advice on wording/tone of birth plan

[qqquavers]

I know that everyone recommends a polite and friendly birth plan, and I agree that they should be. But how can you make it clear that what's on there is not just a minor preference for one thing or another, but that you feel strongly about something? I plan on leaving irrelevancies off my plan and trying to make it brief, that might be a start. Or should I start with a few sentences about how important that everything is discussed with me first being done, that informed consent is important to me?

I don't want it to be so friendly and lovely that it makes me sound like some pushover and accepting of anything. How can you say things without sounding hostile? or sound like you are telling them how to do their job? I want them to respect my plan and know that I mean what is in it, sounds assertive but at the same time respectful of the people reading them. I've heard midwives are accepting of birth plans but what about OB's if I need them? I know they all try to do what in your best interest, but obviously medicine is as much and art as a science and different training/experiences lead many midwives/obs with different opinions of what is 'best' and what if I get someone who isn't a 'match' for my preferences. I'm worried in what seem to be understaffed wards I'll get somone who is very intervention happy and there not always an alternative.

Know what i mean? Any examples?

I tried to make my birth plan as succinct as possible, without any 'touchy-feely' bits. I made it a list of bullet points, and the parts that really mattered to me, I added 'This is very important to me' at the end of the point. I think the only bits I did this for were the parts about skin-to-skin and breastfeeding.

I think both times the MW had a brief chat with me about my plans. There were a couple of things I'd put in there like no pethidine. This wasn't through some plan to have a natural birth but because 2 close relatives have had it and ended up in resus so there may be some family problem with it. Once she realised that she wrote NO PETHIDINE in capitals and with red pen, just to make sure.

Wouldn't bother with the sentences either just keep it concise. You might have a really fast labour or they may be short staffed and won't have time to read it all.

If you are low risk have you thought about having a homebirth? That way you will have 2 mw in attendance and they are more likely to be sympathetic to your wishes.

Do it as bullet points, and no more than a side or so of A4. There is a template here

I just took each line and changed it to what suited me - for example '?Who you?d like to be with you' simply became 'I would like my husband with me at ALL times' rather than giving long descriptions of my reasoning.

Make sure your birth partner knows the most important points.

And be prepared to throw it out of the window if necessary.

I only put things that really mattered to me.

I'll see if I can find it.

I was looking at the birth trauma association website and they had a couple of good ones in their 'second pregnancy' (think it's called that) brochure. Not bolshy, but very clear and assertive.

just put at tghe top would be like to be informed of all interventions and involved in decision making

Here it is!

Bit off the top cut off due to personal details...

I would prefer to be kept informed of what is happening at all times, and to be involved in decision making before any drugs are administered or procedures undertaken. If I am unable to be consulted (for whatever reason) my birth partner should be asked instead

Pain relief Preferences
During early labour I would like to use a TENS machine, water, and gas and air as pain relief. Later I would like to use gas and air, in combination with pethidine as pain relief ? please suggest these options as I need them.

After the birth
After the birth I would prefer the baby delivered onto my tummy, and for DH and I to discover the gender for ourselves.

DH would like to cut the cord if possible.
I would like assistance to help breastfeed the baby soon after the birth.
I would like my baby to receive the Vitamin K injection.
I am happy to have assistance to deliver the placenta.
If possible I would prefer to stay in hospital in order to establish breastfeeding. Despite breastfeeding my two other children I have always experienced problems establishing feeding. I would therefore like help from a breastfeeding counsellor if one is available.

thanks for your suggestions! Basically I want to be involved in decisions not just 'done to'

Funny, pain relief is not one of my worries - I want to try natural ways or g&a but figure they can't really do an epi without me being in agreement and cooperating :) Same for post birth things like breastfeeding, I can just ask at that point. My concern are VE's, pushing positions, episiotomy and forceps. Just goes to show how everyone is different! :)

Yes it does because none of that really mattered to me too much! LOL. and good luck.

This is my birth plan for my third DC BTW. The first one was an essay and was pretty much ignored. Second one was more like this one and was actually followed, as was this one.

I encountered about 50 hospital staff and my 1-pager was invaluable.
I had a section on how to communicate with me and my allergies, then 6 points on what I wanted/didn't want in the birth including things like "I am terrified of the idea of an epidural but as I can't take pethidine may have to consider it if gas+air doesn't cut it"
Then a section on "Stuff I'm not at all fussy about" which was a couple lines at the end but I think helped them realise I wasn't actually that much of an anal-retentive control freak.

I think a couple words on fears and your reasoning can really help.

Do you not think busy midwives have more important things to think about than your 'playlists' and scented candles?

Weren't those part of her plan for her partner, not the midwife? The birthplans for midwive's perusal here relate to pain relief, positions, cutting cords etc. All pretty relevant to the midwife's role?

As others have said, keep it brief. That way, if the hospital is busy, it'll be easy for your mw to see what you want. Mine ran to less than a side of A4 and things went pretty much to plan (i included a note in caps at the top to say i didn't want to be poked about, given any drug or any procedure without it being clearly explained and consent given!). I gave dh a copy of my plan at 37 weeks and went through it with him and he was fab :)

qqquavers do you know yet where you will be giving birth?

Do you think they would take offence at me writing full page no forceps!!!!!!! ?

On pain relief I put something like:

I plan to use TENS and gas and air for pain relief. I do not intend to have an epidural, however if I change my mind I expect to be taken seriously.

If you feel strongly about something, don't sugar coat it. Write it as simply and clearly as you can.

Yes, you may have no real choice in the end.

my birth plan for DC2 read: MOSP is hospital phobic. Worked a treat. I chose a hospital birth as it was my first attempt at vbac. Had DC3 at home... lovebeingknockedup If no forceps is important insert fluorescent pink paper with that written on. If it comes to assisted delivery would ventouse be acceptable or would you prefer to go for a section - might be worth putting that down. I also think I'd put some notices for DH to put on the doors saying something like 'Entry by invitation or in case of emergency' as my delivery room when I was having DC1 seemed to be a short cut for staff If I ever wrote another birth plan, it would say: Don't touch me, don't look at me. Ask DH.