Birth Plan

[Kt2108]

Hi all

So I'm going to start drafting/thinking more about my birth plan- ive downloaded the NHS guide but would be interested to see what other things you all included that I may miss out?

Obviously I know that sometimes, more often than not, things don't go to plan etc etc, and that some people don't write one- which is fine. But I personally would like to have on to hand for the option of potentially using it, whichever way that may be!

So any help/input is appreciated :-)

I found it helpful to briefly write what I definitely didn't want to happen, in case I wasn't able to explain. Other than that, IMO, there is little point writing lots of detail. I don't even think anyone read mine, but I was induced anyway and had few choices in the end.
No harm in writing it down, just don't be disappointed if you can't have precisely what you want.

My first birth plan had a lot of stuff about labour on it, and it all got thrown out of the window pretty quickly.

My second time around had things like "keep the lights low if possible", "ask me about pain relief on the day", "we don't know the sex of the baby", "Dad does NOT want to cut the cord", "want vit K injection". Very little about the actual birth itself for which I was willing to wait and see how things went, just the peripheral stuff.

Personally writing my birth preferences has been a really important and empowering experience. I have 3 sets of preferences which cover all eventualities from water birth to c-section. Doing this has given me lots of knowledge about all the potential interventions and has encouraged me to do a lot of reading surrounding birth choices. I read NICE guidelines, Cochrane reviews and books such as "The positive birth book" (although I wouldn't rely on this as a singular resource it is fantastic at signposting towards evidence and research on various elements of birth that aren't always discussed), all of which helped me to make informed choices about my birth. Your midwife should take the time to read your birth plan and support your choices to help you achieve a positive experience regardless of what sort of birth you have. Things that I have highlighted are: eating and drinking, low lighting, quiet environment, no students, me to lead discussions surrounding pain relief, limited examinations, active labour, not being on my back, delayed cord clamping, immediate skin to skin. Obviously everyone has different priorities but these were mine.

@Terriersandtea
Have you actually given birth yet?

@PersianCatLady no not yet but the process of writing these preferences has helped me not to build anxiety leading up to the birth which has been really helpful for me in these last few weeks of pregnancy.

I wish you luck @Terriersandtea and I think it is a good idea to write down your plan so that there is a record of your wishes.

One thing I would say is that during birth often things change very quickly and often there isn't time to ensure that your birth plan is rigidly adhered to.

I would ensure that your most important wishes are clearly stated at the top of the plan so that medical staff know what is most important to you.

Good luck, you will be fine!!!

I didn't write one with DD and don't intend to write one this time.

You have no idea what will happen and I found it best to just go with the flow.

Mine said ‘delayed cord clamping if possible’ and that was it. We discussed with the midwives that my partner might want to cut the cord by wasn’t sure (he did in the end), said I wanted the baby to have the vitamin k injection and said I’d decide if I wanted the injection for the placenta or not when it came to it (did as was shattered after 35 hour labour!).

I personally didn’t see any point writing things I didn’t want but might need, but I did have a homebirth so there was far less need for me to state my preferences for lighting etc.

@PersianCatLady thank you that's a really good idea to put them in priority order, I had written it in chronological order but will re-order things now.

With my first I made no birth plan, which was just as well, as noone believed I was in active labour (after my waters had gone for 24hrs), got pethidine to see me through the night to be induced in the morning. I needed a poo shortly after. DP was woken up with a shock to find the place full of medical personnel discussing whether I could possibly be ready for pushing. I was.
My birth plan for number 2 said: leave me and DP alone for as long as you can (cos that had worked ok first time round);
My birth plan for number 3 said the same, plus ff-ing and meds to suppress lactation.
Skin to skin, delayed clamping are all understandable preferences but depend on the condition of the baby. If it's doing well most midwives would encourage this anyway...

Pain relief will always be led by you and skin to skin will always be the priority unless there is some medical reason why you can't so I personally wouldn't bother writing those down.

Mine said I didn't want the Bounty lady to come in, sure enough she barged in each day anyway!

@terriersandtea - can I just ask why you don't want students? When I was training I found that those midwives who had students working with them were more likely to encourage active birth and uninterrupted skin to skin etc. Just something to think about.

My birth wish list qwas fairly short and sweet for my first - which was a planned homebirth and that was pool and entonox for pain relief, physiological 3rd stage, breastfeeding and IM vitamin K. Got all those wishes and didn't write one for the other two births which were the same.

I agree with Daisy: I'd focus more on what you wouldn't want to happen.

I'd written my birth plan to include a water birth, so just gas & air for pain relief.

I ended up with an epidural and ventouse delivery. DP did the skin to skin at first as I was a quivering mess.

As you've said, it's best to keep an open mind. I will just say though, my birth plan wasn't even consulted.

@Dreamingofkfc it's purely because I feel the quieter the environment is the more I will be able to focus and stay calm. I work in the NHS (not as a midwife) and whenever I have a student with me I'm talking all the time and I just don't want that added distraction and extra noise during my birth. I have had student midwives attend my appointments and have no problem with supporting their learning in general it's just for the birth I have requested this.

I had a student midwife with Dd and loved it!

As she was a student, she was beyond keen to triple check ever single little thing which is actually quite reassuring

I really don't think they look at it at all, or at least took little notice. I didn't write anything about a water birth, ended up having one (amazing). Stated I didn't want pethidine, was offered it (didn't take it).

Agree with PP though, more important to highlight very clearly what you don't want. A lot will get overlooked if you write a big script.

Actually if you really want or not want a particular thing, make sure your DP knows. You might be in a bit of a state and then having someone who knows what your want is very helpful. We discussed pain management together and he pushed back on the epidural they offered me first birth (as they thought I was complaining without active labour, I wasn't).

Mine never made it out of the hospital bag as no one would look at it despite me asking. So with the second I didn't bother writing one at all. I was induced first time so maybe that is why no one checked it...

I had stuff on that I did NOT consent to - Keillands forceps, for example.

I found the midwives took no notice of my birth plan!. As I was being wheeled round to the labour ward at high speed fully dialated the midwife shouted what does it say in the birth plan! I felt like screaming at her that it was too bloody late now.

If I have #2 then I plan to staple one to the front of my maternity notes making it clear what I won’t consent to

I am 24 weeks and my partner and mother both been told that I want to avoid an epidural unless in an emergency. That's my only plan at present. I don't want to plan too much as I know is going to be unpredictable and what them to do what is best for our son.

I agree with pp that it can be very empowering and important to write a birth plan even if it doesn't happen the way you hoped.

My birth plan was out the window straight away when I needed an emergency caesarean but I'm still so glad I made one in advance. May sound strange but I enjoyed writing it.

Good luck :-)

I've been told not to bother writing a detailed plan by the community midwife I saw yesterday, and a few friends' who have given birth recently including in the unit I'm using and have had good experiences. I should add I know 3 people who have worked in the unit involved in deliveries, and the unit has a good reputation of asking before each procedure whether you want it or not. Obviously if it's a life and death emergency there is only so much consent they can ask you or your partner for.

I've been told to ensure you know what you don't want, ensure your partner knows what you definitely don't want e.g. epidural unless it is an emergency, high rotational forceps regardless, and make sure your partner knows when you are clearly in pain so they can back you up when you are dealing with HCPs. The last is very important if you are hypnobirthing or have a high pain threshold due to doing a lot of sport.

I've just written my birth plan for my 3rd which is very different from my 1st. By way of example, with my 1st I told the midwife to "throw the fucking birth plan in the fucking bin" when she said "are you sure, you're birth plan says...". I don't usually swear and was very apologetic post birth.

My 1st birth plan was mostly based on the NHS template, typed up and in great detail, running to about 2 sides of A4. My 2nd birth plan was much edited and only included contact details, useful medical info and some preferences (eg would like to try and use a birthing ball and we don't want to cut the chord). My 3rd plan is scaled down even further but also says that I don't want any students (have always been open in the past but had a VERY bad experience during my last labour so don't want to go there again).

I think it's important to say what your preferences are, but also not to think of it as set in stone.

I think it should be called birth preferences rather than plan really - calling it a plan suggests you have more control than is really the case!

I think it's a bit like booking a holiday and saying, ok on Monday I'll visit this place and eat in this restaurant then swim in the pool then relax etc - that could happen but there could also be a thunderstorm/turd in the pool/restaurant is closed etc. Hope for the best but just get through it really.

I'd make it punchy with bulletpoints, then there's more chance of it being read. Also remember to plan for less ideal birth scenarios, like what happens if you need interventions and c-section. We had emergency c-section and small things like wrapping the baby in a blanket that smelled of me and letting DH be the first to announce the sex made a big difference and were in our birth plan.

Ultimately the midwives/doctors are going to focus on safety and only think about preferences if your clinical condition allows and if they have time. Depends how busy they are I think!