...to say that birth plans contribute to womens unhappiness around labour?

[CAG12]

Ive read a lot of threads and a great deal of women seem to be unhappy because they didnt get to stick to their birth plan, for many reasons spanning from medical to facilities not available etc. Should women be encouraged to have a loose plan of how they want their labour but also encouraged not to set their heart on it?

Im 23 weeks pregnant and I know ill be asked about my birth plan soon by my midwife. Just gathering opinion! Thanks for reading

I have always thought that 'birth preferences' would be a better term than 'birth plans'. Plans are so final, like plans for an extension: you put the wall here, the windows there and there. So I can see that if the plan doesn't happen as you've drawn it up then you're set up for disappointment.

Preferences seem, to me to be more flexible term, so 'if this happens then I'd prefer that choice but accept a different choice may have to happen if some other circumstance comes into play'

I think it depends on your personality.

For some people having a birth plan provides reassurance before birth, even if they don't eventually stick to it.

I do think that there are others who unfortunately beat themselves up and see themselves as a failure somehow, if they don't managed to stick to their birth plan.

In my view however, a lot of that has it's origins in the fact that medical intervention in birth has been demonised by some people. The sort of people who suggest women are failures if they have c-sections for example. Women end up judging themselves by unfair standards.

I had a birth plan because I was very firm on my decision to have a natural birth. My heart was set on it and thank God it went as I planned. When you're in labour you are in pain and don't have the energy to talk to midwives about your choices such as what position you want to take during childbirth, do you want baby's umbilical cord to be cut straight away etc. If you have strong preferences about your birth then I'd advise you write out a birth plan to avoid the midwives from doing anything that you wouldn't have liked them to. But you also have to be reasonable that in certain situations plan needs to be changed for the sake of your own or your baby's health.

my birth preferences covered various eventualities. It didnt make me feel disappointed with how things went but gave me a semblence of control in a situation where i basically had none. I stipulated how long I wanted them to wait before cutting the chord for example.

I think that’s exactly what is encouraged: a loose plan.

I agree with you @Ariela should be called "birth preferences".

The plan sheet I had to complete was really just preferences with things like do you want students attending, what pain relief would you like and do you want vitamin K. It didn't ask me about what position I wanted to be in or whether I wanted to walk around.

It’s a good time to state your preferences in black and white. For instance, I declined instrumental birth and indicated I wanted to go straight to Csection if things went pear-shaped (and that’s exactly what happened 🤷‍♀️)

If midwifes/hcp’s who are helping with birth plans would ensure that women know it is just a loose plan and a tool to allow them to question things they don’t understand/feel comfortable with it’d probably cause less anxiety.. I do remember telling my midwife on the induction ward that I hadn’t filled it in yet.. and even after I was handed over to someone else no one looked at it anyway. Fortunately I hadn’t filled it in as I didn’t mind, I would’ve liked to have had a drug free intervention free birth but I also didn’t know what the pain would be or how long it’d last so I decided I didn’t want to box myself into anything. I did however mean to write that I was open to most things.. but i gave birth two days before my antennal class where we’d fill it in.

@Anessia would you have been upset if your home birth had not been able to go ahead?

I think there is a thin line between thinking about what might suit you best and trying to control what happens in your labour and being disappointed when you cant. It is hard to tell which it is when you're speaking to someone else and that's why my thread about my own birth plan isn't bothering my when people say I am naive. I've done the research and I'm fairly confident to give it a try without an epidural or doctors immediately available in the building. I have a really good chance of making it through.

I had my children before birth plans were invented. Fortunately, my labours and births(4) were pretty straightforward and uneventful; first 2 in hospital, second 2 at home. And in spite of having largish(8lb 7oz}+ babies I did not need any pain relief for the last 2. I think the problems with having a birth plan can be that if things don't go quite to plan the new mother may feel she has let herself down.

I think a flexible list of preferences is a good idea. There are some things that are your choice, even during an emergency like whether you want your relatives to be banned from the room.

My hospital didn't ask you to make a birth plan. You are asked where you want to labour [labour ward or birth centre] and advised what you can / cannot have drug and intervention wise. I think that gives them a broad idea of what a woman wants (as in the ideal?)

I of course went and did my own birth plan and stapled it to my notes, what a fool I was

Didn't bother with anything other than opting for birth centre with DC" and had the exact birth from my birth plan with DC1.

DC" = DC2

I think you're taking the term 'plan' over-literally, OP. It's more a loose set of preferences for certain eventualities made in the full knowledge that sometimes things don't go according to any plan. I ended up having a CS, which wasn't in any version of my birth plan, and the only things that ever made me feel bad about it were a tiny minority of other people's, in fact other women's responses -- my NCT teacher, who was going around at our reunion asking everyone whether they'd had a natural birth or not and going 'Oh, well' to anyone who'd have interventions (quite a few), and a friend of a friend who said she 'had to correct me' when I made some reference to having 'given birth' in response to someone else asking me which hospital my son had been born in.

And that was more rage at other people's ignorance, rather than any tsking because I hadn't followed my birth plan. My own feelings are that I was thrilled that modern obstetrics had been able to save me and my baby.

Agree.

I think my plan boiled down to "get the baby out as safely as possible for him and me, while causing as little damage and pain to me in the process, and please explain what's going on to me as things progress."

Was superceded by need for an ECS anyway.

My birth plans were always in two parts: first paragraph Ideally, second^ paragraph But If, Then. ^ One side of A4, about 6 statements per paragraph. All clinically relevant, nothing about music or candles.

I never got all of my 'Ideallies', but having my 'But If, Thens' meant that I was prepared for things not going to plan. I was very happy with my Birth Plans, and the midwives considered them helpful, too. My first labour and birthing was horrible and distressing. This was not in any way due to the birthing plan.

I agree the word 'plan' is problematic. Most of us use the word to describe a set of procedures that are then carried out. It's not an event that you can 'plan' in the traditional sense. Preferences would be better.

My birth plan went out of the window before I even got to write it down with the midwife, not even gonna bother with one if there ever is anothe baby.

I think having an idealised 'plan' gives women a false sense of control over a totally unpredictable, individual situation. I didn't write one, just asked that they let me get on with it unless something was going wrong. And they did, I only knew the second midwife was there when she popped her head under me (I was on my knees bent forward) to tell me DD had lots of hair. I consider myself very lucky that I came away with no injuries and not needing any intervention.

I wasn't disappointed my births didn't go to plan. I was disappointed that the midwife team didn't even look at it

LaurieMarlow

That’s interesting. I don’t use the word like that. I use it to mean “strategy” or “*intended actions”. So if it doesn’t go according to plan I make a new one.

I agree that trying to stick to a birth plan in a first birth can cause problems regarding expectations vs reality. But I think it can be useful for clarifying things you definitely know you don't want, especially in subsequent labours. For instance, I absolutely hated diamorphine in my first birth, it made me feel awful and really slowed everything down. For my second, my birth plan basically consisted of me writing "NO DIAMORPHINE" in capital letters on a piece of paper and sticking it to the front of my notes.

I was never even asked about a birth plan. It was literally not even discussed. Then again I rarely saw the same midwife twice, antenatal care was shocking.

No. I think saying making a birth plan contributes to unhappiness is a sneaky way to victim blame women for poor maternity care and outcomes. If the woman had received good care, she wouldn’t give a fig what her birth plan said. She’d have been consenting and aware and 100% behind every decision made during the birth.