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Birth Plan

Thought I would show you all my birth plan. It is a bit of a work in progress, but I took my last one and made a few amendments:



Birth Plan for Kimberley Scales

Due Date: 27th June 2012



BIRTH COMPANION

My partner Tim Latter, to be with me at all times. Also Student Midwife, Hannah Taylor



LABOUR & BIRTH

Ideally I would like to use the birthing pool for as long as possible

I want to keep mobile, and change positions frequently. I would like advice on this

I do not want to be confined to a bed unless medically necessary, and I do not want to give birth lying down

I would like advice as to the best ways not to tear.



PAIN RELIEF

Preferably water, breathing exercises and gas & air only. I do not want an epidural unless absolutely necessary. If I feel I would like other pain relief I would like advice



MONITORING OF BABY'S HEART RATE

Unless absolutely necessary, I do not want to have the baby's heart rate constantly electronically monitored. Periodical checking by midwife is preferred.



ASSISTED DELIVERY

If necessary, I would prefer ventouse to forceps, but would like to avoid assistance. I would like pain relief to be discussed with me before stitching

DELIVERY OF THE PLACENTA

I would like to deliver the placenta physiologically

My partner has not decided whether he would like to cut the cord or not, but I would like him to be given the choice when the time comes. If he does not I would like the opportunity to do this myself. I would like to see the placenta after delivery



AFTER THE BIRTH

I want immediate skin to skin contact, our baby placed on my chest immediately after delivery without being cleaned. We would like the baby to have the Vitamin K injection.



FEEDING THE BABY

I wish to attempt to breastfeed as soon as possible after delivery and I would appreciate some help. I struggled feeding my daughter and I am determined to do better this time. If I am separated from my baby for medical reasons I would like to use a pump to express milk.



UNEXPECTED SITUATIONS

My partner and I are to be kept fully informed at all times, should surgery be necessary. He is to be my advocate if I am unable to make a decision. If a caesarean is needed, I would prefer it to be under epidural so my partner can remain with me. If our baby needs to be taken away for medical treatment, my husband will accompany him / her.
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Replies

  • WOW - i didn't have a plan for my first - our maternity unit isn't into forward planning they are more we'll go hour by hour people which on my first suited me with not knowing if i'd prefer one thing to another but this time i have definite no no's in terms of positions for delivery etc so your plan is an excellent idea - i might just have to do one myself,

    xx
  • That seems like a really sensible plan! Mine first time round was a bit too specific so I was very disappointed when things didn't go to plan. 2nd time round it was a bit kore likenyours!
  • thats a good thanks for posting it . i didnt have one first time round but really want one this time as although i was clear about having no epidural last time i did end up having 2 lots of pethidine and would really like not to have this time or if i do beg for it i would like to be examined first to ensure im not close to delivery as last time nobody checked and i had it about 10 mins before they realised i was 10 cms and then started pushing , the result was i was so doped up i dont remember the birth .. not sure if i will be able to cope without the extra pain relief this time but going to try water birth and see how it goes xx
  • Thanks for this thread, as a first timer it's really interesting to see your choices particularly when you've been there before.



    Can I ask why a lot of people don't like giving birth lying down? It seems this is what you most often see on TV etc but I've read a lot about people choosing other positions.



    Thanks!

    xxx
  • Although the media shows people laying down to give birth (and you are likely to be in a recumberant position if you have an epidural unfortunately)it's actually not conducive to an "easy" birth as 1) you aren't using gravity to help bring the baby down, and 2)the birth canal tilts up through the pelvis so if you lay down you are actually having to push "uphill" for a time.



    When I was in labour with DD, I pushed on my side and my back (although I didn't want to) but during the 1st stage I couldn't lay down, if I was laying everytime a contraction started I had to jump up quick smart! I really feel for people who are strapped to a CTG x
  • i pushed laying down too as i refused to get up , the midwives were asking and i know that it would have been easier but its difficult when you are in so much pain to want to move , i just refused point blank .. i am going to be much more adamant they make me get up this time but first time round i didnt know to insist this so in the end they just left me be , im hoping a home birth will make this easier as i will be be more active anyway , although i am torn between home birth and midwife led unit as i would like a water birth if poss and dont think i have the room for a birth pool at home xx
  • Very detailed plan! image I shall be pinching a few bits for mine this time!



    My birth plan for my son listed:

    - the pain relief I was happy to receive and in which order (i.e. epidural only if I am really not coping and insisting on having it or it is medically necessary)

    - I wanted an active labour, staying as mobile as possible... However when my waters broke, they were green which indicated baby is distressed so out came the monitors and that was that... I was basically strapped to the bed lying on my back and that was all I could do. Trying a different position (they would have liked my on all 4s to get baby past my anterior lip) made baby's heart rate dip dramatically so that was a no too. Was told I'd just have to push harder.

    - I wanted to try the birthing pool and it was even free, but again because of the meconium in my waters I wasn't allowed

    - I requested the injection to deliver my placenta and reduce blood loss and my son was to be given the vitamin K injection

    - I also wrote in there that I would like hubby to be asked if he wanted to cut the cord when the time came (he had previously said he didn't want to, but then he also wasn't gonna watch and then he did, both of which I am very grateful for that he did)

    Even though things didn't go to plan, they tried where they could to accommodate my wishes and it was a positive experience.

  • Can I ask a few "first timer" questions??



    What's the vitamin k injection for?

    What options are there for delivering the placenta?

    Why are you so against an epidural? I have friends who swear by them and other who didn't want them - just interested in your choices.
  • In terms of vitamin k, I believe that they like to suppliment the baby with this as they are thought to be low in it at birth (though not sure why this is a problem). You can opt out of course (I'm not sure to what extent they would try and pursuade you to change your mind though!). The injection is the standard method as they just have it the once. You can also have it orally but I think they might need it 3 times over the course of a few days as it doesn't take so well



    Standard in this day and age for 3rd stage is active management. They inject your thigh which stimulates the contractions again and it takes maybe five minutes for the placenta to come away. When I had DD they also used some cord traction, so she pulled on the cord to remove the placenta. A side effect of the drug they use can be sickness. Alternatively you can have a physiological 3rd stage, but they tend not to do this if you have had to have any sort of induction, epidural, anything that takes it out of the realm of "normal" I would guess. Basically they leave it to come out in it's own, no drugs, can take an hour



    Reasons I don't want an epidural- I don't want to be stuck on the bed unable to move. I know I can do it without. I want to feel when to push, not be told. I want a physiological 3rd stage. I want a quick discharge. Ideally I don't want to be catheterised as I don't like the struggle to go to the toilet after removal.



    I can understand people's reasons for having an epidural- sometimes people have a very long labour and need the rest, or that lady on OBEM this week who couldn't keep calm. It is right for some, and not for others x
  • phat_sue I'm also a first timer and I really don't want an epidural unless absolutely necessary. I decided this a while ago but also having watched that woman on OBEM this week and them having to watch the monitor to know when the contractions coming to then tell her to push and even then you can't feel yourself pushing so you're getting so knackered but not knowing what you're doing.



    My mum also said the recovery time is long afterwards and others I know who've had it haven't remembered the birth properly because they were out of it which is not a nice thought.



    But as Kimmy says that woman on OBEM this week, she was a different woman after having it and clearly it was a the right option or a midwife was likely to be punched!!
  • mines fairly short,

    my husband to be with my when spinal block administered if possible and all the way through the c section,

    me to hold baby first, skin to skin contact if possible,

    vit k by injection.

  • Phat_sue and pbubs, I am also a first timer and don't think I want an epidural unless necessary. It is very interesting to see a birth plan and reasons for and against certain things because as a first timer I have no idea.....I did know about the vitamin K injection and have already signed the relevant documentation in my maternity file for this.
  • Thanks girls!



    As Aby said it's interesting to hear peoples thoughts and reasons.

    Let's hope we all have births like the girl in the pool on OBEM!!
  • I had in my birth plan that I wanted the injection to help deliver the placenta but landed up not having it and delivering it myself. It was the only part of my plan I didnt stick to.



    The reason they gave was I could get out of the pool if I wanted or stay there and deliver it myself.



    I am so glad that I did it this way in the end and will be asking to deliver it myself this time as well.



    I must add though that it took alot longer than I thought. Kept asking if I should be doing anything and they said no you will know when you need to push. After 40 minutes my contractions started again and I started pushing. It was actually really hard work and I had to push really quite hard (which I also didnt expect)they ended up having to give a little tug on the cord and I gave an almighty push and out it came. It was chuffing HUGE as well.



    I didnt know anyone who had delvered it themselves so thought I would share in case annyone was interested.
  • Thanks for this thread, as a first timer it's really interesting to see your choices particularly when you've been there before.



    Can I ask why a lot of people don't like giving birth lying down? It seems this is what you most often see on TV etc but I've read a lot about people choosing other positions.



    Thanks!

    xxx

    Before having DD2 I really fancied e idea of giving birth kneeling up so gravity was at it's max but at the time I just got onto the bed (after ambulance transfer and being fully dilated!) and just didn't want to move. I don't think I could have to be honest as the contractions were so strong and frequent I didn't have the impetus or inclination to think about positions!



    Re the epidural, I was dead against one first time round as my NCT classes had been so strongly against them as statistically they tend to lead to increased intervention (ventouse, forceps, c section) however they didn't mitigate this with the fact that there is also likely to be another reason for the intervention on top of the epidural (ie baby's position). I had no pain relief bar water and gas and air and ended up with a c section and I felt so cheated!



    2nd time round I was 50/50 about having one but in the end they wouldn't give me one as I developed low platelets during my 3rd trimester so they wouldn't risk the possibility of me bleeding and not clotting.



    Now, having experienced just how much crowning f*cling hurts I am quite tempted to have one this time! The main thing that puts me off though is that I know people who still get severe headaches from epidural side effects nearly 2 years after they had one which I am not sure I want to risk.



    I think will try and go without but I am openminded...
  • G/C from July.. hope you dont mind but as a 1st timer ive also found this soo interesting!!



    Although i know now what i want it makes such sense to see it all written down as who knows what state i'll end up in!!



    I'd love to have a waterbirth as like some of the other ladies have said i'm of the opinion lying flat on my back will not be the best way of getting baby out... The info on delivering the placenta was also really useful as this stage of the birth hadn't even crossed my mind atm!



    Has anyone/ is anyone planning on giving the Vit K orally? When me and DH originally read the leaflet we decided orally as although it would have to be done x3 it has no risks involved.. the risks indicated were super small but we thought why even risk the risk.. so to speak! xxx
  • I have no issue with the vit k injection as the risks are so so rare/minimal and the oral method isn't as effective...

  • We did debate originally whether it would be nicer to spare our son having an injection for the Vitamin K, but when the time came it was so quick and he didn't even flinch (probably was nothing compared to what he had just been through - just like going through labour and then having the injection for the delivery of the placenta).



    Vitamin K is essential as it helps makes our blood clot and prevent internal bleeding. Newborn babies get very little Vitamin K in their diet (unlike us) as they live entirely on milk. Their livers are also quite immature and baby runs a risk of developing Vitamin K Deficiency Bleeding or haemorrhagic disease of the newborn.



    Thank you for your post Wif! I always thought you HAD to get out of the pool for the 3rd stage of labour, but I'll definitely consider the delivery of the placenta without injection if it means not having to jump out immediately after giving birth! If I can even labour in the pool that is ofc image



  • I think 3rd stage depends on your trust- I think my trust prefer you to deliver the placenta on dry land x
  • I must admit to being completely shocked when they said about it. I thought i was going to have to get out but decided to take them up on the offer. Wouldnt mind getting out to deliver 3rd stage. It took a long time to come so they had actually drained the pool by the time i delivered it. Was horrid to hear it splat on the floor.
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