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 :-)

Finding out your areas way of doing things from your antenatal midwife if possible will help keep it brief so you don't have to list things that are standard procedure (as an example, skin to skin right away and delayed cord clamping is now standard in many areas unless there is a medical reason not to do so). One thing often left out of guides which is relevant to some mums is that if you have any medical conditions or concerns, particularly if these might means nonstandard procedures or a likely atypical reaction, put these near the top even if the conditions are listed in your notes. It can feel redundant but I found it more useful than trying to point people to my notes or explaining things while in labour. They're professionals but that doesn't mean they have experience with every condition. List what they are as briefly as possible and how they might affect things.

For my latter birth plans, the first thing I listed that I was very scared and have high anxiety around medical situations and listed a few things that helps me manage this. I then put a medical condition I have which means anything spinal is high risk so a general in an OR situation is needed; and then that I have had previous very bad reactions to the 3rd stage injection and would like to delay using it until after the placenta is delivered if there are still bleeding problems (I did have the injection after the placenta was out which worked far better for me in many ways though this was the only point that I had to discuss and defend beforehand as it is an unusual request but they did support me after discussing the risks and how rare those complications are - they just happened to me twice and the one delivery without went fine).

These were the big things for me so I put them at the top and the anxiety issues I restated a few times when listing a few other things mostly around assisted delivery situations and my spouse's involvement as those were the things I could forsee as most likely to include something that would set off my anxiety. I listed other conditions after that as they're less related but good for them to know. I didn't specify anything for pain relief other than no spinal issue, that gas & air can make ill, and that I brought heat packs as they were very helpful in previous labours (they were great for me, in my last one my heat pack broke and the midwife made a makeshift one and it was lovely, I was so thankful).

I did list my and my spouse's preferences around cord cutting and vitamin K and such though each time was asked to confirm at the time so while it's good to have a plan for this, I wouldn't put too much detail into it on paper.

As others said, prioritizing I think is important and being as brief as possible so the important bits stand out. I did the really detailed one with my older two following a guide and it was way less helpful than doing a short double spaced bullet point super polite list (I think I used 'please' and/or 'I would appreciate' in almost every point and this was commented on by one of midwives. Apparently, one way I deal with anxiety is bring over-formally polite until I freak out). It was both clearer and made life easier for all of us.

Babydoc it’s your sort of attitude that makes women fear trusting health professionals during birth. Smearing at our choices. You might know more about pain management but you just about nothing about me.

Mine was quite short but I’m really glad I did it as all midwives read it and went out of their way to support.

I put in bold at the top that I’m rhesus negative so would like anti d if needed, plus a specific antibiotic I don’t tolerate well, and that anti inflammatory painkillers make me sick so please avoid.

Then I had some preferences - so that we’d done hypnobirthing so I’d prefer low light/noise where possible, not to offer pain relief (I’ll ask), that I was really keen to breastfeed so would prefer to avoid pethidine (which can make baby too sleepy to latch, though in the end I did have some and he got stuck in just fine anyway) and would like help to express colostrum, and for baby to be fed this in a cup not a bottle, should we need to be apart after delivery, and that I was happy for baby to have vitamin k injection.

Then I had a bit at the bottom basically saying thanks so much for looking after us, we understand we’ve not done this before and you do it every day so we’re happy to be guided by you.

I don't think anyone even looked at my birth plan! Not that it mattered as I didn't really stick to it anyway. I tried to keep it quite brief and quite simple. It had lots of 'if possible' caveats on. I quite wanted to try the birth pool. There were no rooms available and ds was born in the triage room while we were waiting for a room to come available. I'm not sure I would have got in the pool anyway, once I had a 'comfy' position I wasn't moving from it! I wanted to be active and not birth on my back. I basically did none of that! I found my position and that was it! One thing I was really keen for was skin to skin and delayed cord clamping. I got neither. Ds needed resuscitation so he was quickly placed on a towel on my chest when he was born, the midwife cut the cord and wrapped him up and whisked him off. In the end, it wasn't about what I wanted, it was about what ds needed. Keep an open mind.

Like DN4GeekinDerby I was polite as well. I decided when people are going to be in my private space I like our relationship to feel warm and reslectful rather than confrontational so tried to set that tone from the outset.

Also @DN4GeekinDerby is your username geographically accurate and were you at the Royal? I was blown away by how brilliant they were.

Thing is, you might think you know what you do or don’t want, but in the event, you could very well change your mind. A friend of mine wrote a very long, step-by-step plan with details of lighting/music etc and “definitely no drugs”. When it came to it, she told me as she was being wheeled through the hospital doors by her hubby, she was screaming “ give me pethidine NOOOOOW!!!”

I didn’t write one. I couldn’t see how I could write a plan for something that I’d never experienced before and that can be a very unpredictable process. But of course you should write one if it helps you feel prepared. But keep it brief and use bullet points! Good luck x

I don’t know if anyone looked at mine, but I treated it as an ‘if, then’ mostly. So it was things like if not progressing, I’d like to try x and y before we go to induction. If problems getting baby out, I will take a c section before you go near me with forceps, thanks. Also preferences like I’m not sure about what pain relief I’ll need but won’t rule things out. I will where possible try for active labour. Please explain to me what you’re going to do before you do it (this is standard for hospital I was at but I wanted to stress importance!).

As it ended up, I went from home birth to an emergency c-section. I felt the ward team really made an effort to accommodate me, so wireless monitoring, birth ball, working with me being active etc. In fact when it came to the point where they realised he was breech at 9cm, they offered me the choice to continue or have a c section, I was thinking ‘can’t you decide?’ :). But having thought through with birth plan, I stuck with csection preference. The consultant said afterwards she thought that was a good call and I agreed.

I found birth "planning" important in order to help me consider all aspects of the process, and to do independent research into the possible scenarios and options. It also prompted me to ask my midwife questions that I may not have thought of.

My birth plan was written keeping in mind that it's something you can't plan for, but in an ideal scenario I would like XYZ and would prefer to avoid ABC.

In the end I was induced via drip (due to waters break) which was "off plan" although it was obviously a scenario I had considered during the planning process - it also made some decisions for me automatically (like I had to have the placenta injection and couldn't go in the birth pool). Having done my birth preferences helped me to convey to midwife that it was really important to me to be as active as possible, despite the drips and monitoring, and we came up with a plan that worked for me, and enabled me to feel in control of the process much more. It sounds like a small thing, but it was really important to me at the time and I think made a huge difference to my birth experience (which was pretty much universally positive). I stuck to my pain relief plan, and plans for after the birth too and felt that the choices I made were the best for the baby and me in the situation at hand.

I know this thread is a bit old now but I just thought I'd pop back OP because I had my baby nearly two weeks ago and I am SO glad I had written down my preferences. As I said before I had a brief outline for all scenarios and in the end I needed an emergency c-section, the team read my preferences before the procedure and did everything they could to facilitate my wishes. We didn't attempt a high forceps delivery, had delayed cord clamping and they lowered the drape so we saw her immediately, we also saw the sex rather than being told. These things may have happened without me writing my preferences but the fact that I was informed about what was happening and why made me feel safe and confident throughout and although a few people have said they thought my birth was traumatic I really don't feel this way at all and I'm really happy with how everything went. Anyway, I hope this helps you to write yours and to feel confident going into your birth.

I didn’t write one for my first but that was mainly because I was disorganised.

Now I’m expecting my second, the only thing I’ll have on it is that DP and I want to find out the sex and not be told by the midwife. The midwife suggested it with our first and it was lovely to look for ourselves (which we forgot to do for a few moments, we were so happy it was a baby!)