Dr Christopher Ng discusses how to plan for a birth in Singapore

By Gill Haylock
Issue 91 - February 2010

I think my husband’s notion of a birth plan was deciding which pub he’d meet his mates at for the “head-wetting” drinks. For me, though, writing a birth plan before the delivery of each of my girls was invaluable. And I don’t mean just for the big day itself. In fact, my carefully constructed plans went out the window on both occasions as the vagaries of childbirth kicked in. But the fact that I’d prepared a birth plan meant, at the very least, that I’d educated myself about all the things that could happen during delivery. This was a great comfort. 

Someone who has probably seen every permutation of birth plan under the sun is DR CHRISTOPHER NG of GynaeMD Women’s & Rejuvenation Clinic. Here, he discusses some of the best ways to approach this important document.

Is a birth plan a good idea?
It’s not compulsory, but it’s useful if you have particular ideas about how you’d like your delivery to be conducted – especially if you have special requests (for example: no epidurals, no episiotomy if avoidable, a warm tub for pain relief, aromatherapy candles, and the ability to ambulate and not be completely bedbound). 

A plan conveys to me in writing what my patient desires, and I try to fulfil her wishes – as long as they don’t include anything that might compromise safety. Of course, this will be discussed point by point before the actual day so that everyone is clear as to what is expected.

I also arrange private tours of hospitals for my patients so they get a better idea of what to expect and are more familiar with the surroundings before their big day.

Are more women writing birth plans in the lead-up to having a baby?
Yes. In most cases, I find that my patients’ requests are pretty much what I practise as standard protocol for delivery anyway, so I don’t find them unusual. As patients are increasingly becoming more internet savvy, I think birth plans will become more popular.

To whom should one show a birth plan, and when?
I encourage all my patients to discuss their birth plans well before their delivery so I can make the necessary arrangements. I usually send the birth plan to the hospital so everyone is aware of my patient’s expectations. That way, alternative arrangements can be made if necessary. For example, a German patient of mine wanted a warm bath and aromatherapy for pain relief. She’d chosen a hospital that didn’t have this facility, so on seeing the birth plan I immediately rebooked her into one that did.

How long should a birth plan be?
It doesn’t really matter, as long as it’s clear and expresses all your requests. Every pregnancy is a unique experience and birth plans should be individualised to the mother’s needs. A short, succinct plan is better for everyone so as to reduce any confusion.

Critics of birth plans say there is no way to plan what happens during birth because it’s so unpredictable. Is this your experience, too?
It’s true that birth can be unpredictable, but most of the time I’m able to meet my patient’s requests – if not fully then to the best of my ability depending on the circumstances. Managing expectations about what may or may not be possible is important from the start.


Putting a Plan Together – Some Points to Include

Pain-relief options
This is very much a personal choice and there is no right way. Every woman has her own preferences. I generally leave it up to my patients to decide what suits them best after I have explained all the various forms of analgaesia available. I will support her decision and encourage her to read more about the various forms available. It’s important to approach labour with an open mind – don’t feel guilty if you change your mind during labour.

Presence of family members
As the birthing process is a very personal experience between husband and wife, most of my patients opt to have their husbands with them from start to finish, for moral and emotional support. Sometimes, husbands faint at the sight of blood. I designate “safe zones” in the labour room where they do not have a direct view of what’s happening, and I arrange for other family members to relieve them if they start feeling woozy so that the mother is never left alone without a familiar face.

Preferences regarding breastfeeding and bottles
Definitely breastfeeding over formula milk, but if for some reason the mother is unable to breastfeed then she is given a choice of various formulas.

Cord-cutting options
Sometimes, more adventurous husbands wish to cut the cord themselves and I happily let them do so. Otherwise, I usually do this.

Contingency plans for unexpected outcomes
For this, I have left clear and concise standing instructions with all six private hospitals that I deliver in: for example, which anaesthetist and paediatrician to call when an emergency Caesarean section has to be performed so that there is no time wasted.

More trivial matters: music, eating, candles and so on
I have no objections to these things as long as they make the birth experience more memorable and pleasurable. My patients are free to play whatever music they like (not too loudly, though!), use essential oils, burn aromatherapy candles, dim the lights to suit their mood, and ambulate if they can. I allow them to eat a light meal in the early stages of labour as they will need all the energy they can muster later on for the “big push”. I’m fine with almost anything, so long as it doesn’t hamper the natural labour process.


GynaeMD Women’s & Rejuvenation Clinic is at #04-03A Camden Medical Centre, 1 Orchard Boulevard.
Call +65 6733 8810 or visit www.gynaemd.com.sg.