Anyone want to post a copy of their birthplan?

[Thandeka]

Should probably start writing mine All I know is I don't want it to be a dickens novel, more a mr man book!

Am thinking doing it brief with headings and bullet points eg.
first stage
second stage
third stage
imediately after birth etc.

Anyone fancy sharing theirs?

I will if I can find it - hang on a minute....

Mine was

Do as midwives suggest and ask for drugs if it becomes too painful

hth

I'll post my epic. It's more war and peace but I 'think' I have left no stone unturned and you might find it useful for things to think about.

Here it is:

Birth Plan for DC2.

These are our thoughts about the way we would like the birth of our baby to happen. We are obviously very willing to change any of it should it be necessary.

Those present:
My husband.
All necessary medical staff.
We do not mind a student being present.

Positions for Labour:
If possible I would like to have the chance to remain mobile during labour.
During this pregnancy I have suffered with significant amounts of pelvic pain (symphysis pubis and SI joint) and this was exacerbated by a nasty fall at 34 weeks. I do find rolling over difficult and painful, and need time to do this comfortably. I do not have a reliable painful gap, therefore will let you know if I am not comfortable at any time.
I would like to labour and deliver in a birthing pool if it is available, and if it is not then in a kneeling position and to use gravity to assist wherever possible

Positions for Delivery:
I would like to use gravity to aid delivery of our baby and think that forward lean kneeling (over a ball or the head end of the bed) might be a comfortable position for me.
I would like to avoid lying supine with my legs in stirrups if at all possible. If I do need to have my legs in stirrups, please could they be lifted up at the same time to avoid any un-necessary pelvic pain.

Monitoring:
If possible, I would like the baby to be regularly monitored with a sonicaid.
I realise that I may need to be attached to a CTG machine for the safety of the baby. Please inform us why if this becomes necessary.

Pain Relief:
I am planning to use a TENS machine in the early stages.
I may find warm baths useful to ease the pain and help me to relax.
I am keen to use entonox having found this very effective while having our first child.
I am concerned about having pethidine due to it potentially making the baby sleepy and hampering our early efforts at breastfeeding, and also as it may make me sick. If you feel that pethidine may be useful, could you please discuss it with us, as I know that the baby?s sleepiness can depend on what stage the drug is given. If I am given pethidine, could an anti-emetic also be administered?
I am not opposed to an epidural if the pain becomes too severe ? if possible please inform me of this as an option before things progress past the point where it would be possible to have one. My concern with an epidural is that it would hide any pelvic pain that I am experiencing.

Delivery:
Please give me as much advice as is necessary, particularly regarding when to push and when not to push. Also please advise me if you think a different position may be beneficial.

Assisted Delivery:
If necessary please try ventouse before forceps.
I am not sure whether or not I wish to have an episiotomy, or to tear naturally. Please explain things as fully as possible should it look like an episiotomy may be necessary.

Cutting the Cord:
DH would like to cut our baby?s umbilical cord.

Meeting the baby:
I would like the baby to be wiped clean quickly before having skin-to-skin contact.
If the baby wishes to feed, I would appreciate help with positioning and attachment on the breast.

Third stage:
I would like to try to have a physiological third stage. Please advise me when I need to push to assist the placenta to be delivered.
If you feel that it would be advantageous for drugs to be administered to aid delivery of the placenta, please discuss this with us.

Feeding:
I am planning on breastfeeding our baby and would be grateful for as much help and advice as possible to ensure that this is successful. I really feel that early skin-to-skin contact is important and so am very keen for this to happen.

As it turned out we made it to the hospital with 5 minutes to spare before ds2 was born - no time to even get the plug in the pool!

Birth Preferences

1. MLU Birth

I am planning a Midwife-Led Birth at Edgeware Birthing Unit and would like as undisturbed birth as possible.

People

I?d like the following people to be there for support. It has been agreed at my booking that I can have the following 3, although I know this is not normal practice.

(Husband).
(Mother).
(Doula).

Examinations and interventions

I wish to avoid internal examinations.
I do not wish to have my waters broken.

1st stage

I will likely require gas and air from very early on. Please make this available from when I arrive.

I would like to use the pool as soon as I feel I need to. This may be earlier than normally recommended. I am, however well informed of the reasons why this is not always recommended and will try to wait as long as possible, but it is likely I will need the benefit in the earlier stages of labour more than the later stages. I will be happy to get out if things slow down. I will not use a bath.

I will probably prefer to kneel throughout labour and concentrate rather than move about but am open to suggestions from my birth supporters and midwives. I would like to try firm massage at the base of my spine.

I would like pethidine (parmagan P) to be available if the water doesn?t help or if I need to get out, but I am happy for my birth supporters or midwife to make further suggestions of things to try for pain relief before given pethidine.

I would prefer the room dim and quiet (although perhaps with music)

Augmentation

If the baby appears to be poorly positioned or labour is not progressing well for some reason, I would appreciate suggestions for changes of position or movements which might help. I do not wish to have my waters broken, or to transfer into hospital for drugs.

Please do not set a time limit on the 2nd stage or encourage me to begin pushing before I am ready.

2nd stage

Provided it is safe, I would like to deliver the baby in the water. I prefer to keel for delivery and would like DH to bring the baby up or do it myself. If not in water, I still would like to give birth upright and DH would still like to be involved. Please prevent me from delivering on my back or in a semi-reclining position.

I would like to be touched as little as possible during this time, although if not in water I would like the midwife protect the perineum if it will help prevent tearing.

I do not wish to have an internal examination to confirm whether or not I am 'ready' to push. I shall only push when I physically cannot do otherwise! If this takes some time then I would like to benefit from the rest. If there is any reason to suspect that I might have a premature pushing urge then I would like to discuss this on the day. I expect to push when I am ready and feel the urge, even if there is some delay.
Please keep the room as quiet as possible during the second stage. I would like to minimise distractions at this time.
I would rather not be told how to push, or guided in the second stage, unless there is a particular reason to suppose that I need assistance, or unless I ask for assistance

Episiotomy

I prefer to tear. However I wish to avoid this too, by being encouraged to deliver in an optimum position and with possible support to the perineum if necessary. Please do not offer an episiotomy simply to speed things up.

3rd Stage

I would like a natural third stage and I am planning to deliver the placenta in the water (although I may change my mind for both on the day).

Please make gas and air available as I found it particularly painful last time.

Please do not rush any aspect of this stage. I would like time to bond with the baby before the cord is cut, even if it stopped pulsating a while ago. I may want to wait until the placenta is out before the cord is cut. Please ask DH if he would like to cut the cord.

Please do not pull on the cord or apply fundal pressure. Feel free to set up any resuscitation equipment close by so that the baby can be attended to whilst the cord is still attached.

I would like to inspect the placenta alongside the midwife and if possible have a brief explanation or running commentary of the inspection.

Baby

Please do not administer Vitamin K by injection after the birth. If the birth is traumatic for the baby or there is some other risk factor, I will be happy to discuss this with the midwife and allow vitamin K if we both decide it is appropriate.

Transfer

If I have been transferred in for foetal distress/emergency I expect a c/section.

I will not be happy to transfer if slow to progress.

If I cannot be admitted to the Edgeware Birthing Unit for resource reasons, I would prefer to birth in either the Ridgeway or Barnet Midwife Led Unit.

2. Hospital

If not in hospital for medical reasons I would like my original Midwife-Led-Unit Birth Preferences to be used.

If possible I would like to be considered for the midwife-led unit within the hospital.

People
DH
Mother
Doula

Examinations and interventions

I wish to avoid internal examinations where possible.
I do not wish to have my waters broken.

1st Stage

I would like to remain upright as much as possible, and be able to move. I would like to eat and drink if I feel like it.

I will probably prefer to kneel throughout labour and concentrate rather than move about. I would like to try firm massage at the base of my spine.

I would like gas and air and pethidine to be available and I am happy for the midwife to make further suggestions of things to try for pain relief (except for a bath).

Please keep the room dim and quiet.

Monitoring

I would prefer to avoid continuous monitoring.

Augmentation

If the baby appears to be poorly positioned or labour is not progressing well for some reason, I would appreciate it if you could suggest changes of position or movements which might help. I do not wish to have my waters broken, and it is unlikely that I will agree to any form of induction. If the baby needs to be delivered immediately I expect a c/section.

Pain relief

Gas and air and pethidine (parmagen P).

2nd Stage

I would prefer to be upright or my knees or use a birthing stool. Please do not let me be on my back or in a semi-reclining position for any part of the 2nd stage. Please do not touch me or rub my abdomen. If I need help getting on or off a bed I prefer to be supported by DH or Doula. Unless I have had an epidural, please do not direct me when to push and please keep the room as quiet as much as possible.

I do not wish to have an internal examination to confirm whether or not I am 'ready' to push. I shall only push when I physically cannot do otherwise! If there is any reason to suspect that I might have a premature pushing urge then I would like to discuss this on the day. I expect to push when I am ready and feel the urge, even if there is some delay.
Please keep the room as quiet as possible during the second stage. I would like to minimise distractions at this time. If you need to discuss matters with the second midwife, please could you do so very quietly and preferably out of earshot!
I would rather not be told how to push, or guided in the second stage, unless there is a particular reason to suppose that I need assistance, or unless I ask for assistance

Instrumental delivery

Please do not assume consent is given for an instrumental delivery or fundal pressure. I prefer a c/section, however, if there is time for a discussion I would be happy to briefly consider or discuss the reasons for an instrumental.

Provided the baby is not in distress I would expect to have tried all possible alternatives to an instrumental delivery or a c/section such as different positions or a tea-break.

Episiotomy

I prefer to tear. However I wish to avoid this too, by being encouraged to deliver in an optimum position and with possible support to the perineum if possible/necessary.
Please do not offer an episiotomy simply to speed things up.

3rd Stage

I would like a natural third stage. Please do not pull on the cord, apply fundal pressure or expect to cut the cord until the placenta is out.

Please make gas and air available.

I would like to inspect the placenta alongside the midwife and if possible have a brief explanation or running commentary of the inspection.

Baby

Provided the baby is healthy, I would like the baby to be given to me immediately before being cleaned or weighed.

Please do not administer Vitamin K by injection after the birth. If the birth is traumatic for the baby or there is some other risk factor, I will be happy to discuss this with the midwife and allow vitamin K if we both decide it is appropriate.

I want to breastfeed as soon as possible, but if I can?t for any reason please do not offer any pacifiers or formula without the consent of my husband.

DH would like to be present for any tests or procedures to be conducted on the baby.

Bounty

Please no visits from them

3. C/section

People

I would like my husband to be with me at all times if possible.

Intervention and pain relief

I would prefer a spinal to an epidural.
I would like the catheter to be put in after the spinal/epidural.

Screen

If a c/section becomes necessary, I do not want a screen. If the consultant insists then my husband has been instructed to hold up a mirror so I can see the operation.

Commentary

I would like a running commentary of the operation please.

Placenta

I would like a running commentary of the inspection of the placenta please.

Baby

Provided the baby is healthy, I would like the baby shown to me immediately before being cleaned or weighed and passed to DH, and for them to both stay with me for the rest of the operation.

I would like at least one hand free to touch the baby as soon as possible.

I want to breastfeed as soon as possible, but if I can?t for any reason please do not offer any pacifiers or formula without the consent of my husband.

DH would like to be present for any tests or procedures to be conducted on the baby.

Bounty

Please no visits from them.

I think birth plans have their place but please do a bit of research before you write one, for example:
find out whether your hospital is 'baby friendly', if it is there is no need to put stuff in about skin to skin, early feeding, breastfeeding etc as that will automatically be the hospital's policy.
Pethidine/diamorphine is routinely administered with an anti-emetic,
ventouse will routinely be used before forceps if the doctor thinks they can deliver baby this way,
all babies will be wiped to a certain extent to prevent heat loss and stimulate breathing
episiotomies are no longer routine, they will be necessary if an instrumental delivery is needed or if the baby is in distress and the midwife thinks they need to come out NOW.
To be honest, if you have a compassionate, intelligent, well trained and thoughtful midwife caring for you you will not need to write all this down as she will do all this stuff anyway and/or discuss it with you. If you don't have the above, they won't care what you have in your birth plan they will go their own sweet way...
And please remember that for who knows what reason, those with the most complicated birth plans tend to have the most complicated labour and birth. Strange but true. Sorry for the long post, I'm afraid you have found me with time to kill waiting for 'Nurse Jackie'!

DS1:
No pethidine.
No blood transfusions.
Assisted third stage, injection as soon as the head crowns.

Gas and Air preferred, epidural if required.
Would like a water birth with minimal interference.

Controlled cord traction.

Skin to skin and breast feed immediatly.

DS2:
No blood transfusion.
Have baby, have tea & toast.

first birth or second birth?

1st one was pages and pages, lots about no pain relief, and detail right down to music and stuff.

2nd plan consisted of me saying to midwife "I want an epidural"

my birth plan for dc 4 was something like this.........(I had booked for homebirth but as with others ended up being induced at 42 weeks)

Dh is here to see the baby being born and carry the bags he is useless as a birthing partner

I would like the midwives to be my birthing partner

I refuse to have continuous monitoring

I refuse to have a catheter if I have an epidural

I have suffered from spd so I will give birth on all fours.

I refuse to go on the Joan Booker ward (the antenatal and postanatal ward)

I refuse blood sugar level testing on the baby

errr can't think of what else - was a fab birth btw

These are really useful.
Note to self - perhaps I need to give mine a little more thought. At present, DC2, knowing that I am going to a consultant led unit and at 37 ish weeks it looks like this.

No induction
No syntocinon
No assisted delivery - C/S in preference
Natural 3rd stage
Immediate skin to skin as I will be breastfeeding
Oral Vitamin K unless contraindicated

x post, ihave

reikizen I'm sorry to disagree, but my first birth plan was short, flexible and basically just to go with the flow but keep it as natural as possible.

The birth was so badly handled and traumatic that for no.2 I wrote my epic, - and the birth was the best experience of my life. Even now I remember thinking upon realisation that she was crowing 'not already. I was just getting into it!'

Heqet - love yours!

OK my 1st went over a couple of pages, all very airy fairy - it wasn't even looked at as I was induced, strapped to a monitor and then had the works with drug relief, assisted delivery and episiostomy.

With my 2nd plan (due end Feb) I'm not doing one! Like Heqet it'll be 'Get the epidural sorted as soon as I get to the hospital!'.

To be honest, I really won't bother this time but will just tell them depending on how I feel at the time. The midwives will ask you want you want at various stages anyway (such as the Placenta injection/Vitamin K etc)

sazlocks, if you are going in at 37 weeks does that not mean you will be induced, or am I misunderstanding?
Starlight, I am truly pleased that your second birth was so brilliant, but I wonder if it was more to do with delivering in a MLU than the birthplan itself?

Starlight I am going to steal some of your bits from that if its ok? I particularly like the bit about not pushing until ready and that will go on my birth plan.

With DS I felt no urge to push - but pushed for 35 minutes and he was born with the 'help' of a large episiotomy.

With DD the fan midwives let me get on with it but still encouraged pushing. I pushed for 3 hours until I felt the urge to push - after that it was a couple of pushes and she was out!

After reading everyone's birth plans on here, I do want to add.... There are reason's why you may be monitored and you may get an episiotomy. In my case, it was to save the life of my baby. So please be open-minded with your birth plan and be open to suggestions from the professionals who are there, ultimately, to ensure the health and well being of you and your baby.

Good luck!

reikizen They were both in a MLU (albeit different ones), with wallpaper, baby-friendly status and everything!

reikizen I probably wasn't being clear. I am just past 37 weeks which was the point I was trying to make about probably needing to give it a bit more thought. I was induced last time and there is no way that is going to happen this time. I saw my consultant last week and she said what you said about the people with the most complicated birth plans.

didn't have one at all. read so many stories online of midwives following birthplans and mums changing their minds but not wanting to say, and things like that so i decided to just play it all by ear

was great because the midwives kept asking me what I wanted and i could just decide at the time

Mine is -

No pethedine, just gas and air unless I ask.

I want to stay active for as long as possible and possible give birth upright.

No forceps - Ventouse or c section.

Would like to try a natural 3rd stage but would the injection if I ask for it.

Fine with vitamin K for baby.

Would like to breast feed.

I think thats it. I didnt have one with dd but since then I have found MN and found out a lot more about other ways of doing things.

The best thing is to be open minded. I have put that I dont want things but when the time comes to it I may well think differently.

Beanigan that is very true. I had always had constant monitoring simply because I was induced (but only with pessaries), but constant monitoring means being stuck on a bed in my hospital which then increases the pain etc etc etc it's a very difficult thing to get right isn't it.

Birth plan:

Introduction: Epidural
Middle: Epidural
Conclusion: Epidural

I think you have to go with the flow a bit, a plan is all well and good, but it possibly gives you a false sense that you can control the situation more than you actually can. Seems there are no two pregnancies or two births ever the same.

I wonder if you could do a plan for having a tooth extraction?

I would echo the please no visits from bounty sentiment though. Though I don't think this has much to do with the birth at all. It is a cheek to be so flagrantly marketed to in a hospital bed.

Wow thankyou so much for all this- lots to think about! Hehe I like mavis enderby's and hequet's best- practically a haiku- oooh that would be cool a birth plan haiku!

Think my plan is one side of a4 is my first baby so not entirely sure what to expect but had an mmc at 10 weeks and distinctly remember saying to dh during that "if childbirth is anything like this I don't want a baby after all" as I was on floor on all fours with the pain and imagine that's nothing compared to childbirth but spose childbirth is a positive thing whereas miscarriage is very traumatic so it affects your pain perception.

Am hoping to go to birth centre and maybe a water birth but will be quite happy with an epidural and labour ward if am not coping. Just mainly want to keep it as calm as possible hopefully.

Thanks for your advice too reikizen (yay please post on all my threads- it's like having a personal midwifery adviser!)- out of interest because this is something that worries me- what happens if there is a personality clash or something between you and a midwife can you request another one? I get on with most people but there are some people who just make me feel incredibly uncomfortable and on edge to be around and would be really worried if I got one of them that it would slow my labour down as I would be on edge. Am thinking booming jolly hockey sticks "don't be such a wimp" types. There probably is a place for the "pull yourself together woman chat" at sone point during labour but I can be uber sensitive at some times. Ho hum clearly overthinking this and luckily 3 out of the four midwives I have met so far I would happily have them deliver my baby. Just a shame none of them are likely to as they are community rather than hospital
midwives! The one hospital midwife I met on labour ward scared me a bit. Yikes retracing my wobble perhaps a doula is looking like a better idea.....

Beanigan You make a good point however, it is extremely hard to seperate the true emergency from the emergency caused by too much interference in the first place.

All too often women will say things like 'thank god I was in hospital because after 3 hours of pushing my baby got distressed and needed to be go out quick', when deeper probing found that they were lying on their backs drugged to the eyeballs with no urge to push being screamed at, increasing greatly the likeliness of the baby being in something other than the optimum position for being born, increasing the need for maternal effort and reducing the effectiveness of it. Do you see what I mean?

Peppa Feel free to take whatever. However, I would advise anyone to research their rationale for what they put in their birth plan. Some things 'go together' more optimally than others i.e. you can't say you want an epidural upon arrival and a natural 3rd stage for example, or continous monitoring and a waterbirth.

Also there can be consequences of your decisions. Absolutely no interference in the pushing stage was important to me. More so than the risk of tearing which can increase without guidance iyswim.