Birthing Plan

How much planning can you really make for a birthing plan?

And what do you need to consider and include in a birthing plan?

I'm becoming increasingly aware of the fact that I'm going to need to have something in place very soon and I've not given it all a lot of consideration yet. I know I want to have a vaginal birth, for both babies and that I want an epidural but I don't know what else I need to consider.

Help!

I remember the main things to consider being - Type, drugs and afterbirth.

Type of birth - You say you want vaginal, but what happens if you are in labour for 24+ hours does that change things?  What about if the babies or you are under stress?  Basically what are your preferred alternatives if things do not go to plan.  Other aspects to consider with a vaginal birth are the use of foreceps or a ventouse.  Do you mind having an episitomy?

Drugs - Read up on the types of drugs available and when they can be administered at the different stages of delivery.  For example, you generally can't get an epidural until you are 3-4 cm dilated.  For some women it takes ages to dilate that much, so you could be having pretty frequent contractions for a while until you can get the epidural.  Gas and Air is an easy one, but they may suggest pethidine(sp?), but there are some draw backs to that one.  What if you can't get an epidural, what then?  Pethidine is the next strongest drug routinely offered I think.  Even with the epidural there are different ones available depending on your hospital, basically a low dose one that allows you to remain mobile or a traditional one where you have to stay in bed cause you can't feel your legs. 

Afterbirth - I forget the term, but basically do you want to deliver the placenta naturally or have an injection of some drug that speeds things up a bit.  I don't know the downsides to the drug, but I am sure you can research it. 

Other than that, just make sure that your partner knows what you want and when to ask for things.  You should be able to eat and drink during the labour if all is going well, so pack snacks and if you do get an epidural bring some magazines. I found once I was nice and drugged up, I couldn't feel anything so I was just laying there bored until it came time to push.  Music options? 

I would make sure that as soon as you head to a delivery suite you tell the midwife exactly what you want, with an epidural you might have to take it when they offer it to you, rather than wait for a point where you are ready for it. Sometimes the anethesia-ologists (can anyone spell that) aren't around when you want it, so if they offer it. Take it.

Have a plan, but imo its better to be prepared and go with the flow, asking for things when you want it etc and remembering that there is no right or wrong, just what you want at the time.

Good luck!!

I did very little if any planning! #1 on my list was I did NOT want an epidural.  I didn't want them to ever suggest it! If it wasn't an option then I just had to suck it up and deal- which I did! I had wanted a water birth but I was induced so that was out of the question.  I firmly believe that not allowing myself to consider an epidural made labour much more bearable!

I agree with the points made by the others.  In saying that, keep in mind that it is a plan, and things rarely go to plan.  In my experience (working with a lay midwife, attending many births in nursing school, being a birth partner to 6 friends and having 3 babies myself) the more detailed the plan, the more the mother can be be disappointed when things don't go according to plan.  I had a rough idea of what I wanted ( ideally not an assisted delivery, open to different comfort measures/pain relief) but in the end, I just wanted a safe deliveries and healthy babies.  I had to be monitored continuously with the last 2 for suspected meconium, which had me stuck either sitting in a chair or in the bed, but it was fine by me even though it ruled out a bath which really was a comfort to me with my first one. 

Have you spoken with your Midwife to see what your options are and to work out your birth plan?  Your Midwife is going to be the best person to tell you what your hospital is able to offer when.  Some hospitals (like mine) only offer Epidurals during business hours )9am-5pm) unless there's a medically necessary reason for one (ie. if you have a known BP issue that requires it or if you're having an emergency Cesarean) - otherwise you're SOL. 

On the second to last / inside last page of your Green Notes be a page to write your Birth Plan, which your Midwife should go through with you to explain and clarify anything that you may not be certain of.  I know I had to sign mine to give consent for Syntocinon (Oxytocin) to help deliver the placenta and for the Vitamin K injection to baby.

Like Lindy I didn't want an Epidural with my first and I don't want one with my second, however I do know that if baby shows signs of distress and I need a Cesarean that I will have to have one regardless.   

Basically get yourself a general outline of how you'd like it to go, but mentally prepare yourself to be flexible.  I think Kathleen put it best with the more detailed you make your plan and then babies don't want to co-operate the more you set yourself up for disappointment.  End of the day you really just want your healthy, happy babies despite it all.

Try not to fret too much and good luck!   

Thanks guys. You've all given me something to think about. I've got a midwife appt this Thursday, so I'll start talking about the options.

I know I want an epidural but I'm also aware that this may or may not be possible. I know I don't want a c-section unless it's vitally necessary and I fully intend to make them aware of that. I have a book somewhere that goes into the pros and cons of the normal drugs they give you, I'll need to fish that out.

I'm concerned about a long labor. My mother took 39 hours with me and I'm afraid I'll be the same, so I'll have to ask the midwife about what we can do to help things along (this is of course assuming they don't have to induce me... which they'll do if I don't go into labor before 37 weeks).

Thanks again everyone. x

They want to induce you if you don't go into labor by 37 weeks?!?!

They want to induce you if you don't go into labor by 37 weeks?!?!

Yeah. Because it's twins. I could refuse if I really wanted to but I don't. Twins are considered full term at 37 weeks and I'm so tired of being pregnant now that I reeeeeally don't want to do that extra 3 weeks.

I agree with the others. TBH, I never really wrote a plan because I had no really strong feelings about it other than wanting it to be as painless as possible! I'm a total wimp. Turns out it was wise I didn't get too invested in a particular plan as I ended up having both my babies under a general anaesthetic!

My advice on a birth plan.. have one ...but just consider it an ideal and don't get too hung up on it. Mine went out the window, but in the end I has nice lovely but little baby boy.

At one of my last midwife appts we went over my birthing plan. My midwife said to include stuff they wouldn't necessarily know about me. She said that they want you to have a natural birth and obviously do not suggest doing an epidural or a c-section unless it is necessary. 

In the end, the three things she said were useful were:
1) Putting on the plan that we did not know nor did we want to know the sex of the baby until it came out
2) That neither of us were interested in cutting the cord (they still asked)
3) We wanted baby to have the vitamin K injection (they still asked)

I said I wanted a natural birth, cried out for an epidural when midwife did a check and said it would be like this for another 12 hours, consultant was in theatre so I couldn't, and had my baby boy after a total labour of 5 hours.

Good luck!

in my experience, the best advice i can give regarding a birthing plan is don't put too much stock in one.

my plan was to have the beastie at home in a birthing pool with nothing but gas and air.

ended up developing obstetric cholestasis, being induced, going through 19 hours of non-productive labour and having an emergency section with a spinal block.

birthing plans went straight out the window.

in my experience, the best advice i can give regarding a birthing plan is don't put too much stock in one.

my plan was to have the beastie at home in a birthing pool with nothing but gas and air.

ended up developing obstetric cholestasis, being induced, going through 19 hours of non-productive labour and having an emergency section with a spinal block.

birthing plans went straight out the window.

My experience was identical to Niku's.  Know what you want, but be prepared to be flexible, especially since you're having twins and the stakes are so much higher.