As yesterday was my last day at work (I’ll come back to that in a mo….), all of a sudden giving birth seems like a much more imminent event! So I thought it was about time that I write my ‘birth plan’. I thought I’d saved a copy of my birth plan for Andrew’s birth, but I have a feeling I didn’t back it up to the server (unusual for me, Little Miss Paranoid Doer of Back-ups) and annoyingly my laptop hard-drive died a few days after Andrew was born. The birth plan must be forever lost in an irretrievable gobble-ti-gook of 1s and 0s. But nevermind. I managed to find a great resource on the NHS choices website, which runs through the various points you might like to include in a birth plan. It even lets you save an online version of a birth plan that you create by ticking various multiple choice option boxes and then printing off a PDF, but I found this a little restrictive and preferred to write my own using ideas from the website.
I’m not a massive fan of the word ‘plan’ in this context, because I don’t think labour and delivery are really things that you can ‘plan’ in the sense that I normally plan things (like what I’m doing next Monday morning at 10am, or when we will go on holiday next year, or what we’ll eat for dinner tonight, for example). Yes I have an image of what would be an ‘ideal’ birth, and actually I came pretty close to this with Andrew (lose the vomiting after the syntocinon injection and it would have been perfect), but I’m not so naive to think that there is no possibility of complications that might cause my ‘ideal’ birth to fly out the maternity hospital window. I’m optimistic that, given previous experience, the birth will go smoothly, but realistic that I have no control over the fact that it might not.
I remember when I came to write my birth plan for having Andrew that I didn’t know where to start. Although I had some ideas about what I wanted and didn’t want, I also had no idea how I would react to and cope with the pain once I was in labour, having never experienced anything like it before. So most of my points were couched in a ‘I’d like it to be as natural as possible but if I scream for drugs then please give them to me’ kind of tone. This time, of course, I know what it’s like, so I found it easier to write down what I hope for, complications and long duration notwithstanding.
This sets the scene for my birth plan, which I’ve set out below. I will print this out and keep it with my maternity notes, so that whichever midwife gets the job of helping us through labour will see it when she looks at my notes – this worked well last time, and she was keen to read what I’d written before doing much else with me. I’ve probably forgotten some important points, so if you think of anything I might like to mention, I’m all ears. Next week I have another midwife appointment, so I might have chance to go through it with her too, particularly as she’s coming to look at the flat in case of home birth necessity!
Ruth Cumming’s birth plan
This is not so much of a ‘plan’, because I’m not sure you can really ‘plan’ labour and birth, but rather it’s a list of things that I would like and not like to happen, if at all possible.
My preferred place of birth is in the Rosie Birth Centre, because I had my son at the former MLBU, and I liked the relaxed atmosphere and received excellent care from the midwives, who helped me but did not take over.
However, if baby comes even faster than my son did (which was pretty fast), I may decide that I’d rather stay at home, because I’d rather not risk being in advanced labour in the car – I’d rather have a ‘home birth’ than a ‘car birth’!
Of course if there are complications, I understand that going up to the delivery unit in the main Rosie hospital would be necessary.
My birth partner is Tom, my husband, and I would like him with me at all times during labour, no matter what happens.
Labour and delivery
I would like to be in a birth pool during active labour (another reason for choosing the Birth Centre); this helped me a lot for my first labour.
If possible I would like to deliver the baby in the water. Last time the midwife could tell that being in the water was relaxing me too much and she was concerned that I wasn’t pushing as hard as I could during the final stage in there, so she suggested I got out for delivery. She was right, because I gave birth within minutes of getting out, as I pushed much harder ‘on land’. If this happens again, I’m not against getting out of the water if necessary, but would rather have a water birth if possible.
Last time I used a birthing stool for the final pushes – this worked well and I would like it again if ‘on land’.
I am happy for baby’s heartbeat to be monitored like it was last time – with a detached probe device every now and then, i.e. I’m not constantly hooked up to a machine so I can move around freely.
I will move around during labour before the pool is ready, and get into positions that I find most comfortable at each point. This could include getting on all fours (possibly on the bed) and walking around. But I hope to spend most of the time in the pool.
I hope to deliver in the water, squatting or upright in some other way, or if I’m on land, squatting on a birthing stool worked well last time. I do not want to be on my back, lying down or completely horizontal in any way.
If I am in the water for delivery, I would like to pick baby up myself from the water, and sit there skin to skin for a while until I feel I’d like to get out.
If I am on land for delivery, baby should be delivered straight onto my tummy, without being cleaned, so that we can have skin to skin time. This worked well for my son, and he latched on for a breastfeed almost straight away. I would like this to happen again if possible.
I would like the midwife to cut the cord (Tom is not particularly keen to do this).
I do not mind if there are trainee midwives in the room.
For pain relief, I would like to try and use just natural methods – breathing, movements, and the water of the pool. This worked for my first labour and I didn’t need any drugs.
However, if labour goes on for a lot longer than my first labour, I may decide on other pain relief methods. Gas and air would be my first choice. I didn’t find a TENS machine helpful last time, so I won’t try it again.
I would prefer not to have an epidural, but I can see that if I’ve been in pain for several hours and I’m exhausted, that this would be something I would consider and would want to be given if I decided on having it.
I had a 2nd degree tear with my son, so I’m prepared that this might happen again. I’d rather not have an episiotomy if at all possible, but would consider it if the midwife thinks it is necessary if baby was in trouble.
I would rather not have an assisted delivery with forceps or ventuose. But if baby was in trouble and therefore it was advisable to have these interventions, I would consider them.
After my son was born I opted to have the syntocinon injection, but in a reaction to this drug I vomited several times and felt nauseous for about 6 hours after the birth. I would rather not have the syntocinon injection this time, but if the midwife thinks it is necessary because I am bleeding a lot (and I know I’ve had a slightly low platelet count that might not help the situation), I am prepared to have the injection. I would like Tom to be able to stay for as long as possible after the birth this time if I am feeling sick.
I would like my baby to have the vitamin K injection or oral drops.
I am going to breastfeed and this is extremely important to me. I struggled with breastfeeding my son in the early weeks, but eventually got on track with it and have continued to feed him until now – I plan to tandem breastfeed if he still wants to continue after the baby’s birth.
So I would like my baby to stay close to me at all times and not be swaddled – I would like to remain in skin to skin contact for several hours after the birth, so that baby can feed off and on whilst lying on me.
If complications arise and I need to be separated from him/her, I would like Tom to be able to have skin to skin with baby whilst I am out of action. I would like baby to be brought to me as soon as possible if we are separated, and have help with positioning baby on me for feeding if I am in pain from a difficult delivery (e.g. c-section).