First time mum to be, would like some advice!

[Ozziegirly]

At my next appointment with my Obs apparently we are going to talk about my birth plan. Now, I have done some reading and also have some ideas, but what I don't want is either to be bamboozled into something I don't know about, or not ask the right questions.

So, basically, I guess my "aim" for the birth is:

"To try to avoid induction for as long as possible, although I am happy with as much monitoring as you wish. I would prefer only to be induced if there is a medical reason and not on an arbitrary day.

I would like to labour in a calm atmosphere with minimal examinations, I would like to be able to move around as much as possible. I will probably want gas and air for these stages.

I would like to avoid pethadine. I am scared of a foreceps delivery more than of a c-section. I may want an epidural, but if a mobile epidural was available I would much prefer that".

So does this seem realistic, or will she look at me like this and think "here comes another one with unrealistic expectations"?

I think that sounds quite reasonable.
Can I ask why you fear forceps more that a C-sec?
My ds1 was forcep delivered. It's not bad, the after effects (for me anyway) were no different than when I had ds2 who was natural.

Just because it seems such a brutal and scary thing to be awake and have these big things inserted.

I've also read about the higher chance of incontinence problems afterwards, which I would really rather avoid if at all possible.

It's not necessarily a rational thing for me, but I kind of tense up when I have a smear, so the thought of these giant metal prongs being inserted does kind of make my blood run cold and make me feel rather shivery.

Really useful to have your comment though as all the people (only 2 people) I have spoken to said that "things have never been the same down there" after their forceps birth...

If you do end up with forceps make sure you have proper pain relief in place.

I had them without and it really was horrendous being able to feel everything. So maybe put in your birth plan that forceps are absolutely not to be used without adequate pain relief (sometimes there isn't time, but that's not what happened in my case).

Regarding monitoring - as much monitoring as they like may involve you having to lie on the bed so probably best to discuss what they have in mind here.

I had forceps and woke up in the morning quite thankful that I was mobile and would be leaving hospital that day rather than in 3 or 4.

Not saying that I would actively seek out the forceps () but recovery was far quicker than anyone I know who had a CS.

My expectations were greater than that (e.g., no induction, no/minimal monitoring, no drugs esp no epidural) and my GP treated me as if I was perfectly reasonable, and the midwives were wholly respectful at the hospital. In the end I had a couple of fairly minor interventions; an episiotomy because the cord was tight around her neck and we needed her out fast, and the cord cut immediately so we could get her to the resus table. And my GP kept apologising for the fact that she'd had to do those things.

So no, I don't think you should be worried. Do be aware that the more monitoring you agree to, the more likely it is that there'll be interventions. And most hospitals have policies on induction (the friend I had who laboured at yours was told 40+7 which is not too bad) although it might depend on the Ob not the hospital. But don't be ashamed about having your preferences and expressing them.

Thank you withorwithout - that's good to know for both of those.

I kind of pictured monitoring as me coming in, them having a feel/rummage and then saying "yep, baby still seems happy, you can go home".

This is what I mean - I don't really know the detail.

And that is v interesting mamibabi re the forceps and recovery time.

Maybe I should say "I am scared of a forceps delivery but appreciate that in some circumstances it is necessary. If it is necessary I would like an epidural, but I would really like to try anything first to avoid the use of forceps"

I think it sounds fine in principle. But I would say, be prepared for everything to change; you kins of just have to go with the flow, and alter your expectations as things develop. Dont be gutted if it doesnt all follow your plan beautifully.

No one even looked ay my birth plan btw so I didnt bother with one for ds2, and didnt even pack a bag other than baby clothes and nappies!

There's no standard recovery time from forceps. Took me a couple of weeks. I know a lady on another thread who had months and months of physio and still suffers with problems. Other people get over it quite quickly.

Monitoring tends to mean monitoring the babies heartrate - often they do it with a belt and sensors strapped to your tummy. They do have lots of other ways of doing it though which are less intrusive.

Thanks tortoise, that is also good to know.

I think in my booklet it says that they will induce at 40+7 but if everything is ok, I would prefer to be left for a few days, as long as the baby is happy.

I just feel that if they start off by inducing you, then you're already on that treadmill of intervention and monitoring anyway and then it kind of gets away from you right from the beginning.

They decided to go down the forcep route with me because I'd been pushing for 2 hours, my ds1 was back to back and then through an internal examination, they discovered he was positioned diagonally so wouldn't make it out on his own.
They took me to theatre and gave me a spinal block which is similar to an epidural, but kicks in instantly. I was numb from the chest down, and tbh, at this stage I didn't care what they did as long as they got that baby out and I could relax/sleep.
I didn't feel a thing. I heard them cut me, and I felt a fair bit of tugging when he was pulling the baby out but it was not painful or uncomfortable, just weird!
Afterwards, that whole area was sore for about 2 weeks. I couldn't stand up or sit down without having my hand pressing against 'there' because the sudden change in pressure gave me this very unpleasant horrid feeling, but it soon passed.
I was advised to start pelvic floor exercises as soon as I could as increased blood flow in the area would aid recovery.
I had a slight problem holding in urine, but tbh, I think that's pretty normal from any delivery, not just forceps, and that too improved.

C-sections are serious operations and I think any hospital would persue other options first.
Try not to worry about anything, it will all be ok and whatever happens, you will get through it and you will recover.
Goodluck

Withorwithout, and can they do that monitoring without admitting me to hospital? For example, can I just go in on a daily basis, or is it the kind of thing that suddenly deteriorates, and I would be expected to actually be in hospital?

mustrun, I agree, and i am pretty flexible, but also I want her to have in mind that she shouldn't just press ahead with a medicalised birth unless it's actually necessary, IYSWIM.

Silvery, see your experience actually sounds like something I could cope with (although still pretty scary!).

My fear is lying on the bed, feeling everything, having the baby yanked out of me with no pain relief and all my insides ending up horribly mangled.

But I have no idea if this is based on reality or my own fears.

I'm just talking about monitoring in labour as I only went 2 days overdue so never had any extra monitoring for being overdue.

There shouldn't be any reason to monitor you constantly in labour unless there is anything that makes you high risk (an epidural will make you high risk though)

Ozziegirly that is based on reality, it's what happened to me.

I'm having a c-s this time. It's the only way I can be sure someone won't do that to me again.

I understand.

I might have to do some more research about how long it's safe to not be induced for.

I don't want to do a single thing to even vaguely put my baby at risk, but equally I have had a very straightforward pregnancy and if it's a case of leaving him in there for a couple of extra days until he's ready to come out, then I would really prefer that.

I'm just off home now, so not ignoring anyone, but I'll be back on later.

Thanks so much for all your comments and suggestions, it's really helpful.

There would not always be time for an epidural. My dd was getting distressed so they decided to try a ventouse and i was told if she wasn't out quickly then the foreceps were ready (i could see them on the tray). Now i have to say i am also completly shit scared of foreceps. I pushed dd out in 5 pushes after that. Its amazing what can help you get them out

I didn't write a birth plan, when i arrived at hspital midwife asked me what my thoughts were and that was it.

Fuck, WOWY - it's impressive that you have basically lived my worst birth fear.

r e s p e c t.

It's good to know that this can happen so that I can at least prepare for the situation.

Can I ask (and I probably don't need to), if you could turn back the clock, would you go for the same birth, or a c-section?

oh and they put a local in to do it.

I didn't get a local either - didn't get that til they were stitching me and it finally dawned on them that I could feel it all.

Ozziegirly, I genuinely would rather they had done a c-section than go to an assisted delivery.

Physical recovery might take longer with a c-section but I would rather have had a long physical recovery and felt psychologically ok than the other way round.

Sorry, I don't mean to scare you, just really trying to say - write it in block capital letters on your birth plan - no forceps without adequate pain relief.

Make someone be on your side to do everything they can to get you a spinal or an epidural if it looks like it's going in that direction.

I didn't have forceps but tore quite badly when my daughter came out recently. I can honestly say I didn't have a clue I'd torn or what was really going on down there as I was so focused on the delivery. But they gave me a local before I had stiches and it kicked in almost immediately after they gave it so I didn't feel a thing. And just generally, hopefully no midwife would query your birth plan which sounds entirely reasonable to me.

Ozziegirly - with regard to induction the thread "sign in here if you are overdue" discusses due dates and delaying induction.

In thinking aqbout forceps - it is worth going back over old threads as there has been discussion of instrumental intervention. One aspect of forceps that does not seem to be readily acknowledged is the possible injury to the baby There are posters on MN who were damaged this way.
I too would want a c section rather than instrumental intervention because of the chances of long term physical and psychological problems. There are women who have had faster recoveries from c sections than VBs so dont think that cs always = terrible recovery.
Make sure that your birth partner knows that they must advocate for you to ensure that you have adequate pain relief should they need to.

Hi Ozziegirly!

I think your birthplan sounds reasonable. My plan had clearly been read by everyone I came in contact with. A couple of things I had which you might want to consider:

• no examinations/touching me unless they explain who they are and what they are doing.

If intervention is necessary this helps retain a sense of control.

• Students may observe but may not conduct any procedures which must all be conducted by fully qualified practitioners.

Re: forceps: I had them. DD was in "transverse arrest" meaning she was stuck with the side of her head blocking the exit after being back to back, trying to turn and getting completely stuck. It's not always best for you or baby to go straight to c-section in this situation. That said, I had been given spinal block so felt nothing...until the morphine suppository wore off 24 hours later. I had a pretty horrible recovery after that so don't think it would be helpful for me to add any more details.

One other point about induction: my hospital appointment was at 2pm but they made me wait until 9pm for a room/bed so I sat all day on a horrible waiting room chair. It was during this wait that dd turned back to back, undoing weeks of good work sitting on my birthing ball etc. I'd try to avoid that if you can.

Herethere - that is rubbish about the chairs, how awful for you.

They should try and put birthing balls in maternity waiting rooms if they can.

I am also thinking about my birth plan and have read some horrific threads about the damage forceps can do.
I was planning on writing in capitals on my birth plan that under no circumstances is anyone to use forceps on me = i want to go to emcs rather than forceps.

Can i insist on emcs if it comes to this?

Obviously if it is a matter of life or death then i would consent to forceps but to be honest i would expect intervention before it got to this point.

I am also instructing DH to ok all decisions made as i have heard of women signing consent forms not knowing what they were consenting to whilst off their heads on G &A/pain. I will sign nothing until he has read first.