to want the down to earth experience of MNers to help me write a birth plan

[dozyrosie]

Bit of background. I previously posted re antenatal classes, I went today and it was a bit of a shambles tbh and most of it was just common sense. So I could do with your help, you last advice was great.

I'm 32 wk pg with DC1. I'll be under consultant lead care because of epilepsy. I still get a say in how things go, unless I get badly affected if I have a seizure, in which case I'd have to have an emergency C section. Obviously I want to avoid this at all costs. My epilepsy is medically controlled atm so fingers crossed I'll be OK.
I know that if you get to follow your birth plan exactly then you are lucky. I certainly don't intend on having a rigid birth plan and my initial plan was simply; do whatever it takes to give me and my DC as safe and quick delivery as possible. But now the more I think about it and read the more I'm not so sure what to do.

With the benefit of your experiences, what would your birth plan be?

I have no experience of epilepsy so please forgive me if I sound daft. Are there any drugs you won't be allowed to use? And how do you feel about drugs as pain relief on the whole? These things are vastly important. If you are against mind altering (ie pethidine) then this would need to be made clear.

With my last child (dc3) I didnt write a plan-but I went into the labour room and discussed my plans with the midwife as soon as I got there. Luckily I had a fab midwife who not only listened but also respected my wishes and gave me the birth I wanted.

Ask them to give you scan before you go into labour to check the position of the baby. If the baby's posterior, breech, cord wrapped twice round the neck, etc., you know in advance and can have a plan, esp if you have obstetric led care. If all's well just go with the flow but i would be minded to insist on a named and experienced midwife.

My birth plan was:
stay mobile as long as possible
to not have an epidural
to avoid stiches at all costs (!)

all went to plan :)

in my experience, keep your birth plan as brief as possible.

Hi .. Ok well i think from my own experience i would write anything you defiantly dont want .
For me with my dc2 this was no meptid/pethedine because i felt with dc1 this slowed down labour and made me feel out of control.
I would perhaps write if you want baby to be put straight on you before being cleaned or if you want baby cleaned first .
You have the right idea with nothing too rigid because obviously sometimes things have to be done to ensure mum and baby are safe.
I cant think of anything else right now.
Good luck with everything

What was important for me was

• to be able to be upright and mobile as much as I could
• to avoid continuous fetal monitoring
• the option of an epidural if I wanted it
• to avoid a cs unless it was absolutely essential

Is it possible for you to speak with your epilepsy service to ask what they would advise/recommend for you?

Hi rosie,
I had no birth plan with DS and was very much of the school of thought that the less I knew the better so didn't have any plans til my waters broke! I started in the bath at home for about 3 hours before I left for the hospital 2nd time (after being sent home after waters breaking) and then spent alot of time in the hospital bath before transfering to the water pool. I would have happily stayed there to give birth had DS's heart rate not dropped and had to get him out quick! strangely enough before my waters broke I was adament that a water birth sounded horrible but the bath and pool were lovely very calming (well as much as they can be when your giving birth!) and a bit of a distraction from the birth process!

I think best laid plans and all that means you should not rule out anything yet, pack a bikini top and do what you feel like at the time! might help also if your epilepsie is stress related?
Good luck!

Best birth plan:
Be ready for anything because anything can happen.
do whatever it takes to give me and my DC as safe and quick delivery as possible this sounds like a good plan.

I agree with keeping it brief. Mine was:
Stay mobile
Use non invasive methods for pain relief eg water, massage
Gas and air if I needed something more
Avoid epidural if I could manage the pain without

Don't be too prescriptive as ime the women who wrote ten pages detailing everything, are the ones who end up doing the opposite

Ask them to give you scan before you go into labour to check the position of the baby. If the baby's posterior, breech, cord wrapped twice round the neck, etc., you know in advance and can have a plan, esp if you have obstetric led care. If all's well just go with the flow but i would be minded to insist on a named and experienced midwife.

This might depend on where you live. I am not aware of units that will offer a scan for position on request if not clinically indicated (not saying it won't happen just not aware of it). Also you might not be able to insist on a named midwife (often it will be who is working and available at the time - unless you are in an area that uses caseloading approach.

That said, ideas might include do you want students present, who is to cut the cord, do you want active management third stage, vitamin K for baby?

When writing your plan keep it brief. You don't know how long you'll be in labour and if a new shift of MWs/consultants come on they might not bother to trawl through 2 sheets of A4 (seriously, I have seen this!)

This was mine:

Pain Relief

? TENS ? Plan to use, have own unit
? Entonox ? Would like to use
? Pethidine ? Happy to consider if feel I need it
? Epidural ? Avoid unless feel necessary

Post birth

? My husband would like the option of cutting cord if possible
? Would like baby to be put straight onto my tummy
? Happy to have injection to help with delivery of placenta
? Happy for baby to have Vitamin K injection
? Plan to breastfeed, would appreciate help with getting started

If I am too overwhelmed to make a decision, please discuss any issue with my husband as we have already discussed my wishes.

Marriedandwreathed Where I am you can't have a scan for position on if not clinically required.
Neither can you insist on a named midwife, though you could say that if XXX is on shift you would like them.

Mine would be "play it by ear"

quite simple and flexible enough, I think

I was under consultant care because I had pre-eclampsia and induction both times, and played it by ear, but I refused in advance an episiotomy. My (Ex)H had to disarm the midwife the first time, but the second time I was very clear!

First birth plan: I didn't write anything. I had no experience of the process so I just went with the flow.

Second birth plan: In the box I wrote, in my teacher's red pen, DO NOT LEAVE ME ALONE FOR THE FIRST HALF AN HOUR AFTER BIRTH as they had done that the first time around and I'd nearly bled out when they didn't realise I was heamorraging.

what dialm said.

After a premature, induced labour due to pre-e and IUGR, that lasted 38 hours and had everything go wrong (except the ultimate outcome) all I wanted second time was a healthy, happy baby.

Surely that's the only birth plan anyone wants.

My MW said (about an hour before I gave birth, as it turned out) "have you got a birth plan?" and I said no, I didn't see the point, to which she said "yes, you're better just to take it as it comes, really". IME people who have had very firm ideas about their births have felt terribly let down afterwards, whereas I stayed wilfully naive (no OBEM for me!) and was pleasantly surprised.

What DialMForMummy said. And anything you definitely don't want.

My first birth plan was quite detailed, and pro non-invasive techniques.

My second one was along the lines of:

Any pain relief except pethidine, if I ask for it.
I haemmorhaged a lot last time so please watch out for this.
Do whatever is best for me and the baby.

You cant plan for what you dont have any experience of, so go with the flow is probably the best thing unless there is something that you 100% about such any treatment you must or mustnt have due to your epilepsy.

I only wrote one for my last (6th) baby because the MW insisted, I didnt want to as I knew from experience what a waste of time they were! And true to form it wasnt glanced at afaik!

Make sure that you discuss your plan with your dh/birth partner, as when you are in the throws of labour he will be able to stand up for you when you are potentially vulnerable.

Even if most of it will be play it by ear, you may still have some definates that you want him to stick to. Mine with dd2 was no students after I got so peed off during dd1's labour with being essentially ignored while they were busy with the students.

I'd agree with the general go with the flow sentiments. There are some things I'd like different if I ever have another.

I'd have to say that the mothers from my Anti natal class who had the most detailed plans seemed to be the ones who had the most problems afterwards, eg feeling "cheated" about the experience. Especially the first time mums. There's a lot of guff written about what a beautiful experience it all is, and these mums I knew didn't really spend enough time on the possible problems, and so were not prepared for it to be anything other that that beautiful experience......

Buy this
www.amazon.co.uk/Orgasmic-Birth-Elizabeth-Davis/dp/1605295280/ref=sr_1_2?ie=UTF8&qid=1323207224&sr=8-2

I was acting cool but was freaking about the birth until I read it and I think you can you can apply the principles with your birth. I was expecting to give birth at home in a birthing pool but ended up in hospital with 2 midwives on a bed. I also nearly didn't make it to hospital and had to climb 4 flights of stairs to reach the maternity ward (the lift was out of order) turns out I was also fully dilated whilst doing this. I recall the birth of DS with such happiness and I think it is really down to the book.

Good luck with your birth :)

icooksocks I'm allowed any form of pain relief I want, so will be having a combination of gas, pethidine and epidural if needs be I'll get high as a kite.

maxpower I have a specialist epilepsy nurse but she will only advise on epilepsy related issues and will not advise me on labour.
grumpydwarf Extreme stress combined with extreme fatigue may trigger a seizure. So I aim to get as much sleep as possible in the latent stage with help of pain relief. I also want the delivery room to be as calm as possible. DP is a star and great at keeping me calm if I feel a seizure might happen. I would be aloud to use a pool in the early stages but not when it comes to the push as it's to much if a risk if I did have a seizure.
marriedandwreathedinholly I have a final scan booked for 36 weeks but they probably won't do another one later.
callmemrs My friends plan was huge and paned like a military operation. Luckily she got to follow it as her labour was 6 hours long and felt like "just bad period pain" It's good to know that every one thinks I should keep it brief, simple and open as possible.

Do any of you think I would be UR to ask for...
-An induction as I feel this would help me to be as relaxed and rested as possible in advance. Do hospitals even allow you to have an induction on request?
-To stay in what they call an LDRP room on the NHS birth plan template (scroll down to the special facilities bit), if they don't have one then ask to stay in the room till I go home.

Dozy We have a MW led birth centre and then a LDRP unit within the main hospital. I think newer hospitals have LDRP units and older hospitals are less likely to, my old hospital was built in the 60s and it had a labour ward but women only stayed on that until shortly after the birth then they were wheeled around to the PN ward and if it was night time the husbands/partners were told to go home.

You need to find out what your hospital/area can offer, you may be able to pay for a private room within the normal labour/PN ward even if there are no LDRPs.

An induction might actually increase your likelihood of a seizure if tiredness and stress are triggers. Induced labours (particularly first ones) are notorious for being longer and needing more pain relief and intervention. Natural labout would be your friend here I think.

A private room would be a good idea, you can pay for them in some hospitals, especially ifthey dont have a LDRP room and you need to stay in.

I think they are called Amenity rooms or something.