...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

agree . How Many times have i wryly smiled at first time mother waxing in about their planned natural births who end up with crash c section or forceps

Really? Who do you wryly smile at? And actually how many times has it been? Presumably these women aren’t your friends?

My birth plan was useless as the Midwife’s completely denied that I was in labour until I told them I was pushing! The Midwife then shouted where’s the birth plan as I was being wheeled round to the labour ward at high speed!

Birth plan was would like to try the birthpool. Didn’t happen as midwife wouldn’t believe I was in labour. Birth pools available as far as I was aware. Would like pain relief if requested. Ended up with zero pain relief not even gas and air.

I wasn’t upset that my birth plan wasn’t followed. I was upset that the Midwife’s on the antenatal ward gave zero care and didn’t listen to a word I said and ignored the fact I was in labour!

@my2bundles it wasn’t your birth plan first time round that caused the need for medical intervention, that caused you the stress. Was your stress because you didn’t follow your plan, or because it was a difficult situation medically? And if there was an extra layer of stress that you didn’t ‘get your plan’, do you think you would have felt that way even if you hadn’t committed a plan to paper - because you still would have had an idea in your head of what you would like. It wasn’t your plan that caused your interventions.

My second birth ‘plan’ - agree that preferences is a much better term’ was another of the ‘x if possible, if not then would like to try y next’ variety.

I also used it to very explicitly refuse consent for certain procedures - particularly forceps and to go straight to a c-section instead of an instrumental delivery. Partly because of my age and likelihood of injury, partly giant size of baby, and partly because the midwife for my first birth was pretty hazy around consent (and her command of English wasn’t great either) and I know that under pressure my husband’s instinct is to defer to anyone who works in a hospital. So it was important to me to have written down.

@RightYesButNo I’d prefer to see much more detailed research statistically analysing what was in the plan, vs what were the reasons given for dissatisfaction.

I really wanted a water birth (not just pain relief - to birth in the pool too). I swam almost every day in pregnancy, the day I had my IVF blastocyst transfer I drove to the beach to watch the waves for hours. Swimming was a big part of my pregnancy, emotionally.

On the day, my MW read my plan and said “OK, we have a pool free, the decision is yours and I will support you using it. However, your 9cm on arrival and I think this baby is coming very very soon. You clearly don’t need it now for pain relief in early labour, so it’s all about the birth. You have some bleeding that I’d like to keep an eye on honestly that’s going to be harder for me to do if you’re in the water. What do you think?”

I said - let’s crack on, on dry land then. And I had a very positive experience.

But if she’d said dismissively “oh you’re too far gone for it to be filled in time” or worse “we’ve had to close 3 of our water rooms because of funding cuts” then I’d have reported a high level of dissatisfaction.

I’m interested what they mean by dissatisfaction. My one area of dissatisfaction was a MW on the phone saying “it’s too soon, you can’t come in in a very dismissive war. My NCT leader had told us that one ‘test’ was if you could talk through a contraction, you weren’t ready to come in. I actually deliberately paused and puffed on the phone. I actually spoke ALL through ever contraction - my delivering MW kept taking the piss about it!

Anyway, as above, I came in anyway - and was 9cm on arrival. I would report a level of dissatisfaction because of that.

So in research, I’d rather see an analysis that breaks down: birth plan ‘realism’ (e.g. reference to flexibility), reason for dissatisfaction, and an assessment of feelings about that dissatisfaction.
I still remember being dismissed by the front desk MW - but it didn’t change how I felt about my labour.

How Many times have i wryly smiled at first time mother waxing in about their planned natural births who end up with crash c section or forceps

That seems a bit mean. Do you also wryly smile at first-time mothers who plan on getting an epidural and end up with the anaesthetist not getting to them in time?

Crash c-sections are pretty terrifying no matter what you'd planned.

Why would you wryly smile at that pp

Being encouraged to think about birth preferences means that you're encouraged to find out about the many different possibilities and scenarios. THat's it really. Nobody promises anything.

My mother turned up to give birth knowing shit all, got no pain relief and was traumatised. US friends are just told they will be labouring on their backs as their insurance won't cover anything else. Unsafe birth is a killer the world over. We are so bloody lucky even if the system is underfunded and imperfect.

Type-A people who go into it with a rigid 'it will be perfect when I give birth my way' mindset should ideally be taking away the fact that things can and do go differently and find themselves able to allow for those eventualities.

People who want all the drugs and interventions should be taking away a bit more information about those so things don't just happen to them that actually in retrospect weren't maybe ideal.

People who think 'women have been doing it for millennia without all this nonsense' should quite quickly find it does actually need thinking about, even if the end result is you cough once and the baby comes out.

People who are scared should find comfort in being able to go through some options with a professional and not some faceless internet poster.

People saying there is no point to a plan and the only thing that matters is getting the baby out safely are wrong. The mother is the patient. Her choices matter. Her comfort matters. A plan helps to ensure that she is making the choices.

I thought a birth plan was good because it made me think about things and anything I partic hoped for wanted eg I wanted my children to have "inny" tummy buttons! And you know they nearly ignored this and my son nearly got an outie ... it was just that I happened to reiterate it in my zombified state just in time.

Saying that whilst I hoped for a birth with min intervention, I knew this might not be poss. I think I was unprepared for the whole issue of being induced and what this meant and so on

The midwives at the antenatal class told us the birth plan was to give us a sense of control, something that I was always dubious about.

They strongly encouraged us to make one, to the point that I was harrassed into completeing mine after I was in labour and it was obvious that the things I might have preferred weren't going to happen anyway - like being mobile and not flat on my back.

They also only paid any attention to it at all at times that were inconvenient anyway, like when I was specifically asking (begging actually) for an epidural. That's when they chose to look at it. But the only reason I hadn't wanted a bloody epidural was because I'd wanted to be mobile, given that that wasn't happening what was the point in denying me the epidural.

How many times have i wryly smiled at first time mother waxing in about their planned natural births who end up with crash c section or forceps

Absolutely, those silly little flibbertygibbets with their plans. How much better for them to find themselves subjected to a frightening and invasive medical procedure for a first-time birth. They'll be sadder and wiser women after that, won't they?

How Many times have i wryly smiled at first time mother waxing in about their planned natural births who end up with crash c section or forceps . Not because I am Pleased they had a stressful birth but you have No choice , what happens

actually you do have a choice. I could have chosen not to consent to the high forceps delivery that ripped me apart, triggered a pph and nearly killed me and asked for a section instead. In the middle of labour wasn't the time to give an informed consent. If I had thought through the options and done some research beforehand, I'd have done just that. We educate ourselves and plan for most things. Why sneer when women do it for giving birth.

Absolutely, those silly little flibbertygibbets with their plans. How much better for them to find themselves subjected to a frightening and invasive medical procedure for a first-time birth. They'll be sadder and wiser women after that, won't they? hmm

And they’ll know better than to have ideas about things. 🙄

They never even read mine when I went in anyways!
I always seen them as preferences, then if they didn’t plan out the way I had wanted I wouldn’t be as upset I didn’t ‘follow my guide’

I think it's important that women have a realistic view of birth plans. Ideally, it all goes to plan but various reasons mean it most likely wont.

I wanted a simple one:

Birth pool
Very little pain relief
Quiet environment
Very little monitoring
Natural placenta delivery
OH to be birthing partner
Vit K injection

That's about it really. Anything else would have complicated it more.

The only thing that didnt go to plan was the birthing pool (someone was already in it) and the quietness I wanted was rudely interrupted by my own screaming during each contraction.
Consultant was pleased with my managing of Gestational Diabetes so she OK'd birthing pool and minimal monitoring.

I was happy I was in the right hands, I was being listened to and my wishes were being respected. I was lucky I guess.

I think there needs to be more emphasis on the fact that you can make decisions about your own body. It's vital to have someone there who can back you up on this, just in case you're too tired or weak to convey your decisions. I was adamant I didnt want any intervention unless it was absolutely necessary and every other avenue had been explored. I trusted those professionals but equally important was my experience of what was happening. I think mothers do know more than they're told sometimes.

I think there also needs to be more emphasis on the fact that as long as mum and baby are healthy at the end of it, that's a successful labour. Sometimes pain relief is needed, sometimes it isnt. Sometimes baby needs some help, sometimes they dont. No birth is a failure.

Having a preference is nice but accepting it may not go to plan is the best way forward. Birth can be complex and you have no idea how you will feel or how it will go until it actually happens. Better not to have many expectations of it really.

The trouble is that all sides see birth in simplistic and binary terms.

You get natural birthers saying 'if only you think positively it'll be fine'.

You get others saying 'you have no control whatsoever and you just need to accept that'.

I suspect the reality is somewhere in between but I seriously take exception to the idea that women have no control.

There are some scenarios where a baby is huge, transverse, there's a cord prolapse. Those situations, no, there's no control. But most births aren't drastic emergencies.

I birthed twins, the first of whom was back to back. Mentally the birth was deeply traumatic but physically quite easy. I am sure that the fact that I walked up lots of stairs in labour and refused to remain on my back helped that. I had a panic attack during labour due to the way I was treated, but I am also sure that the extensive hypnobirthing I did helped mitigate that and make it 'just' a panic attack and not a full-on suicidal episode or break with reality.

I was also at risk of hypertension in my pregnancy and advised to have prophylactic aspirin. I ate a religiously low-salt diet, exercised every day, and did meditation. Did that prevent full-on pre-eclampsia? Nope. Did it help keep my BP under control and stop it edging into 'mild hypertension'? Yes, I think so. My BP was consistently 110/65 throughout my pregnancy as opposed to my first pregnancy where it was about 140/90-odd at the end and where I ate and exercised badly.

I think the idea that we have no control whatsoever is wrong and disempowering.

At 17 with my first I was told by my midwife I HAD to have a birth plan. So we spent time going through it. She said I could write in the plan that I wanted the bum injection (sorry I have no idea what it is ) but I didn't want them to tell me when they were doing it because I was very nervous about it.

Then giving birth the midwife told me my plan was ridiculous and as If they could inject me without permission.

Seems they're a bit pointless to me and definitely anxiety provoking

Admittedly I am not one of life’s planning gurus and like to freewheel a bit, but I have always thought these are a complete waste of time and contribute massively to the sense of disappointment women seem to feel when birth doesn’t go to plan - as is normally the way.

I think they should be discouraged. At least until the NHS is able to be more publicly honest about the limitations in what it is able to offer women in their birth choices.

With my first I had PND and PTSD afterwards as I felt like a failure to my son for not having hypnobirthed him out into a pool- so I get it OP.

My NHS hypnobirthing instructor's words of affirmations felt like taunts of weakness and failure. I felt like I put us both in jeopardy, it was me that gave us sepsis and me that contributed to his jaundice because I knew that assisted delivery and pain reliefs gave us a higher chances of having those complications. My hypnobirthing instructor's words of how natural childbirth is and how any woman can have an easy birth if they are strong and trust their bodies felt like confirmation of how much of a shit mother I was and would be.

Now though I know I didnt really have a choice in how that birth went - without going into details.

Also, after losing my second son to sepsis after he was born along with understanding of what happened in both my labours I found my PTSD from my first labour eased.

For this baby I am currently carrying, my birth plan is going to be based around the best outcome to ensure my 3rd son is safely born and stays alive.

I agree with Ariela, birth 'preference' is a better choice of phrase than 'birth plan'.

We all have preferences but realise they're not always achievable; a birth 'plan' indicates something more definite and it could be disappointing if adherence not possible.

When I had mine we had no birth plans, we just did the best we could when the time came.

I have not and would never sneer at women who want a natural birth and don’t get it . Sheesh 😒

Am sadly old enough and ugly enough to have consistently seen that what you want and want you get don’t marry up . Births are highly unpredictable by their nature . Why even encourage a Plan and then disappoint people

And Whilst pallisers says you have a choice - a scared first time mother at 4 am after 2 days of pain isn’t really quite in the optimal position to exercise her choice

The midwives told me I had to make a birth plan, and at the same time constantly told me there was no guarantee they could stick to it. They said it was my choice but then ridiculed me for everything I suggested.
I ended up feeling like I was being managed by people who were pretending to give me a choice.

I agree preferences would be a better term.

What I didnt get was being FORCED to write one by a long stream of professionals who chuckled about things never going to plan and that anything i wrote would be meaningless - my only plan was 'get baby out', literally didnt give a shit how, but i had to write some bollocks which no one looked at because they went on about it so much!