Advice re birth plan

[FredKiller]

So, tonight's project is to write my birth plan. I'm 33 weeks with dc2.

DS's birth was pretty horrible, although outcome was healthy baby etc so I'm not complaining too much. Short version is waters broke, i didnt progress, ended up with antibiotics, epidural and sintocin. After 2 days in hospital (no food or sleep), he was delivered by ventouse and i had an episiotomy. i was very out of sorts afterwards, didn't really have any interest in holding ds, didn't even ask if he was boy or girl (and no one told me) and didn't bf him for 30 hours or so.

Now, whenever I think about his birth, I get very emotional (and not in a good way). I've tried talking to MWs about it, but usually get too upset.

This time around I want to avoid some of the things that happened to me, although I realise they were all out of my control.

Key points for me are:

Want to try and progress naturally as much as possible. But after last time I will probably need extra reassurance that my body can and will do it, as I have my doubts.

If I need an episiotomy, I want them to tell me/ask me and not just cut me like last time.

I'm terrified of forceps and want to avoid them at all cost. Can I ask for a CS instead if they look necessary?

Skin to skin and bfing are really important to me, an I want to be helped to do them, if I don't have presence of mind to initiate them myself. Ditto re telling me the sex!

Basically, I want the MWs to read my birth plan and take it seriously. I don't want to bang on and on about last time, or look like I'm complaining about it, but I really want to get these points across.

Any tips on writing an effective plan would be gratefully received. Thank you.

I'm sorry to hear your first birth wasn't great op, but glad you and your baby are ok. Tbh I think you have every right to complain about the episiotomy without consent and the lack of encouragement to bf.

From my (limited) experience, the most important part of my birth plan was making sure that my DH knew exactly what I wanted, in particular the aspects that I had specific concerns over and the bits that I felt were non-negotiable. That meant that when I was out of it, when events took over, or when the mw didn't have the time/inclination to pay it much attention, I had someone who could speak for me. He knew the things to question and watch out for. So if you have a birth partner, I'd advise you make sure they know your birth plan backwards.

I also found it helped in the early stages, when things were slow and calm, to explain some things that were important to me to the m/w. She wrote some of this down in the notes, which meant the m/w she handed over to midway through labour also knew these aspects. That's probably more effective than having a separate birth plan as they HAVE to be referring to and writing in your notes constantly, so are more likely to pay attention to what's in there iyswim.

Good luck and I hope you have a more positive experience this time.

From reading your post you have pretty much written your birth plan. Start with just the key points like you have pointed out, and give a copy to your DH so he knows.

Yes you can express a preference for c-section if forceps are lookin likely but as with everything you need to keep an open mind that it may not be possible.

I agree with the previous poster that its good to tell the midwife your preferences in the early stages, or if you find things progressing fast make sure your DH can speak up for you.

I had an awful experience with my DS but i had a preference for vontouse over forceps if it came to it, and the consultant did try vontouse first but we ended up with forceps and a huge episiotomy.

Thanks for your replies.

DH is well aware of my preferences but I'm not sure he truly understands why I have such strong reactions to DS's birth, given he arrived safely. i think he secretly thinks I'm being a bit hysterical about it all. He also doesn't get why I beat myself up about having had an epidural, in his eyes if you're in pain, you just take the drugs! However, I did get him to concede that he would be upset about anyone cutting his genitals with scissors with no prior warning. I'll have another chat with him once I've written everything down and make sure he can speak for me.

I do accept that, to a large part, what will be will be. I just felt so out of control last time and my reaction post-birth re my lack of interest in DS still haunts me. I so want to have that fuzzy, warm, post birth snuggly time you hear about.

The MW told me that there was nothing I could have done to prevent DS's birth from going how it did. I found that comforting, as I had always believed that my choice to have an epidural messed everything up. However, she informed me that I would have needed antibiotics and induction because so much time had passed after my waters breaking, so in all likelihood I would have ended up flat on my back with drips in place.

I know there are no guarantees but I'm hoping everything is a lot more straight forward this time round.

Could you arrange to go through your notes from last time with your DH there too, so he might be able to understand a bit more but also to help reinforce what you dont want to happen.

I had ptsd & pnd following my DS birth and had counselling which really helped.

If its any help i too questioned whether having an epidural was part of the problem but when discussing it with my DH he said no, i needed that epidural as he could tell i would not have coped with the pain any longer.

It does sound like a debrief would be beneficial for you both - if you can understand a bit better why things happened the way they did it may help you to approach this birth with a bit more confidence.

All hospitals have their own procedures but to get mine I made a formal request for my notes to the records department and in the letter requested a meeting with the consultant to discuss my care. They phoned me within a couple of weeks to suggest some dates and we had the meeting within four weeks of me making the request. Your hospital's website should have info about how you can request a debrief and your notes.

I can honestly say that having a debrief has really helped me understand how my (fairly traumatic) birth of DD went the way it did, which has sort of helped me to put it behind me. It also highlighted a few things that I'd like to be different next time (eg I didn't get cuddle time or skin to skin either) and helped me work out how I can make sure they happen differently. I really feel like I can be a bit more in control next time.

Good luck with whatever you choose to do.

You can have a debrief to discuss your first birth for any amount of time after it has happened. I was induced with epidural too, less traumatically but all very quickly done, leaving me with lots of questions etc. I found that being given the chance to talk about it (mine not til an ante-natal class during this pg) really helped me.

Ref the birth plan, I'd copy and paste what you wrote, print it off and put in your notes and show it to the midwife caring for you on arrival.

Can you afford to consider having a doula with you? Your DH may not understand as you say, and on the day his focus will be on ensuring a healthy baby, possibly by whatever means are suggested or instigated by the medical ream. A doula may be a good option as a birth plan representative for you and a mediator of sorts between midwives/doctors and you and your DH.

My first labour was also pretty awful and was a list of how things shouldn't be really. However, even though I didn't write a birth plan I had plenty of opportunity to talk to mid wife during labour about what I wanted second time around. Birth was easier, I felt more in control and I felt that midwife was asking me as and when necessary about preferences. By all means write it down but you might also find that your experience will be different given that your body has been through it and also that you now know more anyway.

Before I had dd1 I kept drumming into dh that his job was to be my advocate! In fact I probably told him his job was to make people do exactly what I wanted...

Seriously, I think it is important because you are not in much of a position to put your point of view across while giving birth.

I agree with all the above comments, such as maybe getting a doula, and definitely printing out a list of what you want. You can then give it to husband as well as putting it on your notes.

PS - in my labour I wasn't asked to do a birth plan because I was baby was high risk. When I asked about it the doctors said I had been medicalised (!). However, the only thing I really knew was that I didn't want an epidural (scared of them) so there wouldn't have been much to write.

FredKiller, can I say just two things?

1. Please stop fretting about having had an epidural. You had a very traumatic first birth (remarkably similar to mine actually) and you absolutely needed an epidural. That's why they exist - and hallelujah! You and I were unlucky first time round - whatever certain posters on that other thread think and no amount of "breathing the golden thread" bollocks could have helped either of us. Just be thankful the pain relief was made available when you needed it.

1. Please don't worry about forceps. Firstly, it's unlikely to come into play with a second birth. Secondly, I had them - the low ones, baby was really far down just a bit stuck - and he came out with not a single mark on him. Yes, I had an episiotomy first, but healed quickly and am very relieved the forceps worked and I didn't need a c-section. C-section is major abdominal surgery and not to be taken lightly.

Good luck!