Printable View
I love thinking about this. For me, I had a fairly predictable birth plan for the average BB user. It worked really well for me, and I had a great birth.
This time I have a different midwife, who I click with even more than the last (who I was madly in love with, for those who recall) and a support person I adore.
Not sure why I added that bit. Hmmmm.
Anyway, just interested in what you changed from one birth plan to the next. Or if there's anything you would change. And your experiences.
Not so much a part of a birth plan as I didn't have a written plan but a general idea of the less intervention the better which I discussed with my midwife before each birth (midwifery group practice)
But with dd3 I had a waterbirth which was wonderful in its self but I also used my hand to feel/control her head when she crowned and it was the most amazing feeling. I hadn't planned on it but was so glad I did it, wish I had done it with my other girls too.
I had IM synto after the first two births to deliver the placenta but didn't ith my third and the after pains were more bearable.
I also delcined hep b for dd2+3 which isnt really to do with birth but something I had considered before hand
For me it was no prophylactic antibiotics if baby came early as dd1 and 2 were born at 35 and 36 weeks but if bubs was earlie than 35 weeks or there was another indication then I would have agreed to antibiotics.
Due to my first two some of my birth plan or 'birth ideals' weren't possible but I still had great births. I actually don't like the term birth plan as I'm a control freak and if things don't go to plan then I feel like I have failed but if it's a birth preference or ideal and things have to change I can cope with it better lol, I'm a bit anal I think :). For me the importance was on being flexible as things can change quickly, but also considering a number of scenarios and what my preferences were.
Interesting question Audax!
Birth plan for DS1 was the "normal" BB stuff: no drugs, no interventions unless all options explore and I was booked in with the birth centre. DS1 was a good birth - though had an vacuum as he was posterior with his hand up beside his face. Not a lot changed in the birth plan between DS1 and DS2, except for a few tweaks. I came to know what I liked and didn't like in labour and so was able to add that to the birth plan.
Changes to birth plan between DS1 and DS2:
- no canula unless it is an actual emergency (they put a "just in case" canula in and said they needed to give me fluids - but I would have preferred to have been told to have a drink!)
- more direction from the midwives in suggesting positioning and breathing
- no ARM (my one regret from DS1's birth is that our lovely pro natural birth centre MW suggested and did an ARM when I was fully dilated and I think I trusted her judgement a little too much and she did it but DS1 was still posterior and then couldn't turn)
Also, I had a lot of discussions with DH (who was a great support person) about minor things I wanted him to do as I might not remember:
- making sure I had lots to drink
- talking for me (i don't like to talk when sick or in pain)
- ensuring he understand how VITAL it was that I have the TENS machine on - I got very cranky when he didn't get it on fast enough when i said I wanted it.
- of course knowing the birth plan and being ready to stick up for me
My partner ;) haha
The only things I have changed were things that were because of my previous experience: No assumed consent, and things that will support the scartissue from last birth and subsequent surgery.
sent from my watzamajig so may not make sense....
I added- no VE's, no routine cannula, no time limits, no ARM unless it's an emergency, no continuous monitoring. I was having a VBAC though so it was expected I would have all those things and I had to make it clear I was not.
I didn't write one second time, I just made sure I had midwives who actually knew me and what I wanted and who I trusted.
Easy.
No epidural, whether I beg/scream/threaten assault for it. No epidural.
No episiotomy, unless I say so.
i was wanting the same things 2nd time around, i just chose the right support people who would help me get them.
First time was I think relatively standard, but not overly long. I had less criteria second time around, with things like "if I want an epidural I'll ask for one, so please don't offer" and stuff like that. Pretty simple.
This time around when the midwife asked me what my birthplan was I said it was to have a baby. The only stipulation I had was that I was keeping my placenta for encapsulation. Otherwise, told her I've been there done that, have complete trust in my OB to be as low/no intervention as safely possible, trust in my DH to support whatever it is I say and not push me down any particular road, and trust in myself that I'll speak up if necessary. I know from past experience that I birth extremely well, so provided nothing goes pearshaped, it should all be fine.
Next birth plan will be the same (it's mostly for in case of transfer) but I'm going to add some post-birth stuff, especially about the check for tears. I may even refuse that if I feel like I did this time, since I had no tearing.
I'll also put something in about expected speed of active labour.
I didn't have anything I would call a plan, but I did have brief notes about stuff like I wanted to exhaust each pain relief option before trying the next, wanting to get in the bath, DH announcing the gender etc. that kind of stuff. A lot of the stuff I see in birth plans about skin-on-skin asap, BFing asap, and those types of things are just standard procedure with the midwives at my hospital so no need to document that. Like LuluHB says my ob and I had discussions about my hopes for the birth and she got where I was coming from and I trusted that would continue in the delivery room (and it did).
Second time around it was very much the same with a couple exceptions - saying no labouring on my back (pushing on my back fine, labour HELL no) and mostly just a few cautionary notes about the labour being quick and the midwives needing to be ready for a quickie - us being caught of guard with the pace of things first time around caused us some issues.
So pretty similar ideas going in, pretty different outcomes but that's babies for you!
This is brilliant. Thanks everyone.
I'm pretty sure, then, that I can go in the same as I did last time. I didn't want to blindly do so just because it worked last time, but I think I have all bases covered. Including support personas, which is a really good point.
You will have your DD to plan for too this time, where will she go and when, when and how will she meet the new little person, do you have extra support in the early days for you as a family (either care for your daughter or help with meals etc so you can spend time with both kids). I found the freezer was my friend even more 2nd time around.
I wanted things to be almost totally different 2nd time around.
First time I actively avoided induction (This was very stupid), 2nd time lined up for induction 2 weeks early.
1st time tried to labour without gas or drugsbut ended up using them, 2nd time was willing to use gas but no other drugs.
1st time asked for a CS but ended up with an induction VB. 2nd time didn't want CS but ended up with one because the induction didn't work out.
I was supposed to hve skin on skin 2nd time (this didn't happen 1st time) and it didn;t happen because of emergency CS and baby needing oxygen.
The outcome was totally different 2nd time, I got a breathing baby.
My first, I was only 18. So other than telling them I wanted it as natural as possible, I really had no idea. I'm still thankful it went as well as it did considering! They were talking about inductions & a c/s.
My second I was more prepared having been there before. This time I had better mw's who encouraged me to be active. I also waited til my contractions were 5 minutes apart before heading to the hospital, rather than going straight in. My fave birth out of all 4 of them. I handled it so well!
Third I had mecconium staining, so I was kind of expecting it to go haywire. I was trying to let go of all my plans, because I didn't know what to expect.
Fourth. Active labour, hands off middie, no internals & delayed cord clamping. Ended up having 2 internals, which I needed. The second one the mw felt swelling on my cervix, so it kind of woke me up to what I was doing (posterior baby, severe back pain, thought pushing would help :rolleyes:) I refocussed & got moving.
#4 was the only one I actually asked for specifics & had them noted on the hospital system. Its a midwife run labour ward thats only open when someone is admitted for birth. If i could I'd tell everyone to go there for their babies. There were no questions about what I wanted, when I booked in or in labour. Only thing they have is a BMI limit, which they think is unfair themselves. They will take somene over that limit in an emergency though ;) They did when I was there, but the poor womans BP skyrocketed & they had to transfer her.
Thanks, that's a good point. It's all covered as my mum will be here for the whole month of November, and, more importantly, my in-laws won't!:
The only thing I changed was in my first birth plan I asked to be left to labour on my own or something like that. This resulted in my midwife practically not speaking to me or offering any suggestions. So for my second I stated that I would like to be left but would appreciate any guidance etc if that makes sense :) Am happy to say it did the trick and I had a fantastic birth thanks to my midwife.
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! :)
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!
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).
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.
My first birth plan
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 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
:
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.