Birth plans

[magnumicelolly]

Tell me about yours? What was/is on it? All thoughts appreciated!

They can assess you without doing an internal. I only had one, at about 6cms in my last labour. It was clear from my contractions (and my behaviour) that things we're progressing and I was left to decide when it was time to push.

Mine was more about birth preferences too.

I think a plan is the wrong word. Preferences more like it. I wrote that I thought I might like a water birth. It meant that it was offered at a point where I wasn't really coherent enough to ask. (It was fab!) I also said I'd like to try TENS (not in the pool obvs)
I think it's important in that it gives you a chance to think about how you might like to handle labour.
Babies often have other ideas. DC2 was a planned home water birth. Well she laughed in the face of such plans!

Sorry, just looking at your list...

I also had no internal examinations - may be difficult to avoid if labour doesn't progress

No getting out of the pool to deliver placenta - many reasons why you might not have been in the pool in the first place; a waterbirth sounds great but there are many reasons why you might have to get out of the pool.

No touching me - sadly not possible if the labour doesn't go well

No breaking waters - again, if labour is going badly this might be needed (to give a personal example, my waters had to be broken to get a fetal blood sample because they needed to work out how ill my baby way)

No touching the baby until after his/her first feed - again, if intervention is needed this wouldn't be possible

If you have a plan for every eventuality, you can get what you want.

Why would a midwife have to know how dilated you are?

Yes, but every eventuality involves medical and/or surgical intervention, sadly. I had a terribly vague birth plan and was ready to go with the flow, but I wasn't prepared for what might happen if my baby was taken immediately to NICU.

I don't mean to say your birth plan was bad. Just that it is misleading to tell anyone that they have complete control over their birth or that a plan can make a labour go well.

As for knowing how dilated you are, yes you could always refuse it, but after several days of labour it is probably safest for everyone to find out how dilated you are to get an idea whether you've completely stalled.

Blimey, why would none of my birth plan be possible?

But to ask directly, how is it not possible to not have an internal examination even if labour isn't going well (and how do you define a not going well labour?)?

How would someone get someone out of a pool against their will?

Why is it not possible to avoid touching someone if labour isn't going well (and again what criteria would you use to define this?)?

How is a midwife going to break the waters of a fully clothed woman against her consent?

I concede, that once the baby is born, depending hugely on the circumstances, he/she might need to be touched if in immediate life danger, though most of what can be done can be done in the mothers arms, or by the mother.

Starlight I am with you although I made the mistake of not writing those types of thing on my birth plan which led to confusion for the medics who didn't think I was in labour 'properly' or that my contractions were 'strong enough' until it was time to push.

I did hypnobirthing and practised yoga breathing. These rely on you having complete confidence in your body's ability to give birth without intervention. If you think about things which might go wrong in advance then it undermines your confidence.

They don't need to examine you - you don't need to push for ages when you don't have any urge to push (as I was encouraged to do unnecessarily ) just because they say so. It's your body but it's hard to remember that, the way they try to force things on you.

I did my own internal examinations with my 3rd birth (only out of curiosity in a kind of science way). With my second I just didn't have any.

I have no idea why you would need to do an internal examination to find out whether your labour had stalled. Didn't you kind of know this anyway?

I literally had to beat them off with a stick trying to get me on oxytocin drip ...

I think "getting what you want" isn't necessarily a helpful term here. Some people want a water birth - this is a black or white issue. I wanted a safe delivery where I felt empowered and informed to make the right choices for me - this was achievable with a variety of outcomes.

I was lucky there were no complications, but being broad or open minded about your definition of success does allow you, to a degree, to guarantee the birth you want (complications aside).

I think having a plan that sets the scene for you midwife (ie shows where your red lines are) is more helpful than "no forceps".

I'm not sure that you can plan for every eventuality, and if something happens which you didn't meticulously plan for, it's likely to cause you a huge amount of stres

X-posting, sorry. We're obviously posting from the experience of very different labours.

By not well I mean 2 days of regular and frequent contractions but no indication of dilation. By getting out the pool, if you or your baby seem unwell, or if there is meuconium in their waters, it is probably safest for you to get out of the pool. And by breaking the waters, as I mentioned, sometimes it is necessary to test the baby. So it's not a "fully dressed woman", it is someone who is in hospital because things have gone on for days and are going downhill quickly. And if a cs is needed, that's quite hard to do without touching...

In an ideal world I would have wanted to try the pool, I would have preferred a vaginal delivery if possible, but healthwise it wasn't possible for me or my baby. So from that perspective I think it is better to say to first time mums that hopefully they will get everything they want but there are things in labour that are sadly outside their control and they should be slightly prepared for that.

Labour stalling - "Didn't you kind of know this anyway?" - well, with a first birth, no, not really. But I guessed after 2 days that things probably weren't going too well, no....

Like what twisted. I can assure you that every eventuality was planned for.

YY, twisted

No one can force you to have your waters broken or have internal exams (although they did try to bully me into having my waters broken).

So can I ask what your plan for a stalled labour and severe dehydration leading to tachycardia in the mother and a raging infection bad enough to require nicu for the better part of a week in the baby was? I obviously didn't plan properly there

My advice is to have some idea of what you would like but be prepared to go with the flow as a straightforward labour can change very suddenly and the priority is the safe delivery of the baby.

Having something on your birth plan also doesn't mean you can't change your mind on it if HCPs put forward a good case for necessity.

Stalled labour = wait/relax/initiate oxytocin release.
Illness in mother/risk to baby = c/section

Those who make detailed birth plans, do so because they believe that they can 'control' for the safest delivery of the baby. They don't do it for themselves or an ideal or an experience.

You can control birth? My second made a rapid (and bloody) appearance in under an hour. I couldn't have caused or stopped that.

No much 'need' for a plan then.

Those aren't really answers to the situation I presented. Mainly because I imagine it's almost.impossible to decide someone is ill enough for a cs without some examination and interference

Someone else put it far more succinctly than me upthread - by all means have an ideal birth in mind but be prepared for things to change and for hcp professionals to suggest things. Planning can't prevent everything and I know people who have been quite traumatised by very fixed birth plans.going awry.

I agree with Starlight. I had 3 of my DC at home, no MW, no HCP - just me and DH. I didn't have any internals, monitoring or any other intervention.