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?

Mine (for a VBAC but covers the main points aiming for as natural a birth as possible) is below. Typically I ended up with a section under GA so the plan was virtually useless but great to have thought all this stuff through.

Labour

I will be accompanied by my husband. (I also had an IM with me so the plan says who she is and what her role is to be).

I would like the room to be dimly lit.

I do not wish to be continuously monitored. I will accept monitoring with a hand-held device. If this suggests that CFM is needed then we can of course discuss this.

I would like to keep vaginal examinations to a minimum. I find these very uncomfortable and sometimes painful.

I would like to labour ? and possibly to give birth ? in water.

I would like to have an active labour and will want to be mobile.

Please keep interruptions to a minimum.

I am aware of the pain relief options available and will request them if necessary.

I will be aiming to avoid epidural.

I do not wish my labour to be augmented by the use of drugs or ARM since I believe that these may increase the risk of scar rupture or foetal distress.

I will continue to eat and drink as I wish during labour.

Second Stage

I am happy for a student midwife to be present during the birth but do not want the student to actually deliver the baby.

I do not want an episiotomy unless it is necessary to get the baby out quickly. If I do need an episiotomy I would like a local anaesthetic if there is time.

I would like the baby given directly to me. If I am unable to take her, please give her directly to my husband.

I do not want the cord to be cut until it has stopped pulsing unless I am bleeding excessively or active management of the third stage is necessary.

Third stage

I would prefer to have a drug-free third stage, although please ask me about this at the time.

If I need stitches please make sure I am given adequate local anaesthetic.

If a caesarean section becomes necessary

I would like what is happening to be explained to me until my baby is born.

Please ask me if I would like the screen to be lowered so I can see my baby born.

My baby should not be taken out of sight of me/my husband

My baby should be given to me immediately on birth. Unless there is something wrong with the baby she can be assessed as I hold her.

I am keen to have skin-to-skin contact as soon as possible and so it would be helpful if any monitors that would normally go on my chest could be put under my arms or on my back. If I cannot take the baby please give her to my husband.

Retracing!? Rereading - stupid iPod. Thread moved on a lot while I was writing- even more to think about! ace I love mumsnet.

Thandeka I had a mc at 9 weeks and the cramps are indeed like early stage labour. The thing is though early stage labour might be less painful, but in many ways it is the most difficult to cope with because you're not yet 'into it' iyswim.

By the time you get to the hardcore stuff your brain should have switched off and you should be off in a coping world. One of the reasons why it can be disruptive to not have your details written down and therefore a well-meaning mw pestering you for a decision every hour.

i didn't do a proper birth plan with either of mine, however dds birth was so mismanaged i wish i had, the mw basically did every thing to her plan rather than asking me what i wanted, i was talked into a head clip for dd which meant that i had to birth on my back, even though looking back there was no indication for one.

with ds i stated home birth on my notes from day 1. there was no way i was going into hospital again!
it basically said no narcotics, tens and entonox only
birth at my own pace, no cries of push!
dh to cut the cord
no internals
no ARM unless necessary

ds was out an hour after the midwife arrived.

I wrote one for my first birth, no pain relief, active birth etc etc... In reality it all went out the window as I was induced, stuck to the bed, in labour for 27 hours, went through all the pain relief going and had my epidural topped up 4 times!.. still ended up in theatre for an assisted birth.
Basically nothing that I wanted but thats what was needed.

This time (due in May) my plan will be to basically go with the flow as you dont know what each labour will bring.

I haven't really thought about mine yet, didn't bother with one for DC2, the one for DC1 was more for DH's reference

It'll probably be...
I will consider at the time about how assisted my assisted third stage will be (I was supposed to have a drip last time)

Oral vit K for the NB

wow i had no idea what to put in mine so thank you one question vitamin k- oral or injection or not at all- i dont know anything about this or what to put in plan. Could you advise?

mine all had oral vit K because I didn't want them having a needle stuck in them have just been born!!! With oral you need them to have a follow up dose I think it's 10 days later whereas with injection you don't need to at all.

It's only vit k so surely not harmful at all???

I am pregers with my 1st so this is very useful and interesting (also funny ).

My question is....

My experience of hospital wards, including maternaty wards (from work) is that they are busy places and if it is a busy day/night they are ultra busy.

So if you write pages of info do the MWs really have time to read it all? I am just wondering what can you realistically expect them to be able to read and follow?

Thanks

The question isn't oral or injected vit K.

The question is oral, injected or NO vit K.

SSummerhols You can have bullet points above each section, or bold the section headings.

My MW sais 'wow' when she got my 7 page birth plan but I was able to reasure her that at present only the first page was relevant.

Agree with Starlight - No Vit K is also an option

This is mine, 1st baby. Booked at Crowborough birth centre, known for waterbirths and active birth.

Birth preferences

• physiological 3rd stage, breast crawl & cord to be cut after placenta delivery. DH to cut cord

In event of transfer

• Would prefer not to have continuous monitoring
• Do not want unnecessary V/Es
• Would prefer to move straight to CS over prolonged instrumental delivery
• Please try and facilitate natural 3rd stage if possible
• Would like to avoid pethidine

Starlight - yes I agree. DD was a home water birth with very little intervention - just heart beat monitoring really. I had to get out of the pool at the end though as I had been pushing for too long. They 'let me' carry on as her heart rate was so good but if I had been able to think more clearly I would have realised that my body has this natural break it seems.

I am getting considerably more opinionated with each birth

I really would avoid writing an essay - medical staff do not have time to read it and will probably think you are one of those nutty patients that drives them up the wall.

Keep it short and sweet - just a few bullet points.

Mine goes:

Labour companion - partner

Pain relief - TENS, Entonox (mouthpiece preferred), epidural on request (mobile if pos), no pethidine or other opiates.

3rd stage - skin to skin contact, wait 5 mins before cutting cord, thereafter actively manage.

Vitamin K by injection.

Private post natal room if available.

Starlight - yes I agree with your point as to the difference between emergency medical intervention and invervention being required due to positioning. In my case I was also booked at Crowborough as is Fibilou but the reason I was induced at the Royal Sussex was due to the baby being is such distress in the first place (had to go in to be monitored once waters has gone). Although a non too pleasant labour (until the epidural of course) the good thing is they had to get DC1 out in double quick time so I was manually dilated (don't worry - had an epidural at this point) and from 5cm dilated to delivery - it was only 45 mins! super fast.

I also agree with the point made regarding pages of birth plans and no time for the Midwives to read them. Particularly at my hosptial, Royal Sussex - you were lucky to see a midwife as they were so incredibly busy - hence the midwives didn't have time to look at them and just asked.

Oh here is something for those to think about who may be debating the Epidural opption - the anesthetist told me which I thought was very apt "You wouldn't have a tooth taken out without any anesthetic so why have a baby out without any?"

Regarding Vitamin K injections or tablets - please also bear in mind why they were introduced in the first place.... They would issue them unless there was a reason. I certainly don't want to scare-monger so will let people do their own research!

Obvoiusly meant to say wouldn't issue Vitamin K unless there was a reason....

Here's mine... (well most of it as I've anonymised it a bit) for what its worth, I'm a doctor and have worked on both the labour ward and NNU of the hospital I am delivering at. I also delivered there last time and had a normal delivery with no intervention.

This is my ?wish list? and I understand that very little can be predicted. Overall I want a safe delivery for myself and our baby and am open to any reasonable suggestions provided they are fully explained to both me and my husband. If I am not able for some reason to consent to any intervention then I would want full discussion with my husband as he is best placed to know my wishes and I give full consent for my medical care to be discussed with him.

Please Read!
** Our first son was small for dates and born at XX weeks weighing XX
** He had poor APGARs and needed resuscitation

Please Note,
**I have an irrational fear of cannulation/epidurals etc
**I am very scared of tearing and would appreciate guidance when pushing but would prefer to avoid episiotomy where possible (no tears or epi last time).

Ideally, I would like;

1)A hospital birth on the consultant led unit
2)My husband X to be my birth partner, cut the cord if appropriate and stay with the baby if it has to be transferred to nnu.
3) Female staff where possible
4) No visitors until after the baby is born and then only with my express consent.
5)Entonox as analgesia (although I might need cyclizine as entonox makes me vomit) with local anaesthetic if sutures are required
6)To stay upright and mobile as much as possible and I found a birthing ball very useful last time.
7) I would prefer to have IFM rather than CFM if appropriate and am happy to have active mangement of the 3rd stage.
8)To breast feed my baby. Please do not offer bottles.
9)We would like our baby to have IM Vitamin K.
10)I would like a 6 hour discharge if possible to get home for my son.

I'm on birth plan number 3 and it will be the same as the other 2 - go with the flow. DS born in hospital with ventouse assistance - distressed and heart beat dropping - so get him out asap was my reaction. I was 9cm dilated when arrived at hospital so nothing to do with hospital staff that he was distressed etc. DD was also born in hospital, approx 45 minutes after arrival. I was 10 cm dilated on arrival and had to be dragged off the loo as said I needed a wee when in fact I was reday to push. Birth plan this time is "if in daytime and can get childcare then go to hospital and if at night and not feasible to get a babysitter have home birth". I know friends with 3 page birth plans and birthing CDs and Moroccan lamps to make the room more cosy who all laugh at their plans now. Half the things I packed in bag for DS never came out, the whole thing was so momentous and awe inspiring and strange that I felt no need to be my usual bossy, opinionated self. Gas and air and 2 beatiful babaies one 8lb one 9lb 3. If it makes you happy to write a long plan then do it but don't expect to stick to it. Is some truth in what earlier poster said re longer the plan the worse the birth. And it does not help to have view that medical staff are the enemy. They may be busy and sometimes brusque but sometimes that is what is needed to deal witthe situation not a long discussion.
Good luck

It´s Very interesting to read these plans but I´m curious to know is this birthplan something they want a mother to write before the due/the labour?
I´m from Finland and I´ve never heard this- here mothers don´t write any plans, they might discuss about their feelings with the nurse at some point but that´s it.

Johsibo - when I had my first baby at no point was I given a chance to talk over my preferences with a midwife, so actually writing a plan would have been a good idea. Instead I just went with the flow and endured hourly internals, every intervention going etc, much if which I now realise was not necessary. For me, no plan meant I hadn't really thought things through.

It is true that if things go wrong the first casualty is often the birth plan, although it can help to have thought through what you might want in those circumstances. This is why in my plan it asks for local anaesthetic before episiotomy (in the event a doctor actually suggested performing a large episiotomy on me and a forceps delivery with NO pain relief) and deals with emergency CS too. Fair enough, busy medics are unlikely to wade through the whole thing but since I was well beyond answering questions it was good for my supporters, when asked, to be able to tell them what I wanted and to be able to point to my birth plan as evidence that those were my wishes. Particularly useful if you have a doula, I reckon.

here's my offering! Just to say, my experience was that the midwives were brilliant and explained everything they did and also asked permission for everything. My birth went pretty well to the plan, until the pushing stage when needed to have an assisted delivery and then after that had retained placenta...
My view all along was to be open minded. I think having an open mind about the options helps you to deal with things when they aren't progressing as you would 'ideally' like. Also, bear in mind, that labour might be much more/much less painful than you imagined. In my experience, it was much more painful and at 4cm dilated I said i really wanted an epidural, but MW's convinced me to try waterbirth with G&A (which was in my plan) and i actually did all the rest of my labouring that way. Finally, just to say, i was terrified of being cut and of the whole labour process really, but in the end i had episiotomy, ventouse, cord snapped, lost loads of blood and had to have a spinal block for manual removal of the placenta....and it was not that bad!
Good luck

Birth partner.
My DH

Pain relief
Relaxation and breathing techniques for as long as possible; TENS, then gas and air, meptid and an epidural in that order, if needed. Would also like to use the pool/water if at all possible. However, if an induction is required, might be more tempted to go for an epidural.

Interventions
As few as possible -- I really do not want to have an episiotomy or forceps, but of course will have them if necessary.

Delivery positions
In the pool if poss and if not, active and moving about.

Immediately after the birth/3rd stage
Would like to have immediate skin to skin contact with baby; if this is not possible for some reason, i would like DH to have this.
Would like to try to deliver the placenta naturally, but if this takes a very long time, am willing to have the necessary injection.
Would like the cord to be cut once it has stopped pulsating.

Feeding
Breastfeeding for preference, but bottle-feeding if I have problems.

Vitamin K
Happy for vitamin K to be given.

All of the above is of course the ideal, but very happy to take advice if circumstances dictate. DH is fully aware of my preferences and i would like him to be with me at all stages during the delivery.

Johsibo - My handheld maternity notes had a section in them for 'your birth plan', definitely expected by the community midwife to fill it in. Mostly seemed to be so that they knew I had thought about issues like pain relief, cutting the cord, vitamin K and 3rd stage.

FWIW, my second birth plan only used the template in the handheld notes. So basically said:

Home birth, in the birth pool.
Gas and air / water / TENS. No epidural.
I agree to transfer to hospital if necessary, and understand under what circs it may be necessary.
Don't cut the cord till it has stopped pulsating.
Vit K fine.
I want to breastfeed.

As it happens I laboured alone (DH had to look after 3 year old DS), and it was a fab birth with an understanding midwife.

My first birth I needed a 'plan' far more, as I was much less in control and had basically no idea what was going to happen to me.