I think birth plans are over rated. Birth involves a mother and a baby and when babies have their own idea of what’s going to happen it can be difficult to predict how the birth will pan out.
What I have learnt from being a midwife and from having 3 (very different) births myself is that it is important to be well informed, have birth preferences and also to control your birth environment. Here are a few suggestions for your own birth preferences. It is split into 2 parts, the first is comprised of things that your midwife may like to know about what you want from birth. The second part is for you and your partner.
Notes for my midwife
My birth partner is/are (insert name) and (insert name). You can have 2 birth partners in Gloucester and Cheltenham hospital.
These will be my preferences for childbirth. I am aware labour and birth can be unpredictable so I would like to use the following tool to help me make any choices. Sometimes things crop up in labour that you didn’t consider. This tool is a great way of assessing the situation. It’s also a great tool for birth partners to use so they have an active role in decision- making!
- Emergency – Is this an emergency? If the answer is yes then ask what is going on, keep calm and know that you are in safe hands. If the answer is no then continue with questions.
- Benefits- What are the benefits to this?
- Risks- Are there any risks?
- Alternatives- Are there any alternatives?
- Nothing- What happens if I do nothing?
In a situation where I go into theatre I would like to take (insert name). If you have 2 birth partners and need to go into theatre for either a forceps delivery or caesarean then only 1 birth partner can go. Choose now to avoid conflict at the time!
My ideal birth would be in water/ on land.
I know about my options for drugs for pain relief in labour. I would prefer to ask for these drugs when I feel I need them rather than be offered them whilst in labour. This is put in especially for the hypnobirthing mums. Sometimes if you are using your breathing techniques and are offered pain relief it can feel suggestive that you are not coping and throw you off your mindset. Alternatively, if you want to use drugs for pain relief you could write ‘please tell me when I can have the drugs’.
I am open to (paracetamol/codeine/gas and air/pethidine or diamorphine/epidural). I would say to keep an open mind, however there may be certain drugs from the selection that you really don’t like the thought of. This is a good place to make sure the midwife is aware of any drugs you don’t want to receive.
I would like skin to skin… initially/for as long as possible/not at all. Skin to skin is encouraged in all hospitals. You can have this after any birth whether that be a caesarean or vaginal delivery. You can have skin to skin for as long as you like. It is great for maintaining body temperature of baby and keeping their breathing and heart rate steady.
I would prefer the injection to deliver my placenta …or…. I would prefer to deliver my placenta without drugs. If you don’t know the differences in this ask your midwife or find out at your antenatal class.
I would like my baby to have the vitamin K by injection/orally. Same for this too. You will get a leaflet about this from your community midwife by 36 weeks.
I would like to bottle/breast feed.
Notes for myself and my birth partner
I already use this to keep calm…. (think date night)… walking/ music/ meditation/ bath/ candles/ funny TV
Remember lots of these basic tools can be used at home, in the car, during tightenings, in an induction, walking through your labour, having an examination, during your caesarean, during pushing, during an epidural siting. If you use music to remain calm, having your headphones in can be used in any situation. Same with essential oils or your hypnobirthing.
My birth environment will include:
- Smell- bath bomb/ essential oil
- Sight– wedding/couple/family pic. Favourite item/ flicker of candle.
- Touch– massage. Relax shoulders/ open palms.
- Taste– chocolate/ refreshing drink
- Sound– My music playlist and headphones are found …
My favourite hypnobirthing script to use is going to be…
What is in your birth environment can be controlled, even if your birth can’t. Music can still be played in theatre. You can also have a flannel with your favourite smell on. During induction you can use massage in addition to your familiar items such as a pillow or wedding photo. All these tips create an abundance of oxytocin, which creates endorphins (natural pain relief), strong tightenings and a smooth labour. Oxytocin, being the love hormone, also helps with bonding between you and baby. For more info about the hormones and how this can help with childbirth read here.
Breathing techniques– Remember to use my UP breathing count in (nose) 2…3…4 out (mouth) 2…3…4…5…6…7. You can choose your own number but ensure that it is consistent and that both you and your partner know it so that if you feel like you’re losing focus they can count with you. It makes the world of difference. Controlled breathing and a long out breath, again, increases oxytocin in your body. It also ensures that your body is relaxed, a cervix needs to be relaxed to dilate!
My visualisations I will use for my up breathing are… bubbles/sunrise/door frame. You don’t have to use visualisations if you prefer counting. Again, make sure your birth partner knows your visuals so that they can remind you of them at the time.
My DOWN breathing a quick breath in through my nose… pushing… breathing out through my nose.
My visualisations are ripples, waterfall, opening flower.
Remind me to:
- Stay upright / leaning forward. Great for optimum foetal positioning.
- Go to the toilet ( roughly every 3-4 hours) A full bladder will prevent baby from travelling down the birth canal and can cause bladder damage.
- Drink regularly (water/squash/ isotonic) Your uterus is a muscle and will need to be hydrated to contract regularly
- Remind me of my birth affirmations (Yesmum cards) to stay positive.
***Birth without fear***
***Control what you can and let go of what you can’t***
Most importantly, remember it is great if you use these techniques at home to keep you calm and focused on your way to hospital until/if you have an epidural. It is equally great if you use these techniques throughout your labour and birth, both in a vaginal or caesarean birth.
I have purposely missed off certain options that you may find are included in other online birth plans. For example an instrumental delivery… It would be very easy to think now that you don’t want a forceps delivery or a ventouse. However, they would only be offered to you in times of need for either you or your baby. Thinking about options like this for birth during pregnancy can cause unnecessary stress and can contribute to the ‘birth plan fail feeling’ that we are so desperate to avoid. Use your EBRAN tool and remain calm so that you can make choices from a place of confidence and positivity; not from a place of fear. Lots of the points in this blog we go over in antenatal class and hypnobirthing. If you want information on any of these birth courses then contact The Bump to Baby Chapter here.
Stay strong and sassy!!
An Endorsed Blog from Beth Kitt
Beth from The Bump to Baby Chapter is a midwife working at Gloucester hospital. She runs positive antenatal classes at The Hatherley Manor and realistic hypnobirthing groups in Cheltenham. She is a mother of 3 children and 1 boxer dog. She is always well caffeinated and is often seen not far from a coffee shop. You can find The Bump to Baby Chapter on Facebook, Instagram, and Twitter.
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