Writing a birth plan

[mrsnlw]

How do you do it?

I know pretty much what I do/don't want. I have a pre-existing medical condition and will be seeing the consultant MW on 17 July at 36 weeks to write my birth plan but what do I write/expect when I see her?

Write what you'd like to happen. An what you'd not like to happen. Birth partners, ideas about pain relief, mobile or otherwise labour, water birth etc.
It gives a rough guide to how you'd like things to go, given the option. And allows you time to think about things.
Remember though that's it's not really a 'plan' as such. Especially if it's your 1st and you have no idea of how you'll labour or how you'll cope with labour.
Be very prepared for the entire thing to go out of the window if circumstances dictate - be it that you change you mind (as is your perogative!) or if the clinical situation dictates.

Write what you would like but also be prepared for other eventualities.

I was very much aware (thanks to a few friends experiences) that birth plans are not always worth he paper they are written on.

As such I didn't do a birth plan, I just mentioned things like vitamin k, third stage management and skin to skin.

Probably a good thing as my birth was nothing like I would have hoped. Never mind, there is always next time

And good luck! No matter what happens, you won't care once you have your baby in your arms

Write what you want to happen as the ideal but also spend time working out what you would want if problems occurred. talk those complications through with your partner/birth support person.

For example I wanted skin to skin contact, if that was possible I wanted OH to have skin to skin contact.
People tend to poo poo birth plans but I think if you use them to look at all sorts of birth options they can be helpful and empowering.

Thanks for your advice ladies. I didnt want to end up writing war and peace so might even do a table of "Under no circumstance" "With advice/Consultation" and "Definites"

Has anyone got proformas for birth plans for people with medical conditions ? Most of the ones I have seen are about 'preferences'.

Mine needs to have things like "Do NOT freeze placenta, courier to Prof xyz at zyx." and so forth on it.

Also what I found comforting is more that OH and I were on the same page.

Squizita If I was you I'd download the NHS one and then add at the top the most important bits. Or even have one page that you put right at the front of your notes with the very important bits to do with your condition. That worked for my name.

one huge page of
my name is hazchem
you say it
Ha-ZCH-EM
Also make sure you helper knows those things really clearly.

Some key points, with headings and bullet points, and all on one side of the paper, should make things clear.

Don't forget to think about what may happen in the event of a CS too, you never know (happened to me) - e.g. If you want screen lowered, skin to skin etc.

And jcb's and pinot's advice above is good - be prepared for the best laid plans and all that ...

Thanks Hazchem :)

I did a google and found this on another thread. I've taken the hospital birth plan for myself. The poster says it was an NCT exmaple and I quite like it :)

HOSPITAL:

This plan is a reflection of my wishes for the birth but is in no way inflexible. I understand that for many reasons my plans may need to change to suit the needs of myself and Emily.

Induction – If it comes to it, I would not like to be induced any earlier than the 16th February.
Companion – I would like my husband David to be with me at all times. Should I not be in a position to make an informed decision, I will trust his judgment to do what he feels is best for myself and the baby. I would not like to have groups of medical students involved in the birth.
Monitoring – I would like monitoring of the baby to be kept to a minimum unless there is cause for concern. If a short, constant monitoring period is required I would prefer to sit upright or stand rather than lying down. I would prefer to be vaginally examined only when absolutely necessary.
Mobility – I would like to be as mobile as possible during labour and free to try various positions for both first and second stage. Ideally I would like to remain as upright as possible to allow gravity to take its course.
Coaching – I would appreciate being informed of what is happening during my labour and having all processes explained to me before they are undertaken. Should myself and/or David need to make a decision regarding intervention I would appreciate reasons, all alternate options and amount of time available to make a decision being explained in advance.
Pain Relief – I have a TENS machine which I would like to use for as long as it is effective. In addition I would like to have access to Entonoxand possibly a hot bath for further pain relief for as long as possible. I would like to avoid epidural or pethidine altogether.
Second Stage – Gentle support and firm guidance on when to push and how to minimize any damage through tearing would be appreciated. I would like to be advised if an episiotomy seems necessary and all efforts made to avoid this being the case.
Intervention -If assistance is needed, please use suctionrather than forceps.
Theatre – If it is absolutely necessary to undergo a c-section I would like David with me. Please use a spinal block. I would like the catheter inserted after anesthetic.
Post Birth – I would like Emily to be placed on my stomach/chest immediately after delivery and have skin-to-skin contact for as long as possible, and to allow her to find my breast. We would like to take photographs but not of the moment of birth.
Umbilical Cord – Please wait until the umbilical cord has stopped pulsating before allowing it to be cut. David does not wish to cut the cord.
Placenta – I want to deliver the placenta naturally and without the aid of drugs, unless absolutely necessary.
Vitamin K – I would like vitamin K to be administered to the baby via injection.
Feeding – I would like to breastfeed Emily. I would like her to self-attach but if this does not happen then I would appreciate some help getting her latched on and getting my positioning right.

HOME WATERBIRTH:

Dear Midwife,

Here’s our plan for our baby’s birth, preferably in water at home.
Please feel free to help yourself to drinks, food, the bathroom…

During Our Baby’s Birth

1st Stage
I would like to remain at home for the birth.
I would like my husband (Steve) and son (Robert) to be present. Also my friend Rachel. My son will go to a childminders if convenient, but if he wakes up in the morning and I am in the later stages, he will stay. If this happens, Steve will look after Rob so Rachel can be my birth partner.
I plan to have my natal hypnotherapy CD and birth music playing.
Please let me wander around and be on my own if I want to.
I would like to have the curtains closed and dim lights
I would like to remain as active as possible. Please encourage me to use my birth ball and to try gas an air (I wasn’t very patient with it last time)
I would like monitoring of the baby to be kept to a minimum unless there is cause for concern.
Pain Relief
I would like to use my TENS machine again as it was brill last time. Please encourage me to try gas & air.
I would like to stay out of the pool as long as I can so it feels more blissful when I do get in.
I would like to use the water birth pool for 1st stage and maybe the 2nd if all is well.
Advice will be welcome. Gentle support and firm guidance will be appreciated.
Transition
I wish to be very centred on myself at this stage and to have no intrusion.

2nd Stage
I am flexible about delivering baby on land or in the water and would like to play it by ear.
I wish to know when the head is crowning.
I will appreciate advice and guidance at this time to hopefully prevent a tear.
I am very anxious about tearing as I feel my previous stitches were very tight. Please do everything you can to guard my perineum.
We plan to take photographs but not of the moment of birth
I wish to hold my baby straight away. I’d like to spend a long time holding baby and letting her find my breast. If placenta is delivered then, all the better.

3rd Stage
I wish the baby to suckle to encourage 3rd Stage.
If placenta hasn’t been delivered already after spending time nursing baby, I am happy to have an actively managed 3rd stage.
I wish to exit the pool to deliver the placenta. I wish the cord to remain attached until it stops pulsating. Steve will decide on the day whether he wants to cut the cord.
We would like our baby to stay with one of us at all times.
I wish to breastfeed as soon as is appropriate.
We would prefer Vit K to be given orally unless things have gone very wrong and forceps or ventouse have been used. Then injection would be preferable.

Tears
I hope to avoid this and will appreciate support to adopt positions to minimise tears.

Emergencies
Me or Steve will discuss all eventualities as they arise. Please share any concerns with us as soon as they arise. It will help us to know the answers to these questions:
What is wrong?
What do you suggest and why?
What would be the possible outcomes with and without this intervention?
How much time do we have to make a decision?
Are there any other courses of action open to us?
We will be guided by your advice.
If we go to hospital I would like my husband and you to be with me in the ambulance. If Rachel is there, I’d like her to come in the ambulance and Steve to drive with Rob. Please remind him to bring the car seat!
In the event that assisted delivery is necessary I prefer ventouse to forceps.
If baby has to be separated from me for any reason, please let Steve take a photo of her so I can see she’s ok.
Birth Room(s)
I intend to labour in the sitting room, dining room and bathroom.
The birthing pool will be in the dining room.