Birthplans - how useful and did you forget anything?

[Lupe]

Has anyone got any tips for birthplans - I mean doesn't everyone just put in the obvious stuff like "would prefer not to be cut, induced unless absolutely necessary"?

Was there anything you wish you had put in yours that you remembered after (or during!) the event?

And do people really take any notice of them?

You may find writing a birth plan gets you into the spirit of things to come - it did for me but when it actually came to being used, the midwife just laughed at it (and I too when I saw the funny side)! Everything I put down that I didn't want to happen, happened, and everything that I put down that I wanted to happen, didn't! The active, natural, calming drug free birth that I longed for turned out to be an overdue, arduous inactive labour with monitors attached to me constantly, 2 (much needed) epidurals and an emergency cesarean. I can now say that I shan't be wasting my time when it comes to being needed 2nd time around (one day!). I've actually kept a copy of it and to this day it makes me chuckle at how further from reality it really was!

Lupe,

I actually didn't write one as at the time I felt it was pointless to try and indicate what I wanted/didn't want when I had no idea how I would be able to cope with the pain, etc. and how my labour would progress.

Having been through it once, I also wouldn't write one for the next time either. Main thing I think is for you and your birth partner to be pretty well informed about what you want and what you don't want - but be prepared to go with the flow depending on what happens. IMO not having a birth plan doesn't mean you can't make informed choices and dictate the progress of labour birth as it happens.

However, if writing a birth plan will help you get your thoughts together and help you personally prepare mentally for the birth - then go for it!

Best thing to remeber is to have a flexible birth plan you can't know what might happen/ how you feel - I think it is best to tell birth partner anything you definitely do not want so they can help back you up -- my birth plan was read and I think ignored but through dtermination I did not have an epidural or c section wwhich I was set against having so it all worked out alth they did miss teh bit about likely to have panic and asthma attack (luckily dh was there and sorted it out )I think most important is let birthing partner know what you want / do not want and to let them know any fears you have they are your mouth piece whilst you are in labour

I know alot of people have different experiences but my birthplan was GREAT
The midwife followed it to the letter and explained why they had to do things i'd said i'd rather not have.

I think it is mostly the obvious stuff, what kind of pain releif you's like (but be open minded to anything), partner cutting the cord, being cut or tearing.....

Some midwives do pay attention to the birthplan so still worth filling one in, but your DP will be your best chance of letting the midwives know what you really want. Make sure your partner knows what you definately want/do not want. he'll be more help than a piece of paper that the midwives may not read. My midwife read mine after ds was born
What's obvious stuff to you "would prefer not to be cut, induced unless absolutely necessary" will not be standard for everyone, make sure you still put these things in.

I wish that I had included something like:

"Please do not offer me pain relief. I will ask if I feel I need it."

I know this may sound a little harsh, but after being offered pethidine/epidurals about 20 times and saying politely "no thank you" I got more than a little annoyed.

I think this was partly due to the number of different midwifes I had during labour - it was a busy night at the hospital and I didn't seem to have any particular midwife assigned to me.

Agree with what others have said. You partner really is the person to argue for you as you will have other things on your mind

I've just done a draft of mine for my homebirth in August. I didn't have one first time round as I just didn't know what to write! I felt in hindsight that although DH tried to make my wishes known, it would possibly have been helpful for him to have my wants laid out in writing. (He was struggling to 'double check' with me during labour as most questions directed at me were met with with either giggles or inane waffle about pethidine and gas and air, trees, flowers and whatever else sprang to my addled mind!) It also scared him to see me in pain, so it was hard for him to repel the midwife's insistance that I take pain relief .
This time I've highlighted things such as the importance of keeping DH and I fully informed if any problems do arise, how often I'd prefer to be monitored and examined, and the fact that I don't want any distracting 'cheerleading' when I'm trying to concentrate on pushing! I've made point of saying how I'd like my baby to be fed, particularly in case of emergency. I've explained how I may well be extremely vocal during labour, and that this shouldn't be mistaken as a need for pain relief, rather it's just my way of coping with it. (I was dissapointed to have had pethidine forced on me during my first labour - because I made a lot of noise!). Oh, and as it will be a homebirth, I've explained where the refreshments will be just in case I have DH in a headlock and he can't play 'host'! I've mentioned how I'd like the 3rd stage handled, which intervention I'd find acceptable, and which would be less preferable, all that kind of thing! Having said all that, I'm now in the process of trying to shorten mine a bit - I can't see the midwife being too impressed when she's met at the door with two full A4 pages worth of type!

Mine said (I promise you this is what I wrote!)

'Just get it out!!!' and that was it!

I was terrified of the whole thing and as it happened I had pre eclampsia and was induced and epiduraled etc etc

No help at all........sorry!!

All three of mine were verbal. I discussed what I wanted with DH before the births, and with the MWs at the time. But TBH I think I've been quite lucky in that, between contractions, I'm always pretty lucid. I only really used entonox, and it doesn't have that strong an effect on me (well, it helped a lot with the pain but didn't make me see leprechauns or anything )

The only real difference from the first is that with 2 and 3 I made sure the MWs knew that I wanted to know EXACTLY what was happening and why. I hate being out of control, I don't mind what they have to do so long as they tell me first and I have an opportunity to say 'bugger off'!

i did my birth plan and the nearest i got to useing it was
midwife:do you have a birth plan
me:yes what do you need to know or would you like me to get it
midwife:no was just wondering what drugs you wanted
me:the useual
midwifeh ok
and that was how much they followed my birth plan hope there are some better stories for you on here

I planned a hospital water birth, but our ds arrived with a very fast, home birth. I know I'm lucky to have had such a positive time of it. But I reckon its really important to to be able to go with the flow if the birth doesn't go "to plan".

The only planned part of 2nd stage to work out as I'd expected was that I wanted dh to tell me what sex our baby was. I'm really pleased now that it was his voice to tell me we had a little boy.

I didn't write a birth plan first time around just said that i'd see how things went at the time.

After that experience this time I around I wrote a birth plan. Mainly said, going by first experience, what I Didn't want, followed by things like...

if I want an epidural/ gas and air/diamorphine I'll ask for it.
if i need a section/forceps etc I want everything to be explained beforehand, disscussed etc.
and I didn't want to be strapped to monitors unless medically necessary.

went into labour went to hospital the midwife read my birthplan and she stuck to it. I can honestly say it was brilliant. Wasn't offered anything they just let me get on with it all myself and it was brilliant. towards the end about 3 hours before I actually delivered the midwives changed but the 2nd one was just as nice. She asked me what I wanted and I said I'd had enough and wanted a section, I didn't really was just fed up and had had enough, she reminded me that I had put that I didn't want that and did I want to try gas and air. I tried it after thinking about it for an hour but was sceptical (sp?) since it had made me feel so ill the first time but this time it was ok and I felt a lot more in control. dd2 as delivered naturally 2 hours later. The best experience of my life.

I'd say that you do have to be flexible you don't know how things are going to turn out during labour but to have a rough idea in your head and having it written down can help. Also to let your birth partner know exactly whats in your birth plan so they can reinforce any of your requests if the midwives don't read it/stick to it.

Good Luck

I spend a good time writing it, at the end I had not even the energy to pull it out of my hospital bag, I don't think the not-so-nice midwife I got would have been interested.

Go with the flow, sometimes you need to adhere to what the doctors/midwives suggest. One could wish but, most of the times, they know better...

I've written a really detailed birth plan, but I'm having a CS so I guess it's easier to plan?

A lot of mine is reminding people how impt skin to skin is to establish BF and how I'm not to be trated like a single parent.

We'll see...

I would say things that are LESS usual are worth writing and HIGHLIGHTING to the midwife.... like wanting no syntometrine (the injection for the placenta) or no vitamin K.
If you genuienly do not want an epidual, say so and maybe explain why like intense fear of needles - if you don't want pethidine it may be because you know you react very badly to that sort of anaesthesia.
If you want to deliver the placenta and only THEN clamp and cut... of course you need to write it up and say so before the baby is born.
Other "unusual" requests are use of alternative therapies like homeopathy, aromatherapy or massage. Though they are not a problem, it is useful for the MW to know you are into this.

Episiotomies are usually only done when necessary.... and regardless of what you write some MW are cut happy and others are not.... you can't avoid that !

Generally I would say your partner should tell MW to READ the birth plan (if she hasn't done so on arrival) otherwise most don't (and they expect all births plans to say the same things....)...

I have found some MW very receptive and supportive of women wanting a natural (no drug) birth - so it is important to say if this what you are aiming for.... and they might help you achieve this by giving you more support.... technically you will need less support if you go for medicated pain relief.

I didn't find it very useful the first time but I think that's because I'd set my heart on a water birth and needed inducing. I hadn't said a definite no no to an epidural and as labour lasted 16 hours I ended up having one.

The second time though it did come in useful as I'd put on it I wanted to use TENS etc.. and lavender oil. The midwife did read it and noted my needs.

looking back on my how silly was i.....

I put no pain relief i want it "o natural" and in big big writing no way will i have an eperdural.

Make sure the baby is cleaned before passed to us....

I'd like a nice bath afterwards

When in reality.

I had every thing as far as pain relief went - gas n air - pethadeine two failed eperdurals.

Baby was cleaned up as was coved in blood

bath didn't have one till the next day (dd born 11.27pm) as was far to knackered.

So next time i will jsut go with the flow.

First time round, the midwife didn't read my birth plan and although I had gone through it with dp we were both 'inexperienced' and didn't really push for stuff we wanted/didn't want. Also, I had planned a home birth but ended up being induced so I think the assumption was that nothing on my birth plan applied when in fact it still did.

This time round, I'm still planning a home birth. Have talked to the midwives about whether it's worth writing a birth plan and they said just give us a list of bullet points, so mine includes stuff like 'able to move around', 'preferably no internal examinations', 'natural third stage' and, v.importantly 'no formula for the baby even if either of us has to go into hospital' since ds1 was given formula on two occasions in the hospital - not a good idea because dp and I both had cows milk intolerances and ds1 ended up with one too.

I think writing a birth plan helps you to really think about what you want. I am very pleased with the midwives and hopefully they know enough about my wishes to avoid doing stuff that I don't want - but if I were in hospital again I would want someone around who knew my wishes inside out and was prepared to be assertive about them - so it's important to go through it with your partner too.

If you have strong feelings about what kind of pain relief you want (or if you don't want to be offered any) I think you should make it clear because otherwise (hospital) midwives will probably offer you whatever they think is standard.

hth

Sam

My hospital had a birth plan questionnaire they made you fill out before you were admitted. Things like did you want a water birth, birthing ball, what for pain, etc. I didn't know how it would go, so mostly I put wait and see. That was a good thing, cause when I got there I was 8 cm dilated, and most of the stuff was too late to happen anyway. To top it all off, they had lost mine. I had wanted drugs, but ended up having a 100% natural birth, as it was too late for the epidural, and was afraid of IV's.

It is part of the admission process in my unit that midwives go over women's birthplans. They have a preprinted sheet in their hand-held notes which the community midwife goes through with them around about 36 weeks.

I have to say that the majority of women have no plan at all and are just happy to do what is advised. I find that quite sad really because I really like it when someone has a detailed plan with alternatives because it shows they have researched labour.

The downside though is when a plan is made that is completely rigid and then the woman is unprepared for things 'going wrong' such as the baby passing meconium during labour which is an indication for continuous fetal monitoring which rules out waterbirth for example.

The other issue for me as a midwife is when a couple have agreed that under no circumstances do they want an epidural. I have had instances where the woman is asking for one and her partner is insistant she has not to get it because that is what they have agreed. Fair enough if delivery is imminent, but if the woman is experiencing an unexpectedly painful/complicated labour, it puts the midwife in a very difficult position. It saddens me to hear women apologising to their partners because they have asked for an epidural and he takes the huff .

What are the views on that?

I did one for both natural and c-section deliveries.

Not only were they good for reminding DH what I wanted and didn't want to happen but I also wrote his name on it so the midwives could call him by his first name. Reminders that I wanted to feed the baby before being weighed, etc.

Apparently women don't normally do them for c-sections but there were still things that were important to me that I wrote down and I think I was more involved because of that - may have been wrong there but that's what I felt. I was trying to reclaim it as my baby's birth and not another operation.

I'd recommend writing one. Regardless of whether the midwives look at it in labour, it's good for getting your thoughts in order. Having said that, my midwives read both of my plans and stuck by them, asking me when things warrented deviating from it. They're great to help your partner remember what you want too.

I would have been seriously annoyed if DH had told me I couldn't have something because we'd agreed not to have it. I think I may well have kicked him out of the room - probably literally!

Sorry this is long - I got a bit carried away!!

We had a birthplan and it was great - the wonderful midwives discussed it before the birth and then it was followed through. A couple of things I think are really good to put on (if they're important to you - and bear in mind I'm based in the US where birth is even less personal than the UK - apologies to any American MNers - just my observation!) -

1. I would like to wear my own clothes to labour and deliver in - not some sterile hospital gown

2. Skin to skin contact - absolely crucial to us

3. Leave the umbilical cord intact until it stops pulsing to allow maximum transferral of antibodies (this couldn't happen for us when it actually came down to it as dd had a very short umbilical cord and in order to try BFing my dh had to cut the cord whilst it was still pulsing)

4. Don't offer me drugs (as mentioned by PreggieMum earlier) - believe me I will ask for them if necessary! I think this is really important as if they are not offered (and my nurses & midwife really stood by this)you're more likely to have the natural birth your after (if that is what you are striving towards)

5. Lights dimmed and room as quiet as possible for entire labour and delivery

6. Baby to remain with mother for at least one hour before newborn exam takes place (not sure what the protocol is in the UK but here they would have tried to take my dd away after about 15 mins for anything up to 4 hours - how terrible! This didn't happen to us thankfully.

7. NO BATH FOR BABY! This was a battle for us but worth it, dd had her first bath aged 7 days and dh and I cried - her gorgeous smell was washed off....though of course she smells equally gorgeous now! Again, I have a hunch that UK protocol doesn't include a bath for baby but I'm not sure.

We also did a post birth plan for our dd - the main thing was no formula to be offered, the baby will be breastfed only.....as it turned out she didn't actually breastfeed at all until 72 hours old but that's another story !!

I think the main benefit of doing a birthplan is so you can learn/research and think about how you want your birth to go - if you don't think about it or plan it at all you will most likely end up with a hospital managed non-active birth - and you might secretly be hoping for a wonderful life enriching experience....you might feel disappointed afterwards. Of course it is very important to be flexible on every part of your plan - birth is a big unknown until you're doing it and we all handle pain/stress differently.

I hope you have the birth you are after. Good Luck!

I kept mine very simple, reckoned that way the MWs would remember it, find it easier to stick to. Just a few lines, something like:

"As few interventions as possible.

Gas and air -- yes please!

No syntometrine.

Don't cut cord until it stops pulsating

No Vitamin K."

I think that was about it. I had the syntometrine in the end, after the placenta was born, due to PPH -- you're allowed to deviate from the plan, after all.

ps: MummyinTExas I think you're right about bathing newborns being unusual in UK. I found it bizarre when I found out babies are routinely bathed when born in US hospitals doesn't the poor thing cry its head off? Am sure mine would have. I can't see the point.