ummm, my birth plan.

[shouldIbecrossaboutthis]

So I haven't discussed this with my MW yet as only 34 weeks, but going away this weekend and want to pack a quick one in my bag for emergencies sake!

In terms of pain relief, am I being an irrational person in thinking if I need it, I will go straight for an epidural? Is this a weird thing to ask for? Should I try other things first (obviously will be doing hypnobirthing, tens, G&A and pool first). But if drugs are needed epidural seems like the best one to me, it's the only one that doesn't zone you out and is the only one that doesn't get 'into' the baby. Also I'm a puker and I hate not feeling in control so I think the others would ruin me! I'd ask for the sort of epidural you can have to still be able to walk around and also turn down when you need to push.

Also, another thing I'm not sure about is ventouse and forceps. I don't want them. I know if the baby is stuck then they are necessary, but really if it's looking like it's all going wrong can I ask for emergency c-section? I know there are more risks with a C-Section and I'm not making my decision rationally. It's based on personal circumstances really.

Is there anything else I should think about? I want my DP with me the whole time, is this a given?

Any tips would be fab, I don't want it to be too long either!

Bear in mind that epidural may make it more likely to need ventouse/forceps - with an epidural you will need monitoring which usually means you are less mobile/baby doesn't always move down so well.

Epidural doesn't always work well, or may not be available if the anaesthetist is tied up in theatre. Pool not always available either. Are you going to a consultant led unit, birth centre, MW led unit? Or considered a homebirth?

There are side effects to most things unfortunately - pethidine/diamorphine can make the baby rather sleepy if given close to the birth. If you need a c section they will do one without you asking but they try to avoid it as much as possible. Have you considered a doula? They can be good for support too.

Pain relief wise I wouldn't worry about deciding too much now - just look into the options and put down if there is anything you definitely don't want. You may change your mind on the day.

I think that all sounds like a great plan! Agree with straight to epidural if needed and with idea of c section. But your partner better be prepared to fight as it will take a strong argument to go for c section if you think you need it. A friend did exactly that and her husband had string words with docs. In labour you probably won't be up to it so plan your reasons in advance. I could send u my birth plan if you would like.

So for pain relief you are happy to have anything except dimorphine/pethidine? That was more or less my birth plan with DD2. I had pethidine with DD1 and it had really not agreed with me and made me too 'drunk' to properly use the gas and air. But gas and air make some people sick so there is an element with a first child of trying things out and seeing what you need.

I wouldn't be so specific about forceps/ventose but see what the doctors say if you end up in that situation.

You might not get your dp with you the whole time, you might be on an antenatal ward for a bit and they don't allow partners to stay overnight. But once you are in labour proper every maternity unit will allow you at least one birthing partner.

Thanks everyone, yes just the "ine" drugs I don't want really. I'm actually planning a home birth, this birth plan is more of an emergency one as I'm going to a festival this weekend and don't want to end up going into labour (unlikely I know) without one especially as my DP hasn't yet "read up" on all the options.

Good news about DP, I thought he might have to leave if I had a CS or other theatrey/instrumenty procedures. Glad he can stage for the duration.

I had a look at some templates and think I have done it now. It's 2 pages long, seems mad, will they really read it? the beginning starts off well I think,

"Please do whatever is necessary to keep me & the baby safe.

Ideally I would like as natural a birth as possible and hope to use hypnobirthing techniques, but I am open to all options."

I'm afraid you're mistaken about epidurals not effecting the baby. The drug administered certainly does have effects on the newborn.

Having said that, since you are considering using pharmacological pain relief, you are right in thinking the epidural has less effects on the baby than Pethidine etc (in terms of breathing and alertness).

As has been mentioned though, the epidural could increase your chances of needing forceps or ventouse, since you will not be mobile enough to adopt a favourable birthing position. I have heard of women asking for the epidural to be turned down (to release less drug) so that some feeling and mobility returns before the pushing stage. I don't know much about the ins and outs of this, or whether certain hospitals have policies relating to this. Worth asking about though, maybe?

Just try and keep an open mind. The more prescriptive you are the more likely you will feel disappointed if things don't work out exactly as you planned. I think the first line of your plan is a good thing to remind yourself of as you go thru labour. Don t be too fixed. Good luck with everything

My birth plan (first baby) was as follows:

Go to hospital. Have baby. Bring baby home.

Thankfully the NHS did not let me down and I got all three of those things. You really do need to keep an open mind. You are going there to have a baby not a birth "experience". I wanted all the waterbirth hypnodolphinmusic stuff too and I didn't want a lot of the things I ended up with (induction, continuous monitoring, stuck in bed, pethidine) but I am not disappointed about that because I was fine, the baby is a picture of health and they did their best to keep us both safe, which is more important than trying to deliver an idea of what I though birth should be like when I'd never had a baby before.

On the delivery ward that same night, another couple were not as lucky as us. So I just count my blessings that my baby was born safe and sound.

A c-section is a major operation and perhaps there would not be time to do it in some circumstances when getting the baby out by assisted delivery would be quicker. It's fine to mention that you would prefer a c-section to an assisted delivery, but remember the doctors don't perform these interventions for fun.

Bear a couple of things in mind:

An epidural can increase the risk of needing ventouse/forceps delivery.

I do not think it is possible to have an epidural that allows your to still walk around. I was told at my ante-natal class that if I have one I should not count on being able to weight bear at all.

There are other risks/possible side-affects so you need to research these properly before you decide.

You said you hate not feeling in control. I have chosen not to have an epidural for this exact reason! But I suppose being physically out of control (epidural) and being mentally not in control (pethedine) are different and one may not bother you as much as the other.

Ventouse and forceps are usually used when the baby is already low down and it is therefore too late for a c-section, rather than it being a choice of one or the other. Although I completely understand your feelings, I don't want that either!

The NHS is slow. My midwife has being honest with me that if I ask for an epidural I'm looking at an hours wait at least before it actually happens.

HTH, and hope you don't think I'm putting down all your choices, I'm just trying to play devils advocate because I think its important to look at all sides.

Good luck!

If the babies too far down I don't think they can do a section. (I'm not sure though).

I had a forceps delivery on a local anaesthetic as I wasn't well enough for a epidural. Before that I was on g&a and fentonil (amazing drug!). Do you know something, see once I had him, the labour and birth went out of my head and I'd do it all again.

Should have said I also wanted the option of a water birth but ended up on continuos monitoring so on bed for all of labour.

My birth plan (for dc4) is simple:

Give me gas and air.
Don't come anywhere near me with any sort of injection.
No forceps or vontuse unless it's critical that they are used and there are no other options ie c-section.

Some hospitals do have mobile epidurals.

When I had a emcs under GA with DD, DH was not allowed in. Not that I noticed, as I was unconscious, but just to let you know that your DP may not be with you all the time. DH was sitting by my bed with DD when I came round though.

I agree with orange's post.

Think about what pain relief you might like if (and there's a good chance you will) you're going to have to wait a while for the epidural - you'll probably want something else during the period you're waiting for the anaesthetist to be available. You may also find - I did - that you labour too quickly to have one anyway! Gas and air is out of your system really quickly and as far as I'm aware (someone please correct me if I'm wrong!) doesn't affect the baby. It's not the most effective form of pain relief, though.

I love the first line of your plan and think as long as you keep that in mind throughout the whole thing, you'll be just fine.

my consultant told me - it can be chicken and egg with epidurals and needing intervention or slowing labour down.

she said alot of women are on thier way to intervention anyway with epidurals and that is why they have been given them to aleive pain on a rougher labour...ie it wasnt the epidual causing this.

the problem is you wont know! you wont know if an epidural will simply take pain away for you etc.

if your community mw is at same hosp where you will give birth - ie part of same trust - ask her for her honest opionion on how they administer epidurals.

obvioulsy if you go in very dialated they will be reluctant to give you one, but some seem to be anyway - trying to encrouage you without. .....

Thanks for all the great advice, a mobile epidural is definitely a real thing, not all hospitals have them though. It's the mentally being out of control I don't like, and the feeling woozy. I've had hypermesis through this whole pregnancy and really don't want any drugs to trigger this in labour as I will not be able to stop throwing up! I know that I might start throwing up regardless.

I understand that sometimes assisted delivery is unavoidable. But I would rather, if they think the baby wont be getting out for some reason (ie. I'm knackered/a puking mess/he's already a little distressed) that we went straight to Csection rather than trying to humour me with an attempt at pushing. I don't really have a strong preference for a natural vaginal birth, just a prefernce for us both to be ok at the end.

I have been at 10 births so I think I have a good idea of what to expect in a medical sense; it's the feelings/pains I can't be sure about. I just wondered why some people had the 'ine' drugs. I guess though if you have to wait over an hour for an epidural that explains it, or if your scared of needles?

Birth definitely isn't about me having a great time. I just want the baby out safely and don't want to be incontinent afterwards my biggest worry for some reason. There will be no incense sticks or whale music. I did hypnobirthing as a tool to use in labour, if it works great, if it doesn't - nothing ventured nothing gained.

elizaregina, I agree with you on the epidural front. It is a mixed bag really and hard to detangle the ifs and buts of it. A mobile one seems like the solution to me

Just wanted to add to some comments above - apologies if repeating things already said...
If you have EMCS with a spinal anaesthetic, your partner will be with you when they do the procedure but you will be separated briefly beforehand while you are prepped for theatre and partner scrubs up and gets his sexy gown on Couldn't tell you exactly how long the separation was for (things were a bit hazy at that point) but don't think it was longer than 10 mins or so...
Good luck

By all means research pain relief and birth methods so that you can mae informed choices but there is a good chance your birth plan will go out of the window!

Sickness is a possible side effect of an epidural - mine made me throw up quite a bit but there are anti-sickness drugs for this. Apart from this though, the epidural was fantastic and my baby was born healthy and alert, not drugged up at all. If your hospital doesnt offer a mobile epidural, you can ask to be given a smaller dose of the drug so that you can still feel the contractions if you prefer.

Good luck and best wishes for your birth! Not long now!! :)

I had my ante-natal class on pain relief and interventions last night and your questions OP, are much the same as the ones brought up in class.

Someone asked about mobile epidurals but the answer was basically, yes you can shuffle about on the bed a bit and at a push some women can walk with a lot of aid, but they are not truly mobile - you couldn't hop off the bed and stand around stretching for instance.

One couple asked if they could refuse forceps/ventouse and ask for a C-section if the baby was stuck/in distress. The carefully worded response was that the doctor would discuss your options with you, but if the baby was sufficiently far down the birth canal, it would take a couple of minutes to get it out with instruments and rather a while longer with a C section so if a) the baby was quite a way down and b) time was of the essense, a C section would not be advisable.

whatsoever, I have seen 3 people have mobile epidurals 2 could walk properly, the other could move about in the bed but not bear weight; I think it depends on the person administering it and also how you take to it?

I do know that once the baby is in the birth canal assisted delivery is unavoidable. I just would rather not get to that point IYSWIM? If I'm knackered and don't think I can push and a c-section is an option I would rather that than trying for v-birth.

laughingGnomette, I'm some sort of super human and anti-sickness drugs don't work on me, well so far! Didn't know epidural could potentially make you sick too! Booo

Ps> shuld add that by having a mobile epidural all I'll be hoping to do is deliver on my knees. Not do the can-can or anything.

I'm not really sure if they would agree to a c-section for the reasons you stated to be honest. If you were tired/baby in distress it's highly likley they would try ventouse/forceps first.

Why would you want a c-sec at that point anyway? You would have done all the hard work only then to have major surgery? I had a threatend c -section but they managed to do ventouse in the end and i was hugehly releived to meet my baby quickly and to be able to hold him right away.

Katiecubs, I think you can insist on a c-section? As someone upthread said. That's what I wanted to check. Obviously this assumes a c-section is safe to do and the baby isn't in distress. I know there are more risks with a C-Section and I'm not making my decision rationally. It's based on personal circumstances really.

zzzzz, I know I won't start pushing until the baby is in the birth canal. But I would rather, before the pushing stage, if they have a teeny thought the baby wont be getting out for some reason or I feel like I can't go on any more (ie. I'm knackered/a puking mess) that we went straight to Csection rather than trying to humour me with an attempt at pushing. IYSWIM?

I don't really have a strong preference for a natural vaginal birth, just a prefernce for us both to be ok at the end.

I had a mobile epidural and it was fab! I could still feel contractions but they weren't painful. Unfortunately my DD decided she was staying put and despite my best efforts at pushing we ended up with EMCS. My birth plan was a page long, bullet points of our wishes (including no forceps unless absolutely necessary). Keep it short, midwives don't have the time to read big long birth plan essays!