Midwives Attitude to Birthplans

[Hermya321]

I went to my first antenatel class yesterday at my local birthing centre and it came round to discussing labour, all was going well until someone mentioned birth plans.

The Midwife started then talking about how pointless birth plans were and that she'd rather chat to people rather than get paper shoved in her face (now I can understand the bit about paper not being shoved in her face).

She then continued on her rant about how useless they were and that she wouldn't go to a mechanics and tell them how to do their jobs, and that she didn't appreaciate being told how to do hers.

I did find it a bit bizare to be honest, maybe I'm being naive but I thought the majority of midwives encouraged you to write a birth plan.

"you know, the ones they don't even tell you about or are even in childbirth books."

erm, like what. I am scared!

I'm sorry, but 'strict instructions about where to site a canula'? 'Please do NOT offer me any pain relief, if I require some I will ask for it' - It's a bit "talk to the hand".

My birth plan is, I want a safe delivery and a healthy baby. Do whatever you have to do.

made me laugh. You can't control how your labour will pan out, talk to your partner about what you would prefer if you think you will become incapable of communicating for yourself. But the whole 5 page long laminated birth plan thing. Really?

That would my birth plan also crumpetsolo. For medical staff to do what they have to. If it came down to medical intervention or a dead or injured baby, I know what I'd choose.

To each their own but will you really still remember or care that the MW told you your baby's sex when you go their graduation?!

My hospital had an antenatal appt set for writing a plan - basically one side of A4 to help when new staff needed to get up to speed in labour. The MW said as long as it's expressed in terms showing you understand that births don't always go to plan and the facilities may be limited, they should follow it.

I went through over 50 staff by the time ds came out so was really glad they were all aware of allergies, disabilities and what they needed to know about them, and that I wanted explicit consent for anything involving touching me. Well worht doing.

I really hope that people who trust blindly that all hospital staff will be both willing and able to act in their best interests, find that this trust is well placed during their births.

In reality, many doctors and midwives are overloaded with work, bound by hospital protocols (which may not be evidence based) and afraid of being blamed when things go wrong. They do not all have the time or energy to focus on you as an individual and human being rather than just a patient / someone taking up a bed. A handful (just like in other professions) are careless, arrogant, insensitive or downright callous.

An indication of preference, and demonstration of some level of understanding, is likely to be helpful to the first category. I hope it would at least prompt the second category to think twice about the standard of care they offer.

I'm sick of hearing stories from friends and relatives who went in for hospital births with total faith that someone else would do what was best for them, only to have a hellish experience of birth and aftercare.

The only positive birth stories I hear IRL are from those who took some kind of responsibility for themselves, whether it was in terms of writing a well thought-out birthplan, engaging with their consultant to fully understand and negotiate birth options and risks, or choosing homebirth.

Of course you can't control birth. However, you can express preferences which will make you more comfortable, you can minimise risks associated with certain interventions, you can (and should) think about the most important decisions which might come up and make them while your head is clear.

I found that my birth plans were taken seriously and were useful both times I gave birth.

I think the important thing is for a birth plan to be flexible and realistic. Ie. mention the important things and go with the flow for the triva. A good birth plan can be read in about 10 seconds flat.

For example it is quite important for a midwife to know that a woman has Symphis pubis dysfunction and has been advised by an obstetic physio on birthing positions. Ie. deciding to be on her back is not a middle class fad, but is done to prevent long term disablity.

Writing a birth plan is a brilliant way of thinking through the issues before you go into labour, and covering the essential points for your birth partner and MW.

I think birth plans should address the reader (MW) politely, as a professional.
They should not use language that implies there is no room for debate with the mother (e.g. the episiotomy vs bad tearing discussion).
They should include useful information for the medical team (allergies, details of medical conditions or medication, needle phobia etc.).
They should document decisions (such as Vit K injections,mangement of third stage) that the mother has already made, and choices e.g. wishing father to have skin-to-skin contact in the event of an emergency CS.
Keep it to one side of A4, in a legible font size. You want your MW to be able to quickly read and understand what you are talking about, and to realise that you are wanting to be helpful not adversarial.

The most important thing to remember when preparing for birth, is that you and the MW have absolutely no idea what the baby's birth plan is so you need to have a very flexible approach to events otherwise I think that disappointment/guilt/blame becomes more likely.

I wrote a birth plan for both my births. The MWs followed what they could, some of my ideas changed as we went along. But I still felt I had had control and influence of the course of events - even if things weren't exactly happening as I would have dreamed.

What togarama said.
It is your baby. It's best not to blindly hand your responsibility over to other people (like I did the first time round ).

good post togarama.

I get annoyed by people say there's no point having a birth plan. Of course you can't always expect to get the birth you want and you do need to be flexible but far too many people give out the 'advice' that there's no point or that it will all go tits up anyway. I wonder, and this is something my mum said recently, if people who have bad experiences just like telling women that they will have the same?

It's good to find out as much as you can about birth and all the things you can expect, imo, and writing a birth plan can help with that process.

I didn't write a birth plan and as it happens I didn't get chance to even get my notes out as my labour was so quick!

May be the midwife actually meant that so many people change their mind so the plans become redundant.

Or may be some women feel that they have written it down and as such can't change their minds...

[shrugs]

Also, many people put things like "no episiotomy unless necessary" What? Do you think the midwife is desperate to cut you?

ok - I don't even know what a Canula is

looking it up - it's something to do with an Epidural, right? Or do you get one put in 'just in case'?

birth plan is a wish list,you have to be adaptable and realistc about labour

Canula is the needle that is put in to give fluids etc. Usually left in for other fluids or medication.

ok - is a canula routine?

cannula is only used to deliver/remove fluids.should oly be used where clinically indicated

Good link crumpet!

sorry - I am probably being really thick. I am guessing the Cannula is the same thing I had when I had the IVF, put into my hand so they could give me the sedative for teh egg collection?

No a canula is only really used for C-sections or if you are induced.

Yes dueling probably

<a class="break-all" href="http://www.google.co.uk/imgres?imgurl=upload.wikimedia.org/wikipedia/commons/2/26/Placement_of_intravenous_cannula_3.jpg&imgrefurl=commons.wikimedia.org/wiki/File:Placement_of_intravenous_cannula_3.jpg&h=750&w=1000&sz=518&tbnid=NlayZR7PKByz4M:&tbnh=112&tbnw=149&prev=/images%3Fq%3Dcannula&zoom=1&q=cannula&hl=en&usg=__u5CBduarWROR2TRkkCmCTm5OcWY=&sa=X&ei=606VTKWEDdvNjAfTg5CSBQ&ved=0CDIQ9QEwBQ" rel="nofollow" target="_blank">canula

cannula a needle with port to insert/remove fluid.