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Childbirth

Share experiences and get support around labour, birth and recovery.

Please could one of you lovely kind MNers review my birth plan? Thank you so much!

143 replies

LoveInAColdClimate · 17/01/2012 13:58

Is there anything here that looks insane or that I don't need to say, or something else I should be including? I have a one-page bullet point version and a three page Blush full version. Please see below. Thanks so much! Hugely appreciated.

Short version

? I would like to use the pool if at all possible for labour and delivery.

? I would like encouragement to use different positions, particularly upright. If I become too tired to remain upright, I would like to be encouraged to labour and deliver on my side and to avoid labouring and delivering on my back.

? Please offer me gas and air.

? Please do not offer me an epidural ? I will ask if I want this. I would prefer to avoid pethadine.

? I would prefer intermittent monitoring (to enable me to use the pool and labour as actively as possible).

? I would prefer to tear than to have an episiotomy, unless the midwife considers that I am likely to tear particularly badly without an episiotomy. I do NOT want to be offered an episiotomy just to speed up delivery unless this is necessary for the baby?s safety.

? Please do not use Keillands forceps on me ? please proceed to a Caesarean instead should their use be indicated.

? In the event that the use of low forceps is required, if you are not 100% confident that they will succeed, please do not try them but please let me have a Caesarean instead.

? Immediate skin to skin please ? with my husband if not possible with me.

? Please offer me encouragement to breastfeed immediately. If for any reason I am unable to breastfeed immediately, I do NOT want the baby to be given a bottle. Please give him milk from a cup instead.

? If I require stitches, I would like them to be administered (with pain relief) by the most experienced person available.

? I am happy for my baby to be given vitamin K.

Long version

Where to give birth
I would like to labour at home for as long as possible then transfer to [ ] to labour and preferably deliver in the pool in the Birthing Centre.

Companions
I would like my husband to be with me during labour and delivery, including if I require an instrumental delivery or a caesarean section.

Special facilities
I would like to use the birthing pool if possible, for both labour and delivery.

I would like to use the birthing centre's pool, birthing ball, wall bars, bean bags etc as appears appropriate and as I wish during labour and delivery.

If at all possible, I would like a private room for after the birth. I do NOT wish to be on a ward unless absolutely unavoidable.

I would like the lighting to be kept low and for quiet, calm voices to be used in the delivery room.

Monitoring during labour
I would like intermittent monitoring (to enable me to use the pool and labour as actively as possible) unless the midwife has reasons to believe that continuous monitoring is necessary.

Keeping active during labour and positions for labour and birth
I wish to remain active in labour and to be encouraged to find positions which are comfortable and helpful for me.

I wish to remain in an upright position as much as possible.

I wish to labour and deliver in the pool if possible. An alternative which I would like (if I find I do not like the pool) is to use a birthing ball.
If I become too tired to remain upright, I would like to be encouraged to labour and deliver on my side and to avoid labouring and delivering on my back.

Skin-to-skin contact with my baby
Skin-to-skin contact immediately after the birth is very important to me.

I would like the baby to be delivered straight onto my tummy.

I wish the baby to be given to me without being cleaned. I wish to put the baby straight to the breast.

In the event that I am unable to hold the baby, I would like him to be given to my husband so that he can have skin-to-skin contact.

I would like my husband to be given the opportunity to cut the cord.

I would like the three of us to be left alone after the birth to bond, so far as is possible.

Midwives, nurses and doctors in training
I wish for my labour and birth to be as quiet and private as possible. I do not wish for anyone other than my husband and the midwife to be present unless a doctor's presence is needed. However, I am prepared for a student midwife to be present, although I would like to be able to ask her to leave if at any point I feel uncomfortable with her presence.

Other issues
Please do not use Keillands forceps on me ? please proceed to a Caesarean instead should their use be indicated.

In the event that the use of low forceps is required, if you are not 100% confident that they will succeed, please do not try them but please let me have a Caesarean instead.

Pain relief options
I would like to use TENS in the early stages of labour, and then to use gas and air and the pool. I would prefer to manage with just gas and air and the pool but am aware that I may wish for an epidural. I do not wish to be offered an epidural, however - if I want one, I will ask for one. I would like the option to remain upright during labour and to use the pool so would prefer to avoid an epidural.

I would prefer to avoid pethadine.

I would like to be encouraged to move around and try different positions in labour. I would like this encouragement to come from both midwives and my husband, who has attended Active Birth classes with me. I would like my husband to remind me of the positions practiced in those classes, and to use the massage techniques learnt in those classes.

Having an episiotomy
I would prefer to tear than to have an episiotomy, unless the midwife considers that I am likely to tear particularly badly without an episiotomy.

I do not want to be offered an episiotomy unless the midwife thinks it is necessary for the baby's safety.

I do NOT want to be offered an episiotomy just to speed up delivery.

After the birth
I would like the syntometrine or syntocinon injection to avoid the risk of heavy bleeding.

If I require stitches, I would like to have local anaesthetic and gas and air.

If I require stitches, I would like them to be administered by the most experienced person available.

In the event that I need to be taken to theatre after delivery, and it is not possible for the baby to come with me, I would like my husband to stay with the baby and not go with me.

We would like a private room after the birth if at all possible (and are happy to pay for that).

Feeding my baby
I would like the baby to be encouraged to breastfeed immediately.

I plan to breastfeed exclusively and would like any help that can be offered to enable me to succeed in this.

If for any reason I am unable to breastfeed immediately, I do NOT want the baby to be given a bottle. Please give him milk from a cup instead.

Vitamin K for my baby
I am happy for my baby to be given vitamin K.

OP posts:
Are your children’s vaccines up to date?
NewYearsRevolution · 22/01/2012 21:19

Exactly! My second labour was just the environment your cat would choose! Go for it!

LoveInAColdClimate · 22/01/2012 21:22

I'm not sure I'll fit into the drawers under the bed (our cat's chosen place) but I'll certainly aim for the nearest possible equivalent Grin.

OP posts:
NewYearsRevolution · 22/01/2012 21:53
Grin
Fiolondon · 22/01/2012 22:06

This reply has been deleted

Message withdrawn at poster's request.

HardCheese · 22/01/2012 22:09

Thanks for info LoveIn - it makes sense, I was just wondering whether there were Terribly Obvious Sources of Episiotomy vs Tear research I was somehow overlooking. (You'd never know I was an academic in the way in which I approach my first labour, would you...? My midwife keeps saying 'STOP READING ABOUT PLACENTA PRAEVIA AND SHOULDER DYSTOCIA!'Grin)

NewYears - could I hire you as a doula? I swear, I would pay big money to have someone as reassuring as you about while I climb the walls, capsize the birthing pool, and have hysterics about birth injuries.

HardCheese · 22/01/2012 22:11

FioLondon - why not gas and air if you are doing hypnobirthing/breathing exercises? Does it interfere too much with thought processes/breathing?

NewYearsRevolution · 22/01/2012 22:21

HardCheese - Believe me, I would be useless. My doula on the other hand, was the dog's whatsits! I'd pass on her details, but you'd need to be in East London and about 12 weeks. She seems to book up as soon as people pee on a stick these days!

Seriously though, if you think you want one, it's worth looking even though iirc you are quite far on. It was great for us.

NewYearEverything · 22/01/2012 22:30

This reply has been deleted

Message withdrawn at poster's request.

MariaCallous · 23/01/2012 05:49

Love,
One thing to think about but not necessarily add to the birth plan - do you want to ramp up the pain relief if you need syntocin? I asked for an epidural to be administered prior to the drip. Ended up having the baby before I got either but it did slow down the intervention and allow nature to take it's course.

mathanxiety · 23/01/2012 06:07

I would not be dead set against an epidural and I would definitely opt for an episiotomy over an uncontrolled tear. You can ask for and get a lovely neat lateral episiotomy.

You could try perineal massage with warm oil to stretch out your perineum maybe ask that this be done? but please don't rule out an episiotomy. They are not as dreadful as they look or sound and an uncontrolled tear can bring no end of trouble afterwards and a lengthy stitching process. You will really not take any notice of an episiotomy while it is happening, and recovery is often easier than recovery from a tear. Ask for ice packs on your fanjo afterwards for a couple of days.

Ask that no internal exams be done during a contraction and that internal exams be done only by your own nurse or mw and not random medical strangers, and kept to a minimum.

Don't let them speed up the placenta detachment unless it has been there too long. No tugging.

It is a scary thing to be approaching an experience that will bring with it pain and possibly loss of autonomy, certainly less dignity than we are normally used to, but please do not think you have failed if things go awry and you need monitoring, or if you decide you really want an epidural. Don't approach it as if it's going to be a battle between you and your DH and the hospital staff. Stuff can happen that is beyond your control during delivery.

mathanxiety · 23/01/2012 06:13

Oh yyy, if you end up on syntocin, please let them give you an epidural. Contractions on synth reach a peak faster and feel a good deal more painful as you have less time to brace yourself. An epidural can feel like a godsend if you have synthocin.

Bear in mind that there is a window of opportunity for insertion of the epidural needle and that you can have the needle in situ without having the epidural itself. If they ask do you want the needle inserted you might consider agreeing and then you can decide as things progress whether you want the drug administered.

If you need an IV, do not let them insert the large bore IV needle without numbing your hand or arm first with the much smaller needle.

LoveInAColdClimate · 06/05/2012 13:26

Just wanted to say thanks to everyone who helped with my birth plan - the product of my lovely, almost pain-free water birth is currently asleep on my chest. It all went brilliantly, despite being induced - getting to 5cm was quite tough, but as soon as I got in the pool the pain all but vanished and an hour later I was at 10cm. I loved the pushing stage and delivery and am thrilled with the result! I did have to have an episiotomy due to a rigid perenium, but got him out almost all the way by myself before that was needed, and the extra help was fine. Thank you, everyone!

We did have a few issues afterwards as my placenta wouldn't come out, but the birth itself was wonderful. Thank you again.

OP posts:
Flisspaps · 06/05/2012 13:27

Congratulations Grin

LoveInAColdClimate · 06/05/2012 13:29

Thank you! All that worry for nothing Grin. Glad I was as prepared as I was, though.

OP posts:
Billy11 · 06/05/2012 16:44

Noboby bothered looking at mine...i had the time i was in labour for 24 hours..
my advice...have 3 to 4 lines if you would like them to take it seriously ...

mine was short and yet nobody looked at it...
all it said was give me an epidurl and do not give me a c section ....

may be different for you and i hope it will be ...

iamusuallybeingunreasonable · 06/05/2012 16:51

Sounds fine, now bin it!

Babies and children are nothing if not unpredictable, no midwife will have time to study your essay and carry it through, and finally shit happens... just chill out and give birth, a piece of paper with bullets won't be required once its happening, sorry to be harsh!

LoveInAColdClimate · 07/05/2012 22:47

Thanks to the last posters - sorry, my last post was a thank you to everyone who helped me write the plan, the baby's now 5 weeks old. The birth was brilliant, very similar to the plan, and EVERYONE involved was amazing about helping me follow it. I really couldn't fault the hospital staff - they were incredibly respectful of my hopes for the birth and helped me realise them as far as possible. It was a fab experience - can't wait to do it again!

OP posts:
LoveInAColdClimate · 07/05/2012 22:49

Oh, and everyone involved (I think a total of about ten midwives!) read it and discussed it with me - I think I was very lucky with the staff.

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