Meghan and Harry should set out birthing plan in final weeks of pregnancy

The Duke and Duchess of Sussex should be drawing up their birthing plan in the final weeks of pregnancy as Meghan prepares for labour, an antenatal expert has suggested.

Val Willcox, of the National Childbirth Trust (NCT), said the decisions the royal couple make will be very individual and should be based on what suits them best.

A water birth or hypno-birthing could be options open to American former actress Meghan, as might the newest range of pain relief drugs or even a caesarean.

NCT antenatal teacher Ms Willcox said the duchess and other pregnant women ought not be judged for the choices they make.

“I would encourage Meghan and Harry to think about what’s important to them and to start drawing up some preferences,” she said.

She added: “It’s a really personal thing. It’s really important that women don’t feel that anybody is going to judge them for the choices that the make.

“It is such an individual thing and it’s not a competition.

“If you give birth without using any pain relief at all and that works for you – fantastic.

“Or if someone else gives birth having had an epidural and quite a lot of medical intervention, if they’re happy with that experience, that’s good for them.”

But Meghan and Harry will also need to be prepared to deviate from their birthing plan.

“It may not pan out in the way that they expect. It may be much more straightforward … but when things get more complicated that’s when you’re grateful for the expertise of doctors or midwives,” Val said.

If Meghan’s labour is expected to be straightforward, she might be able to opt for a water birth.

Around two in ten women giving birth in England use water or a birthing pool for coping with pain, with one in ten delivering in the pool, according to a recent national maternity survey of more than 17,000 women by the Care Quality Commission (CQC).

A home water birth is also a possibility with the hiring or purchasing of an inflatable birth pool.

Meghan is an avid yoga fan and Harry now meditates each day, most likely inspired by his wife, who has also told of her love of the practice.

The couple could choose to try hypnobirthing – pain management using a mixture of visualisation, relaxation and deep breathing techniques.

Ms Willcox cited the benefits, saying it could help the duchess – and even the duke – stay calm.

“Using techniques of self-hypnosis can be incredibly helpful. It won’t change somebody’s birth journey but it gives the woman tools to react differently to what’s going on,” she said

“It can be a really powerful form of relaxation.”

She added: “If a partner has been practising some of the techniques and helping support the woman, it actually can help partners stay nice and calm, so they avoid that ‘running around the room like a headless chicken’ reaction.”

One in three women now use natural methods during labour, such as hypnobirthing and massage (34%, up from 32% in 2017).

The most popular pain relief is Entonox, otherwise known as gas and air, which was used by 77% of those quizzed by the CQC.

The mixture of oxygen and nitrous oxide – also referred to as laughing gas – is inhaled through a mask.

Meghan might opt for an epidural – an injection in the back to offer complete pain relief – which is used in 30% of labours in England – or she may even choose to have an elective caesarean.

Some 12% of births are by planned caesarean and 15% by emergency caesarean, according the CQC.

The drugs pethidine or diamorphine can also help relieve pain.

One of the newest methods of pain management is Remifentinal – a morphine-type drug administered by a drip controlled by the patient which offers powerful, but short-lasting pain-relief.

The drug, which is not available in all areas, is expensive due to the necessary kit and the mother’s oxygen levels need to be monitored throughout by a midwife.

Ms Willcox said: “What most women want is for birth to be as straightforward as possible and as safe as possible for them and their baby, and what that straightforward and safe looks like will be very different for different women.”

She added: “Some women really don’t like feeling woozy or feeling a little bit high and a little bit spaced out, so they probably avoid pethidine or diamorphine.

“People also draw on their own previous experiences.

“If Meghan has ever had any strong painkilling drugs she might already be thinking, I like the idea of that or I don’t like the idea of that. It’s a really personal thing.”