big welcome: where will you labour and how? Who will be around you when you do? How do you expect to feel before, during and after? All these questions are your starting point for your birth plan.
We spoke to UAE-based doulas about making birth plans, what they should encompass and look like. Here’s what they had to say.
What is a birth plan?
Shereen Zarroug, certified birth doula and coach, antenatal educator, hypnobirthing practitioner, breastfeeding counsellor and founder of pregnancy centre Belly Baby Mom, explains: “A birth plan is a document that highlights your vision and preferences for your upcoming birth. The goal when working on a birth plan is for an expectant woman/couple to put down all the ways they would like to be supported informationally, physically and emotionally during the birth experience, so that their birth team is aligned in the support that the couple would like to be given.”
It minimises the scope of disappointment for a couple. It’s important to have as much detail as possible on there, because your idea of a ‘natural birth’ may not be the same as your doctor’s.
Jasmine Collins, hypnotherapist, theta healer, natural language processing practitioner and doula, urges couples to have the conversation about birth plans early in pregnancy so both couples and their doctors can be on the same page. “Every doctor has a different style of birthing,” she explains. The questions to ask, she says, are:
A father’s role
It’s important for the dad-to-be to be informed about what’s expected and why; he can explain these choices to the midwives (shifts may change and debriefing may be needed) or doctors on the big day. “Your husband is your biggest advocate (if attending the birth) so it is important for him to support your wishes, ask questions and speak out during labour/birth if needed,” says Zarroug.
How long should the birth plan be?
Short and concise, say the experts. No more than a page or two. Zarroug says: “There are different ways one could work around their birth plan – some prefer a straightforward point by point A4 document, others opt for visual birth plans which are simple and highlight the important points graphically.”
There are different ways one could work around their birth plan – some prefer a straightforward point by point A4 document, others opt for visual birth plans which are simple and highlight the important points graphically.
Essential details
Names of parents, other relevant details such as medical history, type of birth and who will be there are all important things to note down.
Zarroug says other things one should specify are:
Delphine Dumur, a UAE-based doula who runs the Instagram account @letsbirthtogether, adds: “It should include your personal information such as:
Sections to consider
For easily readability, says Collin, you may want to divide the plan into segments:
Induction
Is this something you are okay with or only want to do if there’s a medical necessity? If yes, what types are okay and in what order. Your medical options can include:
Membrane sweeps: “This is when they do a cervical check with their fingers. They separate the amniotic sack from the cervix. It’s a way to get things going at the end of your pregnancy,” says Collin.
Pessary (or tablet)
Breaking of waters: You are examined internally and using a small plastic hook the membranes are caught and broken, explains UK-based National Health Service (NHS) on its website.
Synthetic oxytocin
Start of labour
When your contractions begin, you need have preferences about:
Once at the hospital
Pain management questions
a. Do you want an epidural?
b. Do you want an epidural to be your last bet and use other pain-relieving methods such as:
Labour stage 1: Thinning and opening
This is the longest stage and as it progresses, the contractions will get longer, closer together and more intense. Things to ask yourself:
Labour Stage 2: Descent and birth
Labour Stage 3: Placenta
In case of a C-section
In case you need to have a C-section, says Collin, think about a ‘gentle C-section’. “This is where the head is assisted out but then you wait for the baby to push itself out of the incision, and this kind of mimics the vaginal birth more than the grabbing and pulling them out,” she explains. The surgery is explained, you can do delayed cord clamping, and have skin to skin contact.
Should a birth plan also include post-natal preferences?
Yes, say the experts. These include:
Skin to skin contact: This refers to the practice of putting a newborn on a mum’s chest right after birth. The benefits of this action, various studies have shown, are numerous and it stimulates certain areas of the child’s brain. United Nations International Children's Emergency Fund (UNICEF) says the benefits include:
Your feeding philosophy: Formula or breast milk. You can write in your birth plan, says Collin, that no formula or pacifiers can be used without consent.
Delayed cord clamping: This is the practice of not immediately clamping the umbilical cord thereby allowing blood from the cord and placenta to flow into the baby. Read all about delayed cord clamping here.
Stem cell collection: That is the collection of stem cells from the umbilical cord shortly after birth. This is sometimes in conflict with delayed cord clamping however, warns Collin. Read all about stem cell collection here.
Routine actions affecting your baby such as nose suction or vitamin K shots or vaccinations.
Why does a baby need a Vitamin K shot?
Dr Anuradha Ajesh, Specialist – Paediatrics at Abu Dhabi-based Bareen International Hospital, says: “The American Academy of Paediatrics recommends that all new-borns, whether breastfed or formula-fed, should receive a one-time intramuscular shot of vitamin K within six hours after birth.” This, she explains, is because babies are born with very little vitamin K in their bodies and Vitamin K deficiency in newborns can cause Haemorrhagic diseases. Dr Puneet Wadhwa, Specialist Paediatrician at Prime Hospital, explains that vitamin K does not cross the placenta within the womb and breast milk too doesn’t contain enough vitamin K to make a difference in the child’s levels. A deficiency can cause bleeding in the intestine or in the brain and can be life threatening. A child is at risk of suffering from a deficiency fallout up to their first six months of age. Dr Ajesh adds: “Vitamin K is necessary for the body to form clots and stop bleeding. Without sufficient vitamin K, babies cannot make the substances utilized to create clots, called ‘clotting factors.’” Vitamin K can be given in either oral or injectable form – put your preference down in your birth plan.
Baby to be around you: Your demand that anything related to your baby be done in your presence.
The vernix: This is an anti-fungal, anti-bacterial, moisturising white substance that coats the newborn. “It smells like amniotic fluid so it makes your baby feel at home and calm. It doesn’t mean you don’t clean face and genitals, it just means you don’t immerse them in a bath,” says Collin.
When the baby is born through the virginal pathway, they pick up all the good bacteria that they will need to create the flora and fauna of their microbiome. Unfortunately with C-section this doesn’t happen. But there are some ways to do the seeding.
Microbiome seeding: “When the baby is born through the virginal pathway, they pick up all the good bacteria that they will need to create the flora and fauna of their microbiome. Unfortunately with C-section this doesn’t happen. But there are some ways to do the seeding,” she says. US-based Cleveland Clinic explains the process as: “Vaginal seeding is the practice of wiping a baby's mouth, face and skin with its mother's vaginal fluids after C-section. This process transfers vaginal microbes to the baby to help establish the baby's own microbiome to promote good health and fight disease.”
When should you write the plan up?
Zarroug says: “It is important for a woman to start thinking about the kind of birth she wishes to achieve, and how she would like to be supported throughout her experience, early on in her pregnancy. However, I would say an ideal time to start putting these preferences down and formulizing a plan, would be sometime around 25 to 32 weeks.”
Who can help you with your birth plan?
If you are taking a birthing course or working with a doula, she can help you create a plan. “If a couple hires a doula, they can most definitely work together on the birth plan, where the doula can share some suggestions, recommendations and evidence-based resources for the couple to make well informed choices and preferences to include into their plan. Sometimes, the couple prefer to work on it on their own, and as their doula, I would review it and offer helpful feedback if requested.
It cannot be stressed enough that the pregnant person needs to take ownership of her plan, and have her team entirely on board. She is the leader of that team, and they should see her strength and commitment to the plan before they do.
“Once a birth plan is finalised, it is recommended that the couple present it and discuss all options with their doctor, so that their provider understands and supports their wishes, and keeps it in file for the midwives team to review during your labour. Additionally, the couple can then also determine whether their provider is aligned with their preferences or if it would be best for them to find a different provider, that may be a better fit,” says Zarroug.
“It cannot be stressed enough that the pregnant person needs to take ownership of her plan, and have her team entirely on board. She is the leader of that team, and they should see her strength and commitment to the plan before they do,” adds Dumur.
Arm yourself with information when you plan your big day. And remember: Your body, your choice.
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