Birth plan - ok? Not tooooo long!

[hopingforanother]

Hello

I'm 36+4 with DC2. I feel like this birth has a lot to live up to as my previous experience was really good (I know, lucky me!) and I'm worried that things are going to be horrible because I have to go in to hospital earlier than I want to for antibiotics. I've also had a bit of high blood pressure, which is controlled well (I had the same last time).

I don't really know what I can put in - this is what I've written, does anyone have any comments? Basically I want to be left to get on with it without endless monitoring and without being told what to do (I stayed at home til I was 9cm last time) have I conveyed this in my plan?!

Birth Plan
Thank you for reading my birth plan. I?d like a low intervention, no pain-killer, active labour and am very frightened of being ?strapped to the bed? with continuous monitoring, I would like to avoid this wherever an alternative is safe.

I found that staying upright and mobile was enough to manage my pain during my last labour and it helped things to progress. I was happy to be alone with my birth partner until I got to the pushing stage. I enjoyed giving birth and found my midwife to be very professional and honest, so thanks in advance for all your help.

Antibiotics
IV antibiotics are needed 4 hours pre-delivery due to previous identification of GBS colonisation

Food and drink.
Eating and drinking during labour is preferred if hungry....

Intervention
Minimal monitoring and intervention would be preferred during labour unless there is an indication that more intervention is required for safety reasons.

Preferred positions
Walking, squatting, standing, kneeling and crouching are preferred positions. Lying and sitting are least preferable and if safe, to be avoided. Staying active, upright and mobile is essential to me. If this is thought not to be possible, the reasons and options need to be explained and action agreed.

Pain relief
It would be preferable for no pain killers to be used, staying upright and mobile were excellent forms of pain relief in previous labour. If pain killers are needed, paracetamol is preferred at first.

Foetal monitoring
No continuous foetal monitoring is preferred unless other (i.e. intermittent) monitoring has indicated this is necessary.
If additional monitoring is necessary, as much mobility as possible and an upright position i.e standing should be retained and encouraged to help things progress.

Placenta
A managed 3rd stage is fine. During my last labour, the placenta was delivered in a managed 3rd stage after 45 minutes ? i.e. a little longer than normal but with no problems.

i dont think its too long. i would say you dont need to mention the GBS thing, there should be a big yellow sticker on the front of your notes.

i think you need to think about yr views on other pain relief should paracetaml not be enough. ie i didnt want pethidine to avoid sleepy baby.

bring your own food n drinks just in case, also some fr birthing partner!

finally make sure your birthing partner knows you birth plan too they may be critical in making sure your wishes are met.

I'd make sure you're knowledgeable about the different forms of pain relief, so that if you need more than paracetamol, you know what you would like to try (e.g. happy to try G&A, would really prefer to avoid pethidine because of the time it takes to be broken down and would really like to avoid epidural but if needed definitely want a mobile epidural).

Some of it seems a bit obvious to me (but I'm no expert!)...e.g. surely most women would prefer to have minimal intervention.

Also, on food/drink, I'd be more dogmatic about food/drink being available if you want it, unless they feel you may need a CS, in which case you would prefer clear fluids to remain available.

Definitely make sure your birth partner is confident with it...and knows what you'd like them to do if you start asking for pain relief (e.g. say "no", ask "why?", ask you to wait 10 minutes, or just let you have it).

Thanks for your feedback! That's helped me set things straight in my head.

I do have some big stickers on my book - but amazingly, when I was talking to a doc involved in my care, who had my book in her hands and had just been 'reviewing' me- they said 'what antibiotics?'!

I have snacks available to take with me :-) I'd quite like to chuck the babygros and shampoo out to fit in some more actually...

Yes you would think it seems obvious that most women would want minimal intervention, but I'm confident about getting on with things in the same way as last time and my worst nightmare is getting stuck on a bed, not being allowed to move about and then it cascading from there, so I feel I need to say minimal intervention in my plan. If nothing else, to make ME feel better...

I am struggling with the idea of pain relief a bit, I don't want G&A, pethidine or an epidural and I am hoping I can get away without anything again - it may or may not be a realistic goal, but I think I need to keep it in my sights and see what the need is if there is one. I know a bit about all three so I have the facts to hand should I need to do something around pain in the end.

Thank you!

aah babygros- don't get rid of them! you reminded me of something i wish i knew before i had my DS- or had figured out....

you need to pack enough baby clothes for the 2 days you'll be in hospital for the post birth GBS checks they do on baby. i just packed two of each, as most lists on teh web said, but didn't realise that they're written for ms average who leaves hospital within hours of birth

my DH had to nip over to tescos to pick up some more after two pooey incidents left us a bit stuck!!