What do I need to write in my Birth Plan for an Elective C-section?

[GoldenSnitch]

I had a truly awful birth with my DS that began with Pre Eclampsia and an induction and ended in an Emergency c-section. This time I am having an elective section as I just cannot face going through it all again.

Last time I wrote a short but comprehensive birth plan that was completely ignored until I was being wheeled away to the Operating Theater.

I'm tempted to not bother to even write one at all this time given the attention that was paid to the last but I know I should.

But what do I need to write?

Obviously all the stuff about about labour that I had last time is unnecessary now - or is it? What if I go into labour before my section date?

So confused. Thinking about it reminds me of last time and makes me feel out of control and scared all over again - but not having one on the day would probably make me feel the same way too.

Can anyone help?

I didn't write one for my elective c-sections. Because I was not in screaming agony labour I was able to ask for what I wanted. Eg you see the anaesthetist beforehand and I was worried about some aspects of the spinal, particularly if I had to have a general I wanted DH to still witness the birth, and she said, that's fine, he just has to go out while we put you under then he can come back in. That reassured me a lot.

I am not sure what I would have put in if I had written one. I guess if you want to make sure you get skin-to-skin or try that thing (sorry can't remember what you call it) where the baby crawls up you to latch on, you could put it in a birthplan.

Ooh and if like me you want your DH to tell you what sex the baby is.

I can assure you that an Elective c-section is very different to an emergency. It'll be great.

Oh and usually the surgeon pops in to see you just before as well so you can mention things to him/her.

And you have quite a bit of time with the midwife before it all starts, so there is plenty of time to discuss things.

If you are booked for a section and go into labour before your due date they do a caesarean as an emergency. Don't worry - they don't make you try to have it normally.

You poor thing - your experience with DS sounds miserable. I think you will probably find an elective section will leave you feeling far more in control.

I wrote a basic plan for mine. There's not a huge amount you can choose. I think it mainly revolved around feeding. I wanted to breastfeed and I wanted to have skin to skin contact as soon as possible. I also wanted husband to tell me the sex.

It's a very calm and controlled atmosphere as they've done it loads of times before and everyone knows what is going to happen when. Hope it all goes really well .

Thanks BalloonSlayer.

I think it might make me feel better that it's all in writing just in case I end up with a GA and can't tell them what I want and also because I seem to always leave a consultant appointment thinking "damn, I forgot to ask x, y and z"

They wanted to rush DS off to SCBU after his birth as his 1st APGAR scores were so bad ) and I know DH was flustered (and wobbly - he doesn't do blood) and wouldn't have been much use even if he'd have gone with him. Poor kid had been in distress for 36 hours. Luckily, he recovered quickly and didn't have to go but he wasn't allowed to come to recovery with me so I couldn't see if he was OK for 2 hours - was supposed to be 1 hour but they couldn't find a porter or a bed on the ward.

DD (we already know the sex as I am imptient ) has too much amniotic fluid apparently, so there is a good chance that she'll need to be whisked off and suctioned too and I don't want the same thing to happen again. I will never stop hurting that I missed the first two hours of my DS's life.

Thank you too Hatty.

Golden, you poor thing. If it's any consolation, I had a GA for the birth of my twins. I had a reaction to the GA, nothing serious but it meant that I couldn't see the babies for a couple of hours. DH got to cuddle them though!

I worried for ages that perhaps somehow I hadn't bonded with them, that if I'd been awake/there/instantly in contact with them I'd somehow have a different relationship with them. Which is bizarre as I loved them from the start, I was just worried that perhaps I'd have loved them even more - whenever I felt tired or fed up with them I'd think that somehow if I'd had a perfect straightforward normal birth I'd never feel fed up with them as I'd have a different relationship!

The thing that put my mind at rest was when my third DC was born. Straightforward easy vaginal delivery. She was given to me immediately to hold and feed. I adored her from the start but the thing that made me happiest was that I could tell that instant that I loved her just the same as my twins, not more, not less. The birth didn't matter.

Which reasssured me massively that the birth doesn't matter/ how soon you get to hold your child doesn't matter - it's the rest of their lives that count. Not trying to belittle the awful experience you went through but just to try and help a little by saying please don't beat yourself up for not being there the second he arrived - I'm sure you've compensated for that a million times since!

Oh, Thank you Hatty. That does help.

You're totally right, I do worry that because I didn't get to hold him for those first hours that somehow I hadn't bonded with him properly.

I really struggled to feed him at first and I blamed not holding him. "Daddy" was his first word while "Mummy" was about his sixth and I blamed not holding him. I still sometimes feel that he loves his Daddy more than me and I blame not holding him. I've worked so hard to make sure he knows I love him more than anything else in the world but I just cannot shake the guilt that I missed those first precious hours.

Daddy's always their first word because you are always saying it to them!

It sounds like you had a dreadful time you poor thing.

DD (DC2) was taken off me about an hour after birth due to "grunting" and taken to SCBU for a couple of days. She was never in any real danger - didn't need oxygen - for example, but I can still remember the distress at being separated from her.

We bonded fine - she's 8 now!

I am going to have a think now of things you can put on your birth plan.

Birth-planny things to mention for Elective C-Section.

• I want to get breastfeeding established so please can I have some time skin-to-skin with baby

• Can someone keep a sympathetic eye on my DH as he is not good with blood.

• If I have to have a GA can my DH be present to see the baby born

• Do I have to wear those godawful stockings?

• What is the procedure on the ward for meals for C-section patients (ie do they bring them to you, bring them to you first 24hours only, does your DH have to get them?)

• Can I have music of my choice played when baby is born.

Good point about DH and the blood BS Poor thing gets all wobbly at injections!!

I've put the bit about hubby being there if I have a GA too.

The stockings aren't that bad - at least they keep your feet warm

Have asked for stitches rather than staples as I got in infected wound last time too.

IIRC mine was something like..

• skin to skin in theatre (but I asked the consultant this at 36 weeks anyway and they encouraged it)

• I wanted to see the placenta (P went very green as it was under his nose )

• lots of help for bf, we never needed it as dd was a dream to feed (unlike her big brother).

And I was a bit of a diva with the midwives and got them to do the nappy changes for the first 36 hours so I could rest and only get up to feed dd. Best thing I did as I recovered so well.

You may feel very nervous walking to theatre, I was shaking and weepy but the theatre staff were amazing and talked me through everything as they hooked me up to the machines and put the spinal block in. It is a very calm, controlled experience compared to an em cs.

I planned a VBAC (first time round was similar experience to you) so had 2 birth plans - 1 for VBAC and 1 for section.

I ended up with a semi-planned c-sec (waters broke and I didn't go into labour so I went in for a c-sec). They didn't look at the plan but I did make sure I told them the important things and they did stick to them.

I'm sure I've posted mine before on here - will see if I can find it and link.

here it is

BIRTH PLAN IN THE EVENT OF CAESAREAN SECTION

Assuming time and circumstance allows the following I would like:

? The option of the screen being lowered to see the baby being born
? To hold the baby immediately with skin to skin if possible
? To find out the sex of the baby ourselves
? The baby to stay with me as much as possible

In the event of the baby needing to go to SCBU, I would like:

? For DH to stay with the baby

I intend to breastfeed so I would like this to be attempted before any formula is provided.

On top of that they asked DH to choose the music - I hadn't bothered about this as didn't think I'd really be listening to it (which I didn't really) and was more concerned it would be something the surgeon liked .

I think a lot of it came from what I had issues with first time around as a result of a highly medicalised c-sec (obv all medicalised but dd1 had IUGR so was whisked off to be checked/ no one even told me what sex she was).

Meglet - I too was in a bit of a state going into theatre but agree - the theatre staff were fantastic.

I was too! And I was so cold, what with having had nothing to eat as well.

I forgot that the spinal makes you go all warm and cosy, like you're in a warm bed.

Ooh, daren't do the placenta thing Meglet. DH would definitely be on the floor!

I am actually a little concerned about the going into labour thing Wheelybug. I've seen about 4 consultants and the one who was supposed to book my section didn't, meaning that I wasn't offered a date until gone 37 weeks! Because of this, I had a choice of Christmas Eve or the 5th or 11th January (at which point I would be 42+1!!) After a lot of arguing and crying, they rang on Tuesday with a cancellation for the 17th Dec but I have been warned that as I will only be 38+4 and they don't like to do sections before 39 weeks, I am first in line to get bumped if someone else needs the slot.

I was also told at my 36 week scan (to check my placenta had moved as it was low and anterior - it has, thankfully!) that I have a lot of amniotic fluid. One of the side effects of this is an increased risk of early labour. Midwife was also shocked that DD is already very low and on the edge of being engaged.

If I don't get my section on the 17th, there is a very good chance I will go into labour before I get another date.

If you want to breastfeed, it's really important to be persistant about getting help through the first night.

I didn't realise how much my dts ought to be feeding and the midwives were so busy they only were able to help me get them latched on a couple of times. I couldn't pick them up myself. Both ended up on formula in NICU for a couple of days due to low blood sugar .

12 weeks now though and apart from the first 2 days, fully breastfed

Good luck with the section!

I know it's not ideal - but could you go for the Christmas Eve slot as a back up? Like you I'd rather be in control and at least then you would know it was all booked in. When is your EDD?

My DD3 was born on Boxing Day last year so I remember well the agonising over having a Christmas birthday!

OK, here's what I have so far... Bit longer than Wheelybugs!

Birth plan for GoldenSnitch

This is my second baby. I have chosen to deliver her by Elective C-section as I had a very traumatic experience with my first child?s birth and am eager to avoid repeating the experience. I am aware that circumstances may make a change necessary. This plan is meant as a guide to my preferences only.

I am happy for plans to change and recommendations to be made as long as any changes have been discussed and agreed with me and/or my Husband and are in the best interests of me and my baby.

Birth Partner - I intend my birth partner to be my Husband. I would like him to be with me at all times during my labour and delivery.

Anaesthetic ? I would like to be awake during my c-section and have my husband with me. If a General Anaesthetic is required, I would like my husband to still be present at the birth if possible.

Delivery ? I would like my baby delivered straight onto my chest if possible with skin to skin contact to aid breastfeeding. If I cannot hold the baby then I would prefer if she were given straight to her father.
I do not wish for the screen to be lowered during the birth.
I would like my husband to be able to take photographs as our baby is born and weighed etc.
At my last scan, I was told that I have a large amount of amniotic fluid so I am aware that she may need to be taken away and suctioned after birth to clear her lungs.
Please advise of any issues with our baby as they arise. I would also like to know what her APGAR scores are as they are taken.
My husband does not wish to cut the umbilical cord.

Wound ? My previous c-section wound became infected. It has been suggested that I would benefit from stitches rather than staples to close the wound this time.

Baby ? I would like to have my baby stay with me as much as possible. I do not want to be separated from her unless absolutely necessary.
I am happy for my baby to have a Vitamin K injection after birth.
If my baby has to go to Special Care for any reason, I would prefer if her father went with her.
I would prefer to try to express milk for my baby rather than give her formula milk if I am unable to feed for any reason. I do not want her to have formula unless absolutely necessary.

Recovery - I would like my baby to come to the recovery room with me if possible.

Feeding - I intend to breastfeed and would therefore like skin to skin contact with my baby as soon as possible after birth and possibly help getting baby latched on properly. I do not want her to have formula unless absolutely necessary.

On the Ward ? Please could someone show me how to detach my drain bottle from the bed when my catheter is removed. This did not happen last time and as I could not bend to see what I was doing, I ended up pulling the tube from the bottle and losing suction.

Home ? I would prefer to take my baby home as soon as possible assuming both of us are well enough to be discharged.

Does that sound OK? The phrase "if possible" comes up a lot!! I hope no-one takes offense at the formula bits. I have no problems with people feeding their babies however they want but I would like to breastfeed and am worried that formula may hinder that - it almost certainly did last time...

ps I think an awful lot of babies say "dada" a lot before "mama". Isn't it to do with the order they learn sounds in? Will try and find a link!

Re the bonding thing - I remember my midwife saying that the fact it concerned me so much showed how much I had bonded - as otherwise I wouldn't have been so bothered! She was very supportive.

I was incredibly sad about the whole thing and found it hard when other people talked about their birth experiences as I felt I had been cheated of mine. But my midwife said lots of people who haven't had sections are still out of it on the pain relief they've been given and can't remember much at first and that many mothers who had had vaginal deliveries had been worrying about bonding too.

I so hope it works out for you this time.

Sounds great!

Why would anyone be offended at the formula bits? My DS1 has a serious milk allergy, both my subsequent DC's notes had NO FORMULA AT ALL!! written all over them.

Birth plan looks great. . Don't forget that you are also more experienced this time so easier to be firmer about what you want and need and to know what will make things easiest for you all.

Hatty, the Christmas Eve slot will have been given to someone else by now but I couldn't do it anyway.

DS is almost 3 and not 5 minutes ago we had this conversation...
DS - "Mummy, I'm excited"
Me - "Excited about what sweetie"
DS "Christmas Mummy"

Because of swine flu, DS would not be allowed on the ward to visit me and I would totally miss the first Christmas that he's "got it". Boxing day would have been better.

My EDD is the 27th Dec.

The midwife who came to check my BP the day after the booking appointment doubted I'd make it to the 24th anyway as DD was so low. That and my BP is already creeping up and I had Pre Eclampsia with DS.

I just didn't want anyone who had chosen to Formula Feed thinking I was disrespecting their choice.

Snitch you're so sweet!

I had 'no formula' written all over my BP too - and they wouldn't have needed any if I'd known then what I know now!