Writing a birth plan

[Izzy82]

This is probably a stupid question but I'm 38 weeks pregnant and have no idea how to go about writing a birth plan.
the midwife has never mentioned writing one and my next appointment with her isn't for another fortnight so there is a chance I'll have given birth before then.
So a) where do I write it
B) what do I put on it
C) what do I do with it once it's written
D) does anyone have one I could look at

Thank you
Xxx

Yes, should have added that Squizita. Keillands forceps are a rather different kettle of fish to normal low forceps. With my first, the registrar literally had both brought to the delivery room as it was a last minute decision whether he felt he could get enough grip with the ventouse. In the end, because of slight fetal distress and it being borderline, he decided to go with forceps rather than risk more distress to DD by the ventouse popping off repeatedly.

sorry, that should read "literally had both forceps and ventouse..."

I'm sorry whyoh but if you have been told that they they are not acting ethically. I don't believe a hospital could ethically allow this as policy.
As a mw I can tell you that often people say 'no epidural' on their birth plan and subsequently change their minds. This is their right no one knows what their labour will be like or how they will cope until the day.

I have never known an anaesthetist to refuse an epidural because of a birth plan written when not in pain in fact I've never known an anaesthetist to read a birth plan. Their job is to provide pain relief and medical assistance and in my professional experience they are more than happy to do so.

To those refusing ventouse or forceps, in some situations it could be more dangerous for baby to do a Cs if they have moved far enough down the birth canal as it would involve the surgeon or midwife pushing the baby's head back up. Of course rarely this must be done if forceps do not work.

I think my birth plan for my youngest was far better than my others. I cut out most of the lists and just thought about what I wanted to make sure anyone who was caring for me needed to know.

So I listed my medical concerns (history of...can't have...need...) so it was really clear, wrote my top needs and goals for the birth (don't ask my partner to leave, give me my baby as soon as possible and if not let me see as much as possible, delay the post-birth injection until after the placenta comes out as it's gotten stuck each time I'd had it before) and wrote down my fears and that I was scared of being in hospital and had had bad experiences before and how much I would appreciate any extra kindness and gentleness they would give.

It resulted in a far better experience (even though it was a very rough birth) and a lot better communication than when I had the entire checklist of things I'd been told I needed to write in long form.

me23 its 3 different hospitals that have said it. One hospital is in a totally different area of the country to the others. So its not an isolated hospital saying it or even hospitals in one pct area.

I think your birth plan should be to deliver a healthy baby and come out alive the best way possible whatever that may be. I had a plan in my head and it all went to shit when I had to be induced, then DS was back to back, then I was begging for an epidural, then DS heart rate dropped, then he got stuck, then I was told I would get a section then they changed their minds in theatre then I got forceps (and a spinal) then I was to tired and out of it to breastfeed and couldn't hold DS because I couldn't feel my arms and couldn't bottle feed him again to tired and unwell....

So yeah do what you have to to get me and my baby though birth alive well and healthy and i'm good is my birth plan in future.

Just don't be wedded to it. When I did obstetrics we sometimes had women come in with a four page laminated birthplan and the absolute expectation that it would happen. They were inevitably the ones that ended up with a crash section in the middle of the night.

As has been said already - live and healthy you and baby. By all means express preferences, but the rest is just froth.

kiki0202 - Obviously the main goal is to have a healthy baby and of course, if problems arise then do whatever possible to get back out, alive, and healthy but a birth plan is there to ease the stress/worry of a mother going into labour, if she's worked up, or stressed, or worried because people are not listening to her or doing things she didn't feel comfortable with then that can make labour worse, IMO.

If I were to give birth again my birth plan would be:

Give me All The Drugs.

Leave me alone unless requested otherwise.

Bring me hot buttered toast on brown bread with coffee and water straight after.

Tell the woman from Bounty not to even attempt approaching me.

I had most of the usual things about preferences for pain relief, skin-to-skin, delayed clamping etc.

But I think the most useful things on there were

• I am happy for students to be involved (I had a final year student deliver DD)
• Please keep me informed about what is going on - I'll let you know if I'm feeling overwhelmed
• Please feel free to use technical language - I'll ask if I don't understand

I think the midwives who read it got a bit of an idea about what I was like, so they knew how to approach me. I needed stitching by a medic at the end of it all, and it was very obvious that she hadn't read my birth plan when she started talking about my "water works". Compared to the respect* I'd felt from the midwives, it felt a bit patronising.

*Of course, others may wish to be treated differently. When I say "respect", I mean respect for my stated preferences.

I agree. I had very briefly outlined at the start of my preferences something which happened in my first birth and really scared me. My plan then had something like "If you need to use medical terminology in my hearing, please explain it to me. I will get very upset if I can't understand what is happening".

My lovely MW read this and, when she accidentally forgot a couple of times all I had to gasp out was "what does that mean" and she understood exactly what I was asking and why it mattered to me. It helped her to look after me as an individual, not just a generic patient.

Am 15 weeks and reading this with interest.....

I know it may not be possible to avoid forceps per se, but just to be clear, is it always possible to specify C section in favour of Keillands forceps? On the logic that if the baby is that high up anyhow, a section should be possible?

I get that with lower cavity forceps it would be too dangerous to try pushing the baby back up, but does that apply if they are considering high rotational?

MultipleMama if the mothers worked up and stressed because people are not listening to her then they are hardly going to bother with a sheet of paper when they are not listening to the mothers actual words.

IMO the best thing you can do is go in saying do what you need to do and go with the flow you can't predict your labour or how you will be in labour you have no idea until you are in the moment and someone waving a piece of paper at you saying but you didn't want an epidural won't matter in the slightest to you. You can actually still speak to your midwife and tell her what you need or what and if they are not listening to your words they are not reading a sheet of paper either.

No Kiki. But lots of people lose the ability to explain themselves well in labour (I do) and lots of women feel more comfortable knowing that their partner has a document to help them explain things on her behalf.

You're also still thinking in terms of some of the more 'wish listy' birth plans. Yes, "I'd like to avoid an epidural" isn't a particularly useful statement. On the other hand "I go into myself in labour and generally prefer to be quiet and not chatty" may be very helpful for a midwife. Or some of the other examples I have given on this thread.

Haven't read all responses, but strongly recommend you look at lots of different scenarios of birth as in:

If I have a CS I would like (e.g.screen lowered/skin to skin/DH with me/delayed cord clamping),

If I am induced I would like (e.g. to avoid syntocinon/have intermittent monitoring/access to bath or shower in early stages) etc....

Also consider if you go overdue how far over you want to go, monitoring, whether you want a sweep, learn about options/treatment if meconium is seen when your waters break etc...

IME I would have been far happier if I had a grasp of my options in different scenarios as nothing went to plan with my birth (Induction at 42wks, EMCS) and my birth plan was largely ignored as it referred to natural birth or options that weren't protocol in the circumstances and I wasn't in a position to argue when it got to that stage my birth plan didn't make me seem well informedenough even though there were aspects I would have liked them to have stuck to despite the circumstances. Also helps you're birthing partner if you discuss your thoughts and feelings before hand as nothing prepares you for the helplessness you feel in the face of labour!

A healthy dose of realism! Check the stats on unassisted / assisted births for first time mothers at your choice of giving-birth place as a starting point. And remember, even if you really really really want
and prepare for a certain kind of birth, it doesn't mean it will be the one you get. Good luck!

My original birth plan also read "live baby, live mother" and I am also a Dr, so know where Yaki is coming from...

My husband re wrote mine, also laminated it - just in case it fell in the birthing pool. The midwife didn't even glance at it!

Now I'm on the second time round, I am far more open minded. Even after a very straightforward labour, I would be keener or more drugs and an epidural. I said I didn't want the injection - but had it straightaway as after 6 hours of labour I was in favour of anything that speeds up the next bit! Made me vomit everywhere, worth knowing, have a bowl handy!

kiki0202 - If they had the sheet then they'd understand and may be able to accommodate to some of her wishes, instead on going in "blind". IMO, having the birth plan, and having the MW read it or skim through it in front of me, helped, and to know they took even just 30secs to try and respect my wishes and treat me like an individual patient helped. But like I said in my pp, that's just my experience.

This baby #7 for me and even though I've never been afraid of childbirth, I do become anxious saying "what if, what if, and running through every possible outcome. The birth plan helped ease my worries. Even though my birth plans went out the window most of the time, it was helped to know it was there, and it helped that DH knew my wishes too.

Like I said that's just my experience, and I'd rather have a birth plan than nothing at all but ultimately my baby's health comes first, and if things needed to be done, I want to know my options rather than them just "going for it".

OP yours is not a "stupid question". It's a very sensible one for someone 38 weeks pregnant.
In maternity as in any other situation in life, the only "stupid question" is the question that did not get asked because the enquirer was too shy to ask it - that would be really stupid.
When you're in labour ask as many questions of the staff as you like.

revoltingpeasant not many places use kiellands forceps anymore. However you can refuse consent as if considering using kiellands then baby would still be quite high in birth canal. I would not give consent for kiellands to be used.

I didn't have a birth plan- I can't see the point. I hadn't had a baby before so how could I possibly know what I wanted?!
I didn't bother with subsequent ones either.
I was open minded and went with the flow. I had 3 lovely births in 3 different hospitals.

A few additional things. I wrote Student Midwives welcome, mainly as I was scared to death of been left on my own. No students were on duty when I gave birth but I did get a newly qualified midwife ( co incidence or not I don't know) but she was with me all the way through except a couple of times she popped out but was only in labour 21/2 hours.

Also re position. I was induced so monitored throughout so position wasn't an option but I had a compulsion to sit up through every contraction. Something I didn't know till I was there.

Also I gave birth with gas and air. I didn't really have the strength to chat discuss anything. All my energy was in dealing with labour.

Revolting there are pretty much no hospitals on my side of London which still use Keillands - a PP claimed it might put baby at risk... But if they don't have them (I was basically told they're physically not there to use) I would say they'll be used to cesareans instead of them.
They are not the same as vonteuse/shallow forceps, which are uused.

Only I would suggest checking stats for women like you for your chosen hospital. Age, ob/gyn history and so forth.
My hospital is the one they airlift/ambulance women to in the area and also complex cases and premis are sent there. They also have a MLU and pools in the labour ward.
There are two distinct "cohorts" of mum: the whole stats say slightly above average for cesareans ... But its actually loads from one "cohort" and average for the rest iyswim. With the MLU ladies having typical (lower) MLU intervention rates.

Sure squizita - that said, all 9 mums in my NCT group, all on our first babies and fit & healthy 30-35 year olds had midwife-led care throughout our pregnancies and all went to the MLU in the local hospital when admitted in labour. All nine of us delivered in the consultant unit, most with
From what I've heard anecdotally that's not unusual here. At my birth review meeting, the Head of Midwifery admitted that the vast majority of first time mums they see need an assisted birth. That's not what they tell you as they happily show you round the sparkly MLU in your final trimester though...!