Birth plan - what to write??

[Cornberry]

I'm 36 weeks and I know I need to write my birth plan but I'm not really sure what to put down. Seems odd to write a p,an for something that's bound to be unpredictable. I sort of want to write no drugs unless I feel they're necessary and that's it. What else can you put? I'm drawing a blank. Advice welcome!

You need to also take time to think about what you want to happen if things don't go to plan. Who should your partner for with if you are separated from the baby, if you want no intervention when should they broach alternative options if your way isn't working.

The problem with birth plans is that so many people see any alteration as a failure by them or the nhs. This is normally a massive issue for people who haven't accepted that the birth process is in part one where you give up control.

My midwives have always read mine, and if they disagreed with anything, we would discuss it, like after my 3rd degree tear I was recommended to have the injection to speed up the placenta, which I was fine with...

My second birth plan said "I do not consent to an episiotomy" as I feel that tearing naturally is easier to recover from. It was the one thing that I definitely do not consent to under any circumstances. I go to a birthing centre so I would have to be transferred to the labour ward for forceps etc, and I think I'd rather go to a Csection if forceps were required...

Mines probably a VBAC so slightly different. I've listed things I don't want in big letters: no Bounty or sales reps, I'd rather be on a single sex ward overnight, if things slow down or at the slightest sign of trouble move straight to c section. No induction.

That's about it really. My first birth was an emcs with no labour at all (bleed from low lying placenta) so try to keep an open mind on how it'll go

Having read a horror story online, I had a phobia that I'd end up with a 3rd degree tear as a result of an episiotomy so, in my first birth plan, I indicated this and said that I'd like to avoid one at all costs.

When I was in labour they told me that they'd like to do an episiotomy and pull my baby out with forceps. I cried and, when they asked what I was scared of, I mentioned the three degree tear. They said that only happened in a tiny percentage of births.

So I had a spinal tap and baby was born. And then they gave me a lovely sheet of paper explaining that I was one of those tiny percentages who had suffered a three degree tear .

In the end my recovery wasn't really that bad so I was very lucky.

This time around I'm just going to write that I want pain relief and that the health of baby comes first. I'm also going to add a note that I'd like to donate my baby's cord blood.

My first one was basically:
-pain relief and intervention as deemed necessary
-skin to skin with both parents immediately after birth
-I can't function without my glasses
-dh to remain with baby if we need to be separated

This time I'm adding
-make sure I stay hydrated and mobile
-no opiate based medicines
-please use cord tie (provided) not plastic clip

I never wrote one either time. The whole process is too unpredictable for me and I'd rather make decisions at the time based on how things are going.

I know too many people who were disappointed that it didn't work out the way the had planned (those who had planned every last bit) which is a shame to feel like this.

I had a very, very rough plan, for my first DS (7 weeks ago..). I was consultant led because of various problems with my back, and it had been agreed that I would have an epidural as soon as I was in established labour. I stipulated no opiate pain relief, delayed clamping, skin to skin, avoid episiotomy, breastfeeding.
What actually happened was a thirty hour labour where I didn't progress. Getting to the point where i could have an epidural took 12 hours of three minute contractions almost without a break, so when the MW offered me some Diamorphine, I almost snatched her hand off. I had three goes of that before blissful epi. Delayed clamping didn't happen has I had a PPH, skin. To skin was brief, as DS was ventouse, and in distress and I missed all the weighing and checks etc as I had an episiotomy which I tore straight through. So a two hour repair on a 3rd degree tear. At the time I didn't really care how they got him out, just that I wanted him out, so I'm quite glad I wasn't massively invested in the rough plan, I think the disappointment might have made a traumatic birth even worse! Next time I'll just ask for an epidural again and see what happens.

Nothing! Get baby out safe and sound. If you can labour safely, you will. If you need an emergency c section, well that's that. If you don't know how much pain you will be in, what's the point of deciding on pain relief in advance when you can tell them what you want on the day...

Things like skin to skin are well embedded now and you can take your top off yourself and hold baby. As for birth partner, well hopefully they will be coming in with you!

Sometimes I feel that childbirth, a natural, special but ordinary process, is being turned into an event with a guest list and order of service! We're not in charge, our body is.

Preferred name if shortened version etc.
Name and relationship of birth partners
Any other expected or unwanted visitors and what to do with them (eg I do not want sil on labour ward, mil will be looking after older dc, so please pass on messages asap from her)
Dietary requirements eg vegan, carnivore, foody intolerances that aren't classed as allergy elsewhere in notes and if your birth partner has medical issues that could be a problem eg diabetic, include location of his meds/carbs etc
Ideal world pain relief plan, anything you want left as a last resort.
Thoughts on managed or physiological third stage (injection to lose less blood on delivering placenta or not) delayed cord clamping
Thoughts on going off piste: will your birth partner cope in theatre, any previous issues inc anxiety re anaesthetic, back problems, issues with previous regional anaesthetics, metalwork in situ (eg previous broken bones)
Vitamin k for baby (there's sometimes a box in the notes to sign to give consent for this)
How quickly you want to hightail it out of the postnatal dungeon/not be pushed out of nurturing postnatal environment before bf established etc depending on your thoughts on that (seems a marmite topic to me) don't expect a six hour discharge if you didn't mention it until the five and a half hour mark!

I never bothered with one last time and don't think I will this time either. Anything relevant - vit k injection, delayed cord clamping etc was all discussed with the midwife when I was in labour. It was more important for me to discuss my choices with DH so he could be my advocate in labour.

I was told by a midwife though that if you do a birth plan make sure it is easy to read - a few bullet points like the ladies above have suggested - and also to have it on a separate sheet of paper clipped to the front of your notes so midwives are more likely to read it as they don't have to leaf through all the notes. Also give a copy to your birth partner so they can support you in your choices.

I wrote one with DC1 which was either read and then ignored or never read at all. I didn't bother writing one with DC2.

I wrote a birth plan but got none of it in the end which made me miserable. I think a good thing to put in would be what to do if a certain scenario happened. Or whether you would like to know how you're progressing and want communication.

I wanted my son put straight on to me, have a natural delivery of the placenta and cut the cord myself when it was out. But instead they cut the cord when he was out, wrapped him up and fussed over him for what seemed like ages before giving him to me then gave me an injection for the placenta. I was confused about why this happened as I wasn't given any heads up about what happened to him or me. I just thought they were doing a routine thing as it wasn't discussed about what I wanted.

Mine for my first birth was all water pools, soft lighting, hypnobirthing mantras, yoga practise - the works.
When all that failed after 24hrs and I ended up with both me and DS in a very bad way, failed ventouse, failed epidural and forceps, I felt like an utter failure. Repeat use of the word fail is intentional!

This time around my birth plan will be non existent. I've learned to go in with an open mind.

Mine were a while ago now but a few thoughts ....

I did find them helpful to write both times and they seemed to be accepted OK by the midwives.

First time I think I went slightly overboard on some NCT typical stuff eg.about management of third stage which actually I didn't really care that much about. Second time I concentrated more on what mattered more to me such as immediate skin to skin with my baby (& DH really wasn't bothered about cutting the cord either so we just had midwife do that bit)

Both times I had very natural births - first one in water pool, second one on land (upright in ridiculously high NHS standard bed but leaning back on DH - sadly no pool available)
Au naturel with DD1 (dd) bit of gas and air with DC2 (ds) during shorter probably more intense labour.

Think the birth plans helped with the preparation and then I was lucky
Good luck to you all dear readers!

I would much prefer to keep my options open. Especially if it is the first and you have no idea. I can see that it would be a real pain to keep saying 'I know I said that but I have changed my mind' - much simpler to decide as you go along.

The best preparation would be to have a good chat with your birth partner about how they can support you. Also take plenty of rest, fill your fridge, and buy a decent box set; you'll be spending hours feeding your little arrival.

I began mine with; 'I'd like it to be quite quick, and not to hurt. Thank you. '

Then continued on with all sorts of things, including not an injection to speed up placenta delivery. After a very very long labour, it was over and the lovely MW suggested I have it and I replied 'Oh FFS YES!!!! Let's finish this fucking thing!!!!!' [yelled loudly].

I think the thing that really comes out of this thread is how mis sold birth plans have been! People have this idea that a birth plan plans your labour. It obviously doesn't. It's a road map for different scenarios.

Mine got longer over three births as I knew more about what I felt strongly about ("If I need an epidural, please ask the anaesthetist to talk through the procedure as it is happening. I had a bad experience with my first and need to know what's going on" etc)

However, even with your first there is stuff to say:

• any relevant background about you. Like if you tend to vomit a lot in pain, that's quite good to warn them about. I, for example, now know that I lose the ability to speak in later labour. If you want to communicate with me you need to ask yes/no questions! Other stuff like I can barely see without glasses, or I have nerve damage down my left arm from an old car accident. I will get really annoyed if you shorten my name.

• any relevant info about your birth partner (e.g he often faints at the sight of blood. Try and warn him!)

• any pain relief you strongly want to avoid (pethidine for me)

• how you feel about students

• instrumental delivery

• if things go tits up, does your partner stay with you or go with the baby?

• if you don't know the sex, who should tell you?

• do you want delayed cord clamping?

I have had 4 DC and never had one and was never asked for a birth plan.
My 'wants' that I had in my head and told DH incase I couldn't talk- which never happened.

I really don't know how you can be expected to know much of that in advance, Libraries, especially before the first.
Much prefer Notso's approach.
e.g. DH had never seen a birth so absolutely clueless as to any relevant information. Does it matter who tells you about the sex?

I went two weeks overdue, that wasn't in my plan. I was induced, again not in the plan. I planned not to have pethedine, I agreed to have it the nanosecond after they offered it to me. I had the epidural, not something I planned. I laboured for two days, and after DS turned his head and I started to have some complications I agreed to an emergency c section. That really wasn't in the plan.

That said, I felt in control at all times during my labour. It was still an empowering and positive experience and I don't regret a thing. It's good to have a think about these things, but don't expect it to be the script of how your labour will go, it's likely to be very different (but still a great thing which ends with you having your baby).

Had I had a plan I would have said 'no pain relief' - whereas when asked I said 'yes anything! ' . As it was I was too late anyway and just had gas and air.

I never wrote a plan. Was induced unexpectedly due to the start of PE just before my birth plan midwife appointment.

I ended up just responding verbally as the midwives pretty much asked me everything. Yes to vit k, yes to baby being delivered straight onto my chest, OH was to be the one to tell me the baby's sex. The rest were just kind of vague requests - can I put music on please, can I walk around please, can I sit up please. The only one I was really strict about was that I really really didn't want an epidural/spinal block unless medically necessary.

Thankfully despite a drip induction I was able to stay active and didn't need the epidural, and got everything else on my wish list too!

The things you can control - vitamin K, where you want the baby delivered etc - and the things that are health/emotional factors such as no VEs, no epidural for me, then a birth plan is great for making a note of them, but I think people need to be a bit more chilled out in general rather than this whole I SHALL HAVE A BEAUTIFUL WHALE MUSIC WATER BIRTH WITH A CHORUS OF ANGELS HERALDING THE ARRIVAL AND A DOUBLE RAINBOW ALL THE WAY ACROSS THE SKY and then getting really really depressed (I don't just mean a little disappointed, that's understandable) when they, like many women, end up having a shot of diamorphine or giving birth with their legs in stirrups. It's unreasonable expectations that we place on ourselves at an already stressful time :(

Mehitabal - what of my list would you not know with a first? I gave one example from me, but stuff like vomiting with pain was a general observation. Some people do know stuff about themselves and their likely reactions.

Re Pethidine - I knew various accounts of responses to it and I knew I wans't willing to risk some of them to find out how I reacted. That was something in my first birth plan.