What did you change from one birth plan to the next?

[BlackRose]

This time I asked for pethidine on arrival and gas/air available all the time (rather than right at the end -no one thought to offer it to me!!). I haven't specified 'no epidural' because I'm still open to it if things get too much but I've told hubs that I'd like to exhaust all other options.

I've requested that they rupture my sac earlier so that babies head descends onto the cervix hopefully helping labour along a little (waters weren't broken til I was 10cm and they were strong with DS).

Also, I have put in my birth plan that if I do need a CS that hubby doesn't want to come with me (it's the only thing he said he wouldn't be able to do) so If my mum isnt around as well I guess I'd have to go it alone. I don't want anyone pressuring him into coming into theatre when I know and respect the fact that he can't handle being there. So need to be upfront about it in the birth plan.

If bubs needs to be given supplemental formula for low glucose like DS was I've requested that I bf during the drip feeds rather than bubs be given it through a bottle so that there isn't any teat confusion.

Ummm I think that's about it!

[Jessiebean]

I had a "normal delivery" for son #1, shower and birth ball and tens for pain relief (I tried gas 10 minutes before crowning) syntocin for placenta delivery, vit K and hep B injections, bubs rooming in.

Son#2 Birth centre, understanding midwive planned for water birth but bubs came too soon so back in the shower, only one internal, managed 3rd stage- after cord stopped pulsing, oral Vit k and no Hep B injections

daughter #1 (due September) I am aiming for a water birth (or tens, activity, showers etc for pain relief) no internals, no interruptions, no injections ( no syntocin for me, Vit k or hep b for bubs) no oral Vit K, delayed cord clamping. DH has been briefed so he will be there to look after my interests and supports me fully!
Mind you all this may not be an issue- son #2 was born so fast I might not make to the hospital this time!

It's great reading other people's guidelines- we are all different!

[Three Graces]

Well I had 3 birth plans and tried to VBAC twice and ended up having 3 c/s's. Most of the stuff remained the same - although going VBAC they wanted constant monitoring and a cannula in the hand. I didn't want Hep B for my babies at birth and said that I would request pain relief if I wanted it. I think with our first labour when I was induced, I did so well breathing and meditating through the contractions, that the midwives didn't believe me when I started asking for some pain relief. So I made sure that DH and our doula were onside with number 2 & 3 that when/if I asked for something, I really meant it!

The only thing that I would recommend is to have a sentence or two in your plan if things go awry and you end up in theatre. I got pre-eclampsia with our third pregnancy, at 40 weeks and didn't go home from my antenatal appt that day! It's suddenly the hospital/Dr's space and not your birthing space anymore (no dimmed lighting and soft music!) and can be very scary when DH has to wait outside til they're just about ready to start. I never, ever thought that I would have a C/s with our first (let alone 3) and the thing that I wish I'd pushed for most, was to have my babies with me in recovery. They will do this for an elect c/s, but often with an emerg c/s they don't have spare staff and it took an hour or two to hold my first two babies after birth. So I would highly recommend putting in something about not giving consent for you to be separated from your baby (unless medically necessary).

[Jennifer13]

My birth plan included instructions for all scenarios, including a c/s and what we wanted postnatally for me and the baby in every one.

Of course, in the end for DD2, I didn't have to use my birth plan because we were at home and able to go with the flow. Plus, my midwives and doula had discussed every aspect with me that I could think of.

I wish I had thought to do a birth plan with DD1. Just because she was an elective c/s didn't mean there weren't things we should have thought about. But then, I would go back and change every single thing about her birth.

[meow]

My first birth plan

Birth Preferences

Our names are xxx
We like to be called xxx
Our Birth Attendant’s name is xxx

We’re hoping for a natural childbirth without unnecessary interventions or the use of drugs. We have asked a Birth Attendant to be present at the birth to help us work towards this. We appreciate your support with our birth preferences.

This plan represents our preferences; however we recognise that in the event of unforeseen difficulties it may need to be re-negotiated. Please discuss all options with us, in the presence of our Birth Attendant. We would then like the opportunity to contemplate our options without the presence of any medical staff.

ACTIVE BIRTH

We would like the birth experience to be respectful and private, with minimal interruptions and quiet voices.

We would prefer all examinations and monitoring to be kept to a minimum, with intermittent external fetal monitoring unless continuous monitoring is medically necessary.

I’d like the freedom to choose positions, use the shower or bath and walk around in labour as desired.

Please don’t offer drugs (including gas); I am aware of the options for medicated pain relief and will ask for it if needed.

I have discussed with my support team my desire to be encouraged and supported in achieving a natural birth, including during times when I may struggle and ask for interventions

I wish to be free of time limits and not have my labour augmented unless in a medical emergency.

Please allow time for the perineum to stretch naturally or tear. I’d only like an episiotomy if there is a genuine medical emergency.

I would prefer to follow my own urges to push. Please ask if I would like directed pushing before proceeding to this, unless it appears that I need to be reminded of some needs, such as to slow down during crowning.

INDUCTION / AUGMENTATION

If baby and I are well, I would like my baby to decide his/her own due date. I am happy to discuss a plan should my pregnancy reach the end of term at 42 weeks. Should labour induction become necessary at any time, I'd like to start with the least artificial means first before a medical induction. I would like time to allow the natural inductions work.

If this is unsuccessful and a medical induction or augmentation becomes medically necessary I’d like:

To only have my waters to be broken at first instance if my cervix is open. I would like to be given a generous amount of time for labour to establish upon rupture of membranes (i.e. more than just a few hours) before other forms of medical induction / augmentation. I would like to go home if all is well, until labour is established.

If I require Syntocinon, I would like a very low dose, to be increased gradually and slowly. Once my labour is established I would like to choose to stop the dose being increased, lower the dose or stop the drip to allow my body to continue to labour without artificial oxytocin. Please put the cannula in my arm and not my hand so I have more freedom of movement.

CAESAREAN

If a caesarean becomes necessary I’d like:

For my husband to be with me. We’d also like to have our Birth Attendant with us, who has been present in caesareans previously and is there to help enhance our experience of birth, no matter what form it takes.

For discussion to be respectful and minimal - only what is required medically and to inform me of what is happening.

For the cord to stop pulsating before clamping, to allow my baby to receive the valuable blood and iron stores.

My baby to be placed skin to skin on my chest without wrapping while you complete the procedure, unless prevented by medical emergency.

To be sure that a double layer suture is used and not a single layer in order to improve my chances for a future VBAC.

The opportunity to breastfeed our baby in recovery. If you do not have the staff to enable this, I wish to have my Birth Attendant with me so I can breastfeed in recovery.

BIRTH AND SOON AFTER

Presuming baby and I are well, we’d like:

For my husband and I to ‘catch’ our baby and determine the sex then for us to hold our baby immediately after the birth.

To wait until the umbilical cord stops pulsating before clamping, to allow my baby to receive the valuable blood and iron stores.

For all newborn procedures (weighing and measuring) to wait until I have had time to bond with and breastfeed our baby and then for them to be performed in our presence.

Not to have the routine Syntocinon injection to help deliver the placenta, unless medically required.

For our baby to have vitamin K as an oral dose.

For baby to be given only breastmilk – strictly no water or formula.

To defer Hepatitis B injections at birth, until baby’s first vaccinations.

Please sign our birth preferences in good faith that it has been read, will be treated respectfully and that we have your support in all of the above.

________________________________ Signed

________________________________ Name

The second birth plan is shorter as it was only in case of hospital transfer. As I had IMs I trusted I was happy with what would happen during labour at home and also with the support they would offer at hospital. I wanted the hospital birth plan to be to the point as it may need to be addressed during an emergency and I wanted to be more clear and assertive about my preferences.

Birth Plan: xxx

Husband: xxx
Midwives: xxx

Labour & Birth
I do NOT consent to vaginal exams.

I do NOT consent to artificial rupture of membranes.

I do NOT consent to an episiotomy.

Do not offer pain relief medications. I am aware of my options and will ask for them if desired.

I am reluctant to undergo an instrumental delivery and would like to discuss further options should forceps or ventouse be required.

I would like to discuss all interventions in private with my support team before making a decision.

My husband and I wish to discover the gender of our baby.

I wish to have a physiological third stage and do NOT consent to the use oxytocics unless life is at stake.

I wish to delay the clamping of the cord until it ceases pulsating and I wish to cut the cord myself.

If stitches are required I wish for them to given by a consultant only. Having suffered previous trauma from stitches I may decline to be stitched and wish to discuss this further at the time.

Baby Care
I do NOT consent to the administration of vitamin K or Hep B vaccine.

I do NOT consent to the use of formula. If baby needs feeding my milk is to be expressed, even if unconscious.

Written consent must be obtained from us before ANY procedures are carried out on baby.

Caesarean Birth
My partner and midwife are to accompany me into surgery and recovery.

I wish to have a spinal block, as opposed to a general anaesthetic.

Baby is to placed skin to skin on my chest immediately after birth, while still in theatre, and we are not to be separated unless life is at stake.

I wish for my uterus to be stitched with double-layer uterine stitching.

I wish to establish breastfeeding while in recovery.

If baby needs to be taken to special care then baby’s father, xxx, is to remain with baby at all times.