Birth Plan

nicowa

Hi guys,

I was just wondering what you have in your birth plan? Is it very different from the hospital's normal procedure? Or is it just to allow you to know what you'll be doing once you get there? I've still plenty of time (week 28 at the mo) so I haven't talked to a midwife yet about it. Last week at the ante natal class the midwife went through the normal procedure in the hospital. The only thing is that they were suggesting pretty much every intervention that has been talked about here in a negative light.

With oxytocin I've heard many talk about the sudden increase in pain (though that does seem logical). People have talked against the breaking of waters, fetal monitering where paranoid hospitals opt for c-section at the slightest sign on the monitors.

I guess I'm just wondering what are people's thoughts on a birth plan. Do you trust your doc/midwife to suggest the best possible option for you? Or do you assume they're working against the risks and only offering what works best for the hospital?

I also want to know where the dad comes in in all of this. Yes, he's there for the labour, to hold your hand and be the best possible support. But where does he come in for the bonding with baby when it's born? The midwife said nothing about that in the class and it's something I'm slightly worried about - more that I might be hogging the baby than anything else .

Hannibal Smith

Morning Nicowa, I don't have a birthplan and didn't on my first either. I'm a kind of, they're the experts I'll go with what they say kinda gal.

If there are things you definitely don't want, put them in your birth plan, they will follow them if they can, but at the end of the day it depends on the health of you and your baby. When you get to the delivery ward, they are lovely and they do work with you.

I believe the hospitals have procedures in place for a reason, there has to be a uniformity in how they deal with situations, whether it be for practical reasons, efficiency, or to avoid litigation, but if you have a baby in a hospital i do think you're going to have to take some things on the chin. I know I'm in the minority with that kind of thinking though

Cat Melodeon

Often the antenatal classes go through all the options and interventions just so you know what they are in case they do become necessary, but that doesn't mean that those interventions are actually routine. When I spoke to the antenatal clinic midwife about it (I was hoping for a pretty normal intervention-free birth) she was completely supportive and got me to write down all those things that would help me achieve that (ie that if I asked for an epi they should wait 20-30 mins and then ask me if I REALLY wanted it). On the labour ward, they looked through and said that's grand and it all went mostly to plan - I was induced but no further interventions were needed, no syntocin/oxytocin, no rupture of membranes, no epi etc. There were some things they insisted on, like constant monitoring which was a bit of a pain, but in the bigger scheme it was okay.

I know that if complications had arisen, I would probably have needed some sort of assistance and there would have been no argument from me under those circumstances. However, because of the birth plan, the attending staff knew that I was clear about what I wanted and weren't offering pain relief etc for the sake of it. They might have done that if I appeared to be less prepared or unsure about what I wanted. Instead, I was left to my own devices for much of the labour and only asked was I okay rather than asked did I want drugs. It doesn't worked out that way for everyone, but I'm glad I had my birth plan, I feel it gave the staff more confidence in me. If they trust you, you can trust them. I think if a woman appears to be a bit clueless, they may be more likely to start making decisions for her. Finding a balance is important.

As for the dad, there are a few things that worked for us. First, he wasn't there just to hold my hand - I was on another plane so it was up to him to listen in to what the nurses were saying and to make sure he knew my wishes inside out so that should someone start pushing an unnecessary intervention (like the nurse who covered my midwife's tea break and started prepping me for an unasked-for epi), he knows to get them to slow down and explain what they are doing. He was also hugely important for the pushing bit (mine was a bit useless but has been warned for next time). Once baby was born, I left it up to him whether he wanted to cut the cord or not (he didn't). I was so dazed and dizzy from the gas and air and the shock of birth that I got him to take the baby almost immediately - I held him for less than a minute - as I was afraid I'd drop him. I needed stitches, so hubby held on to our son for all of that. Then I took him and did the whole proper bonding thing, in my right mind finally, the midwife got him to latch on and hubby went off to make phone calls, so it was just me and baby and a cup of tea for nearly an hour (bliss!).

Your experience will be different depending on where you are giving birth, how long it takes etc, but just try to imagine what it should be like (hard on your first) and plan for that, accepting that things might have to change a bit as you go.

annamcmahon

Hi Nicowa. Before having my daughter in Jan, I had I put together my birth preference list rather than a birth plan. I think mentally it meant that if the whole thing went out the window I wouldn't feel like I'd failed. I'm due my second in April and plan to do the same. I've read a lot of threads on various boards and the women who have the most definite plans of what they want seem to be the ones who feel like things went wrong when it didn't go exactly to their plans. They seem to blame themselves. Just my observation over the last year.

I did a one day ante-natal course where we got a tick list of all of the options so I marked yes or no to each question. I think the most important thing is that your birth partner knows exactly what your preferences are. They are your voice during the labour. I know I couldn't think straight initially due to the pain, I went for 0 to 7cm in a few hours at home, and then from the gas. Also I found that there were things my husband assumed I would want which I didn't, eg an epidural as soon as I went through the door. By doing the plan we were both on the same page.

I think the most important thing is to be positive and assume that the midwives want to do what's best for you but also be sure of all the information before you go into the hospital so you are making informed decisions. As Cat said if you seem unsure they are more likely to make decisions for you. Also be prepared for things to change. I was dead against an epi, but when I had contractions constantly for 3 hours at home with no pain relief I changed my mind just so I could rest for a bit. As it turned out I was so dilated when I got to hospital I didn't need it and couldn't have it if I wanted to.

qwertytlk

Hi nicowa, i just had a baby 3months ago and tbh when your in the thick of labour my birthplan was the last thing on my mind. But you may feel different. I ended up being induced as i went overdue so had to have the montior on constantly. Baby wasnt showing much movement and then when i was brought into the labour ward once i got to 4cm, they kept loosing the heary beat. Basically alot of things happened that i never could have planned for so what im trying to say is, if your doing a birth plan be sure to know that it wont be set in stone as things may happen where you/baby will need medical intervention. And in my case anyway they didnt rush for a section even though i know they doc and midwife were worried as they kept loosing babys heart beat. They ended up having to try get him out quickly so personally i think they did everything else there was to do, and if it hadnt of worked i would have had a section, but thankfully he came out naturally. As for after the birth, they gave baby to me for a second when he was born then took him to check him over while i was being fixed up, then dad held him for a few min before they took him and put him under my nightdress, resting on my chest. They left us alone like that for about half a hour. Thats the skin ot skin contact. And thinking back on it now, they were more focused on me bonding with him than dad, but at the time neither me or him minded as we were just in awe of him and in a bit of daze at everything that had happened. I guess it all depends on how things go for you personally. So if you want a birth plan then do one up but make it flexiable. Best of luck with everything and enjoy the rest of your pregnancy

How Strange

I think a birth plan is a great idea but it's better to consider it a list of preferences. Be opened minded and aware that everything could go out the window on the day. I had a list of preferences, they were put on my chart and each midwife who dealt with me read them. I didn't want an epi so asked not to be offered one and I wasn't. I didn't want an episiotomy. I didn't want a c-section unless absolutely necessary. I didn't want continuous monitoring but had to because my baby had an irregular heartbeat. I didn't want to labour on the bed but had to because I couldn't get comfortable anywhere else. In the end neither mattered because the midwives treated me with respect throughout and discussed things.

I think that's really the most important thing about birth plans. Not all hospital
staff treat patients with respect and a
lot of women come out of childbirth
feeling very traumatised because
procedures were done to them that
they had no knowledge or control of.

My husband was my voice during labour because I was totally out of it on gas and air. He knew beforehand what I didn't want unless it was an emergency and for the epi we had a code word that he'd know I'd changed my mind and wanted it. After my son was born, like cat, I gave him to my husband to hold because I was so out of it. When I was stitched up etc I held him and the midwife latched him on. The three of us spent about 2 hours together in the delivery room which was lovely.

SarahC11

anything i was against went out the window once real labor kicked in i would have took anything to make it stop!! epidural was great in my opinion! my ma says 'u check ur dignity at the door of the rotunda' and i was all like no way im not gonna be screaming and all but she was right once i got in there i didnt care, i just did what the docs said they know best!!

SanFran07

nicowa wrote: »

Hi guys,

I was just wondering what you have in your birth plan? Is it very different from the hospital's normal procedure? Or is it just to allow you to know what you'll be doing once you get there? I've still plenty of time (week 28 at the mo) so I haven't talked to a midwife yet about it. Last week at the ante natal class the midwife went through the normal procedure in the hospital. The only thing is that they were suggesting pretty much every intervention that has been talked about here in a negative light.

With oxytocin I've heard many talk about the sudden increase in pain (though that does seem logical). People have talked against the breaking of waters, fetal monitering where paranoid hospitals opt for c-section at the slightest sign on the monitors.

I guess I'm just wondering what are people's thoughts on a birth plan. Do you trust your doc/midwife to suggest the best possible option for you? Or do you assume they're working against the risks and only offering what works best for the hospital?

I also want to know where the dad comes in in all of this. Yes, he's there for the labour, to hold your hand and be the best possible support. But where does he come in for the bonding with baby when it's born? The midwife said nothing about that in the class and it's something I'm slightly worried about - more that I might be hogging the baby than anything else .

If you're talking about H.Street then having written birth preferences works well if you prefer not to have the one size fits all birth management.

H.Street does some things really well - VBAC, breech options and induction of labour - but straightforward normal uninterrupted birth wouldn't be their forte.

Less than 4% of women have 100% spontaneous labour without routine intervention in H.Street. Yes they have 10,000 women coming through their doors this year and 9 delivery rooms so staffing/overcrowding is part of the reason for production line care but that's not your problem to solve.

All of the hospitals are busy and if you don't state any particular preferences then the staff are obliged to follow the hospital's policy which involves getting you through the labour ward within a set time limit. If you arrive into hospital in good active labour then chances are you won't experience many of the routine interruptions to the birth process.

If you are admitted in early labour you've more chance of having your labour managed by practices that are no longer routine in most of Europe and are definitely not based on best practice - but thats a minor detail not discussed in their antenatal classes.

Lola92

I had my daughter in Holles St. in December last year.

I made out a birth plan, initially it was just so that I would be clear in my own mind of what I wanted and to put it on the record so to speak.

I wanted my partner to be present at all times including for all examinations.
I did not want to be induced.
I wanted to be free to use a birthing ball and move around during labour.
I didn't want continual monitoring unless the baby was in distress or it was otherwise necessary.
I didn't want any epidural or pain relief other than gas and air.
I didn't want an episiotomy or c-section unless it was 100% necessary.
I wanted to be given my baby immediately after the birth for skin to skin and breastfeeding.
I wanted the cord not to be cut until it had stopped pulsing.

and most importantly IMO I wanted any and all procedures to be discussed and explained to me and my partner before hand - informed consent and all that

In the end my birth plan mostly went out the window, my waters were broken 26 hours in because I was getting pains but not dilating and couldn't go home because I would not get back in with the snow!! Then got stuck at 3cm so needed oxytocin drip and ended up having an epidural and episiotomy because my little one decided it would be fun to come out with her elbows by her head :rolleyes:

But I did feel empowered that the midwives were clear about my wishes, even if they were not all possible, and that I had researched and prepared for the birth the only way that I really could. One student midwife told me later on the post-natal ward that it was impressive that I, as a young mum, had obviously taken a lot of time and consideration to try and do what I felt was best for myself, baby and partner. That is all that any of us can do really!