Birth preferences

[HopefulllHolly]

Hi all!

Wondering if anyone has advice/views. Will be my first baby (and likely only as she is a long awaited IVF babe!). I will obviously chat to my midwife but I am the type who likes having a bit of a plan to begin with or I just end up agreeing to whatever and feel cross at myself! 😅

So…

I want to have a natural birth but with an epidural but I don’t want any interventions like forceps or the suction (read a lot about tearing and the babies come out bruised and all misshaped so I just can’t do it), I would have an emergency caesarean if they couldn’t get baby out in this situation.

I also strongly don’t want an induction at all, so I want to opt for having sweeps instead and hope baby comes on its own and if she doesn’t then have a caesarean so I’m not too past my due date. Is this allowed or is it totally pointless?!)

So two questions (and I’ll obvs ask midwife but I was wondering if anyone here had views - especially those who are well researched or have babies already):

• What day should I start having sweeps? Guessing the midwife will advise when they’d usually start them but just interested!
• What day should I give as a deadline for baby to come naturally? I don’t want to go too far past EDD tbh because it’s a slight increase in risk the later you are (and my partner was 2 weeks late and came out scaly 🤣). I was thinking of opting for a C-Section at 41 weeks and give her a week to come out naturally - that way it’s kind of the best of both. Does this sound reasonable?

Anyone have thoughts? Thanks in advance! 😘

Hey. I don't really have advice or comments on all of your points, but my midwife said she could start sweeps from 39 weeks.

I ended up having 3 sweeps, none made any difference at all.
12 days over, balloon induction, oxytocin induction and he wasn't coming!
Ended up in a very pleasant (strange to say) emergency c-section.

I think just discuss what you've written here really.
You should be supported as much as possible to have the birth you want....as much as baby allows anyway as they are all different.

@SeLHopeful2024 Thanks for replying - that’s helpful! Sounds like you had a long ride! Would you say inductions and sweeps were horrible? I’ve read lots of horror stories but ideally I just want little one to come without too many interventions. I was going to choose and elected caesarean but as she’ll be our only baby I don’t want to miss out on the excitement and surprise of going in to labour 😅 I appreciate I sound bonkers!

Do remember a sweep is a form of induction. I’d recommend Sara Wickhams book about induction. Especially as it makes you realise how random due dates are so I wouldn’t get too hung up on specific dates. And do remember babies can get battered from a c section too! They sometimes have to use forceps in a c section. And likely a c section cut will take longer to heal than a perineal tear. Only a small % of women get a more severe tear. I’m same as you I don’t want an induction but will consider sweeps from 40 weeks. But I would only have a c section if absolutely necessary, I’d prefer assisted delivery.

Didn't want to read and run! I'd definitely have a good chat with your midwife, let her know all your worries and concerns and write down any questions :) I had an induction with both my children. I also had a forceps delivery with my first as he got stuck in the birth canal and forceps were the only option as he needed to come out quickly. Although he was slightly bruised it only last a day or so. I had a epidural so didn't feel anything. I did also tear though and took about 4/5 weeks to heal. (Didn't tear after the second child!)
I would just keep in mind sometimes birth plans don't always go to plan. As long as you and baby are safe. Good luck with your pregnancy x ✨

@SparklesandRainbows Oh absolutely - it’s more come from the fact I had my anomaly scan and then had an appt with the obstetrician (who wasn’t there and it ended up being a registrar) and she kind of pushed me to start answering questions about my birth choices and I felt so unprepared and almost backed in to a corner. I don’t want to feel like that again. Obviously opting for a natural/vaginal birth it’s anyone’s guess what will actually happen but I’d like to have some strong preferences so I feel a bit more empowered to push back when people suggest things. If that makes sense?! 😅 Thanks so much for replying - really helpful!

Under my NHS trust they don't offer sweeps until 40w as standard.

You can say no to sweeps.
You can say no to being induced (although if you reach closer to 42w you'll be pressured).
If it's not a planned C-section it will be an emergency C-section.

I had 2 sweeps with my first baby and a long and difficult birth ensued. I refused sweeps with baby 2 and the birth was so totally different and such a dream by comparison. I put that down to part having no sweeps but part being baby2.

I didn't want an instrumental birth (this was baby1) but at 30hours of labour, at the last hurdle with no energy left, ventuouse it was. It was the safest and quickest way to get baby out and for me in that moment the choice was safest means instruments. Tearing wasn't as awful as I was expecting it to be. You aren't left torn you are stitched up promptly (with dissolving stitches). You heal and recover. The whole area needs to heal and recover anyway! Felt more like a little graze than anything. It sounds a lot worse than it was in my experience!

Birth preferences are more about being informed so if it doesn't go as you hope it does then you know or have an idea of what happens next and you, or those advocating for you as birth partners, can make an informed decision in the moment that is in baby's and your best interests.

Have an open mind 😊 and congratulations on your pregnancy

@HopefulllHolly you're very welcome! Absolutely get all the information you can. Fingers crossed it all goes to plan for you x

DC2 was forcibly removed from my (planned) section incision with forceps as she didn't want to come out so she was still a bit battered and bruised around one eye just fyi but the swelling didn't last long!

I'd have a chat with your midwife, good luck! It feels like a huge deal when pregnant but as long as they get here safely that's all that matters in the end!

@Peonies12 Yeah I get that - it’s more because I’ve read the induction (not sweeps) are more likely to end in interventions and aren’t pleasant at all. Dates are a factor for me as my baby is IVF and because conception is so accurate they get a bit antsy about you going over your due date because of the risk of still birth going up (from 1 to 2% so not massive but still doubling). I’m trying to balance that risk with also allowing her to come out when she’s ready - who knows she could be early or I could have to have a caesarean early and all this thinking is pointless 😂
Thanks so much for replying and I’ll definitely try and get that book to add to my ever growing library of pregnancy and birth books! ☺️

@HopefulllHolly I'm not going to lie, I had an awful experience with the sweeps and balloon induction.
The sweeps were horrific. Not being too graphic, I swear the size of the midwife's hand makes a difference. I just felt violated and I remember thinking she just wasn't physically long enough to reach were she needed to be.

The balloon induction (possibly pushed more due to tail end of covid) caused horrendous cramps but zero progress.

I had an epidural before the drug induction, so from then on it was all absolutely fine and I quite enjoyed the active labour part, even though it turned out not to be active.

BUT....
You will find positive stories and awful stories about every type birth.

I think educating yourself on the various options, hoping for your plan A, but being prepared for plan b, c etc is all you really can do.

If you do have a planned section as you hope for, I wish you a speedy recovery and a positive experience.
I wish I'd skipped straight to the section knowing how my body was not going to work.

I'd encourage you to not be too rigid to start with and to be guided by your midwife before the birth and during. It's okay to have preferences but you have to be aware that how things progress when the time comes can be unpredictable. The best thing for you and the baby at any given time point may not be in line with your previous choices. Probably the only way to circumvent this entirely is to opt for an elective c-section, but even then there is still room for the unexpected. This isn't a failure on your part or theirs, it's just the nature of how unpredictable birth can be. For reassurance, I had an episiotomy and a small tear and honestly wasn't aware they were doing it. Once I was past the first 24 hours I was also barely aware of it having been done, it healed incredibly easily. It goes both ways for all aspects of birth, there will be people who've had good experiences with that intervention/method of delivery and people who won't. You have to decide what's right for you but be mindful it may not pan out how you plan (frankly I don't know anyone who had the birth they planned). Best of luck when the time comes.

Just to add in relation to your previous post - the anxiety around IVF pregnancies going overdue is an old school of thought but oddly still exists in some places. I checked with both my NHS team and my private consultant during my last pregnancy. Many areas of the country are happy to treat you in the same way a naturally conceived pregnancy would be so long as there aren't any complications. Ours was an IVF pregnancy and I delivered at 40+5 but there was no intention to induce me earlier than they would a regular pregnancy if needed.

You'll need to speak to your midwife, there's a couple of things you've not got quite right.

For example, your chances of needing forceps or ventouse are much higher if you have an epidural.

Also, it's not as simple as setting a date for an elective c-section if you go past 40 weeks. Also the difference between an elective c section and emergency c section is huge.

Finally, you often don't get to choose. If the baby is stuck, it can often be too far down in the birth canal for a c section. Sometimes forceps is literally the only way to get them out.

@JumpstartMondays @SErunner Thanks for your helpful insight! I absolutely get it isn’t ever going to be a firm plan - I know it will absolutely always be in flux. I just want to feel slightly empowered to have a certain list of preferences where I can rather than feel like I’m totally powerless. (Kind of explained a previous example of feeling that way up a little bit). God knows when it’s happening all I’ll want is for the best outcome for me and baby and however that looks I’m ok with - but I would like to try and avoid certain things until they are a must. Hope that makes sense!! 😂 @SErunner My trust have kind of suggested they’d prefer me not to go over but weren’t pushing hard - I want a vaginal birth but equally don’t want any unnecessary risk. (It might be that the placenta degradation isn’t a thing like you say, but everyone I’ve spoken to in the antenatal unit and my community midwife have mentioned it, so I kind of have to take that advice - at least in my mind!! 😅 There’s too many opinions on all things birth it feels like!) Big thanks again!

@SeLHopeful2024 Ah haha no worries. I’m under no illusions that anything will be particularly pleasant about it! Sorry you had such awful experiences though!! (Btw I don’t want a caesarean - my #1 choice is a natural birth but because they are twitchy about me going too overdue because it’s ivf that I’d opt for caesarean over other things and at a certain point). I don’t know if they’ll even agree to this though it’s purely my little brain going turbo time about birth 😂😂 Thanks again for your help!

@justleggingsandatee Thanks! I’m totally coming at this cold currently - I’m only 22 weeks but just trying to start thinking about it and getting opinions. The midwife is going to have to go over her 15 mins with me at my 25 week appointment 🤣🤣 Thanks for your help!

@Rockandgrohl Oh yeah - the poor wee ones get battered in any situation I imagine!! (As do the mums!) Definitely have an open mind to all options and as long as baby is safe (and hopefully me too) I won’t mind. That’s always the main thing. I’m sure in the moment I’ll be just telling them to get her out 😂😂

Sorry @HopefulllHolly ... the perils of replying with a 3yr old going wild instead of to bed.
Mis-read your post.

Sending all positive thoughts for a straight forward second half of your pregnancy and a natural birth as possible.

Sweeps only "work" if your body is ready to give birth anyway. I don't believe in them and the science behind them is very hard prove! I had one extremely uncomfortable one and one fine one but the doctors knew at that stage I was going to go myself as I was getting very very mild contractions. Neither sweep sped things up!

I also had an instrumental delivery with no tearing and no damage to the baby. I can't imagine they would have had time to do an emergency c section in that time to be honest. So I don't know how that would fair out in reality. But I'm sure a midwife would advise you on that!

I fully agree with your c section over induction wish! Anyone I know that was induced when they were well overdue ended in a c section anyway but had a few days hardship before it because of the induction.

Having a very detailed birth plan can mean you end up disappointed or feeling a failure because it didn't go to plan.

By all means read up on options but at the end of the day you want a safe birth. What that will look like may be very different from what you have imagined.

Giving birth is a lot like having a massive poo. You can plan it all you like, but it will come when it wants to and you can't really control it, your body does it for you.

I had emergency C-section then vbac section time, I planned all this stuff how I wouldn't have epidural or be flat on my back, guess what I ended up on my back asking for an epidural. It was fine.

You just have to take it one step at a time. Your uterus hasn't read your birth plan!

I've had an assisted delivery and I didn't have a choice, it was too late to have a C section by that point. I had an episiotomy, and whilst healing took longer than my second birth which was vaginal, unassisted, I did heal fine. I've never had a c section or an epidural but I think your chance of an assisted delivery is higher if you have one. By the point they bought out the venteuse with my first I just wanted my baby out safely however he came! He was born with a red lump on his head from the suction cup but it was gone within a week.

He was a sleepy baby who struggled to breastfeed and had clearly had an exhausting birth but that was just the length of the time i was in labour and the position he was in. It's good to have a plan for best case scenario then be adaptable.

@SeLHopeful2024 Thanks so much! Good luck with the sleep fighting toddler! 😂🦸

had my first sweep at 38 weeks but my midwife wasn't able to fully do it as my cervix was still too high . Was then booked in for the following week which was done successfully and within a hour I was having contractions and had my son the following day on Valentine's Day . Some sweeps are successful and some aren't . I wish you all the best

I wouldn't have any sweeps before 40 weeks as they only work if your body is ready. They also carry the risk of your waters breaking and if that happens and you don't go into labour within 24 hours then you need to be induced anyway.

In terms of an ELCS at 41 weeks that is a good plan to allow your body to have a chance to labour but to come out at a safe gestation- do go off growth scans and advice from your consultant though. If there are any concerns of your placental function then do go for induction or c section.

The only thing to bear in mind though is that you can't always say no to forceps or ventouse and go for an EMCS, baby could potentially be so far in the birth canal that they have to be pulled back out with forceps through your abdomen which is more traumatic for baby. There will be circumstances which you can decline them and go for an EMCS but not all just so you are aware. If baby gets distressed and is right there then they will need to do an instrumental delivery as the safest thing.

@PreggersWithBaby2 Thanks that’s helpful! ☺️ I shall add induction firmly to the hard no camp 😂

@Sandpitnotmoshpit Ah bless him! Well good to know no lasting damage on him ☺️ I watched some of that Emma Willis delivery babies programme and some of the little babes were purple from the forceps and all misshapen. I’m not at all bothered about myself really - mainly her little noggin! But good to hear your little man was fine and a little snoozer!

@lkddp I absolutely know I can’t plan a blow by blow account of my birth, all I’m trying to do is get some preferences of things that are hard no’s, some that are maybes if and some that would be my preferred route. I’m not that daft don’t worry 🙂 Every book I’ve read and podcast I’ve listened to has suggested women have preferences - so that’s what this thread is to start exploring.

@Haroldwilson Haha good analogy. No absolutely - I just want to feel more informed and empowered to make decisions in the moment, and be able to say “no thanks I don’t want that but I would be willing to try xyz”. I’ve read most women who suffer PTSD after traumatic births suffer not because of the trauma of birth but the trauma of feeling out of control, so I’m just trying to get some idea of different situations and what my response would be (without being able to plan for everything, because that’s silly).

Thanks so much for your helpful responses ☺️ Too much to think about but thankfully a long time to do it! 🙂

@Nursemumma92 Thanks that’s so helpful! I hadn’t really considered that. Ofc if baby is stuck and forceps are the only option then that’s what will happen - it’s more like if it’s a case of either or id prefer caesarean. I think I’ve mistitled my thread - it should be birth preferences as it is basically just helping me to make a list of things I’d prefer over other things unless it was a risk to the baby. Big thanks for your help! ☺️☺️