Birth plan for second birth after traumatic first birth

[Fosemary2021]

Honest opinions please. Am pregnant with dc2 and am getting very anxious about giving birth again. Dc1 was a bit of an induction nightmare, very overdue, 36 hours, failed ventouse, forceps etc. All very traumatic and I felt like pretty all my wishes and preferences were overruled. Had massive PND afterwards, felt suicidal for first month. On antidepressants for a year, saw therapist etc.

So here I am about to do it again! First time around I didn't have a very detailed birth plan at all, I was very naive and thought hypnobirthing would help me etc. Anyway second time around I am determined for it to go better, and I have drafted a more detailed birth plan. I don't want to annoy them, or for them to think I'm difficult, but at the same time I just can't risk having the same experience again. I understand things can go wrong in birth, of course, but I just can't feel the same way again.

So what do you think of my birth plan below? Honest opinions. Anything you'd take out, insert?

I found the birth of my first child very traumatic, and I suffered from depression and anxiety afterwards. I am extremely anxious about giving birth again.
The health of me and my baby are obviously paramount, however I have a number of preferences for this birth that I would like to be respected.
I would like to go into labour naturally.I would ideally like to have a natural birth with minimal intervention, if that is possible for the health of the baby.
I would like to give birth in the birth centre.
I plan to not have an epidural. Please provide encouragement and support during my contractions.
I will use gas and air and a TENS machine.
All interventions need to be fully explained to me.
If it is decided that I need to be continuously monitored, then I would like the wireless monitors. I would like to be able to move around, I do not want to have to lie down on a bed.
Please do not remove any items of my clothing without my explicit consent. I would like to keep my top half covered during labour.
I would very much like to avoid the syntocindrip. I will not consent to the syntocin drip simply because my labour is progressing slowly. I am happy for it to progress slowly if the baby is not distressed.
If, due to foetal distress, it is recommended that I have the syntocindrip and I fully agree to it, then under no circumstances will this be administered without a fully working epidural in place first.
There is a chance that I will, rather than have the syntocindrip, instead request a c-section. I understand that this is my right according to NICE guidelines.
I do not consent to high (Keilland's) forceps. Instead, I would like a c-section.
After the birth, I would like a cot to be placed near the bed for the baby.

Jesus - most of what is there is very basic requirements of informed consent! They stripped you last time?! Does your midwife know what happened? In general though, I'd go brief bullets points where you can for ease of reading, put your absolute deal breakers (i.e. no forceps - c section instead) in bold and prep your birth partner to advocate your wishes. Just my thoughts to make things really clear.

Yes to all the consent stuff, although shorten it to bullet points of key points. Your DH needs to be your advocate there. The thing is, that however detailed your birth plan, you still can't control everything. Is that part of why you struggled afterwards last time? There's a lot of pressure on first time mums to have a perfectly planned natural birth with music/water/hypnotherapy but in my group of friends the reality was always very different!

Personally, I found having my first very difficult to adjust to as I am a planner and a bit anxious and like to know what's going to happen. Going with the flow (feeding, naps etc) took me a little bit of time to adjust to, although with 3DC I'm now ok with it! I also had a very traumatic first birth, shoulder dystocia requiring forceps. Very scary and we were in hospital for a week afterwards both battered and bruised and DS not feeding properly. I was offered an ELCS second and third times and they were great experiences. If that's an option I can recommend it!

Were they well aware of your birth plan the first time?

Only asking because I presumed they would be aware of my birth plan when I had my first and turns out they needed me to go through in detail my birth plan with them when I go in and give them it all written down when I went into labour and confirm everything on there with them!

I spoke to a friend about it and she said the same, that she didn't realise she needed to go through it all with them as soon as she went in!

So I'd say make sure they're fully aware when you first go in. Hand it straight over.
Although even with my second, this wasn't the first thing on my mind 😂

In your shoes I would do the opposite to what you have outlined and ask for an elective C-Section as the least stressful option. There is a reason senior female obstetricians choose them for themselves.
My first birth was induction, tens machine, gas and air, epidural, episiotomy, failed ventouse, successful forceps.

My childbearing days are over but I would have gone for an elective if I had my time again - natural birth is much overrated (rewarded with PTSD and incontinence in my case). Two ventouses prior to that but the natural one was flat out the worst. Sorry, I know it's not what you want to hear and it is not like that for everybody I know but you need to be set up for all scenarios - my second birth went the way of the first and yet I still went for it on the third one to my utmost regret. Also do be aware that an epidural is not always foolproof - if they allow it to wear off so you know when to push then it feels like pain 1-10 in seconds (much like the syntocinon), it might not be readily available, it might only take on one side (that really sucks) or it might lead to standstill and interventions anyway (ventouse for me).
Wishing you luck and peace x

Hi OP, I had a traumatic birth with my first child. Forceps, episiotomy that was excruciatingly painful for a long time afterwards, PND, unkind midwives. I think your birth plan is very good and you have thought about all the right things. As others have said, it would help the staff if you made it more concise and put the thing you are most worried about in bold at the top. I don’t know exactly what that is, but for example something like ‘Traumatic first Labour leading to postnatal depression - please respect my wishes - no syntocin drip’.
My DH wasn’t an amazing advocate during my first birth - not his fault, it’s a very hard job especially if it’s your baby and your partner having it. After much thought about why I found my experience so awful - including some therapy and going through the notes of my first Labour with the head of midwifery at the hospital - I hired a doula to be my advocate. She knew my history and what I was scared about and looked after me. I went into that Labour knowing she had my back and she was brilliant. I managed to have a homebirth for the second one and it was a brilliant experience and amazingly had the effect of restrospectively making me feel better about the first one. If you possibly can, get a doula. You don’t have to be a homebirther to have one, they will support to give birth in whatever way you choose.
I would also recommend the book ‘Your No-Guilt Pregnancy Plan’ by Rebecca Schiller. The only thing I thought about your birth plan is you sounded a bit apologetic! Don’t be. You have every right to express preferences. It actually helps midwives and doctors to know how you feel - nobody actively wants you to suffer, you just have to make it easy for them to know how to look after you in a way that would help you. Good luck, you can do it!

I had a traumatic birth first time and felt I'd really let myself down by going against my preferences because I felt so out of control. So I decided not to make a birth plan for my second. It wasn't how I'd have wanted things in an ideal world- I did have to be induced on health grounds etc- but even tho a lot of it wasn't how I'd have chosen, by not writing preferences I don't feel like I failed if that makes sense and that made my second birth incredibly healing. You don't need to agree with any of this but thought I'd offer a different perspective

Thank you for your comments everyone. I will shorten to bullet points and try to be a little less apologetic in tone!

Is it possible to just say that I refuse the syntocin drip - can I do that? That’s the thing that gives me total nightmares. It was the most horrendous experience, in agony within 10 minutes, back to back contractions and being told I had another 12 hours to go.

@MadreDios I had an epidural first time around after an hour or so on the drip and it only worked on one side. Pushing was totally impossible because one side numb other side in total agony!

@littlemisslozza I know what you mean, I definitely hoped for the all natural birth, but at the same time I am realistic. I know things can go wrong and I’m grateful for modern medicine. The thing is, with my first birth I just felt that literally every single thing I wanted to avoid was just steam rolled onto me.

I’m so sorry to hear about your experience first time. It is very similar to mine, and I haven’t been able to have another biological child because of it. (Although I have been lucky enough to adopt my dd, so every cloud and all of that!)
Anyway, my point being that when I needed help from a gynaecologist a few years after birth of ds, they advised that I would absolutely be offered a c-section should I be able to overcome things and get pregnant again. He said that it would be best to have it in place way before labour and I would be put under specialist care. This was a different hospital from my first as I didn’t use my local for ds, I used the hospital closest to where I worked. My local hospital asked for my notes and funnily enough, never got them.
Please don’t worry about all of this birth plan stuff, they never take any notice of it. Elect for a c-section and take control of things. It’s what I would have done. Congratulations on your pregnancy. Take care and good luck

You don’t have to have the syntocin drip, you don’t have to be examined for dilation, you don’t have to have anything you don’t consent to.

‘If a person’s consent is not obtained, the medical treatment will be against the law. It will be negligent, and in England and Wales, it will also constitute the crime of battery, and a civil wrong of trespass to the person.’ From here: www.birthrights.org.uk/factsheets/consenting-to-treatment/. Have a good look at their website.

The only thing to add is, when you are in your giving birth frame of mind, pants off and very possibly mooing like a cow (or was that just me ), it’s hard for you to read and understand and argue about for example the forms they get you to read and sign before they do forceps or emergency C section or ventouse or whatever. That’s why it’s good to have a birth partner who can advocate for you. Often it’s not a matter of saying no and getting into a fight. You can just ask to wait for a bit longer and see what happens.

When I went back to read notes from my first birth, I learned my baby was fine and I could’ve tried pushing for longer before I had forceps. I assumed because they suggested forceps the baby was in trouble. In fact, the hospital just had a policy that after a certain amount of time pushing, instrumental intervention should be offered. I didn’t know this and assumed the fact that a white-coated doctor turned up talking about forceps, it meant the baby was in difficulties. A doula would’ve questioned why they were suggesting it. DH and I didn’t know any better so we just agreed. My undercarriage hasn’t been quite the same since!

Sounds like a perfectly reasonable plan to me !!

Nothing in that at all makes you sound awkward. It’s your basic rights as a woman & a human. I had an induction & I can completely understand every single point you made. Stick to your guns !!!

Your birth plan sounds totally reasonable. You might find this book useful. www.amazon.co.uk/Rights-Childbirth-Matter-Pinter-Matters/dp/1780665806/ref=mp_s_a_1_1?dchild=1&keywords=human+rights+in+childbirth&sprefix=human+rights+in+chi&tag=mumsnetforu03-21&qid=1617804367&sr=8-1
I had a traumatic birth with my first and decided on a home birth for my second. A good friend also had an awful first birth and opted for an elective caesarean birth for her second. We each made the best choice for ourselves, very different choices but both right. You might also find this book useful to help you process things www.amazon.co.uk/Birth-Trauma-Second-post-traumatic-following/dp/1910923028/ref=mp_s_a_1_1?dchild=1&keywords=birth+trauma+kim+thomas&sprefix=birth+trauma+kim&tag=mumsnetforu03-21&qid=1617804557&sr=8-1

@VantiniLaBoop good point about the doula. Are they available at the moment?

It’s very wordy.

When is your baby due? Have you had any maternal health support furring pregnancy or spoke to a PMA?

I used these icons
www.positivebirthmovement.org/visualbirthplanicons/

I had a plan A for a VBAC and a plan B in case of section.

I am in a similar place OP, can I jump on your thread?
Long labour, sent home multiple times, unwanted/unasked for examinations/felt very helpless and like a failure then struggled for several months afterwards.
This time I am tossing up between vbac and elcs and can’t decide. The interventions are what freak me out, and losing control again like last time. However I do t want to regret never having a natural birth for having complications from another cs.

To the poster who said I can refuse dilation exams, what happens instead then? That’s what worries me most is the internals when I haven’t consented again.

I’ve just read your second post. You can revised to consent to anything - it’s your body and your choice.

@shittingthreeeyedraven You can absolutely refuse internal exams. I did exactly that for my second birth and asked for one (and one only) when the midwife saw that I was starting to push. She was right as I was fully dilated. I was monitored in other ways - careful observation of my behaviour by midwife, baby's heart rate etc. It sounds dramatic but an internal done without proper consent is assault. I can't bear the whole "just pop on the bed mum while I have a quick check" schtick. That's not informed consent and makes my blood boil. Again, I suggest a read of the human rights in childbirth book I linked above. It's a very quick but very informative read.