Is no plan a good plan?

[frogalou]

Hello
I am 30 weeks pregnant and I have decided not to have a birth plan. I have done an ante natal class where we talked about breathing, but I have not decided if I will ask for pain killer or not, it is my first baby and I want to just see what happens.

Am I being very naive? Some friends of mine had plans, but few were followed, so I feel it is better to go with the flow rather that get frustrated about nothing going to plan.
Are there things I should plan no matter what?
Thanks

Hello, my experience was that everything went a bit wrong anyway (wanted natural birth, ended up with premature, breech baby cesaerian) and also, I did have a birth plan and absolutely no one (including widwifes) looked at it! So from my experience I'd say you've got the right idea. Perhaps just make sure you know the key options you might have and if you have any really strong feelings about things, you might prepare your answer, but I think it's good to go with the flow.
Also, on a positive note, while my whole plan went out the window it was still a great experience and I have lovely memories of it.
I hope everything goes well for you, and you can relax, go with flow, and enjoy whatever it brings your way.

I had no plan and am glad. You have no idea what it's going to be like or how you will cope. Just go with the flow, they are trained professionals after all!

I don't think you can plan a birth. (Love the idea of deciding when labour start and how long it lasts for!) I think it is useful to consider the options and write down what you think you might like. Eg. I wanted to try and avoid pethadine and epidural. Sort of thought I might like a water birth and my DH didn't fancy cord cutting!
You are unlikely to be articulate in full on labour so if you have any strong opinions (eg do you want skin to skin after birth) it is best to have a note of them. You can't really decide exactly what you want in advance (glaring at DD who ruined planned home water birth by rocketing into the world in 59 mins!) but it does no harm to let your MW know any preferences.
Good luck.

I think it's the only plan!

Your labour might go as you expect without a hitch, or it might descend into some sort of chaos, in which case you'll end up agreeing to what the HCPs tell you they need to do in order to get everyone out the other end safely.

Your idea sounds fair enough to me. Good luck!

Entirely up to you if you want to just see what happens.

Have you thought about if you'd like a managed or physiological third stage? Baby straight on you or cleaned up? Oral or injected vitamin K for baby?

I wrote a very detailed and naive plan, all thrown out the window. I think it's good to write down anything that's important to you, but also need to be flexible as so much is out of your control. Therefore if there is nothing that you feel terribly strongly about, you don't really need one.

Out of my NCT class of 8, I think 1 had the birth she had planned for.

I had no plan and didnt attend antenatal classes (did fe a little guilty!) but loosely wanted a natural birth in MLC which would mean nowt stronger than pethidine. Ended up admitted to big hospital for high BP, went into labour spontaneously ten day early. MW saidy m contractions were Braxton Hicks and then realised 6 hours later (me being in full. Low. Labour alone in the dark for ages!) they were in fact contractions. I worked my way through gas and air and pethidine before demanding an epidural(!) then had drip to speed up contractions, ventouse and episiotomy. No way I could've foreseen that! Think about different scenarios to prepare and prepare to change your mind completely when it comes to the crunch! Im sure you'll be fine!

Surely there's a middle ground here? How about a short list of preferences? Or how about noting down a few things that are important to you?

Keeping an open mind about how things will go is very sensible, but that doesn't mean you can't voice your preferences.

Part of the benefit of getting a few things down on paper, is that it gives you a chance to really engage with your feelings about birth and your choices.

Putting it on paper, won't make it happen, but it can be a useful way to communicate your wishes.

FWIW, my birth plan was really respected by the midwives in the birth unit where DS was born. It wasn't prescriptive or particularly detailed. It also meant that when I arrived at the ward in FULL ON labour, the midwives didn't need to talk to me too much to find out how to care for me. This is good because being questioned and required to talk during established labour can be VERY difficult.

Think of it as less of a "plan" more a few notes about your preferences.

I didn't have a birth plan for any of my 5 births.
I just went with the flow of how I felt on the day.

My birth plan for ds1 was written. A few lines basically do what you need to but no pethidine
Nothing for ds2 but DH knew. No pethidine or similar.

And I wanted to bf with skin to skin, not let down

I wrote a lovely birth plan and then realised I was being ridiculous. now I've got 1 page that includes:

• a short list of preferences (e.g. rather give baby straight to me instead of washing him first, delay cord clamping if feasible, DH not interested in cutting cord),

• what my lifelong medical condition means in practice (e.g. epidural/local may not work so be vigilant, pushing on side is preferable), and

• things that are likely to upset me based on medical history/previous trauma (e.g. being restrained during CS may upset me so please be compassionate).

Keep it to 1 page or less. Start with most important and move into less important. My doula is an ex-midwife and she says anything over a page and hcps are going to glaze over/get annoyed.

Lots of bullet points. Keep it short and clear, they need to be able to scan it within seconds and get the gist (since you may be less than coherent and in need of immediate attention).

I didn't have a plan. I booked a home birth and it all went well, but didn't feel the need to write the details down. Now I'm pregnant with DC2 (due Monday) and in another country, my mw hasn't asked what I want, other than knowing i'd like to try the birth pool, and DH knows my basic views but anything goes!

I don't have a 'plan' for birth in the sense I haven't written down that the 2nd stage will be 33 mins and I will be listening to Kumbaya when baby is crowning or some such!

However I have looked at the different possibilities that may happen and educated myself about what the options are. E.g. if I need a c/s I will need a GA, if there is a choice between forceps and ventouse I want ventouse unless the registrar has had more training/success with forceps, I want a physiological 3rd stage unless there is a clear medical indication that syntometrine needs to be administered, then I want cord traction following the injection.

I don't want to be in the position I was in with my first where I was told what was happening and I had no choice but to do it because I didn't know what the other options were or even if there were any other options! That was not a good birth at all, but DD2's where I had looked into the options/possibilities when so much easier even though I didn't actually need to make any decisions (I just gave birth!).

I had one last time saying. Epidural please and avoid ac section please. Just two lines. Doctors were aware but on the day no one looked at it. This time midwife only glanced over it but again i had an elective c section. But no one really paid attention to it. Have 3 bullet points. Busy hospital staff wont read it if longer in my experience

I disagree with all but Badgerina.

A written birth plan in your notes need only be a couple of lines. With my first mine was active birth, avoid epidural, no episiotomy.

I was fairly active (well upright as much as I could bear) avoided an epidural and didn't have an episiotomy. The midwives had read my plan.

Second was a home birth, no written plan needed.

My point though is that a 'birth plan' isn't really about what gets written in your mat. notes but about your own thoughts and feelings about giving birth. For example think about what you will do to cope with contractions 'plan' in this respect and you will have more confidence in your ability to deliver your baby. Straightforward births are normal - not lucky.

I found Ju Ju Sundin's book "Birh Skills" great for giving confidence in what your body can achieve with some forethought by your brain in advance.

Best wishes with everything.

I didn't have a plan - I thought if I had a plan and it went 'wrong' it would make the whole thing much worse, and it would make it feel like I'd lost control.

The only thing I wanted was my partner there at all times.

It is good to note down other things though - whether you want baby to have vitamin K injections, that kind of thing.

A birth plan is a bit like a marriage plan?..its a good idea to identify whats most important to you but with an awareness that you cannot to control messy reality.

As a midwife, I always read birthplans because it gives me an insight into that womans preferences and needs. Even if circumstances interfere, I know what might be a big issue for her.

No plan, no expectations as it all goes out the window anyway.

Plan to be calm and happy and welcome your baby however he/she chooses to make an entrance and things will go the way they are meant to.

Good Luck!

Just wrote mine (2nd dc):

"yes please- :) gas n air then EPIDURAL when in established labour

No thanks :( pethedine or equivalent."

It was written complete with smiley faces.

Due baby number 4 in 8 weeks, and I've never written a birth plan. I genuinely don't see the point unless there's something vital you really, really need them to know in the event you can't tell them yourself for whatever reason.

Honestly, how helpful is it to say that "no one reads the plan anyway" or "it won't happen the way you want anyway"?

Saying things like that is akin to making a mental plan for "failure" in any case.

Midwives DO often read what you've written, and it DOESN'T always go tits up. Sometimes, someone might unfortunately meet unsympathetic HCPs; sometimes, someone might experience a difficult birth and be disappointed.

Why project such negativity onto everybody's potential experience?

Best thing to do: be informed, be open-minded, be prepared to be taken to an emotional and physical place you never imagined existed.

Oh I do feel unprepared!

Managed or physiological third stage? Oral or injected vitamin K for baby? No pethidine? If I need a c/s I will need a GA? Physiological 3rd stage unless there is a clear medical indication that syntometrine needs to be administered, then I want cord traction following the injection?

Erk... I don't know what any of these things mean (I have a degree and everything (!) but I am clearly ignorant when it comes to giving birth). I better get reading, maybe I will look into Ju Ju Sundin's book "Birh Skills" too.

Thank you all for your pieces of advice.

x

I have no idea either frog, and I've had 3 dc .
You are very wise to go with the "see what happens, and how I feel and make decisions then" approach, IMO

If it helps I have OCD which manifests it's self as (mainly) a need to research and fact find on everything baby/child related, hence the level of research into birthing options/possibilities. I need to prepare myself for the birth by researching, not because I think I can control the outcome (which of course I can't and I do know this) but so I am prepared for what decisions I might have to make (and so DH is prepared in case I am unable to consent/inform).

I found having a birth plan essential for my twins birth. It was viewed and agreed upon by my midwives and OB prior to the birth and was made available at the hospital. Everyone involved had read it and stuck to it, including not offering me pain relief unless I asked for it. Which meant when I bloody wanted gas and air but couldn't speak as I was having back to back contractions I just had to do without .

But it was simple, laid out my philosophy rather than hard and fast rules and showed that I was very well researched, therefore informed consent was a real option.