Birthplan - do you think I've missed anything??

[Chelle1986]

So...it prob won't end up getting followed to the last letter due to the unpredictability of childbirth!! But.....this is what I have so far - does anyone more experienced than me think I've missed anything??

?I would like there to be a bath available during labour.
?I want to be as mobile as possible during labour.
?Medical staff in room to be kept to a minimum.
?DP is to cut the umbilical cord, where he is unable to do so, Mum may do this if she so wishes.
?Baby should be delivered on to me unless treatment is needed for the baby immediately after delivery.
?Besides medical staff, only DP and Mum to be allowed in to the room during labour and recovery period.
?Gas and air to be provided in the first instance.
?Not strongly opposed to any type of pain relief / Csection etc, however where consent cannot be sought from myself it must be sought from DP.
?Should I end up in a position where I have to be put under general anaesthetic or am incoherent, I consent to DP to be able to make decisions on my behalf.
?Should I remain incoherent or under general anaesthetic after the baby is born, no one other than medical staff or DP are to handle the baby before I do.

Legally speaking your DP cannot give consent on your behalf (unless he has Power of Attorney for you which is v. unlikely) but can idicate what you would've liked (as indicated on your birthplan). Ultimately the healthcare professionals will have to decide what they think is in your best interests if you cannot give consent yourself. I guess that's why a birthplan is important in some ways.

Vitamin k? Physiological third stage?

Intervention? Are you happy for ventouse or forceps to be tried?

Episiotomy or tear?

I am not sure who else you think will be entering your labour room apart from medical staff or your DP/DM?

A genuine question as I am not sure who else would be there.

Here is an abridged version of mine;

Birth Plan for cece

My birth partner is my husband, DH

I would prefer to be kept informed of what is happening at all times, and to be involved in decision making before any drugs are administered or procedures undertaken. If I am unable to be consulted (for whatever reason) my birth partner should be asked instead

Pain relief Preferences
During early labour I would like to use a TENS machine, water, and gas and air as pain relief. Later I would like to use gas and air, in combination with pethidine as pain relief ? please suggest these options as I need them.

After the birth
After the birth I would prefer the baby delivered onto my tummy, and for DH and I to discover the gender for ourselves.
DH would like to cut the cord if possible.
I would like assistance to help breastfeed the baby soon after the birth.
I would like my baby to receive the Vitamin K injection.
I am happy to have assistance to deliver the placenta.

If possible I would prefer to stay in hospital in order to establish breastfeeding. Despite breastfeeding my two other children I have always experienced problems establishing feeding. I would therefore like help from a breastfeeding counsellor if one is available.

perhaps OP means students? If so that is a better way to put it

Oh well I would count a student as medical staff, so yes, perhaps it would be better to specify no students.

You can have mine if you want. I didn't get to use any of it.

Mine said:

Minimal intervention
Natural 3rd stage
Do not offer pethidine

In the event it was not required as DD was delivered 15 minutes after ariving at labour ward

I hope it doesn't have to be followed to the letter! It's quite pessimistic - it's very rare to end up having a general anaesthetic, but I guess it's best to be prepared.

The first thing I thought about was your mum's role - I notice you don't want her holding your baby before you or DP. Would it be an idea to clarify further - do you mind her staring at the 'business end' for example, or is she there for hand holding and mopping your brow? Doesn't necessarily need to go on the birth plan but worth discussing with her.

Do you just want a normal bath or a birthing pool if available?

Do you want vitamin K by injection or orally?

Do you plan to breastfeed? Do you want help to establish this?

Any random things that might annoy you, or requests to make it easier? For example, my plan said nobody was to call me a 'Good Girl' cos that would really piss me off!!

My midwife laughed at my first birth plan; was 2 sides of typed A4 . But I cut it down by reading the NICE guidelines which the medical staff should adhere to. After reading the guidelines I just put in my birth plan anything that was different/optional according to guidelines. e.g. guidelines say immediate skin to skin after birth, so missed that off birth plan. Had things like physiological 3rd stage, no internal exams, and vitK jag in though, as these are all options in guidelines.

This cut my birth plan down considerably...

Also have a think about pre-birth stuff e.g. what do you want to happen if you need to b induced (or would you refuse induction?)

I would like there to be a bath available during labour.

DO ALL THE ROOMS HAVE BATHS?

?I want to be as mobile as possible during labour.
THIS MEANS NO EPIDURAL.

?Medical staff in room to be kept to a minimum.
OK

?DP is to cut the umbilical cord, where he is unable to do so, Mum may do this if she so wishes.
I THINK IF YOUR DP IS UNABLE WHY WOULD YOUR MUM BE ABLE TO - DH ONLY CUT THE CORD ONCE, THE OTHER 2 TIMES THE MIDWIFE DID IT QUICKLY AS DD AND DS2 NEEDED EXTERNAL OXYGEN.

?Baby should be delivered on to me unless treatment is needed for the baby immediately after delivery.
??? NOT REALLY SURE WHAT YOU MEAN BY THIS. IF YOU ARE MOBILE, IE STANDING, SQUATTING HOW IS THE BABY GOING TO BE DELIVERED ON YOU??? I THINK DELIVERED ON YOU ONLY APPLICABLE IF LYING ON BACK?

?Besides medical staff, only DP and Mum to be allowed in to the room during labour and recovery period.
REPETITION OF COMMENT RE: NO EXTRA PEOPLE ABOVE

?Gas and air to be provided in the first instance.
OK

?Not strongly opposed to any type of pain relief / Csection etc, however where consent cannot be sought from myself it must be sought from DP.
NOT SURE IF THIS IS LEGALLY POSSIBLE?

?Should I end up in a position where I have to be put under general anaesthetic or am incoherent, I consent to DP to be able to make decisions on my behalf.
AGAIN NOT SURE IF THIS IS POSSIBLE.

?Should I remain incoherent or under general anaesthetic after the baby is born, no one other than medical staff or DP are to handle the baby before I do.
WHO ELSE WOULD BE HANDLING THE BABY? IF YOU ARE UNDER GA VERY UNLIKELY YOUR DP WOULD BE ALLOWED TO WATCH. SOUNDS A BIT PESSIMISTIC TO EVEN MENTION POSSIBILITY OF GEN A.

YOU HAVE MISSED OUT:
THIRD STAGE
VIT K
WOULD YOU CONSIDER PETHIDINE OR PREFER TO GO STRAIGHT TO EPIDURAL.
WOULD YOU LIKE SUPPORT TO AVOID EPIDURAL OR DO YOU WANT EPIDURAL?

By the way here is mine, maybe that helps??

Environment
I would really like to give birth in a birth pool. I would like low lights, music, etc and as few interruptions.
I don?t want extra people in the room.
I would prefer to stay at home for as long as possible.

On Arrival
My DH is my birth partner.
I do not want to have any internal examinations or CFM unless medically essential.
I would like to be admitted directly to the room I will give birth in.

Pain relief
I will have my own TENS machine and I will use gas and air.
I do not want Pethidine as I like to be in control and I am concerned about its effects on the baby.
I do not want to have an epidural.
I want to be in water, especially for 2nd stage.

Other considerations
I want to be encouraged to remain active and mobile throughout; please don?t ask me to lie on my back on the bed.
I would like a hand off approach, i.e. to birth and deliver the baby myself.
I do not want to be told to push (unless medically necessary e.g. baby distressed and needs to be born quickly) however would appreciate being reminded not to push to avoid tearing when baby is crowning.
I will listen to, and follow, medical advice, but please explain thoroughly so that I understand why something may be necessary.

Third Stage
I would like to try for natural third stage but if it?s taking too long I might ask for the injection.

Afterwards
I will probably be too exhausted to hold the baby so DH will hold him.
I want to have the anti-D injection immediately rather than waiting for the baby?s blood group results unless the results can be available extremely quickly.
I would like the baby to have vitamin K orally.
I would like to be discharged as soon as possible after the birth, directly from the birth centre.

OP, your DH cannot give consent for you in the UK. Nor can he make decisions on your behalf.

Do you want to be told the gender or discover it for yourself?

OP, I had the same 'other considerations' section as mumswlondon's- with a few additions:

I requested that the cord was not cut until it had stopped pulsating.

I requested that the baby be passed straight to me.

I made it clear that I did not want students to be present.

Oh, and good luck by the way. Hope you get the birth you want.

Agree you need to think about how the placenta should be delivered. Also (haven't seen anyone else mention this) whether you want the cord to be cut immediately or whether you want the blood still in the cord and placenta to be delivered to the baby before you do so. There are plenty of arguments for doing so - the baby could do with the blood and it makes the placenta easier to deliver. It's a question of whether you want the baby to remain on your chest, still attached to you with the cord still going into you, while you wait for it to stop pulsing.

wow. Never seen so much detail in my life on some of these birth plans.

My top line would be KEEP AN OPEN MIND.You have to believe you are going to do this first and foremost before you go into any details.I have seen so many people end up depressed and with issues over births that didnt work out the way they processed in their minds...even though babies come out healthy and the mother fine....which is the point at the end of the day

My birth plan was to go to birth centre so that birth was mid-wife driven.
See how I manage the pain as to what I need.
Injection for placenta and vit K for baby.

Good luck to you. Relax, keep your fingers crossed and listen to the midwife who knows what she is talking about (there are some of them around). It is such a case by case basis. You dont know what you will end up with.

wow. Never seen so much detail in my life on some of these birth plans.

My top line would be KEEP AN OPEN MIND.You have to believe you are going to do this first and foremost before you go into any details.I have seen so many people end up depressed and with issues over births that didnt work out the way they processed in their minds...even though babies come out healthy and the mother fine....which is the point at the end of the day

My birth plan was to go to birth centre so that birth was mid-wife driven.
See how I manage the pain as to what I need.
Injection for placenta and vit K for baby.

Good luck to you. Relax, keep your fingers crossed and listen to the midwife who knows what she is talking about (there are some of them around). It is such a case by case basis. You dont know what you will end up with.

Didn't bother with a birth plan for first baby. Despite being medical and having watch lots of births, I had no idea how I would handle the pain. Second time around I put down - 1) happy to have students involved, 2) happy to have vit K injection for baby, 3) would probably ask for an epidural, 4) ideally would like a physiological third stage. Got 2/4 (student and vit K).
Keep it brief and to the point. The midwife wants to be looking after you not reading an essay.

Totally agree with Esme01/Lerato, I didn't know how I'd handle the pain as I'd never had a baby before. I didn't end up having anything other than gas and air but kept an open mind as everything was new.

I really thought I'd be up for lots of massage from dp etc. but in reality I couldn't handle anyone touching me or coming near me. Thought I'd want to walk around and stand up lots but in reality, didn't want to move much at all. Birthing pool was great but I'd probably have been just as happy under a bush.

I also know too many people that stressed over not having any kind of pain relief and ended up having loads, then felt guilty about it.

With this in mind, I guess the essential parts are the vit K etc bits. I personally wouldn't want to set any of the birthing process in stone as it can be so unpredictable + you have less to beat yourself up about if it doesn't go to plan.

Here is my birth plan

1. I have tested Group B strep Positive

2.I am allergic to MORPHINE 3.I would like to use the pool in early labour if possible 4.I f I ask for an epidural during labour it means I really want one please don?t try and persuade me otherwise 5.If I am induced and require a Synto drip I want an epidural BEFORE the drop is started. 6.If it comes down to it I would prefer to have an emergency c-section rather than instrumental delivery 7.Happy for injection to deliver placenta 8.Baby to have VitK injection 9.Baby delivered onto me and not taken way at all unless medically necessary 10.My Husband to cut the cord 11.If baby needs to go to Special Care my husband to go with her and not leave her at any point 12.I will be breastfeeding no formula top ups to be given.

The midwives thought it was great. Short and precise so there could be no confusion.

What about your waters are you against them being artificially broken. I bullet pointed mine and gave it to dp ( made him memorize it) so he could tell the mw what I wanted.

I totally second oopsandbabycoconut
Very precise and concise.
Mine says pretty much the same thing exactly and is in bullet point which the midwives much prefer as they actually can read it quickly.
Points 3, 4 and 5 are essential if you ask me. If they put you on a drip to speed things up, don't do it without epidural.
And ditto if they ask to break your waters.

Don't try to predict what pain relief you will need, its impossible to know how your body will deal with it, and not because its the first time, each labour is very different.

I guess oopsandbabycoconut is a 2nd timer or so because like me, she knows exactly what she wants such as bf comment! I plan to ask nurses to have baby on station overnight hence I also have stated NO FORMULA but only because I managed to bf last time.