Would you cast your eye over my birth plan please?

[NarcolepsyQueen]

Hi! I am due to give birth this week (I will be 38 weeks on Friday, but will be induced next Wednesday if I haven't gone into labour before then). Please would you look at my plan and see whether I have missed anything?

Birth Partner

Mr Narco. Please defer to him if I'm unable to communicate my wishes for any reason.

Medical Conditions

Severe SPD
Gestational diabetes (diet controlled)
Underactive thyroid
Allergic to Propofol

Labour

I would like to labour in water, with the possibility of giving birth in the pool.

I would like to remain free to move about as much as my SPD will allow during labour to find most comfortable positions as long as the midwife is happy with this, with monitoring only if required.

I am happy to have student midwives present.

Pain Relief

I intend to use TENS, Water and gas & air, but obviously I am flexible if, for example, an emergency situation were to arise or I decide I really need/want an epidural.

Delivery

I would like to avoid an episiotomy if at all possible, as my episiotomy was painful and slow to heal last time.

I would like Mr Narco to discover the gender of the baby and share the news with me.

Mr Narco would like to be offered the option of cutting the cord.

I would like my baby to be delivered straight onto my tummy for immediate skin-to-skin contact. I am hoping to breastfeed immediately after the birth.

I would like Mr Narco and I to be able to hold our baby for at least half an hour after birth.

I am happy for a vitamin K injection to be administered.

If a C-section is required, I would like to remain awake with Mr Narco attending. Mr Narco will hold the baby after C-section delivery and initiate bonding between the three of us.

Have I missed anything?

Thank you soooooo much!

It reads very diplomatically :).

If it were me, I'd be inclined to make it a little less so (but then I can get a bit bolshy assertive ). In particular, the paragraph:

I would like to remain free to move about as much as my SPD will allow during labour to find most comfortable positions as long as the midwife is happy with this, with monitoring only if required.

I'm fortunate not to have experienced anything other than very minor SPD so can't pretend I'm commenting from personal experience. However, even without any major issues I'd put my comfort during labour above the happiness of the MW - what you've written could be read as "if the MW finds it easier to deal with women on their back in stirrups that's fine" OR "if the MW has concerns and needs me to change position to address those concerns I'm happy to follow her advice". I'm guessing you meant the latter...

Re. monitoring... Again, for me personally, I would be reluctant to accept CFT - especially if the only machines available required me to be in a recumbent position on a bed. I have yet to see much/any evidence to suggest they improve outcomes over regular intermittent auscultation (which can be performed with the mother in whatever position she happens to be in). Given your SPD this is another area where I'd be inclined to do some digging and come up with a personalised view on what circumstances you would consider to "require" CFT.

Re. episiotomy - would you prefer to tear naturally? If so, that might be worth saying (different individuals may have different versions of what "at all possible" might be - its worth making your version clear )

Something you haven't mentioned is Vaginal Exams - are you happy for them in all circumstances? Some circumstances? None? Would you prefer a MW that can do them with you on all fours rather than telling you you "have" to lie on your back for them?

Stray thought, have you discussed your birth plan with a MW yet? Do you know what the protocols for induction are within the unit you are going to? If, for example, protocols state that once women are induced they "have" to have CFT and "can't" use a pool, would you be accepting of that? If not it would be worth talking it through with the Head of Midwifery / a Consultant MW so that you understand the rationale and can make a more informed decision on whether or not to accept the advice - and if you can get the HoM to agree with your logic (being stuck on the bed for CFT with severe SPD is not good...) and sign your birth plan you're likely to have a lot less resistance to not following the party line when in labour...

I'm wondering if there's benefit in preparing 3 variations of a birth plan - a "spontaneous labour" one, an "induced" one and a "CS" one.

(On the CS - something that seemed slightly odd is that if you have a vaginal birth you'd like immediate skin to skin and BF, but if you have a CS you want your DH to hold the baby. I've read of a number of cases where the mother has been able to have skin to skin and BF immediately after a CS - is this something you'd like to do the circumstances of the CS make it possible?)

Sorry - that turned into a bit more than I expected. (I always start commenting and realise I'm a complete control freak when it comes to birth ). Fingers crossed it all goes smoothly and your LO arrives promptly, safe and well :)

I would perhaps consider a bit about how much support you want from the midwife and how you personally deal with pain. My birth plan the second time around had a sentence that went along the lines of :

'Please leave me alone and don't talk to me or touch me unless absolutely necessary. Mr firkytoodle knows my wishes.' as I found small talk etc interfered with my focus and I am not keen on being touched when I am in pain.

Also, do you want the injection to deliver the placenta or would you rather it came naturally?

I'd also put that you would like to give birth in the pool unless advised against it for medical reasons as have heard of women being persuaded out of the pool to be examined and finding it too difficult to get back in again

Hope it all goes well

I too have asked [nicley I think] for everyone to shut up whilst I'm labouring and want none of that cheering me on that you see on 'One Born...'

Also asked not to whisk my baby off/manhandle after birth, agpar can be done whilst on my chest and weight is not going to change if left for an hour or so

Come back and tell us how much of your plan was put into practice please.

Is this your first baby btw?

My birth plan reads...

I'd like to sneeze the baby out in that bit during asleep and awake where if you concentrate hard enough you can imagine you're flying. I wish for this to be painfree.

Whaddya reckon?

Seriously, sounds just fine. Have you had a quick think about instrumental deliveries ie if you are happy with forceps/ventouse (and the episiotomy they require) should the situation arise?

Can't be first baby, can it? Could episiotomy be for anything else?

I might add a little clause that says 'nobody but nobody utter the words 'oh it's a wicked pain my sweetpea and I know you probably want your mummy' as I am 30 and it's highly unnecessary'. In fact if they try it (whilst stroking my frigging leg), I reserve the right to emit some kind of bodily fluid, as yet undetermined, in your simpering direction. Last time I said some Bad Words to that poor midwife.

I love turtles birthplan, wish i had thought of that lol

I find it a bit weird that you refer to your husband as 'mr narco' would you not just put 'my husband joe' for example?
Other than that totally minor thing it reads fine, oh and it wont actually be read, it will stay at the bottom of your labour bag for you to shred when you get home lol

I didn't do a BP with baby no.1 and it all went to shit.

So I did one for baby no.2 that was mostly ignored and the bits that were implemented were argued at length.

I wrote one for baby no.3 but forgot to give it to the mw.... I had to gasp 'I want a natural third stage!' at her whilst clutching ds2 on my hands and knees as i suddenly realsied I hadn't mentioned it

Anywho... have fun with it... birth plan sound lovely but be prepared to fight/have MrNarco fight your corner despite having it all written down.

We have two hospitals in our county. One of them includes a 'birth plan' section in your notes. Asks for all of your fears, previous experiences, ideals etc and they are very, very keen on promoting it.

The other hospital looks at you like you've weed on their sterile floor if you so much as mention any intention of having an opinion.

Thank you so so much everybody!

This is my second child. My DD is 6.5. I used gas and air and a TENS machine last time, but had a 3rd degree tear.

I will use my partners name, rather than MrNarco (narco after my mumsnet name) in my actual plan - I was just trying to keep my details private mosschops30!

TurtlesAreRetroRight - I have added your suggestion at the top! Awesome advice!

Tangle - excellent advice - you are so right. Having re-read it - far too diplomatic!

I will re read through your comments again.

I know I probably sounded off but the idea of a birth plan seemed a great idea at the time but like others have mentioned they often don't get read and the real life often takes over and it's a case of hands to the station and get on with it.

Surely stuff like the vit K will be either on your notes or they will ask you and you can say yes or no.

Sure you would like your baby to put on your tummy immediately. Who doesn't? why wouldn't that will happen unless something more important taked precidence eg an emergency?

Again once the baby is born you will be able to hold the baby UNLESS something more important crops up.

You are likely to be kept awake for a c section. It is much more risky to knock you out so what is the point in asking for that?

All your medical conditions are on your notes so why put them on?

Have you checked with the hospital that they have a birthing pool and have you discussed it with your midwife. Is the birthing pool only available at certain times?

I know it is your second child but it does come across as a bit pompous tbh.
By the time anyone has read your list the baby will be born it's that flippin' long.

To be honest I would edit it.

Upahill - believe me there are lots of people who don't want the baby straight on their tummy. Quite a few peaple want baby wrapped up in a towel and given to them.

Thanks upahill

I can only go on my last experience:

DD wasn't put on my tummy. For no apparent reason. She was taken away and returned in her basket.

I am allergic to Propofol, which is why the c-section comment is there about being awake or asleep.

I was advised by the consultant to put medical conditions on the top of my plan - she said being repetitive with important things is never a bad thing!

Our hospital is brand new. They only have one birthing pool room open at the moment - it will be 3 in September. The midwife and consultant have said the pool will be helpful for my SPD.

Do you really think it sounds pompous? I will definitely edit it again if that is the case. I am high risk under 7 different categories, and realise that we will have to play things by ear - but I think that birthing plans are a good way to focus the mind ready for labour!

The plan actually works out as three quarters of a page of A4 in bullet points under headings - but agree that it does look longer on here!

blimey do we need to write out plans?

for DC2 my birthing plan is:

"get baby out as quickly and safely as possible, avoiding epidural unless absolutely necessary eg EMCS"

do I need to embellish more?

(I am low risk though so not much to think about)

Fine, In that case they can say it there and then.
I just think the birth plan is way to lengthy. A lot of things that the OP has written can be done as they go along and leave the important stuff to the plan.

I hope you get your birthing pool. That would be nice and I believe people have had good expierences from it.

I agree with you about a plan focussing you for the labour and I'm sure you know that sometimes things are 'made up as they go along' I don't mean slap dash but things can change in an instant. (as I found out with DS1)

I didn't have time to get a plan out of my bag with DS2 he flew out that quick!!

Good luck. I hope you have a good birth.
Come back and tell us about it!
x

Hey Narco,

I think it's a very good birth plan. You sound similar to me (in terms of what you want during birth and the control you'd like to assert during the labour and birthing process). In fact, if I dug up my old birth plan I'd say it was almost exactly the same. It's short enough to make sure the attendants don't have to wade through pages of "I'd likes" but detailed enough to cover the most important parts.

Mine had the injection for the placenta mentioned as well.

My birth plan was followed to the letter for both my (home) births, but I think this was largely due to me going through it with the MWs in detail beforehand, and my husband knowing it backwards (control freak, moi?). I was in a bit of a daze after DD1 and it took me a good 2 minutes to realise I hadn't been told if it was a boy or a girl, and then remembered that was because I had written on my plan that I wanted to discover the sex myself - they were all being very patient as I was doing my first feed and catching my breath and wasn't looking to see whether it was a boy or a girl!

It does not come across to me as pompous at all - it comes across as someone who knows what they want, don't want anything to be assumed, and is very straight forward, clear and I would think helpful to the MW. Yes yes, they probably will check the medical stuff in your notes / can ask you whether you want the injection etc, but that doesn't mean it's not useful to have it all written down in one place so the MW can get a feel for how the mother wants things to be handled. I find it strange that women (and it's not the first thread I've seen it on) say "well, there's no point writing a birth plan really - who knows what will happen? You might as well not bother because you've just got to accept what will happen will happen". Well no, actually, I think some of the time how you plan your birth to go will greatly influence the outcome (note I said some, not all) and thus having a plan in place can only maximise your chances of getting the birth you want (note I said maximise chances, not guarantee).

And given most labours take a while (even second babies), I think the length of your plan is not going to be discarded as too long to read as the baby will have been born already (it took me less than a minute to read - I doubt most babies are born in under a minute).

Sorry, I have gone on. But upahill irked me with her dismissive tone.

So sorry!

I don't think it sounds pompous either. If anything too diplomatic as Tangle mentioned earlier. There are so many different options on the day that I think it's well worth clearly stating what you want.

I didn't have a birth plan with dd. I figured I had no control over what happened and it turned out that I didn't. Had a long and very traumatic delivery with lots of intervention and an emcs in the end. After 6hrs of pushing and a hefty amount of damage I had no ability to communicate. I was stuttering and shaking, I thought I was dying. DH was in tears and trembling. When I look back now I am so bloody angry with myself for not speaking up about various things. Nobody told me dd had been born, I didn't see her until she was clean and dressed in an outfit that I hadn't provided. I didn't understand what was happening and I have had ptsd for years. Nobody explained things to me and I felt like a passive observer.

Now I don't have a birthplan this time either. I have a consultant that will deliver this next baby and he knows me back to front. He knows what I am terrified of and how I would like the labour to be managed. But if I didn't have him, I'd be damn well writing something down because I've never felt so out of control and terrified in my life. In fact he's written a birth plan for me and his team are all familiar with it already with 4 months still to go.

Some women need a birth plan for many reasons. Even if it's not adhered to or the points are irrelevant on the day, having gone through it beforehand can be exceptionally helpful in terms of mental preparation.

Ok maybe I was a bit harsh with my terminology!!

(I'm feeling very grumpy and I'm dosed up on Mandafen!)

I think the most imprortant thing is to use the plan to focus and discuss issues with DH so you both know what you want.

I do still think some of stuff in was unnecessay and can be dealt with at the time (Vit K)

Also I personally don't know anyone who has had their plan read. (including me who has written two plans!!) Clearly it could be different in different parts of the country and plans may be have more importance but for everyone I know it was a case of having the baby as safely and painlessly as possible.