DCDA birth plan--what did you write?

(11 Posts)
Linguaphile Mon 12-Aug-13 11:02:10

Not sure what I should even put down as twin births seem to be notoriously unpredictable. Just wondering if anyone has a plan they'd be willing to share? Are there things that, in hindsight, you wish you'd written down? Particularly curious as to what you said (or wish you had said) about:

- Constant monitoring
- Being hooked up to an IV
- Pain relief (what, if any, and at what point in labour to opt for it)
- Getting off on the right foot with breastfeeding
- EMCS plans (skin-to-skin, possibility of GA, etc)

Also wondering who is allowed in the room? I really only want DH in delivery, but my parents will be around so I'm wondering whether or not they can hang out with us for early stages?

andadietcoke Mon 12-Aug-13 11:41:14

Really interested to see the responses to this - I'm sure it will get mentioned at my 36w appt tomorrow. So far I've been told that they would like me to have an epidural, and I'm so anxious that I think I would actually like constant monitoring.

Hadn't even thought about the IV drip. They did say I'd be given something intravenously after birth as a pre emotive measure but I can't remember what it was!!

Franykins Tue 13-Aug-13 14:37:52

The drip they give you through IV after birth is to make your womb contract quicker so less likely to bleed. As wombs get stretched much more with multiples they want it to get smaller as quickly as poss. I can't remember what the drip was called though, but my mw mentioned it on Friday and I was only 24 weeks at the time.

Sorry not much else to add, but will be watching for what people say/recommend. Our little bundles aren't due until November though so have some time yet.

beachesandbuckets Wed 14-Aug-13 03:04:10

Just had my twins, so here was my experience.
Birth plan. Had none. As had two elder dcs, knew the futility of having one, and to avoid the disappointment of writing one only to find that nothing happens as predicted (esp given the unpredictably of twin births). My view also (fwit) is that failure to follow a birth plan can contribute to post birth depression so better not to have one.
IV drip. Was automatically given to me, wasn't much of a choice and I was happy to follow professional guidance. It was to make post labour contracting of uterus.
Pain relief. Again, epidural was highly recommended at my labour (tho I didn't feel pressurised) and I had it. No other pain relief was mentioned and I didn't require any as with epidural felt nothing and it was ace! No adverse side effects.
Breast feeding. Not discussed. assumed that I wld make decision after labour, which I felt up to doing. Not massive amounts of support here, but had taken a twin pillow to the labour suite and felt confident to give dual feeding a try straight away (and it worked).
C section default option. Not discussed at all. Guess if they had had to do one, wld have gone along with it if medically required.
Number of people in room. Was shocked to find out that, in my hospital at least, around 10 staff are required in the room for twin labours, 2 mw, 1 anethesis, one consultant and one doctor per each baby. May be worth you checking what is the position at your hospital. Fortunately mine came so quickly there wasn't time to get everyone in so just me, dh and two midwives. However again, was happy to follow hospitals guidance here, whatever to secure safe delivery.

beachesandbuckets Wed 14-Aug-13 03:07:35

Ps pretty much all of this information was given to me (usually by me asking in the first place) the day I actually went into hospital for inducement and was in the dark up to that point, so don't be surprised/disappointed if your experience is the same.

Cornwall73 Wed 14-Aug-13 07:18:10

I'm not doing one for our c-section tomorrow. I've asked but been told not to bother as it is such a controlled op anyway and I agree that it can lead to disappointment for some people. At our hospital antenatal class they went through what to expect in terms of process and no. of staff at natural and c-section births. Basically a lot of people, certainly 10-12 for a section. Our hospital aim to do skin to skin as soon as the babies are checked in theatre whilst mum is being stitched up if not dad is expected to pop them down his front. BF is encouraged as soon as we get to recovery. Like beaches I'm just going to go with the flow. I was told this info again at the section pre assessment appt on Monday and no doubt they will go through it again with us tomorrow!

If there is anything that you feel very strongly about write it down but otherwise have a list of questions and ask at every appt what options are open to you and what happens at every stage.

I had a birth image in my head. It never materialised.

I saw the girls very briefly once they were born, they were whisked away to NICU. I got to hold them briefly 5 hours later.

They helped me express colostrum soon after the c section in the recovery ward. I expressed that night and for the next 13 nights while they were in special care. I got to breastfeed them on day 4, in a busy noisy NICU ward with a lot of nurses, doctors and parents around from behind a screen on an uncomfortable chair. Tiny baby covered in wires hooked up to machines. This was not good.

They came home on day 14, I breastfed them and expressed. All going well.

Week 4, ended up in A&E on a morphine drip (gall stones) this happened three times in three weeks.

Week 6, emergency gall bladder removal and 3 days in hospital.

Breastfeeding went out the window. Not how I pictured my first few weeks of motherhood!

Bibblebo Wed 14-Aug-13 10:22:50

Neversleepagain, how many weeks were you when you gave birth?
You poor thing, that all sounds very traumatic - I really feel for you.
I am expecting DCDA twins in late Oct. I have a 3 year old and had a birth plan for him.
Although things didn't go exactly to plan, it helped me to avoid a c section as I had researched my options thoroughly. I wanted to remain upright at my will to help labour progress. From quite early on I found myself resisting pressure to just go to theatre. They told me that leaning forward and upwright over the bedstead was dangerous and I might fall. The midwife wanted me in styrups on my back and I tried this briefly to please her and then got straight back up again saying I didn't like it. She told me "you have half an hour to push this baby out or we are taking you to theatre". I had been there since 6am for 4 hrs before they gave me a room (UCH) and then the rest of the day in the room (must have been 8pm when the threats started, busy ward).
When in half an hour I was indeed wheeled to theatre, the doctor said "oh well done! Whatever you have been doing, you've managed to wriggle this baby far enough to avoid a c section". it was a forceps delivery in the end.
I will have a birth plan this time but remain open minded about it all. I just want to remember what my preference was before labor - it's so hard to remember things when in labor. And I'm not opposed to a c section, I just would rather choose if there is a choice. By the way, I totally neglected to take paracetamol or codeine during phase 1 - it never occurred to me! I will this time though, possibly followed by an early epidural but not topping up again and again like last time - baby and I were just sooo sleepy for a week afterwards!

HighVoltage Wed 14-Aug-13 15:05:38

I think Bibblebo is totally right - it's about knowing what your preferences are whilst being open to as much intervention as is necessary.

I had a birth plan with DS1 (water birth, no intervention) but didn't write one down for our DCDA twins possibly because I knew it would be soooo different but did read a friend's which helped me think about and remember my preferences. Also having given birth before I felt a bit more confident about stating what I wanted.

My main priority was staying as mobile and upright as possible as I felt that was the main thing that would aid vaginal delivery. I had accepted that I would need an epidural (friend did not have one and documented she would have a spinal block if required). I was clear I wanted to avoid induction with syntocin if at all possible (it was, they just broke my waters although I had it later after the epidural slowed labour down).

The hospital we were in is v supportive of breast feeding so I didn't feel I needed to state it, but was clear I wanted skin to skin with each twin as soon as possible.

In the end the midwife was the one who made it happen for me - constant monitoring can mean you need to stay pretty still in bed but we had such a lovely midwife who was prepared to chase me round the room in early labour, I was really appreciative. I discussed how I wanted things to turn out with her early in the day because I wasn't in active labour when I arrived so maybe some notes would have been useful if I wasn't so able to speak.

I ended up having a good delivery for both in theatre in stirrups (they wanted to be ready for intervention clearly) but with no assistance, and only a couple of stitches required (less tearing than with DS1).

Bigbird01 Sat 05-Oct-13 23:30:16

I had a really extensive birth plan, but it was really just a wish list of what I wanted to try and I knew I may have to be prepared to forget huge chunks if things didn't go to plan. The main principles were...
I wanted as natural a birth as I could safely have, but I would always take mine or the babies health over keeping to my plan.
I asked the midwives not to offer me any pain relief other than gas and air - I would let them know if I felt I needed anything more. I did agree to have a line put in to my hand so they could put me on an IV quickly if needed later though.
I asked them to let me be as active as possible for as long as possible, including only monitoring when required.
I wanted skin to skin with both babies as soon as they were born unless they needed assistance of some sort.

As it turned out I didn't progress so they had to put me on a drip at which point I asked for an epidural, so then they had to monitor me constantly and I was stuck in bed! The drip didn't work and t1 started to get distressed so I ended up having an emergency c section. But, both babies were born very healthy and were put on my chest within seconds of being born.

Although nothing went to plan I don't feel cheated - the midwives did let me make informed decisions about changing the plan. I think my advice is to try for the birth you want but be prepared to be flexible!

darkdays Sat 05-Oct-13 23:43:42

I didn't have a birth plan. one of my twins had IUGR. So for the last three months of the pregnancy I had to go to the hospital two/three times a week for scans and monitoring. Had aplanned c section at 35wks. I didn't see them for nearly 24 hours. They spent 2 Weeks in nicu/scubu.was great bringing them home. Couldn't get them to latch so I expressed for the first two months. They are now 14 months old and doing great. Good luck OP. Twins are great [grin

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