NHS birth preferences or write your own?

[JustAnotherUserinParadise]

Hi,
We've been doing the positive birth company (PBC) course and she makes quite a big deal of "writing your birth plan". We've had lots of ideas and discussions about it all, and so yesterday went to fill in the "birth preferences" section in my green notes.
It doesn't really seem to match up with the PBC version of a plan though? There is no space to write about the environment or what you want to happen if you have a C section...
Can we write our own out on a separate sheet or have I misunderstood somehow?

You can write yours on a separate sheet.

I wrote mine on my own separate sheet; it was very jazzy, colourful, fonts and everything. I can confirm that it did not leave my hospital bag whatsoever and my instructions on what to do in the event of an emergency c-section (which I had) were not followed or requests observed!

If anything, I'd make notes but be aware that the 'plan' usually does not go to plan!

@Chanel05 haha yes I know that! I think that's why they're now quite careful about calling it "preferences" rather than a "plan" lol

Write it on a separate sheet

I wouldn't waste your time writing it down.
Best thing to do is brief your birth partner on all that you would prefer. They can be your voice in labor as tbh you may be too consumed by pain and exhaustion to do it yourself.

@Chelyanne we wrote it together which was quite a helpful exercise for that actually - I think he's pretty clear on what I want!

No one ever so much as looked at my birth plan. It was a waste of time writing it. A lot of friends feel the same.

Depends how detailed you want to be. But bear in mind that the more detail you have the more likely it is you won't actually get the detailed thing to happen.

It's best to use for the key points. Any pain relief you definitely want? Or definitely don't want? Being clear here can help if you aren't able to communicate in labour (e.g. either in pain or in a moment of great focus).

Labour 1: I felt forced into writing all sorts such as "low lighting" and "relaxed atmosphere" and "gas and air only". All sorts of lovely ideas on top of that. Labour was different to expectations.

Labour 2: midwife made me write in here despite me saying I really didn t care as long as the Baby was born healthy and breathing. Labour 1 wasn t that dramatic but the complete divergence from first "preferences" or plan made me feel either like a failure or like there really wasn t much point in Planning something out that I didn't have much control over.

So the plan for labour 2 was: no student midwives.

Happily managed to meet those preferences. I also decided to not look further ahead than the next step. Take each part of labour as it came rather than worrying if what outcome was going to happen. It wasn't a great labour but I felt like it was positive because I wasn t trying to have the idea labour and birth.

There is so much pressure to plan out labour and birth and I know of two friends who definitely felt like they had failed because they couldn't replicate their very detailed birth plans. These should absolutely be seen as ideas or preferences that can be a reference rather than must happen for a good birth.

Thanks @DanielODonkey it's not super-detailed. My plan is basically to start with hypnobirthing breathing and water pool and g&a, then ramp up as appropriate!

I do have a couple of specific things that I think are important though - I have hypermobile joints so have put in that my legs in particular shouldn't be manipulated - especially if I've had an epidural and can't feel them, as there's a chance I'd dislocate something!

@JustAnotherUserinParadise : your mention of Hypermobile joints made me wonder if you have EDS?

It so, this guide might be useful: www.ehlers-danlos.org/information/a-midwifes-guide-to-pregnancy-birth-feeding-and-eds/

And/or this:
www.ehlers-danlos.org/information/webinar-pregnancy-and-labour-in-eds/

I suspect some very clear guidance on managing your joints would be pretty handy.

@oxcat1 interesting... I don't think so from a quick google, but I'm not a doctor! I am otherwise perfectly healthy, no problems with my skin, veins, digestion.... I'm pretty sure I'm dyspraxic though but have never been diagnosed.

When I was pregnant with DD (2019) during one of my midwife appointments I asked when I should fill in the birth plan bit of my notes. The midwife said, "oh we don't really look at tha-", then looked guilty and changed the subject! This was in a midwife led unit which they're dying to get women to use instead of the local hospital btw, and the "bring your own music and fairy lights!" was a big part of their sales pitch.

I do think it's a good tool to sit down with your partner and talk through what you'd like, but maybe focus on the issues you feel strongly about. No point in your DP knowing your legs shouldn't be manipulated if they're too busy trying to find a plug for your aromatherapy diffuser to tell anyone.

Hi OP, we used the NHS template, it was quite thorough and was good for what we needed it for. Definitely recommend having a birth plan.

I'd second knowing what pain relief you want and when you want it. I was all set on a water birth until my waters broke and all hell broke loose pain wise, then I requested all the pain relief I could possibly have.

Two tips:
If you'd like a water birth or time in a pool then you need to request it ASAP as you arrive at hospital as they may be occupied and it's a first come, first served basis.

Secondly, if you go for an epidural then request it ASAP as it can take a long time for an anaesthetist to be available if there are a lot of emergencies. I waited over two hours for mine. I also didn't need it written down that I wanted an epidural as I was very vocal about it!

On DD2 my midwife said 'we have no time to read your birth plan so what do you want?' All I said was 'skin to skin, vitamin inbetween contractions 30 seconds apart 😆😆 you dont need to spend time writing one. Nobody will bother to read it, and most of the time the little things go out the window. Just make sure you or your partner verbalise what you want to your midwife as you go along, and try to keep a flexible attitude to it all. Babies dont read birth plans lol

Make sure you talk it through with your midwife before you finalise it. I had various half-formed ideas and vague preferences (I forget what, really) which I'd come up with by following a template in a "positive" birth book. My midwife then explained that some of them were already the default at my hospital, and others were unavailable. She advised me to just stick to the things that were most important, so that they didn't get lost in a long list. It was good advice.

@TheCraicDealer that made me laugh!

The template I was looking at had a sort of two-line summary at the top, so I'm thinking that's probably a good idea...
At the end of the day the plan is to get the baby out safely, while damaging me as little as possible, and I'm sure the midwives don't really need me telling them how to do their job!

The bottom of this page has a link to download 'visual birth plan icons' I think its a really good idea because it's super simple, a midwife doesn't have to sit down and read it, so they're more likely to remember the preferences.

www.positivebirthmovement.org/visualbirthplanicons/

In the book, they break the plan down into sections and just put the relevant icons under each header. like 'In labour' 'delivery' 'after the birth' 'in case of caesarean' etc etc (also really recommend the Positive Birth Book if you have time)

Don't bother writing much down, no one looks at it. Go into detail with your birth partner though and get them to understand exactly what you want. When the time comes they will be your mouthpiece.

TBH I think birth plans just cause women to be disappointed when (not if!) the birth "experience" doesn't resemble with the plan.

Write it, then recycle it.

I would remind your midwife about hyper mobile joints when you are admitted and get her to write it in your medical notes so it's actually read by the next shift though. Don't have it in a birth plan that nobody will read!

A plan that would have been super helpful for me would hd s been a meal plan for the first 2-3 weeks at home and accompanying shopping list. Also a plan of who is visiting (at the window or wherever), who is available to shop for extras (eg nappies) and so on.

The birth bit is a day or so and you're not really in charge, but it's after that that you really need a plan ;-)

I just did bullet points and I know they read it because my first one was please call me [shortened version of my name] rather then [long version] and as soon as the midwife came in she addressed me with my shortened name. Apart from that not much went to plan unfortunately apart from them holding the baby up so DH could tell me the sex. I wouldn't put much on really, you have no control over what actually happens

Sorry to highjack, but I have a silly question as a first timer - how on earth do people a) know what the options are and b) make a decision about what you might want? Does it all get explained at some point, or are there books people have read? I'm only 9 weeks so haven't had a booking appointment or anything but it's all so bamboozling!!

@Andthenanothercupoftea

Sorry to highjack, but I have a silly question as a first timer - how on earth do people a) know what the options are and b) make a decision about what you might want? Does it all get explained at some point, or are there books people have read? I'm only 9 weeks so haven't had a booking appointment or anything but it's all so bamboozling!!

Watch a few episodes of "One Born every Minute" :-)

@Andthenanothercupoftea I googled it all. Pros and cons of certain pain relief etc and used the nhs model of a birth plan, with a few extra bits added.

@Andthenanothercupoftea it will get covered at your 34 week midwife appointment - mine is in a few weeks and will hopefully be useful!

Also doing the Positive Birth Company pack and looking on the local NHS maternity site which has antenatal videos which are really helpful!

www.nhs.uk/pregnancy/your-pregnancy-care/your-antenatal-appointments/