Birth plan?!?

[TommyShelby]

Hi everyone,

Has anyone got any advice about writing a birth plan? I’m currently 34 weeks with my first baby and I have no idea where to start!

Same here. Pregnant with my 1st. So many mums say they’re a waste of time and I’ve got some friends who are doctors who have told me they roll their eyes when they see a long birth plan! They never actually go to plan!

The main thing I want is for my husband to be the one to tell me the sex of the baby. I might just leave it as that..

Call it birth preferences.

Other than that easy to read bullet points.

Answer questions like:

Do you want to give birth in water?
Do you want an active/managed placenta delivery?
Do you want pain killers? All of them? Some none?
Do you want skin to skin immediately?
Who do you want as a birth partner?

It can all go a bit out the window but if you have a preference for what’s happening when it’s going well then this is where you write that.

Also this is so people can do what you like why you are either high on meds or in a lot of pain, remember you might not be able to answer the question “what do you want now?” So it’s good to give everyone an idea of what you want before hand.

Second bullet points - I think mine just said -

Managed placenta delivery
Don’t want an epidural, gas and air only
Want my husband to tell me the sex of the baby

It might all go out the window (mine did) but it’s helpful to have a list of preferences. Much easier for midwives etc if it is brief//to the point and easy to read

Definitely be in the mindset of "preferences" and not "plan". In all likelihood it won't go precisely to plan - and that's ok

I started from the NCT template. Mine wasn’t very specific but there were things that mattered to us and some practical elements.

DH wanted to cut cord and we wanted to delay cord clamping/cutting.
I wanted the injection to deliver the placenta and baby to have Vit K
I wanted an epidural (didn’t happen), to be mobile in labour as much as poss (was due an induction but in the end labour was spontaneous).
I wanted to avoid opiates (had a small dose of Pethidine in the end) and had a preference for CS over instrumental delivery (didn’t need either).
I also made it clear we intended to breastfeed and wanted support.

That was about it, pretty short and sweet

So the best advice I got was to refer to it as birth preferences rather than plan, as pp says they rarely go to plan.

Mine certainly didn't. I wanted a water birth, active labour, very little involvement from medical staff, but in hypnobirthing, and absolutely no way to forceps.

Had merconium in waters so not pool, had to have constant ctg monitoring for the same reason, ended up in theatre with forceps. (Though I must admit I was. Or stressed one bit, and well looked after, forceps were absolutely fine, healed perfectly, no lasting damage or pain), baby came out beautifully with perfect shaped head haha.

However, the other things I included such as I wanted a dark room, my husband to be with me at all times and that he could vouch for me, to use and be encouraged to use hypnobirthing techniques, to avoid opiate pain relief was all listened to. The midwives even said when I arrived on ward they had dimmed the lights as per my request etc. The midwife knew to ensure I had skin to skin and delayed cord clamping in theatre and this was respected, as was my request for husband to be with me when/if they had to site an epidural as I'm a massive needle phobic, also that hubby was to announce the gender. All of that I'd forgotten about. It because it was written down, the midwife vouched for it and made clear that's what would happen and it did. Also the vitamin k injection.

When I was back on ward post delivery the obstetrician came down to see how I was recovering as it was a traumatic birth (didn't feel that way to me, hormones are an amazing thing, I was in cloud 9) and that the birth was exactly the opposite of my birth plan, he wanted to apologise for me not being able to have the birth I wanted and wanted to check I was ok. I thought that was really considerate and showed they had read the preferences.

So mine was a page of bullet points under subheadings
Intro: our names and jobs (both work for NHS, felt it was only fair to warn them), first baby, previous losses, very anxious mum

Environment: dim room, fairy lights, quiet etc (it wasn't quiet in the end, I kept making jokes as I remembered I find silence uncomfortable)

First stage preferences: ie being encouraged to be active, try different positions, avoid pain relief

Second stage preferences: be in the pool etc, paracetamol etc.

Third stage preferences: can't remember now

Delivery: inc cord cutting preference, skin to skin, delayed clamping, gender reveal, wanting help with breast feeding, placenta management (natural or injection) and vit k injection for baby.

There's tonnes of templates online but they're OTT and Americanised often.
nct I think has some templates on their website

Thanks everyone, this is very helpful.

All I know that I really want is warm water (either pool, bath or shower - I’m not picky!) and I don’t want the world and his wife wandering in and out.

It’s difficult for me to choose about pain relief etc because I have no frame of reference if you understand me?

All I wrote in mine was that I didn't want any medication that would make me sick!

I'm due in 3 weeks and my plan is simple.

Water birth.
Pethidine and gas and air.
Husband to pass me the baby.
Vitamin k.
Skin to skin contact.
And please dont let me see the placenta.
And anti sickness tablets before the gas and air as after I have delivered I puke Every time including blood. Sorry for Tmi.

I found this www.aptaclub.co.uk/pregnancy/practical-tools-and-tips/birth-plan.html?utm_source=newsletter&utm_medium=email&utm_campaign=1000_days_journey_pregnancy_W30&PID=6DDBDDDF-E173-48F2-9845-D19E5A15CD9F&utm_content=CTA&cid=DM61589&bid=270710021#BIRTH useful (not that I've actually done anything about it yet! (Hope link works)

Mine went completely out the window and the midwives didn't ask to see one at all, so I d just recommend knowing what you d want ideally and what to do in a worst case scenario like what if you have to have a c section for example and be flexible.

I wanted a water birth with gas and air but as they d let me go 2.5 days with one set of my waters broken and a high blood pressure, I had to go to delivery suite and got the drip as I d been stuck at 3cm and needed an episeotmy but I still got the gas and air only active labour I wanted and they asked DH if he wanted to cut the cord (originally DH didn't want to do it but then loved the idea in the moment).

I never wrote one, my midwives never asked for one when i was in labour, and my labour went nothing like i imagined.

I wanted a water birth, and if it was too painful i wanted an epidural.

I laboured at home for 36 hours, got to the hospital at 10cm, no time for water or pain relief, birthed on the bed!

Left it too late to write one for dc1 (39 weeks) and it was so far away from the birth experience I'd hoped for that for dc2 all I wrote was 'get baby out safely'.

My midwives did look at my birth plan and mentioned bits to me as things happened so they definitely read it.

Part of the benefit of writing one is to make you think about what you do and don't want and to understand what might happen in different scenarios. Write it with your birth partner (if you have one). It helps educate you about what options there will be. I wrote what I wanted e.g. waterbirth etc. But I also wrote what I would want if c-section was needed, so it had plans for different scenarios.

I decided to keep mine to things that were in my control.

I gave consent for vit k jab, for a managed third stage and that husband had to be the one to tell me the sex. This last point was the main thing in my plan. It was the most important to me.

The general jist of mine:
Water birth if possible
Dimmed lights / hypnobirth
No coached pushing
No epidural if possible
No pethidine
Minimal internal examinations
Avoid giving birth lying flat on back if possible

Ok with injection to get placenta out
Baby to have vitamin k injection
Hoping to breastfeed
Hoping for delayed cord clamping if possible with dad to cut cord if possible
I also added that if my baby were to need to go into intensive care or similar that I'd like to express colostrum to give if possible.

I know births don't go to plan but I really don't see the harm in having ideas / preferences if you accept they may have to go out the window or that u may change your mind. It's just an 'if this were to happen, this would be my preference' kind of thing. I really can't see the problem in that.

I was very fortunate that I did get my wish of a lovely water birth but so aware it could've been different. Good luck, your plan may well look totally different to mine!

Ooh and I specifically put that I was happy to have student midwives! Very happy I put that as the one I had was lovely and we discussed the perfect cup of tea while I was having my stitches which distracted me very nicely

My preference was water birth but I wasn't able to have this. I agree with you op about not having a frame of reference to be able to choose pain relief. I decided not to rule out any pain relief except the one which can affect the baby and just wing it! That way I couldn't get dissapointed or stressed if things needed to be done differently. I started on gas and air, then I had to go on a drip as I got stuck at 7cm dialated. At that point it got too much and I asked for the epidural. As someone very wise said to me, there is no medals awarded in childbirth! 😂 After my DD was born, they asked my partner if he wanted to cut the cord, and they decided for me that they were giving me the injection to deliver the placenta. But I was so besotted with baby I was just like yeah do what you got to do 🤷‍♀️

You'd be surprised how different people can be in wanting all the drugs and doctors versus whale song and placenta eating.

Making a plan is good to help you think about different aspects eg pros and cons of different pain relief.

It often all goes out the window tho! Reading up on caring for a tiny baby is also handy, eg what you dress them in, what you put them to bed in, taking them outside, how many poos a day, how to formula feed if you want or need to, how to breastfeed if you plan to. How to burp them. It's a steep learning curve and it starts immediately after birth so learning about it beforehand is helpful! There's only so much you can do to prepare for birth.

Thanks all for your guidance.

I think I am just going to go for the absolute bare bones of a list because I would rather leave my options open.
Understand completely what PPs are saying about it often goes out the window - I’m already finding this as the trust I am in has just cancelled all home births due to Covid and are pushing all their home birth ladies to our very small MLU which means I might not get my water birth after all. Slightly gutted about that

Midwife here 🙋🏻‍♀️

I always look for a birth plan in the notes or try to discuss a rough idea if possible to get a feel for what the woman wants and knows. Some people will say, for example, that they know the pain relief options available and don't want to be offered anything but will speak up as and when they do. It's helpful to know how much is known about Vitamin K, placenta delivery, feeding preferences etc. If you're anxious, it's good to know how that might present and how you can be helped with it.

It makes me sad when people put 'no episiotomy unless absolutely necessary' 🙁 believe me I don't want to do that unless it really is advisable and even then with a discussion and informed consent beforehand. Ditto 'no forceps unless absolutely necessary'- the doctors would much rather sit in the office with their coffee. Although these statements make me realise that- for whatever reason- people have lost trust in medical staff and makes me mindful to foster a trusting relationship as an advocate during labour.

Sometimes there are instructions to direct questions and take answers from partners in labour- I understand the reasoning behind this with regards to maintaining focus however legally your partner can't speak for you.

I didn't really write a birth plan myself, but I knew roughly what I did and didn't want.

How exciting!

I found writing a birth plan really helpful. I wrote 3 using bullet points and kept them short - a note card each. I write 3 because I had:

• one for my ideal waterbirth at a MLU
• one for a vaginal delivery at hospital
• one for a c-section

It helped feeling like I had some preferences whatever happened so my plan never went 'out the window'. I wrote things like 'please remind me to relax my shoulders' as I naturally tense there and my lovely midwife did several times.

Mine was very detailed and specific. In reality, it never left the hospital bag because nothing went to plan (33 hour later, followed by a cat 1 emcs). Wouldn't waste my time writing one again.

In terms of pain relief I think I wrote something like "I'd prefer to only use gas & air if possible, if I need stronger pain relief I'd prefer meptid or a mobile epidural so I can still move around". So like others have said, the first choice and the back up preferences. In the end I had a fairly quick labour and managed fine with g&a, though it did end with an episiotomy & forceps delivery on the labour ward rather than the lovely calm water birth I was hoping for