How to pick birth type?

[justhayley]

Hiya I'm only 16 weeks so have a while to go yet but am starting to think about the kind of birth I'm aiming to have. I'm thinking a birthing centre with pool sounds nice - I'd like to keep it as natural as possible - gas an air, I don't take medication in my day to day life - although this is my first and I'll probably be wanting all the drugs i can get my hands on. How do you decide what the best birthing option for you? And can you change your birthing plan last minute? If I decide now I dont want an epidural am I allowed to change my mind when in labour?
Thanks Hayley xx

yes you can change your mind at any point.
your birth plan is just to give the midwives an idea of how you want to labour but of course there are many unforeseen events that can happen and may make you change completely!

Personally speaking, my 2nd and 3rd labours which were both in the pool, no pain relief were far, far nicer than my first which I had all pain relief going!

but it's horses for courses and you do what you feel you need at the time.
It's good to be prepared, and you should read up on all the pros and cons of pain relief (all the different types), being mobile in labour, water births etc... nothing can beat being informed and prepared.
then write out how you would LIKE it to happen so that your midwives and birthing partner can try and help that to happen.
but keep an open mind and be prepared for the fact that you may need intervention etc :)

If I had my time again, I would aim for a homebirth. Planned homebirths, have much, much lower rates of intervention. Even if something happens which means that you need to transfer into the obstetric unit in labour.

You may find that it's not a case of picking a birth option, but going with the flow! By all means educate yourself about different types of pain relief, positions that you may want to try etc, but don't focus on it too much - go with the flow and see how you get on. For example, you may find yourself coping with the pain fine and not need anything more than gas and air, or it may be worse than you ever imagined and you need more than that, or your baby may get themselves into an awkward position and require forceps etc.

Everyone is different and everyone's experience is different. In my case a birth plan went completely out the window, even though my labour had been going absolutely fine - Baby was only found to be breech when I arrived at hospital with 2-3 minute contractions, and I was whisked away for an EMCS. However, I had considered what I would like to happen in the event of a CS - for example, I had requested that my husband tell me the sex of the baby - and this happened. I can't stress enough about not getting hung up on a birth plan - you can't plan it or just decide how it will go, but you can be aware of your options and keep an open mind. Go with the flow.

hope it goes well x

Do also research your birth locations. Birth centres won't be able to give epidurals or most interventions. Some birth centres are attached to large hospitals, for easy transfer if you want more pain relief or there is a problem. Others require an ambulance transfer.

Cingrats! It's great to think about these things but remember a birth plan isn't a contract between you and your body, or you and the midwife, it's a list of thoughts and options. With my first I had midwife led care (which I loved) but it all went pear shaped and suddenly three doctors were there -all was well. With my second I was in second stage labour for five minutes, about four hours from first twinge to delivery. Amazing.

Be very very careful about being too prescriptive. Many MWs are so scared about being strung up for going against someone's birth plan that they stick to it pretty rigidly even if you yourself don't want to. Remember that you may not be able to vocalise what you want when you're in the depths of first stage labour.

You're thread title suggests that, like most first time mums, you may have slightly unrealistic expectations. At the end of the day your baby will decide your birth type.

Sorry if I sounded blunt there, it's just I've been there done that and have the regrets to go with it. On the plus side my second labour was lovely and quick (too quick in fact, ended up in shock!).

Can I just pick you up on this? "I don't take medication in my day to day life". Childbirth isn't your every day life, and you may be better to think of whether you would have any medical procedure done without an anaesthetic if one was offered. Just don't be macho about it. There are no medals for a medication-free childbirth. I've had two as it happens, but I suffered for it the first time around and the second time I was going to ask for an epidural when DD decided to push herself out!

I would read up on everything and keep an open mind.

I never read up on epiostomies, forceps, ventrouse, caesareans, staying in hospitals etc for fear of jinxing myself (stupid I know) - and I needed a spinal block, epiostomy and ventrouse with my second baby. I wasn't prepared for it and felt quite disappointed for a week or so afterwards.

At the end of the day, the most important thing is that your baby comes out healthy. You have no idea how you will be in labour and how easy or difficult you will find the pain.

With my first I was crying in pain at 2cm dilated, (I wanted to die when they said I was only 2cm), then on my second labour I managed to get to 7cm relatively easily - before I was begging for all types of drugs / pain relief / get this baby out!

Be informed but keep an open mind. Imo, with your first I would go to a hospital rather than at home so everything is there if you need it.

Good Luck!

Gaelicsheep said "at the end of the day your baby will decide your birth type". Exactly.

I wrote something like "if possible, I would like to give birth only on TENS and gas and air"- stating a preference but still making it clear that I was entitled to change my mind and if so they were allowed to give me what I asked for

in the event, I didn't ask for anything else and nobody else suggested it either, but it did feel safer to have that flexibility written into my plan

I second just doing as much research as you need to do to make an informed decisioon but keeping an open mind that it may all go totally differently to what you envisage. Go for an an ideal world scenario but when it comes to the birth plan just focus on the very important things like are you happy to have managed third stage, do you want Vit K given to your baby etc.

IMO going for a homebirth with my first was the best decision I ever made, mainly because even considering it forced me to do more research than if I'd assumed I'd be in hospital, so I ended up researching both a lot. But the great thing about homebirth is you can decide at any point for any reason to go to hospital after all, you don't get that option the other way round.

I honestly believe that women should be given the choice and research to make an informed decision that allows them to birth wherever they feel most comfortable and safe - be it surrounded by as much medicine as possible or with only a midwife for company.

Congrats!!

Can't agree more that you do your research and look at all the options. I would draw up an outline of what you would prefer and ensure a partner knows too (you may not be at your most coherent in labour!) I had planned a wonderful home water birth with my second (1st water hospital birth) but bleeding meant I ended up in hospital where she decided to arrive in under an hour. Yes from start to finish!
Just thrilled to have a healthy little one.

One important factor in your decision I think should be how far away the proper medical support is if things do go pear shaped and you need some intervention. Or decide you want an epidural. For example, if you choose a home birth, how long would it take an ambulance to get to your house and then to the hospital presuming it was despatched immediately? Again, if you choose a birth centre, how long would it take to get to the hospital? People who have experienced a home birth or a birth centre will be able to give you more guidance on this but I presume that once you're at home with midwives or in a birth centre, they will be reluctant to send you to hospital unless there is a medical need rather than, say, you wanting an epidural.
Ideally, I would have liked to have had DD in the birth centre 10 mins from where we live. However, thats a 30 min ambulance ride from the hospital so decided against it which was one of the best decisions of my life as, if we'd been in the birth centre, she wouldn't have made that (her heart rate suddenly dropped for no apparent reason and I was whisked to theatre). I'd also thought I'd be fine in labour with a bit of gas & air but was begging for an epidural and was thrilled when I was given one as, after that, things were so much easier.
Obviously those experiences have coloured my judgement but it is important to think about it. So, I'd say bear in mind what you would like in an ideal world and then think about the medical support which may be necessary if that scenario doesn't work. I'm now pregnant with DC2 and some of my friends have had lovely sounding labours at home or in the birth centre but I'll be in the hospital again as, after last time, I just don't want to risk it.

above post is exactly why you need to do your research and not work on presumptions. The vast vast majority of homebirths (thinking in the 80-90% league) transfer because the mother requests more pain relief, not because of a medical emergency. Midwives will transfer in just at the sign of baby's heartrate dropping for example which in the majority of cases will be no problem but they won't risk it just in case.

I also think you need to make sure you do not just basic research but research on your specific area as they all will have slightly different things. And don't listen to anecdotal "evidence", everyone's experience is different nobody knows what the labour and birth experience would have been like if different choices were made.

FWIW I chose a homebirth despite my designated hospital being a 30min ride away in rush hour, but I trusted my midwives and their increased powers of observation due to one on one care (which you are not guaranteed at hospital) that at the slightest sign of everything not going perfectly I would have been transferred in. I researched things like patient/midwife ratio and how long it actually takes to prep a theatre (half an hour) etc etc. I personally think that if you even consider a homebirth you will naturally do more research than if you hadn't - and then decide upon what you honestly feel safest doing. I think no matter what our individual choices end up being, that's what most of us do.