Birth plan options - all opinions/ experiences welcome!

[Rachae]

Hi! 😊

I'm fairly early in my pregnancy and coming up to 11 weeks. I was asked about birthing plan options at my booking appointment and have been researching ever since. What's your thoughts?

Birthing centre - no epidural? Big deal? Or an absolute must?

Normal ward/ epidural situation - too clinical? Loads of women screaming like in the films..?!

Home Birth - definitely a no no for first time mums?

C-Section - apart from maybe needing a blood transfusion... What's not to love about this option?

Xxx

Whatever your 'plan' may end up being don't let it be the be all and end all! You can't predict what your body might do (or not do!) so do go in with an open mind and bit of flexibly. Another recommendation for the positive birth company course which gives a good explanation of the options.

FWIW my plan was birth centre and had both DC there - one with tens machine one with no pain relief. It seems I tend to give birth quite quickly so whilst I wouldn't necessarily suggest no pain relief as a choice it wasn't so awful that I only did it once 😂

C-Section - apart from maybe needing a blood transfusion... What's not to love about this option?

I was rocking, crying and begging for morphine the day after my c section. (And having a horrible midwife who was in no hurry to get it for me). You might have heard that recovering from a section generally takes longer than recovering from a normal vaginal birth. That recovery is not always painless. So if it's pain you want to avoid than a c section isn't necessarily always the solution.

Also, no driving for weeks which is a PITA if you'r baby is in NICU and you're home.

Last month I met a woman in the zoo walking around with her tiny 3 week old baby. 3 weeks after my section I couldn't have walked so far or so well.

Also, if you want multiple children then having a section could mean problems in the next pregnancy or limit the amount of children that is a good idea to safely have.

I'm greatful for my c section, don't get me wrong, but I would never choose it for a healthy pregnancy/birth. There is a LOT not to love about that option. Just to put it in perspective.

I do realise that vaginal births also carry risks. I'd rather be a kangaroo tbh...

I had planned a csection for various reasons but after going into labour at 34 weeks decided to go with it. Progressed too fast for an epidural so it was gas and air only. I only screamd during the actual delivery (when uou can't have gas and air) and never once heard a sound from anyone else. The whole experience whilst shocking esp so early was actually very positive.

The pros for vaginal birth are obv a much quicker recovery fine, baby less likely to have breathing issues, be exposed to the bacteria in the vagina which helps build immunity and that's it really. Obv there's also a risk of things like major tearing and baby going into distress.

As for a csection if planned is more calm and less immediate risk for complication. But it is major surgery and recovery can be slow and painful (having had major surgeries in the past the recovery for surgery is a lot harder on the body), longer stays in hospital and risk of infections etc.

Keep an open mind about the epidural. It works really well as pain relief and it really isn't as scary to have it put in as it sounds.

Thank you SO much for all the responses so far. This really helps as part of my research 😊 Gosh it's a minefield! Xx

Unfortunately sometimes you don’t have much choice and just have to go with what happens. With my 1st I was pretty open minded. I went to some anti-natal classes and a water birth class. Wasn’t against drugs but wanted as natural or drug free as possible. Waters broke a week early, didn’t go into labour naturally until about 17 hours after waters broke, contracted all through the night (had no sleep at all), had to be at hospital following morning around 7am as they needed to get baby out within something like 72 hours as my waters had broke. Got to the hospital and although I had been having contractions for 9 hours I was only half a cm when I got to hospital! Wasn’t allowed to even try a water birth as I had to be induced and monitored. Had the pessary but only took me to 2cms. Then had to be put on a drip to bring on labour faster. Up until that point I had had no pain relief. Once the drip was in all hell broke loose and I literally couldn’t cope, it was the most painful thing I have ever experienced in my life. Tried gas & air briefly but hated it and it did nothing for the pain. So had an epidural. Had this around 2ish in the afternoon and didn’t work properly so they had to do it again. They also realised hours later they had the drip too high so I was constantly contracting for hours with no break or relief between contractions. My body literally took me else where as I was in so much pain. Although I was conscious I have no memory of anything from around 2-3pm in the afternoon until “I came around” at around 9pm once the second attempt of the epidural worked and they had sorted out the drip. From then until my daughter was born just before midnight it was absolutely amazing! The room was calm and quite, I could feel contractions but was in absolutely no pain, the pushing was so enjoyable and pain free and I didn’t feel a thing after when I was stitched up due to a tear. I’m due my 2nd in February and I have no issues with having an epidural again as it was absolutely amazing. But basically I have no plan this time I am literally going to go with the flow & see what happens as sometimes things are completely out of your control and you just have to go with it. Might also get to labour suite and just take an epidural straight away as it was so good

My ideal birth: normal ward (my mum and little brother nearly died in labour, so I knew I didn’t want home birth as that has always stayed with me, despite it being 19 years ago), open to pain relief and a water birth, but not set on anything and happy to go with the flow.

Actual birth: waters went at home, arrived at hospital 6 hours later between 9 & 10cm dilated. Told too late for pain relief and that baby would be here shortly (4:30am), 6:30am told I was 10cm and needed to push, although I had no urge to, 8:30am put on drip to strengthen contractions as I was having trouble pushing, drip didn’t work but by gosh it was painful without any pain relief! 9:30am told I needed a forcep delivery, given an episiotomy, first push delivered her head and gave me a 3b tear, second push delivered her and the consultant dropped her and had to catch her before she hit the floor! Tear was too big to be stitched in the delivery room, so was then given a spinal and sent to theatre while my husband and mum were left with DD. The reason I never felt the urge to push was because my daughter had her head on her shoulder and she was wedged against my pelvis, otherwise my labour would have been much quicker.

I’m hoping this time round to have another vaginal birth, but due to my previous tear I will have to be consultant led, so will discuss with them what they think I should do. Either way I’ll definitely be in a hospital room, so I know I have a good team of medics round me in case I need intervention again.

Always lots to think about when it comes to your birth plan, but just be aware that things can and do go wrong sometimes, and factor that into your decisions so you’re fully prepared for every eventuality

Just for balance: I was all set for an epidural, and determined I wanted one - it was in my birth plan. But my first labour started very suddenly, I got to hospital feeling a need to push already, no time for an epidural (despite my begging!), DD got a bit stuck in the birth canal and I needed an episiotomy, but within 10 mins of pushing she was out. They stitched me up while I cuddled her and gave her a feed, and within an hour I was up and walking around (slightly dazed!) and went to have a shower while DD had skin to skin with DH. Yeah it did hurt but I was up and about at home the same day, which amazed me! Obviously I was lucky, but just to let you know it is possible, and such a quick recovery is very unlikely to have been possible if I'd had a planned C-section or even an epidural. I think this is why people tend to want to attempt vaginal births if they can, because if it all goes OK, it does give you the quickest recovery time. Of course complications can happen, and of course in that case it's about doing whatever needs to be done to keep mum and baby safe.

When I had DD my plan was birthing centre and water birth. When it came to it I struggled with the pain so had pethidene (which was fantastic) but I was between 3 and 4cm four a whole day so they sent me down to the delivery suite to have my waters broken to try and speed things up.

We got put in a room for over an hour waiting to be seen and in that time the pethidene had well and truly worn off and I had no other pain relief. I think I went to about 5cm in that room. It was horrific, I begged for an epidural. Once that kicked in it was such a relief, I actually managed to get a little bit of sleep and when I woke up it was basically pushing time.

I’m pregnant again now (only 12 weeks) and am leaning towards trying the birthing centre again in the hopes that baby #2 will come a bit faster as it was only once the pethidene wore off and I had no gas and air to take the edge off that it got really bad. That said I would take an epidural again if needed, I’ll see how I go. It’s only down the corridor at my hospital so not a long way to go for the hard core drugs! I’d just prefer not to be on my back again as I’m sure that slowed down pushing (and I couldn’t feel a thing so the midwife had to tell me when there was a contraction).

I do think if I’d been able to get in the water it would have helped but apparently that can slow things down early on and I was latent for sooooo long, then by the time it was sensible to get in I was in too much pain to consider it.

If you're likely to have a low risk, low intervention labour then a C-section is unlikely to be a better option for you. That said I'd definitely lean towards one if there was a strong likelihood of complications etc. When DS3 went breech at nearly term I signed the consent forms straight away because I was that sure I didn't want to attempt a vaginal breech birth. He actually turned by himself and the birth was fine.

Is it really no epidural at your midwife led centre, or would you just need to transfer if you wanted one? If that would be a simple process then those units are great options.

Home birth definitely not off the cards as a first timer. I planned one with my first and although I transferred in due to the labour being long, I am a million times grateful that I planned it that way. It was probably the most empowering thing I could have done because it reframed everything about the whole process for me. It was also incredibly helpful to have midwives come out to my home and assess me, rather than me having to travel into hospital, because apparently even after 3 children I'm really bad at knowing when I am supposed to go in! And it's so disruptive to be travelling back and forth. In reality even with a planned hospital birth, unless you get induced the majority of the labour will be at home, so you need some useful home coping tips whether you have the plan to stay at home or transfer in.

Again I would have transferred in at a sniff of a risk factor.

I would strongly recommend doing some kind of birth preparation classes. NCT or independent. The positive birth book is also great, but classes are just another step. If they are doing them face to face now anyway.

Loved my epidural. I was screaming in agony as my daughter was transverse.

I had an emcs at 10cm, which resulted in a major haemorrhage and a blood transfusion. It was extremely difficult to cope on the ward in covid times with no midwifery support.

Midwifery support was non existent even in non covid times, so that would definitely be something I'd consider now. Can your birthing partner stay over for example? With my ELCS aftercare was dire and I really could barely move. This was before covid, so I'd hate to have that experience now.

Actually think if I was reasonably confident I might have a straightforward birth, I'd try to go for a home birth maybe with a doula for after care.