Or is this birth plan okay?

[1997r2017]

Basically, i dont want an extra long birth plan as i feel it will be ignored, also i know that forceps/venthouse could be needed but i feel like they are more likely to avoid then if i just say no.
Is there anything ive forgotten?
Please excuse my writing xxxx

Pengggwn (apologies for mis-spelling the first time), you do not need to buy the book, that was not my point. My advice is coming from being previously involved in a related situation. Obviously, I can't give any details other than to say that the law is very clear: In the event where the mother cannot give consent for whatever reason, her next of kin do not have legal authority to decide for her unless this has been pre-arranged in an enduring power of attorney or similar legal document.

The birth plan communicates the express written wishes of the mother regarding her care/treatment during labour. The fetus has no rights in the UK, Canada and many other jurisdictions until birth (I'm assuming the OP is in one such country). In a situation where the mother is unable to give consent, the mother's legal right to not receive treatment that she has clearly documented that she does not wish to receive, are paramount, over and above the wishes of her next of kin and the rights of the fetus, i.e even if it means risking severe damage to fetus.

So in the example where the mother documents that "under no circumstances do I consent to forceps" or something equally strongly worded and then gets "out of it" during labour for whatever reason, if it comes to a point where forceps are the best option but she is in no position to decide, the legally correct thing to do is to take her to theatre for a C-section, no matter how late in the piece. I am not trying to pick an argument. Categorical statements in birth plans have caused problems. Granted, this is NOT common, but it doesn't mean these problems don't happen ...sadly, they do and with devastating consequences for all involved.

OP - a birth plan is important, you need to know what the possibilities are and what the consequences can be, you may feel strongly about some interventions and you have every right to express that, just don't back yourself into a corner - use the template and ask your maternity care professional for advice with wording if unsure.

By the time we realized we needed the ventouse and episiotomy with my son I had been pushing an hour and he was clearly stuck (shoulder distocia and cord around neck). No way was there time for faffing about for a section, he was out in minutes and no way would I have wanted a section after going through the whole labor. He's perfect by the way and despite the dramatic end I had a wonderful birth experience. (Had an emergency section with my first)

Oh my goodness Steviea88 that's sounds horrendous!

I think it's reasonable to say you would prefer c-section rather than forceps. It means, though, that at the point when labour isn't progressing you'd have to have a c-section rather than wait. When labour is far advanced, or baby is in the birth canal, c-section is no longer possible. There is increasing evidence that forceps can severely damage the mother's pelvic floor. Some countries, such as Germany and Denmark, don't use them at all.

Wow really? I stand corrected!

I think it's reasonable to say you would prefer c-section rather than forceps. It means, though, that at the point when labour isn't progressing you'd have to have a c-section rather than wait. When labour is far advanced, or baby is in the birth canal, c-section is no longer possible

That's a clinical decision, not someting you can write into a birth plan. It's not up to you whether you get a section or not. It's up to you to consent or not, but not to make clinical decisions.

I would have preferred a c-section rather than the forceps that permanently damaged me, but there wasn't time and if I had insisted my dd would not have survived birth.
Your piece of paper is irrelvant when it comes down to it.

That's just your experience hairy. Clinically everyone is different.

Why are you so determined that birth plans are never followed and women never have their preferences met?

I'm sorry to hear your birth sounds difficult to say the least but many women do get a choice and it helps everyone if they've been clear about what these would be in advance.

Good luck OP. I think its good to have something to aim for even if you later deviate.

Better an episiotomy than a tear!

Why are you so determined that birth plans are never followed and women never have their preferences met?

Is that what I said? No. not in the slighest.

When people say too late for a section they don't mean actually impossible, they mean it's got to a point where it's a dangerous option.

A section can be performed at any point before the baby's head is born, but it the baby's head is really low in the pelvis forceps are much much safer for both mum and baby. A section at that point would mean using forceps through the abdomen to remove the head from the pelvis upwards rather than downwards so it would be pointless doing the section to avoid forceps as they would have to use them regardless, if that makes sense.

In terms of high rotational forceps. A c-section is a viable alternative and sometimes they will take someone to theatre, try the forceps first and if not then switch to a section. Some women will prefer to go straight to a c-section.

Hope that makes sense.

I refused consent to Kielland's forceps and had a c section instead, at fully dilated. It wasn't on the birth plan as I hadn't really given much thought to that, but I was able to make my wishes clear at the time. Luckily for me and for DS, he was far enough up (0 station) that a c section was still appropriate. I'm aware that in the case of eg foetal distress of a baby much lower down, refusing an assisted delivery would have been much riskier for the baby, so I'm not saying that forceps can always be avoided, but sometimes they can, and it is good to make your wishes known. If I hadn't declined consent, they would have attempted to rotate an 11lb 9 oz baby with a head off the centile chart in deflexed OP position. I'm sure that in our case I chose wisely.

The fact is that if the correct clinical option is forceps, you can't just have section instead, just because you'd prefer it. If it's not safe, the dr won't perform it. You need to understand this.

By the time you get to forceps/ventouse it is too late for CS - the baby is only coming out one way!

We can all dream - just be glad that the aim of everyone is to have live Mum and live baby. If I had not agreed to forceps for my first, neither outcome (for me and for baby) would have been certain.

That's not true Harry. A woman has the right to refuse ANYTHING even if it's the correct decision, as long as she is aware of the potential consequences.

If someone refuses forceps we wouldn't just force them to have them! We would be trying to get the baby to deliver without them, if low enough, or going for a c-section if high enough. If it became an emergency situation we would explain this and make sure the woman was aware her baby was at risk but if she continued to decline they won't be done.

That's not true Harry. A woman has the right to refuse ANYTHING even if it's the correct decision, as long as she is aware of the potential consequences

Would you listen? My point was that the DOCTOR has the right to refuse to do a plan that is not safe or appropriate. Of course you can refuse the forceps, if you want. And the dr can tell you that if you refuse your baby will die. And you can say you want a section all you like but if it's not safe to do a section they will not do it.

If the baby is in danger and needs to come out and the woman is refusing forceps and she has been told how dangerous it is then yes the doctor would do a c-section as while it's unsafe it's safer than doing nothing. We would make sure the woman was aware however that a c-section at that point is dangerous. That's assuming the baby is low. If high than a c-section is just as safe as forceps and so it wouldn't be an issue.

I think it also depends on the hospital you go to, the midwive you have, the doctor on duty as to whether they pay attention to the birth plan. I see on here that some people were fortunate that they had midwives to paid attention to their birth plan.

Better an episiotomy than a tear!

Why?

The episiotomy might be unnecessary if the HCP is a bit trigger happy, it might be bigger than a tear would have been, it might be in the wrong place... the evidence for episiotomy isn't great. It's not clear at all that they are all that beneficial.

I'd rather deal with a tear than trust someone to cut me in exactly the right place to the right degree at the right time.

My midwifedid look at my birthplan - so I really think it is worth doing.
If I have another baby I will definitely make another one.
I think you should stress that you want a c-section over forceps.
I think forceps are sometimes viewed as the quicker, cheaper option over a c section so it does not hurt to get your preference down on the record. That's not to say that forceps won't be used but having a written document might make it more likely that they might opt for your preferred option if a c section is workable in that situation.
I also put that although I would try for a natural birth, I was very open to all forms of pain relief. I think that helped them take me seriously when I said I wanted an epidural.