Another birth plan thread: cannulas, forceps and cheerleading midwives

[AhickeyfromKenickie]

Hello, I'm PG with my 3rd and trying to write my birth plan. I just have a couple of questions - sorry if they're stupid - if anyone can advise I'd be very grateful.

1. What is the point of having a cannula, and can I refuse one?
2. Can I refuse forceps? If the baby gets stuck will ventouse do the same job as forceps? Any other alternatives?
3. Can I ask the midwife not to cheerlead me, or is this unacceptably rude? With my other two labours, at the pushing stage I had lots of "good girl, you're being so brave, come on poppet" etc. Now I know they were saying that to encourage me, and they were very nice people, but I hated it, it got on my nerves (sorry, I sound really awful, but I lose all my manners when I'm trying to squeeze babies out of me ). With this labour I just want a bit of peace and quiet. How do I write "don't talk to me when I'm pushing" without pissing the MW off?
4. At what point is an episotomy judged to be necessary? My DD's head was bigger than DS's but they cut me with DS and left me to tear with DD. Would much rather tear, tbh. Thanks in advance for any advice!

The reason I ask about the cannuls is that they were given to me as routine with my two labours for no apparent reason, and they hurt pretty bad, esp as I kept knocking it against things, blood spurting everywhere...

You can refuse anything you want (am assuming here that you are over 18 and are mentally competent) It is an absolute myth (in the UK, not parts of the US) that they can "insist" on anything.

That said, there are sometimes very good reasons for listening to WHY they suggest something; ask for their rationale and if necessary you might want to consider requesting that they cite their evidence base.

Very weird that you automatically had a routine cannula; have never had this.

As to asking mws to be quiet, I think asking them not to talk to you so you can concentrate is perfectly polite. FWIW (am pg with DC4) am planning to be rather emphatic on birth plan about NOT being told to stop screaming; it's my birth and I'll scream if I want to thank you very much.

I wish you all the best for a good birth.

Not that I've given birth before, but I'd imagine the midwives don't have much right to be offended if you don't want to be talked to. It's not like you're their dinner guest.

Having said that... LittleSilver, they actually told you to stop screaming?!

Sure I put in my birth plan both times, no cheerleading. They ignored it the first time, but the second time I made absolutely sure they knew.

One of the ways I controlled it was by refusing all internals and clocks!

Yep, all three times "save your energy dear,you're wasting it, use it to push into your bottom."

No, now do sod off, I;m giving birth here.

They usually use cannulas for VBACs or 'high risk' deliveries. My understanding is that they have quick access to your veins if there is an emergency (veins can collapse if you are suddenly very ill, but this is unlikely, especially in a normal delivery). They're not standard practice in the UK AFAIK for normal deliveries. You're well within your rights to refuse.

The silence during pushing sounds like a perfectly reasonable request and not rude at all. I would put it on your birth plan as written and maybe gently explain it to the midwife. If you get a nice one, you can have a bit of a laugh about it with her before you get to the pushing stage. I completely agree with you - hated being talked to during pushing.

I think most doctors will opt for ventouse nowadays but no harm in expressing a preference for ventouse. In a way, they'll only get used if something is going wrong and doctors will use what they're used to and good at. If they really need forceps, they'll probably use them.

You can definitely express a preference for tearing over episiotomy. AFAIK, though, this is pretty much standard nowadays. Episiotomies are usually for emergencies.

RE cheerleading - my birth plans state this:

This birth / My beliefs

I trust my body, and enjoy the miracle of birth. I labour calmly, quietly and quickly. I labour intuitively by turning my focus inwards, listening to and being guided by the primitive instincts of birth.

I hope you feel able to use your experience to support me; by quietly standing back and following my cues, mainly assessing my progression through observation (providing all is well). Please do not distract me, or attempt to coach me at all - doing so would pull me out of my ?birth zone?, potentially causing me anxiety and distress - triggering an adrenalin release which would inhibit labour. If I want direction I will ask.

It works and the last mw only got out of the armchair when I told her the head was coming.

Julie x

Thanks for your replies, I thought I was being unreasonable asking for peace and quiet! I just hope MW doesn't take offence...
It's great to know I can refuse anything I'm not happy about (and I'm really not happy about forceps), I just need to look into the alternatives should it arise that I might need intervention so I can say "no, I'd rather have X instead."
Thank you everyone!

Ahickey What I will say is that forceps and ventouse aren't necessarily able to be used in place of one another.

I was adamant that I was to have a C-section before I'd consider forceps with DD. It was the one thing I'd briefed DH on vigorously - no forceps - I'd read the ragged bits thread on here! When it came to it I was willing to do whatever it took to get her out, and forceps were the only way. I did ask the obs if he'd use a ventouse but he said that wasn't going to shift DD because she was in such an awkward position.

Only had a cannula because I was being induced, and the MWs were very good, barely said a word until the pushing stage, and my god I needed encouraging by then!

Fliss - ahh, see that's what I was wondering, if they did the same job so I could refuse forceps and insist on ventouse, but if they don't... I made the mistake of watching a forceps birth video and I am really frightened of that possibility, especially as my two births were massive with huge heads (crossing my legs at the memory). I obviously need to discuss this with my midwife but as you only get ten mins every appointment...

cheerleading.......take a mouthful of gas and air, shout at her and tell her to be quiet, then blame it on the drugs. Thats what happened to me. Started shouting at her (because I didnt trust her and gas and air sent me off the planet). Did apologies afterwards, but it is always easier to apologies afterwards.

Oh Lord, I think I've apologised profusely after every single birth

I refused a canula Ahickey. Well I said "No" once, then referred the doctor to dh who was primed to take over the er, discussion. I also chose tearing over episiotomy - much better for me.

My first delivery was a forceps delivery which for me was very traumatic. When I was going in to have dd2 I wrote in my birth plan that under no circumstances were they to deliver with forceps,if it looked likely I would rather have a c-section. I also told my consultant that I did not want a forceps delivery under any circumstances and she was ok with this.