to ask if you had a birth plan?

[user1467032004]

First of all, I was going to post this in childbirth but it isn't very busy and thought I would get more responses in this topic. Please move if not allowed.

I'm an avid reader of the Baby Bumps sub on Reddit and noticed that a lot of the woman have birth plans prepared for the hospital. I know that in the US it is different - a lot of people pick and choose what they want to happen in labour. Some women type up massive lists of instructions and others simply make diagrams. A lot of effort goes into these! Most of the time the birth plan seems to go out of the window so I'm unsure if there's even any point.

Do the NHS offer an equivalent? We really want to start trying for a baby but are doing some research first!

P.S I've attached a birth plan I seen on baby bumps so you can see what I mean.

Mine is along the lines of do whatever you need to deliver my baby safely and keep us both alive and well. If I'm not able to hold the the baby he is passed to dad instead.

Birth plan for DCx3 all the same.

Want to birth on hands and knees don't try to put me on my back.
Entonox only ... No other drugs as I wanted to breastfeed.
Check progress only in established labour (I'm not a fucking puppet --added this after DS2 as MW thought I was Orville!!)
Baby straight to mum with cord attached
Vit K okay
Natural placenta delivery .. No injection.

I wanted to breastfeed desperately as I'd done my research and also had a nephew who 7 when DS1 was born and my DB and his DW used to constantly argue about who was going to make, was and cool bottles. They used to get me to do it and what an absolute pain in the arse doing that constantly.
All went to plan and had really easy births but DS2 was born a little grey and cried from the second he was born .. Constantly. He refluxed from birth and had no suck, swallow breathe reflex so was tube fed still is now aged 7. Has lots of disabilities including CP. that midwife was struck off 1 year later thank god!

I didn't bother. Maybe if I had things would have gone better, or maybe I'd just be more hacked off at what did happen.

I think a birth plan is useful so that you can think through the pros and cons of various options, and absolute no-nos so that you don't have to take in lots of new information and make a decision in a crisis. And while you can't have control of how your birth goes, you can control the environment to give your body the best chance of getting on with labour.

So my birth plan (for a home birth) was roughly:

No routine internal examinations.

If there are any internal examinations, don't tell me how dilated I am.

Don't offer pain relief, but have gas and air available if I ask for it.

If you think I am likely to need to transfer to hospital, let me know asap, as I would prefer to transfer at as early a stage as possible.

Keep cord attached until after placenta has been delivered.

Placenta to be delivered naturally.

Skin to skin with me immediately after birth, and baby to be allowed to crawl to the breast.

If skin to skin with me is not possible, skin to skin with the baby's father.

Do not give the baby formula milk. If supplementary feeding is required, please use expressed colostrum/donor milk from x, to be given by syringe/cup/tube as appropriate.

Hmm, well my birth plan states no pain medication aside from gas & air in the later stages if requested, and I'm quite sure I'm in my 'right mind'! I have my reasons.

I think more than anything, writing a birth plan encourages you to do your research. It's quite valuable to know stuff. Even if it gets discarded during an emergency, or you've changed your mind halfway through and want all the available drugs known to woman, you're more likely going to go into this well-informed and aware of your right to withdraw consent etc. Which is important.

user to answer your question re. choosing not to breastfeed from birth, this is exactly what I did with my 2nd and 3rd birth. None of the midwives or doctors I met seemed to care, either way.

My birthplace was to have a water birth. I also wasn't going to have an epidural unless the pain got too bad.

Well my labour was too slow and I could not have a water birth as that would have slowed it down even more and I was managing without the epidural until they started talking about inducing me.... which I knew would make the contractions more painful, so I requested an epidural.

The main thing is to keep an open mind and your goal is to deliver a healthy baby however it happens.

I had one, it wasn't rigid by any means completely open but even that went out if the window.

The only thing I was adamant about was no pethadin

I spent 3 days going over every last detail of my birth plan, it was all presented in a well writer 3 page document detailing everything for every occasion even if something happened to my DS
Then when it came down to it, it all happened that fast 1cm to 7cm in the space of an hour that my birth plan was totally forgotten about

Only skimmed thread but OP you will find a lot of ill-informed smuggery around birth plans. People say stuff like 'oh I just wanted to be alive at the end'. Like yeah, cos everyone else doesn't want that.

Some labours - some - go catastrophically wrong. And you should bear in mind that might be you, and go with the flow if necessary.

But. You can also roughly plan some things in advance. I don't like pain relief. I decided I didn't want any in advance. I stuck to that, even though it was difficult. That doesn't mean I get a medal, it just means it's possible to have a roughish plan of how you envisage stuff happening, and it can work out.

Also, some people have stuff they just cannot tolerate except in absolute emergencies. For me: no VEs, forceps, and no unnecessary people in the room. I.e., no students. Most women wouldn't want forceps if they could avoid them, but would rather that than EMCS - I'd only accept forceps if there were literally no other way of giving birth. A birth plan can communicate stuff like that.

hic birth is messy so surely lamination is a good idea?

I had one. It wasn't rigid in the sense that I knew things might not go to plan but it was quite detailed. In the end my birth experience bore no resemblance whatsoever to my plan. That was nobodies fault, just the way things panned out. I know that the midwives (three day labour so I had a few!) did read my birth plan and attempted to act in accordance with my wishes but several of the things I wanted just weren't possible as it turned out to be a difficult delivery and DD was quite poorly and had to be whisked off to SCBU.

I had specified that I was ok with students being there and I'm so glad I did. I had an excellent final year student midwife who never left my side and was a fantastic support.

People say stuff like 'oh I just wanted to be alive at the end'. Like yeah, cos everyone else doesn't want that.

I'd go as far as to say comments like these usually insinuate that women with detailed birth plans and preferences for their labour are selfish and only thinking of themselves. Which is deeply irritating.

I had a birth plan for all mine. But it was in my head. It was flexible and more like a decision making guideline than a plan. I did tell the mw things that were important that she needed to know like not cutting cord immediately unless it was urgent etc.

yes - for all 3, getting shorter and less demanding each time :) third one was something like, get baby out in one piece, give to me for a cuddle when you can.

not worth the paper theyre written on in less you ae incredibly lucky!

The most useful things that I had on mine were the things that meant the midwives knew how to approach me.

• I'm happy to have students observing / involved (student ended up delivering DD).
• keep me informed about what's happening - I'll let you know if I'm getting overwhelmed.
• feel free to use technical language - I'll ask if I don't understand.

I tore quite badly right near my urethra. That's what the midwives told me, as they explained that I'd need stitching by an obstetric registrar. Said registrar clearly hadn't read my birth plan and starting talking about my water works or something like that. No, it's my urethra.

I like to think of it as being like a shopping list. I plan my meals for the week and write a list of the things I will need to buy.

It might not all go plan - the shop might have run out out of broccoli, so I might get a cauliflower or cabbage instead. And I might be ill one day and replace one of the meals with beans on toast or tinned tomato soup.

But if I don't write a shopping list and just wander around the supermarket without having thought about it in advance, I end up with a load of crap that I don't really need and forget to buy something essential.

That's what a birth plan is, really. It's not a guarantee that everything you want will happen, but a way of thinking through the options and what-ifs in order to (a) make your ideal scenario more likely to happen and (b) help you to get the best outcome Shen things don't go according to plan.

dolly I think that is a very sensible approach

mavis agreed. Some women literally don't care what happens as long as they and baby are alive. I imagine that women who have sadly experienced losses may feel this way

But birth can have huge long-lasting MH implications that go on for a long time afterwards. Thinking about how to avoid upset or trauma in advance may be helpful. I think it's entirely healthy to think 'WWID in x situation?' and 'I think y procedure would really mess with my head so I'll the staff so they can avoid it if poss'.

I don't see why people think that's unrealistic/ precious - I think you probably do have some degree of choice/ control during most births.

I had a plan for my first but had none for my second because the first time went very wrong.
I had a romantic image of it all going to plan and being lovely but it was nothing like I imagined..in fact I didn't even care about the plan once I was in labour,...which lasted 37 bloody hours...

Mine was pretty much 'get baby out safely, give baby to me. Don't give me pethidine if it can be avoided.' (I know more than one person who said it made them feel really spaced out and weird). Good job I didn't have a detailed plan as everything went wrong!

I didn't have one with my first, on my second it was simple - get epidural. I am lucky that both births went how I wanted. No stress, minimal pan, pushed them out easily, no stitches, two healthy babies, home early the next day.

I know that lots of people aren't fans of epidurals and try to avoid them but for me it was the right choice. On my second the midwife tried to talk me out of getting it because I was coping fine without but I didn't want it to get to a stage where I couldn't cope and she respected my wishes.

I had preferences written down; delayed cord clamping, skin to skin etc. I also had the standard water birth, no epidural nonsense as we'd done NCT - I had an EMCS and strongly recommend all the pain relief going! If I could do it over (assuming a normal delivery) I'd have had more of a 'see what happens' approach. I was trying to control something that cannot be controlled!

succulent see I think that respect for your choice is so, so key. That's why I think plans are valuable as they let you think thru choices in advance. My best friend is just the same - she wanted an epidural as early as they'd give it to her, so she could stay calm/ focused!

Me, I was thoroughly terrified of interventions and didn't want to do anything that might increase the risk of them.

There is no right way to give birth but there IS a right way to handle a woman's choice during it!

I put in my birth plan no opiates, skin to skin asap after the birth and under no circumstances would I consent to an episiotomy.
I got my wants for my 3 births but ds2 struggled at the end and needed a few puffs of O2 to get him going and I had to wait for the skin to skin.
You need to have a strong advocate, DH had to tell the dr for my first birth to was his hands after he went to examine me without washing his hands first

I had a very long induction with #1. My birth plan for #3 stated quite clearly that I would not consent to induction again unless I was very favourable (Bishop score in double figures). If not progressing, skip induction and go straight to cs.

Given that I was planning a very crunchy home hypno water birth, the mws and DH were very surprised by that preference. If I'd first expressed it during a failed labour I think I'd have been dismissed and/or overruled; as it was I had long reasoned discussions before the big day and had it in my notes. Fortunately my body and DC3 obliged me.

I gave birth 3 weeks ago and had birth preferences (not a plan as that raised expectations!). My preference was for an active birth where I actually birthed in the water. The other option was an elective c section. I made it abundantly clear about my anesthetic preferences as I have an irrational fear of the washing up feeling. This was agreed with the consultant in advance and was the most important element of the preferences. As it happened I was at home all day and got to hospital at 9.5cm dilated, got in the pool for the final hour and gave birth to a beautiful baby girl in her amniotic sac!!! I had plans for aromatherapy, food, music etc - everything was left in the car as things went so quick, but I managed to listen to my hypnobirthing which kept us calm and minimised tearing.

Do a plan/preference but remember things may need to change or not go as you expect. My baby ended up in special care so rather than wait to deliver placenta I had the injection so I could see her quickly! We were also in hospital for 6 days but this gave us time to bond and get the much needed breastfeeding support!

Congratulations and good luck x