SPD poster girl again...I need opinions/advice on my birth plan please!!!!

[pie]

Ok, I written my birth plan and would like all the advice and opinions you mighty mumsnetters have

I want to make sure the m/w knows what I can and can't do and how bad my SPD really is...

Oh and I'll get those spelling mistakes out asap!

Way to go! That's an excellent, articulate birth plan. The only (tiny) thing I would do would be to emphasise certain points like:
I will NOT consent to an EPISIOTOMY
That looks rubbish, of course, as if I'm shouting, but underlining would do the trick!

One more thing- if you go to the web page your name is clearly visible in the blue bar at the top, so maybe you should take that away asap?

Way to go! That's an excellent, articulate birth plan. The only (tiny) thing I would do would be to emphasise certain points like:
I will NOT consent to an EPISIOTOMY
That looks rubbish, of course, as if I'm shouting, but underlining would do the trick!

One more thing- if you go to the web page your name is clearly visible in the blue bar at the top, so maybe you should take that away asap?

Sorry the PC froze!

It looks great to me, honey. Good luck. I'm very impressed.

Looks good Pie, you have it seems a well thought plan. Hope it goes well for you. I suppose I should do one too.....

Looks good to me.

Maybe you should explain exactly what "pain free gap" means? Of course, a midwife may understand what this means.

Looks good to me, too.

No offence, but why won't you have an episiotomy? I said i would have one if need be (the curved one, away from the rear end) but they said it was not necessary. Unfortunately, i pushed too hard at the wrong moment (v. easily done) and tore from front to back! I had so many stitches internally and externally that the midwife said she didn't know how many there were in total!! I healed absolutely fine but i would have preferred an episiotomy to avoid all the scar tissue. Good luck all the same, your birth plan is excellent! I'm so jealous of you coming up to what will be the best day of your life - pain and all! I have a 14 month old and remember my dd's birth like it was yesterday - all good!! Let us know how it goes - it's so exciting!!!!

Excellent birth plan pie, very clear, hope they stick to it. Couldn't see any reference to cefm (continuous electronic fetal monitoring). Presumably not an issue? I personally wouldn't object to an episiotomy but that's because my experience with them is good. Good luck - hope it all goes well and that you make a good recovery afterwards.

I'm not bothered by the cfm, though it is hard to do as I can't really be in one position for too long.

As to the episiotomy, DD was a 2 hour pushing ventouse delivery I refused an episiotomy then and ended up needing 2 stiches for a first degree tear. The doctor was very surprised that I didn't tear more esp considering the ventouse. I did and do alot of perinial massage.

I guess I figure that if I didn't need one last time and I had a ventouse I don't want one this time, esp if its more for the medical staff's benefit rather than mine. Hope that makes sense!!!

Thanks for all the comments though, I was writing this and thinking does it make any sense???

Meant to say Jude, that I'm not bothered by the cfm as I can't move around anyway, so being hooked up to a machine will make no difference as I'll be stuck in the ruddy bed

Oh Pie, I so want this to be over for you. The plan looks great. Will your dp be good at being pushy and making sure that anyone who comes near you is forced to read and understand it before attending you? I just think it's important they do and that all medical staff understand the seriousness of your condition and act accordingly. Thinking of you.

Actually reading the plan its not very clear why the episiotomy is in the bold/SPD section is it?

If I do have an espiotomy then I will have my periniuem numbed and more than likely they will want to put me up in stirrups, I have been advised that a c/s is preferable to this in relation to the trauma being in the liothomy position can do to my pelvis.

Should I make that clearer in the plan or am I heading for some sort of essay proportion birth plan, will the m/w know that anyway?

When I had my ds at home, I had to have an episiotomy and obviously I didn't have to use stirrups.

Like I've said before though, I had a really good midwife who had done a lot of research to make sure that I coped with my spd as well as I could.

Hopefully you will get an informed midwife and she will make the birth as pain free as possible for you.

Don't know the answer pie but just wondering whether a doula might be able to help with making sure you're looked after/everyone reads it etc?

Pie - your birthplan looks good but I do have a concern about you saying you definately do not want forceps but agree to a ventouse. I want you to think about that one because sometimes the cup of the ventouse pops off repeatedly. If that happens then the doctor should abandon that procedure and change to forceps. The head may be so far down at that stage that forceps is preferable to a C/S. I have only ever seen ventouse deliveries done in lithotomy position as well, never when lying on the side. Also, with an assisted delivery an episiotomy might be needed to avoid a difficult tear. I have seen forceps and ventouse done without an epis. but if the perineum looks as though it is being overstretched, an epsisiotomy might be recommended. I am not wanting to come over all negative - it is just that you might need to face these decisions at the time and at least you will have thought about the 'what if'. HTH.

Thanks mears....

I was told by a mw that it was POSSIBLE to have a ventouse on the side, but I guess in reality it may not happen huh?

I think that I will change that part to if any intervention, such as ventouse or forceps becomes necessary then I want a c/s. Would that work better?

Mears, one more thing as DD was a ventouse delivery, am I more likely to needed interevention the second time round?

I appreciate all the input guys...I really want me and DH to know what is ok before hand so that we can't get pressured into anything when we are so emotional.

I just really don't want to end up on my back with my legs in the air...wish I'd said that 8 months ago

Pie - usually intervention is not required next time around because the way has been made for the next baby IYKWIM. However, that does not mean to say it is not an impossibility that intervention will be needed. Did you have an epidural last time? I can't remember if you said.
Sometimes a ventouse is used when a lot of the head is visible at the vagina but is not advancing. If that was the case - a C/S would not be advisable. This type of delivery if often called a 'lift out' because the baby is so close to being born. If that was the case the last time then iy is highly likely you will manage on your own. Keep positive

I did have an epidural last time, but to be honest I don't know how far down the birth canal DD was, I only needed two more pushes once the cap was fitted. I was left in stirrups for a long time after though, over an hour whilst the staff chatted etc

Just want to say well done and good luck.

Glad you're keeping your sense of humour pie

pie- FYI - if they need to stich you up because you tear you will very likely need to be in stirrups. Of course the same applies for an eipsio.

Pie- another point - IME if you have started your labour naturally (i.e. no induction/no sweep) and your contractions build up naturally, you are likely to manage the drip WITHOUT pain relief. The drip is very painful if it is to induce... but when it is "only" to augment a labour well on its way - its much more manageable.

I DO hope you can labour in a pool - you know that I had SPD and was bed bound from 36 weeks onwards.,... water (birth pool) was my saviour ! This will be great for pain relief and is likely to make your labour faster.

pupuce, there are 2 pools at Queen Charlottes, one in the Birth Centre and one on the Labour Ward...to be honest I don't know which I'm expected to go to. Though of course if the pool is occupied in either one then I will be out of luck. I'm hoping that I get it though.

I have spoken to several women from the Pelvic Partnership and nearly all of them were able to have their stiches put in whilst on their side, the physio has said this is also possible but you really have to insist.

The more I try and write this plan though the more I think maybe I should just have the c/s.

What do people think?

Given the amount of stuff that will have to happen for a vaginal labour to be as SPD friendly as possible and given the fact then non of it may happen and I could get the worst SPD labour, maybe I should just by pass it.

ARRRGGHHHH what to do?