Is it worth having a birth plan?

[Strawberry06]

I'm nearly 38 weeks and my midwife keeps telling me to make a birth plan but I honestly don't know where to start and thinking I won't really know until I'm there and its happening!

I know I want a vaginal birth (if possible) and I know I have to be given antibiotics cause of Strep B (but that's on my notes anyway) and I know I want DH to cut the cord which he is aware of and will say there and then! Other than that I don't really know how I'll feel in terms of what pain relief I want etc so feel like it's not worth doing.

Anyone not done one and just taken it as it comes?

I think having an idea of what your preferences are can help, or what you really would prefer not to have. But a 'plan' is not the right word.

I didn’t have one as didnt know what to expect or what it would be like. Everything went perfectly.

I mean it kinda sounds like you already have one! Just write down what you've said here and add 'decisions about pain relief to be made as labour progresses'. Done!

Something like this might help Birth plan template

Mine did help even though everything went to shit. The one thing I wanted was to be talked to like an adult & consulted along the way. Instead of ‘ok we’re doing this next’ - I got ‘ok, this is our next option, here’s the pros and cons, what do you think’ and I had some autonomy over my birth.

I felt in control and much less traumatised!

Good luck!

I never had one. At the births I was asked how I was feeding, if I wanted baby straight on me and I was given pain relief options as labour progressed. It meant I didn't feel like I'd failed when my births turned out to all be very different.

I wouldn’t get too worried about it, it’s another box they have to tick to say they’re discussed it with you to evidence your aware is the different options e.g pain relief, vitamin K, skin to skin, oxytocin etc and so they can take account of or discuss any strong preferences you have. E.g if you say you don’t want any monitoring is much better they can discuss this with you now so you are doing so with informed consent rather than trying to discuss it with in the throws of labour. They usually provide a template and most women put fairly open minded responses e.g pain relief - aware of options, will decide at the time

Definitely, it's good to be informed. To me it's more about what you don't want. Agree with PP, it's not really a plan, it's more a wish list! Also important that your partner knows so they can be an advocate for you.

I had a birth plan, I was going to give birth in a big teaching hospital and was a housing officer for the University so I made plain I wanted no students in the room as they were potentially people I had to deal with and possibly may have disciplined or have to discipline.

I wanted drugs but ended up with none as labour was so fast, my friend and I were PG at the same time, she wanted a natural birth, it was her first and I remember saying balls to that I want drugs, it was my second child. She ended up with an epidural, she had hired a professional doula. It’s best to make your wishes known.

Just make it brief.

Mine was pretty much epidural ASAP, I'll be formula feeding please don't suggest breastfeeding, please can baby be cleaned before being placed on me.

DH cut his cord, they just asked him if he wanted to.

Great example of how they can work well, not every woman wants to be bombarded with loads of detail in labour and some would find it annoying but it was good for them to know that you did want a detailed discussion at every stage. They essentially want to give care that your happy with and makes the job alot easier for both parties when they know your preferences

What you have here is fine, you just need to have considered what you would like. My birthing pool idea was totally out the window anyway when they had to induce me. So it's best not to get overly attached to anything.

What I found helpful was to research possible interventions and their pros and cons ahead of time.
And decide that way. With room for changing my mind.
Eg pethidine can make baby drowsy but gas and air doesn't. (I was offered pethidine for a previous medical thing and it was AMAZING. I wasn't offered it while in labour so I'm not sure if it's even available, that's just an example)

I had decided I wanted my waters to break spontaneously but when they didn't and the midwife suggested if and said it would move things along I said go for it (and it did move things along!)

I felt best with as much information ahead of time as possible. Not everyone feels that way so do what suits you

@Strawberry06 i think the problem is that they call it a “plan” when it’s really not something you can plan for 😅

Do your research on the options available to you and write down a list of preferences exactly as you have here 😊 Mine was roughly:

• I know my options for pain relief and would rather ask for it when I want it than be constantly offered it
• If possible I would like DH to cut the cord and announce the sex of the baby
• I’m happy for baby and myself to be monitored as the midwives deem necessary
• I would like the Vitamin K injection to be given
• If possible I would like immediate skin to skin with my baby

It doesn’t need to be in depth (and is probably better if it isn’t tbh!) 😊 Not long to go for you now!

Anyone not done one and just taken it as it comes?
Yes, me. There wasn't anything I felt that strongly about. I wanted to not have an epidural but wasn't ruling it out if I changed my mind. I wasn't fussed who cut the cord or told me the sex. I had no idea if I'd want the injection to help deliver the placenta so just decided at the time. I vaguely fancied the idea of a water birth but if there wasn't a pool free I wasn't going to be upset.

Just didn't seem like there were any decisions worth writing down.

My first was born 4 weeks early and so I hadn’t written any birthing preferences down. The midwives/Drs just asked me lots of questions and I answered.

For my later pregnancies I wrote down a few simple sentences down, it doesn’t need to be complicated. It can help the midwives if you are in a lot of pain, out of it, your partner isn’t with you, and you aren’t able to articulate your wishes clearly.

I wrote:

• I am positive for Group B Strep. It is imperative that I am given antibiotics during Labour.
• I have a preference for gas&air and an epidural
• My husband would like to cut the cord
• I would like to have the injection that helps remove the placenta after birth
• I would like skin to skin if possible immediately after birth

I think things like who does cord cutting, skin to skin etc all the things your midwife should have asked you are helpful.

But like you, and having had one already, my birth plan was basically - hopefully vaginal, we'll see what happens on the day!

I think for first time mum's 'planning' gives you a sense of control at an uneasy time. The reality is, it may go really differently!

I had one for my first baby, nothing went to plan (4 inductions over 2 days and a rush to neonatal unit straight after the birth) so didn't bother with the second baby and just took everything as it came.

Basically I said I'd get an epidural if I needed to but would try without, that I'd give breastfeeding a go but no pressure on myself if it didn't work out, that I'd try avoid induction but if I needed one then I'd have to have it. Just a vague idea of what I wanted but staying very flexible.
As it turned out I had an induction at 14 days overdue, got an epidural about 15 minutes before I needed started pushing - had I known it would happen so fast I'd have stuck it out because it was a crap epidural anyway! Breastfeeding went wonderfully luckily enough.

They asked anyway if DH wanted to cut the cord, suggested skin to skin, offered to take photos, asked about Vit K etc. so I haven't needed to have anything like this in a birth plan to help me remember them.

The staff don’t know who is walking in the door and does really help them to know, are you someone who is quite laid back, aware of the options but happy to go with the flow or do you have preferences that you’ll be really unhappy if not considered or maybe things like someone has had breast surgery that means they can’t breastfeed and might be really triggered if anyone so much as asks them how they want to feed their baby. Is good to be aware e.g ‘btw we discussed this with the infant feeding advisor and she said could still breastfeed and would like to try’ or ‘ plan to bottle feed formula due to previous breast surgery’
Even a birth plan that just said , ‘I’m happy to go with the flow’ would tell them so much more than nothing at all. Fine being brief if no unusual strong preferences/issues

It's fine not to have one, I don't think it's necessarily a good idea to have a fixed idea because it causes more anguish if you have to divert from the "plan".

Instead look at what the pain options are, what facilities your hospital offers etc

I didn't make a plan as I was pretty laid back about the whole thing but I did research pain relief options and which options are best for different scenarios.

For example, Pethidine can make the baby drowsy so not advised in later stages of labour but a good option if you are in early labour and still have a long way to go and need a bit of a break from the pain.

It's important to discuss with your dh as he is your advocate and he needs to be clear on your feelings. He needs to be able to ask you the right questions so your needs are taken into account at a time when you are tired, in pain and not thinking particularly straight. He needs to know how to behave in supporting you and understand what is role is eg. My dh kept giving me water as gas/air is very dehydrating and his voice was the only one I could hear so I felt safe cos knows me and knew how to talk me down, help me make decisions. He was excellent! So yes, a birth pathway with options is important.

Yes! If nothing else than to be informed of all the options from going through the exercise.
I wanted a home birth (and had one) but my plan included what should happen if I needed to go to hospital or have a c section.
You should discuss with your birth partner so they can advocate for you as well.

I would. And I think they're sometimes more important for subsequent babies when you have a better idea what you're getting into.

I had fast and relatively easy labours, which was great. But the speed and intensity was overwhelming, and I couldn't really speak. My ability to make simple decisions or requests sort of shut down - I found even yes/no a challenge.

I did not have a birth plan for baby 2 because I knew from birth 1 that everything is unpredictable. But it was actually really challenging not having notes because I couldn't vocalise what I did/didn't want. (and poor dh was thrown by the speed/chaos too) For baby 3 I wrote some notes on my preferences and it made all the difference.

There were loads of small things it helped with but the biggest one for me was prob position. With baby 2, I was moved from kneeling to lying on my back for an exam even though I absolutely did not want to (I did try to say no, but was cajoled). Turned out I was fully dilated and baby was born within a few mins. I could have been examined in an all fours position, but for whatever reason I was moved. And at that stage I couldn't properly vocalise my need to stay kneeling or go back to kneeling even though my body was crying out to move.

To be fair, the midwives prob had no idea that labour was progressing quite that fast - I'd only been in the labour ward for 10 mins. But it's something I could have noted down.

With baby 3, things were progressing fast again. This time the midwife quickly scanned my plan and said 'why don't we stand you up as you have written here you'd like to be upright'. And it was amazing. I felt so supported by that simple thing. Again, I was a lot closer to delivering baby than she expected and baby was born with 10 mins. But this time I was a lot more comfortable. And didn't tear.

I was like you and a lot of questions, especially around pain relief, I answered that I would wait and see at the time. As it was, gas and air was enough for me anyway. Anything you are specific about, e.g. cord cutting, skin to skin, vitamin K, have that noted down. Your ‘plan’ doesn’t have to include everything. One thing I included was that I thought I’d like to try a water birth, the water was amazing for me so I’m glad I did, but it also meant they could make sure I had a room with a birthing pool (obviously I wouldn’t have if they were all full) and get it running as soon as I came in.