Birth plans

[magnumicelolly]

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

No-one has to decide whether a woman is ill enough for a cs. If there is a risk she might be with all the information available, then it would be irresponsible and unethical to do anything other than a c/s, surely?

Wow starlight
Why so many Nos? You seem very suspicious of midwives. I'm not sure your advice is massively helpful to a first timer, there is really no reason to be fearful of midwives or examinations (though of course every woman has the right to refuse them)
Personally I was very relieved to know how many cm I was. I had an irrational fear of being sent home and was convinced I couldn't cope because I was in so much pain (thinking I was in early labour) so finding out I was 8cm was brilliant.

Sugar you were fortunate then. Don't women realise that? A lovely straightforward birth is a good outcome but not everyone gets that. Medical intervention is necessary for some women.

Starlight your last point is odd. If there is a risk a woman might need a Cs, rather than examining her to assess the situation, she should just have a Cs? Really?

Eirikur - the OP's question was "what was on your birthplan", not "tell me what to put on mine"

Finding out you were 8cm might have been brilliant, but finding out you were 3cm might have got you sent home. Not so if you refuse internals.

They would have had to take your pain levels seriously as you reported them not as they assumed them to be based on a ridiculous system with no evidence base.

'Starlight your last point is odd. If there is a risk a woman might need a Cs, rather than examining her to assess the situation, she should just have a Cs? Really?'

How is it odd? What might an 'assessment' lead to? What is involved in an assessment?

Once you start with all the 'assessments', you start with the touching and the intervention and the talking and the getting out of the pool stuff all of which were unacceptable to me and imo not in the best interests of my baby, and quite frankly likely to result in an emergency c/s later in the day, rather than a more relaxed elective and controlled early, which leads to better maternal outcome, not to mention the baby's.

Actually none of the information was available to my healthcare team until they started intervention. They suggested intervention, which yes I could have refused, but without monitoring of me an my baby's heart rate no one could tell how ill we were both getting. Outwardly I presented as just a knackered woman going through a long labour. When I followed the advice of the qualified medical team (as Eirikur says, there is generally no reason to be so fearful of them) to have some monitoring and have my waters broken, essentially all hell broke loose because it turned out we were so ill. No one could have know that with the non-monitored information available to us. And in my situation, it prevented something very, very awful happening.

I am only labouring the point (and I really am very sorry for the hijack, *OP) to highlight that labours are unusual beasts and it's not always best to go in with an exceptionally rigid plan (or to ignore all the HCPs), especially in a first labour where the experience is new to you and no one knows how your body will react.

'there is really no reason to be fearful of midwives or examinations'

There's good reason to be fearful of midwives workloads, and no good reason for internal examinations. They are disruptive, invasive and have no bearing on the length of labour, nor should they be allowed to dictate what a woman needs, though they often are.

I know I was fortunate. I had 3 babies at home because the birth of my first DS was a horrific and traumatic experience. I wouldn't put myself in such a vulnerable position again. I believe some medical intervention is forced upon women because some HCP choose to follow policy.

Starlight, I do very much agree with you that internals can not always be in the best interests and that they can lead to women being sent home. I agree that's wrong, as length of labour has as much impact as dilation. However I know in my hospital, had I gone in but then refused an internal, they wouldn't have just given me a room - they were busy, they didn't have rooms to spare for someone who could easily only be 2cm. Refusing an internal may have had the same effect as being examined at 2cm i.e. being sent home.

They do play their role in the general assessment of a woman and her labour.

You sound as though you have had several children? In which case it is easier to feel more confident about what is happening when you have already been through labour before. If it is your first time then you don't know. I was sure I must be 8cm when I got checked after two days. I wasn't

Starlight How would the medical profession been able to accurately asses the risk to you or your baby, and hence make a decision about a CS, if you weren't going to let them touch you at all.

What assessment would they need to do that involved touching?

Dystocia or foetal distress

Yes I've had several children. If I had been allowed to listen to my body the first time around I would never have had such a mismanaged labour and birth and been subjected to the abuse and assault I was, causing my baby's lifelong neurological disability.

This was in a MLU in a hospital.

OP - I'd stick to one sheet of A4 with the basics and don't get too attached to it.

Having said that I requested a water birth on mine, begged for an epidural when I got there and was promptly reassured that nope, the pool was waiting for me, so they do listen

Problem is - if it's your first, you've no clue how you'll get along, so what you might want after a lovely afternoon at the antenatal class imagining blowing out candles and getting nice back rubs - might not cut it on the big day...

Good luck!

Fetal distress involves monitoring the baby's heart rate. Fetal blood tests involve taking blood samples from the baby's head, thus probably stirrups and definitely an internal examination.

It would be wonderful if they would do this without causing discomfit to the mother, but sadly at the moment they can't. And fetal blood tests are very important in working out why the baby's heart rate is irregular.

How would touching you assess for Dystocia or foetal distress?

Why can't the mother hold the Doppler to her baby's heartbeat?

Sorry, let me put that better. If there were concerns about a possible dysctocia or foetal distress or if there were concerns about your health during labour. A physical exam, and I don't mean necessarily and internal, are in my opinion, vital for a full and accurate assessment of someone.

If my baby's heart-rate was irregular I really wouldn't care why, I'd want him out immediately via the sunroof.

drawohamme, I remember the idea of candles and back rubs! I thought they sounded wonderful. Turned out that I couldn't stand the idea of anyone touching me when I was in labour. I don't know whether DP was disappointed or relieved

Temperature, woman can do herself.
Blood pressure, - woman can control herself.
Position of baby - ime midwives have no bloody clue with me.
Heart rate monitor - woman can do herself
Internal - woman can do herself if she thinks it is absolutely necessary.

What else is there?

So, for example, you would where to place a stethoscope on someone's chest to hear each different heart valve? Are you medically trained then?

There is every reason "to fear midwives and examinations". I was appalled to find out that I could only have pain relief if I consented to an internal to see if I was in labour. I had to agree because I was in agony. The smirking MW stuck her whole hand into my vagina and gave me a sweep. (I did not consent to a sweep). She whispered in my ear that I was not in labour and that she keep doing these exams until she thought I was.

My birth plan said no internals, no drips, no AROM, no students, no male HCP, no Vit K, skin to skin, my DH to cut the cord.

My MW made sure that every wish was ignored.