what do midwives really think of your birth plan?

[flymo79]

I'm 37 weeks and haven't written one yet, I feel like if I do I will be setting myself up for disappointment if it doesn't happen, but also nagging feeling that if I don't set out what I really wouldn't be happy about I'll only have myself to blame re interventions etc. Are there any midwives on here? Or can someone let me know how much your birth plan is actually taken into account?

It really depends on the midwife and the birth plan. You dont need to set yourself up for disappointment, but its handy to roughly detail what you might like or prefer. For myself and my partner we intend to have a water birth, I would like as few VE's as possible and do not want any pain relief besides entinox. This is pretty much the extent of my birth plan, but I put in that I would prefer forceps to ventouse, would rather avoid episiotomy if I can and don't mind about any monitoring if things don't go to plan. We have an ideal that my partner will lift baby from pool for first skin contact and first breaths, pass to me for skin to skin and BF attempt while he cuts the cord and gets out of the pool. Then he can take baby while I exit the pool for delivery of placenta etc that needs attending. But we have that in our minds ad a perfect scene and wouldn't dream of committing it to paper.
Anyway, what I am trying to say is you can have as brief or as descriptive birth plan as you like, but having even a brief one may help you feel more in control (especially when labour is i full force and you are exhausted and have no idea of whats going on lol), more sure of the midwives taking your preferences seriously and also means that if there were any complications, your choices will be considered. For example, under NO circumstances do I want an epidural.
Try googling and reading some examples of birthplans, then you can decide whether you feel the need to have one at all, whether you might like a basic one or have stricter instructions.
p.s. found my NO epidural rule in last birth plan quite helpful as DD was long labour and I had no clue that I had asked until after when the midwives had a little laugh about it.

At the midwife led unit it was read and followed. Then I got transferred and they totally ignored it.

Not a midwife but... I think it helps to think of a birth plan as a 'what I'd spend my winnings on if I won the lottery' list. So much of the birth process is completely out of your control, that you are almost odds on to be disappointed if you fixate on it.

For what it's worth, parts of my birth plan were observed... until DS got stuck and it all got thrown out of the window. I'd previously had to throw half of it out because I needed inducing after waters broke.

So write what you would like to happen if you 'win the lottery'. Include how you want things to go if things get complicated, and if there is anything you feel very strongly about, include that too.

Then sit back, get your birth partner prepped on how they should act in certain situations and hope for the best! Good luck :)

Well my birth plan was 'give me drugs, get baby out' which went rather well!

But it does depend of the midwives. For example, in the hospital I was at, whatever would have been given an epidural when she asked for one. They told us quite clearly at the ante natal classes that if the mother asked for something, she would get it, regardless of the birth plan. They said they were not going to argue with a woman in labour and if she truly didn't want something, she wouldn't ask for it. Best laid plans and all that.

Your birth plan is completely personal and you can have it as detailed as you like. But even without a birth plan you can refuse what you like. I mentioned nothing about interventions, they still asked asked which I would prefer when it came to getting DD out (my answer of 'I don't care, just get her out!' was taken with good grace).

Maybe talk through it with your midwife at your next appointment?

thanks everyone for responses. whatever did you write no epidural then ask for it but they didn't give it to you because you had said you didn't want it?

and I had no clue that I had asked until after when the midwives had a little laugh about it.

This actually terrifies me as a 1st time mum.
How am I to know how I will handle the pain? What if I change my mind about something written based on "book-learning" half way through and am laughed at and denied because of a piece of paper?
That doesn't sound like empathy - at best lack of common sense of the HCP's part, at worst a "you made your bed now lie on it, little miss hippy" attitude!

My notes had a birth plan page, a standard form, which was read when I was admitted. I filled in sections about pain relief I would consider, positions, and then other issues like vit K options, how I planned to feed my baby, if I would accept blood products in an emergency situation and so on, issues that weren't going to change whatever else happened. The long and short of it was that I was going with the flow and would make decisions as needed.

squizita like I said, at the hospital I was at you would have been given an epidural! Birth plans are just that, plans, they are not written in stone or enshrined in law.

View them as a fluid, best case scenario type plan, but keep in mind that they can change if you want them to.

I can appreciate that there will be times, for example when baby is already very far down/crowning, when a woman will scream for an epidural and it's just not going to happen. There is clearly an element of MWs just knowing that there's not enough time/no point in giving you something you think you want, they do it all day every day after all.
But the fact that some hospitals will say they give you what you ask for despite what is in your plan makes it all a bit confusing. Based on comments, and thanks everyone, I reckon I'm better off fully briefing DP on what I/we want and ensuring he is an advocate for me, rather than relying on my wishes in writing.
squiz maybe you'd feel more confident speaking to a MW on the ward where you expect to give birth, seeing what their feedback/advice is with regard to FTM worries and what you say/do in the throes of labour?

I didn't write one. I knew what I wanted, and so did my husband, but writing it out felt weird.

I gave birth in a midwife-led unit, and we were asked a lot about what we wanted at each stage, but also well-guided. I felt like a partner rather than a patient. Having never given birth before, I was grateful for my midwife's suggestions.

The birth plan for my DC3 was short and simple:

"I would like an early epidural"

(history of long labours)

It was immediately ignored and I was talked out of an epidural. By the time I was demanding one, it was too late. I was and remain cross about this.

squiz maybe you'd feel more confident speaking to a MW on the ward where you expect to give birth, seeing what their feedback/advice is with regard to FTM worries and what you say/do in the throes of labour?

I'm not worried about my actual situation: I know they tend to go "in the moment" with what is asked for where I am going.

I was concerned that refusal of pain relief because it was on a FTMs piece of paper was being posted as if it were a GOOD thing. To me it sounds awful, like when you hear of dads saying "No, she told me she didn't want an epidural...".

...it was more the attitude that terrified me. Slightly weird I know.

Main thing on mine was NO pethidine.

I had an epidural and it was looooooovely...

I didn't a day I regret it. My mum. Who was a midwife told me just to say what I wanted but I couldn't at the time. (too much gas and air). I wanted husband to cut the cord and them to leave it too stop pulsing. Little things really. Hoping for home birth this time for more control.

oh, sorry for misunderstanding squiz

I wrote a birth preference list - rather than a plan.
It sort of said PLAN A - home water birth, PLAN B: if this doesn't work out, my preferences at hospital are xxx, PLAN C: in the event of emergency caeserean my preferences are xxx.
I ended up with plan A both times, and I think the homebirth midwives spent some time reading the list alongside my notes. It is a different situation in someone's home though. The midwife feels more like a guest and they fit in with you rather than you fitting in with how the hospital does it.
Would be interesting to hear from midwives re. what they think of plans though!

If there's something very specific you want or don't want then a birth plan is useful for the HCPs. If it's the usual 'I don't want an episiotomy/instrumental delivery unless it's necessary' then it's not as these aren't done unless necessary. The best thing to remember for you and your DP is that you can question everyone and nobody that's looking after you should be offering/suggesting/advocating a treatment option without being able to fully explain to why they think it's best and the risks and benefits at that moment in time.

The main reason for doing a birth plan is for you as it gives you a chance to have a good think and discussion with your DP about what your preferences would be in an ideal world and also if things don't go to plan as it helps you prepare for birth.

I was always terrified of the concept of epidural (and still am, but have NO logical reason as to why) and I wrote in my first birth plan that NO matter what happened, whether I asked or not in the throes of labour, I absolutely did NOT want an epidural. I do think that they would have ignored it, and given me an epidural anyway (when I asked that was) but I was having back to back labour that had been under incredibly slow progress (19 hours of entinox and only dilated to 6cm) but apparently by the time the anaesthetist arrived, my daughter was born, that was what the midwife had laughed about while I was having stitches (sorry if it sounded unclear) Either way, best of luck to the OP :)

I would expect the best, and prepare for the worst. So think about how you want your ideal birth to go, whether that be a water birth or epidural nice and early. Cutting the cord and skin to skin whether it is with you or your partner.
But remember so much of it will be out of your control. I would also give some thought to if things go wrong while you have the luxury of time to get yourself informed. If you find you cannot cope with the pain, do you have a preference for gas and air to start with, or do you want to try pethidine first?? Is your choice dependant on whereabouts in your labour you are? And also what choices you might make in the event of an induction, would this make a difference to what pain relief you would choose? Who, for example, would do you want to come with you if you need an EMC for whatever reason, if the baby needs to go to SCBU, do you want your birth partner to stay with you or go with the baby. If you need attention after the birth, do you want your partner to do the skin to skin contact?
I guess it depends on the midwife, but they do deal with births all the time, I guess they are more mindful of the possibility of having to deal quickly with a change, arm yourself with the information so you can be able to respond to what they ask you when you are likely to be in a lot of pain!

Mine was get baby out with us both left in one piece.
wipe baby before I get her.
That was it.
I dont think they do any intervention or epidural now unless its necessary anyway, well thats what my midwife said.

I wrote ten bullet points and then yellow highlighted the three most imprtant ones. The MW clearly had read and was sympathetic to my three main points.

I intend to do the same this labour but will probably have different things written on.

I had an "in an ideal world" birth preferences sheet. It said things like "support me to keep active", "I'd rather tear than be cut", "delayed cord clamping if possible", "happy to have students present".

It was loose and (I think) realistic and both midwives (I saw a shift change during labour", read it and discussed it with me. I remember we were negotiating a physiological thurs stage due to a condition I had, but it felt like an open discussion.

Anyway, I'd advise you to keep it flexible. You don't want to set your heart on a particular birth as chances are you'll get something different and that could be distressing. It's a starting point for the me to know how to help you, or was in my case.

My birth plan is actually written by a consultant midwife due to anxiety related issues and upon reading it, it has very little to do with getting the baby out as such and more on "how to deal with a anxious boudica" it has the following lines which make me grin;

Boudica may become very blunt and sarcastic in tone

Boudica will tell you multiple times that she does not trust you to carry out certain medical procedures.

Boudica will "get in a state" about the use of any needles.

Boudica will only be using gas and air.

labor is going to be a joy for all involved in my care haha

I think the most important part of the birth plan is the planning bit. So you research different bit of birth and work out how you feel about them. What you would prefer out of a range of options. It can make some things clear decisions eg I'm happy for a student midwife to attend the birth and other will give your an idea of choices you might make on the day, I'd like to try water, I want to try different upright positions. It might help you explore things like which type of vitamin K you want of even if you want it.

It's not a set in stone thing but rather a way to get some knowledge before you birth.