When your homebirth plan is very different from the midwife's plan!

[StarlightMcKenzie]

Booking didn't go brilliantly.

I have to say, credit to the midwife for actually ASKING about my plans as never had that before and am on 3rd pg. However, how far do you argue to make sure they know in advance and how much do you just leave to the day and refuse to comply?

Oh dear! Sorry it didn't go well. What sort of discrepancies are there? ( got my Supervisor of MW hat on for more info to see if I can come up with anything helpful).

Well, they are saying I can't have gas and air available early on, when I need it (don't need it once I have got into the whole labouring thing, but DO at the beginning, particularly if waters have gone, to help me get into the zone and remove panic. Then I need NOT to have it to focus)

However told that it has to be reserved for the end when I will need it

Also told I'll have to get out of the pool to deliver placenta, which I have no intention of doing.

And they're saying have to have internals, which I have no intention of doing unless things seems to be going a bit strange.

My birth plan is identical to what it was for the last birth, which was both agreed and adhered to, but this is a different pct.

Oh dear Starlight. There was even more than the pain relief aspect.

I would personally make your views known on the internals and placenta, but at the end of the day there is nothing they can do if you refuse. You are in control on those ones. It's the pain relief that's the biggest issue as I see it.

Perhaps contacting the supervisor of midwives?

Starlight, you have my sympathies.

Without wishing to hijack the thread or detract from Starlight's issue, can I just ask why so many people advise contacting the supervisor of midwives for support when I have found that the supervisor of midwives at my hospital was the most horrendous midwife I have ever encountered. She was no less than a bully who, by her own admission, was there to protect her midwives and left me feeling completely unsupported and totally unsafe in hospital. I hope never to have to have anything to do with her again. sorry, rant over, just wondering like

I am considering a home VBAC because, following appalling meeting with aforementioned supervisor of midwives and less than ideal first birth there, I have absolutely no faith in the practices at the local hospital. I'm going to struggle, aren't I?

Soozle - that's awful! People suggest contacting her because she should be a senior figure who can be more flexible than more junior midwives. If you want a home VBAC it is your choice. You might struggle to get them to like it, but it's not up to them to say no

The midwife said that I should talk to the midwife on the day about delivering the placenta in the pool and that she is unlikely to agree. I told her I won't be talking to anyone on the day so she told my DH to do it

She was really pushing he injection too, but honestly, I'm less worried about the placenta thing as we can probably discuss it after the baby is born anyway whilst I'm drinking tea and cuddling my baby.

I sent an email to the SOM asking her to clarify that I would be denied pain relief when I needed it if a mw decides that I'm not far enough along.

Mw that came was fine though. Don't want to get at her. We just have very different ideas.

Had call. SOM talked through why not g&a early, then listened to me and agreed it for when i asked and emailed hb team.

Fair enough I guess!

Yeay! Responsive personalised care!

Can you ask for a copy of the email to put in your notes?

Anyone who says you HAVE to have internals is being coercive and misleading. You have the right to refuse ANY treatment if you want.

There may be circumstances when it is a safety issue, but it should be led by what happens rather than just because its standard procedure and 'they way they do things'.

I would actually complain that the MW is doing this, rather than saying they would advise or it is recommended. Consent is an extremely important issue and HCPs should not be doing stuff like this. Technically if they do this, they are at risk of committing a sexual assault because they have deliberately mislead you (though you would be hard pushed to prove this and to win in court I'm sure).

SoozleQ

You have my sympathy., I have just come across very lack lusture unhelpful akward midwife and to my utter amazement when I asked the doctors staff if i could have a diff one, they said - whats your problem with her - she is the matron of them all of the area!

You can change MW and still stay with docs, i am temp registering at another docs and having my 1st wonderful MW back ( hopefully), also .....

can you not think about another hospital, where i am some ladies say its too far to travel 12 miles - instead of winding roads to the other dire 9 mile hosp, but lots of ladies do it - some even go 30 miles away....

I really would try not to have a baby where i didnt feel comfy....and safe.

i think this will all actually depend on the person you get on the day, though in our area if 9-5 mo-fri that would also be your booking in MW.

how does this plan work? i thought you wrote it and shoved it in your notes? No?

internals- as said - totally up to you. she knows that. the MW attending will know that. your doula can back you up.

Ah! Will probably contact head of homebirth team and get it 'approved'. If not doula and DH can sort it in the kitchen whilst I labour in the pool with the radio on full blast to block them out!

Yes, my last was at Edgeware. No problems there. No internals. No getting out to deliver placenta. In fact, cord wasn't even cut until placenta was out.

Either it is safe or it isn't. Or is 'safe' more to do with the confidence/experience of the midwives than birth choices?

In your own home, how would they get you out of the pool i wonder?

putting in cold?

Did you say booking? I would suggest that unless you are booking at 38 weeks(!) you have plenty of time to sort it out!
Rationale for not giving entonox early on - it tires women out if used too early, and is not beneficial if used for long periods (if your labour is 8 hrs long say and you use it for 8 hours). In a home birth situation I would be very surprised if a woman needed entonox in early labour. Oh yes, and it is not legal for midwives to give entonox unless a woman is in established labour (oh these damned laws surrounding administration of medicines & gases).
Rationale for delivering the placenta on dry land - theoretical risk of water embolism. No proof for this but I find often women want to get out instead of sitting in dirty water for an hour.
Rationale for managed third stage - there isn't one unless you have previously had a PPH in which case I would want you out of the pool for the third stage too.
Rationale for vaginal examinations - only really necessary if there is a suspected problem.

Maples :)

although this will probably be alright on the day the thing is that you shouldn't be dictated to in this fashion.

you are an adult, and big enough to take responsibility for your own decisions.

in the (unlikely) event of a PPH (i would think less than 1/50, possibly 1/100 depending which stats you look at) - it isn't them that lose blood.
if you don't have an internal which would tell them (if they couldn't tell by other means ) you were/weren't progressing and the labour was managed differently..it's your labour

I'm 39 weeks on Sat!

reiken, - does the LAW defined established labour as anything particular i.e. no. of cm dilated?

I had a previous PPH CAUSED by the midwife imo - yanking away for physiological 3rd stage, which is why I want to stay in the pool where they can't get to me.

reikizen I meant. Sorry for spelling your name wrong.

I find the 3rd stage quite painful, so believe that using the same strategies that birthed the baby successfully would be important. I know it doesn't have bones like a baby does, but the hormones have changed and the contractions feel stronger as a result, - to me anyway. Being relaxed in water with either a bit of breastfeeding or a bit of gas and air to birth the placenta just seems sensible.

my next doors had an epidural at 1cm......but then from her description it would have been cruel not to..

oh, - good for her! And good on the midwives.

I've just read the NICE guidelines and there it says that if a women is having painful contractions but not in established labour she should be offered support, and on occassion anelgesia.

What does that mean? paracetamol?

And is gas and air even legally defined as anelgesia, coz that certainly isn't what I'd call it!