Preparing for Birth – The Birth Plan

Preparing for Birth

dsc_0744

 

Everyone needs a plan, right? For the big things, for the small things, for the day-to-day mundane things. I’m a big believer in a good plan. Usually my plans take the form of a list; stuff I need to get done. And yes, I’m one of those people who adds extra stuff to the list, purely for the satisfaction of ticking it off. Makes me feel productive.

So when it comes to GIVING BIRTH TO A FULL ON HUMAN BEING, of course I’m all about having a plan. Not only is a plan absolutely necessary in my mind when you’ve got two other kids and logistics to organise (like who will come mind them in the middle of the night?!) but I also believe writing a birth plan (or proposal or set of preferences) is an important and significant step in ensuring you are mentally prepared for birth.

This is because, by drawing up a plan, you are taking time out to really think hard about your birth in a focused way, for perhaps the first time in your pregnancy. It goes without saying that it’s really important to give some serious thought to your birth. Unlike day-to-day parenting, birth is not something you can wing; the more preparation you put in, the better the experience will be and the more you will get out of it. So by taking some time out to draw up your plan, you will be starting to visualise your birth and think about what you want in a really positive way. It’s not all airy-fairy either, you will have a number of things to consider and big decisions to make, from where you want to give birth and if you’d like to to use a birth pool to delayed cord clamping and whether you want a physiological third stage. You will need to research these things and understand the advantages and disadvantages of all your options so you can make informed choices. By drawing up your plan for birth, or at least outlining your preferences, you’re making important decisions for you and your baby, some of which will have a profound and long-lasting effect.

What I will say for those of you reading who like me love a plan, it’s important to realise that birth is unpredictable and doesn’t always go to plan. From when the baby will actually decide to make his/her appearance in that 5 week long period in which he/she is due (the concept of a single due day is such nonsense!) to how quickly you’ll dilate in labour, there are so many unknowns. That’s not to say your birth won’t be beautiful and amazing and empowering and positive, it’s just it might pan out differently to how you expected and you need to be prepared for this. This is why some people prefer to use the term ‘birth proposal‘ or ‘birth preferences‘.

I like the latter best and believe by drawing up my preferences I am making it clear what my first choice is, but also giving some thought to, and allowing there room for movement, if my birth takes a difference course. With this in mind I have a whole section in my birth preferences dedicated to having a caesarean section. Not because I’m planning for one or even thinking I will end up having one, but I’m taking into account it could happen and if it does, I have given thought to it and specified my wishes for how I would like it to be done. This feels empowering and means however my birth goes I will still have made my own choices and will be having the best birth for me on the day.

So to help those who are also nearing the end of their pregnancy (although it’s never too early to start thinking about your birth and researching!!) listed below are the things I believe you need to consider and include in your birth preferences. I have also posted my own birth preferences at the bottom to help you get started, which you’re welcome to use as a template…

THINGS TO CONSIDER/INCLUDE:

* Birth partner details – name, contact number etc.
* Environment – including where you plan to give birth and how you want the space to be
* Positions for labour and birth – as it says on the tin!
* Pain relief – what you think you might want / what you don’t want
* Birth pool – whether you plan on using one for labour and / or birth
* Monitoring – preferences for sonicaid or continuous
* Second stage – how you wish to birth your baby including thoughts on assisted delivery
* Third stage – how you wish to birth your placenta e.g. physiological third stage or active management and if you want delayed cord clamping
* Placenta – state if you plan on keeping your placenta for encapsulation or another reason
* Breastfeeding – whether you plan on breastfeeding and if you’d like support with this
* Special circumstances – your preferences if your birth goes off plan and you decide to transfer in to hospital from home
* Unexpected situations – include preferences for c-section if situation arises
* Vitamin K – confirm that you wish your baby to have this or state if you do not.
* Aftercare – your wishes for afterwards e.g. whether you’d like a private room if on a ward

It’s a really good idea to involve your birth partner in devising a birth plan. Not only so they are involved in the decision making but also because it is their job on the day to ensure your preferences are known, understood and adhered to. It’s a big (and vitally important) job but near-impossible if they are not totally sure what your preferences are! Also, please make sure you do your research before making decisions/writing out your preferences so you are making informed choices that are right for you and your baby. This is most important.

NOTE: I am planning to have a water birth at home and have been practicing hypnobirthing with my birth partner. We have a birth photographer attending and I am having my placenta encapsulated. I also have a history of postpartum haemorrhage and have anaphylaxis. Obviously this is not the case for everyone! You will need to adapt this plan to make it your own and most importantly add any medical information that is relevant for yourself.
 

dsc_0735-1

 

Birth Preferences

We wish to have a calm, quiet, water birth at home with no intervention. We are using Hypnobirthing for our birth and therefore the environment and language is very important to us. Please note that we would appreciate it if you could avoid using the words ‘pain’ or ‘contractions’, and instead talk about ‘comfort’ and ‘surges’. I may describe the power and intensity of a surge but I do not wish to think about or feel pain, as I do not believe birth needs to be painful.

Birth Partner

My partner (insert name and phone number) will be my birth companion and we would like to be left alone whenever possible.

Environment

I would like my own choice of music to be playing (including Hypnobirthing audio tracks), candles burning and a birthing ball and aromatherapy oils to use. We would like to take photos and videos throughout and have a birth photographer booked to attend. We will also be using a birthing pool when labour is established and I have a TENS machine to use in early labour.

It is very important to me that the lighting is dimmed throughout.

Positions for Labour and Birth

I would like an active hypnobirth and to use positions that mean I am upright, forward and open which facilitate an easier and quicker birth. I’d like to remain mobile throughout. If I need to rest, I would like to use my birthing ball and lean over the sofa/bed. In the birthing pool I wish to be upright and leaning forward over the side or on all fours.

I do not wish to be lying on my back.

Pain Relief

Please do not offer any pain relief to me.

I DO NOT WISH TO HAVE AN EPIDURAL. I do not want Pethidine/Diamorphine or any other drugs. I do not like Gas and Air because it makes me sick.

***I developed Anaphylaxis to Paracetamol after giving birth previously and carry an epi-pen***

I do not want any drugs introduced during my labour or afterwards.

I have a TENS machine I can use but please do not offer this to me.

Please remind me of the tools I do have which include: my breathing techniques, visualisations (of a balloon filling as I inhale and a golden thread as I exhale), light touch massage, heat pack, cold flannel, essential oils, relaxation scripts, relaxation audio tracks, positive affirmations, the birth pool etc. These will all increase my comfort level.

Please remind me of my desire to feel and experience this birth and of my previous positive birth experience if I have a wobble.

Birthing Pool

I would like to use the birthing pool during labour and would like to give birth in the pool.

Monitoring Baby’s Heart Rate

Sonicaid please. There is no need to ask when you want to listen in. I would prefer not to be asked questions in labour unless necessary.

I wish to be as mobile as possible / in the pool so only continuously monitored if absolutely necessary. If continuous monitoring is necessary and I am therefore in hospital, I would like to use the wireless monitoring if this is available so that I can continue to move about.

Second Stage

I would like to breathe my baby down so he is born gently and calmly. I would like to follow the lead of my body rather than be coached to push.

I would like to be able to bring my baby to my chest immediately after delivery. If it is not possible for me to hold the baby then I would like the baby to have skin to skin time with James.

It is vitally important to me that the calm and intimate environment is maintained after the baby has been born as I have a tendency to lose blood, so plan to do what I can to encourage the flow of oxytocin: baby to breast, a little placenta to place against my gum, calming touch, warmth and reassurance, low lighting, relaxation track playing.

Assisted Delivery

I would rather wait longer than try to rush the process unless the baby is in obvious distress and needs to be born. I will accept assistance if there is no other option.

Third Stage

It is my preference to have a physiological third stage. I would like to birth the placenta without any drugs being introduced to my body. I would like to wait until my baby has received all of his blood before the cord is clamped and cut.

When the cord has stopped pulsating, please assist James in cutting the cord.

I would also like to place a small bit of the placenta once it has been birthed, against my gum to aid the flow of natural oxytocin and encourage my uterus to contract, as it has a tendency to relax after birth.

I am having my placenta encapsulated so please be mindful of this. It will need to be stored in a sterile container which we will provide and placed in the fridge as soon as possible and certainly within half an hour.

In the event that I experience another PPH, I accept that I will need to have the injection. Hopefully this will be enough intervention. If I continue to lose blood then I accept that I will need to transfer to hospital in order to receive syntocinon via a drip.

It is really important that my epi-pen is with me at all time if transferring to hospital and that the hospital staff are aware I have anaphylaxis to paracetamol and am allergic to latex.

Feeding the Baby

I wish for the baby to be put to my breast immediately after delivery.

I feel confident with feeding my baby and do not need assistance with breastfeeding.

Special Circumstances

If I chose to birth my baby in hospital because of special circumstances, I would like to request a private room with a birthing pool. The environment is very important to us so we would like the room to be as similar as possible to our preferences outlined for home birth. Most importantly we would like the room to be dimly lit, quiet and with as few people as possible present. We would like people to knock before entering and to speak in hushed voices. All communication is to go through James please so that I can labour undisturbed.

I do not wish for students to be present, only those who absolutely need to be there.

I do not wish to be cannulated unless it is essential to do so.

Unexpected Situations

If absolutely necessary, I give my permission for an emergency C-section to be performed.

It would be my preference to be awake for this and to receive my baby to my chest immediately after delivery, certainly before weighing him or cleaning him.

Please ensure any electrodes are placed on my back to they are not in the way and do not inhibit skin to skin time.

I wish for only those who are absolutely necessary to be present in theatre. I would like to be able to see my baby be born so would appreciate if the curtain could be lowered at this stage. I would appreciate it if the lights could be dimmed at head end so when the baby is delivered and brought to my chest, he is not subjected to bright light. I would like my choice of music/relaxation track to be playing in theatre during the birth of my baby.

If there is time beforehand, I would like to be given a pack of sterile gauze strips so that I have the opportunity to seed my baby with bacteria and stimulate microbiome development, which would happen if he were born naturally.

I would still like my placenta to be encapsulated after birth, so please bear this in mind and ensure the theatre staff are aware of my wishes. My placenta will need to be stored in a sterile container and kept cool until collected.

If my baby has to be in the Special Care Unit, then I want to be able to care for him as much as possible and to ensure he receives my breast milk. I would like help with making sure this happens.

Vitamin K

I am happy for my baby to be given Vitamin K by injection.

Aftercare

If in hospital, I wish to request a private room if one is available.

 

Thank you for taking the time to read my birth preferences. I am looking forward to the birth of my baby and planning for a positive and empowering birth experience where my baby is born safely and calmly. I believe this is possible however my birth story pans out.

Thank you for supporting us at this very special time in our lives. We will be sure to appreciate all you do for us, now and for the rest of time.

Siobhan and James.

 

Advertisements

STEPH’S IN THE (MOTHER) HOOD

In the (mother) hood

Today I am so excited to introduce a girl whose haircut I’ve been coveting since I first saw THAT fringe on Instagram. She rocks leather skirts and leopard print (what’s not to love), has an awesome blog, runs an ingenious business, has kids with amazing names (Hello Buster!) and is really bloody nice. Here’s what Steph has to say about Motherhood…

Steph Douglas

Name: Steph Douglas

Age: 34

Location: St Margarets, London

Number of Kids: 2

Names and ages of aforementioned: Buster (4) and Mabel (2)

Was motherhood planned, a lovely surprise or somewhere in the middle?

We’d been married almost 2 years and it seemed like the next ‘sensible’ step. Ahem.

Initial feelings on finding out you were pregnant?

Excited, and like we had the best secret. I also felt relieved – like lots of women I had a fear that I wouldn’t be able to get pregnant.

How did you tell your partner?

I came running down the stairs holding the stick

His reaction?

Lots of squealing and hugging and ‘woah, are we really doing this’. Oh that sweet naïve couple – we had no idea!

Did you glow your way through pregnancy or was it a complete bitch?

I had no health issues for either pregnancy aside from the usual (feeling a bit swollen and constipated) and I quite enjoyed having a big round belly until the last bit when you have to heave and grunt to turn yourself over in bed. I found the mental/emotional side of it more of a challenge. We once went out for dinner on a Friday night after work when I was pregnant with Buster – Doug had booked it as a romantic gesture – and it was this amazing Italian where they just bring out courses and it’s the longest most relaxed meal ever. Except I was hungry and tired and couldn’t neck all the wine so I sat opposite him weeping while he begged me to stop as it looked like he’d taken a heavily pregnant woman to a public place to dump her. We were better at carrying emergency snacks and having early nights during my second pregnancy.

Tell me about your birth experience?

I had no expectation about birth, which sounds a bit odd but my mum was a midwife and gave birth four times herself, and she always kind of underplayed it when I asked how painful it was, and said it hurt but you’re so focused and you hold this baby at the end of it so you just get on with it. So I was kind of relaxed, ready for the drugs if I needed them but aiming to see what happened. When it came to it, my body took over, I stayed home as long as possible (on my Mum’s advice) so with both I got to the hospital and was pretty much ready to go! Finding out you’re almost ready to push as you arrive at the hospital is a massive mental boost so I felt really focused and I did the rest with gas & air, which I LOVED. They had to prise it out of my hands.

Doug gets this funny look of awe on his face when we talk about it, like he still can’t believe what I did. He also remarks on the strength as I pushed down on him during contractions; apparently it smarted a bit…yeah, it did for me too! Sometimes I feel like I’m not supposed to say I had a ‘good’ birth as you hear about a lot of bad ones. But actually, it was really positive, the midwives were awesome and I feel pretty proud of myself. If I do it again, I’d hope for the same. I liked being in hospital and that is part of the feeling relaxed for me – I was on the natural birth ward but had the reassurance of staff and equipment close by if I needed it. It’s a really personal thing for everyone and at the end of it, you gotta do what you gotta do.

Describe motherhood in a few words:

A rollercoaster – with deep ‘what the hell is happening’ lows and utterly awesome ‘I AM WOMAN’ highs.

Can you share any highlights?

Just seeing these two babies that we made become funny, quirky little people and the four of us becoming a proper little unit, with our own traditions like toast in bed on a Saturday and fishfingers after swimming. Hearing them chat together first thing in the morning now they’re a bit bigger makes me feel weepy. It’s lovely.

Can you share any low points?

Those moments when you’re out and everyone is crying, no one is listening, you’re dropping stuff along your way and sweating profusely and feel like everyone is watching and judging you. Also, Mabel recently crapped on the floor in a pub and we only realised when Buster stood in it. That one is a mixture of a high and low point as it was grim, but very funny on reflection.

What do you do when the baby sleeps?

Alas, we’re down to a couple of naps a week as Mabel is almost 3 and not keen most of the time. When Buster was a baby I flapped about doing stuff from The List or divving about on social media. I know people roll their eyes at ‘sleep when the baby sleeps’ but with Mabel I was much better at napping. If you unpack the dishwasher and do a few jobs first, you’ll never do it as the baby will wake up and you’ve missed your window. The trick is to lie down as soon as you put the baby down. Even if you get 20 minutes, it will change your whole day and the world will be a brighter place. The washing can wait.

Have you got a blog?

I write Sisterhood (and all that) – it’s an honest account of motherhood and relationships with the idea that if we’re honest with each other about how things really are and the ridiculousness that life throws at us, it’s often funny and also less lonely. It was kind of a stepping stone to starting the business and I wanted to see if people felt like me. It turned out they did and it went really well, so gave me the courage to quit my job and start the business.

Have you got a business?

I run Don’t Buy Her Flowers selling thoughtful gift packages for new mums. 96% of women receive flowers after giving birth. When I had my first baby I was given eight bunches of flowers and it just seemed such a waste – people were really kind to send something, but flowers are actually another thing to care for. At a time when you’re feeling pretty spent, I thought there could be better gifts that let mum know she’s doing a good job and is loved. The Care Package is our best-selling package, and the idea is it encourages mum to stop and take ten minutes to herself – truffles, tea, flapjack, a magazine and a scarf. I’ve also teamed up with COOK food so their vouchers can be added to any package, so you can give new parents prepared meals delivered to their door. Those are always well received!

What’s the best bits of being a Mama?

Aside from the obvious i.e. two beautiful babies? Women are awesome. Resilient, determined, compassionate, often hilarious and for a lot of women I know, becoming a mother intensifies those strengths. You don’t realise it when they’re small, but you are now a lioness. On a good day, anyway.

What are the worst bits?

The tiredness combined with the feeling I should always be doing something. It can be pretty exhausting and I think that’s the same for most mums everywhere. We’re rubbish at stopping, let alone relaxing with our partner or doing something nice for ourselves.

If you didn’t have your kids for a week what would you do?

Oh SLEEP. And eat at a leisurely pace. We’re actually hoping to take a little holiday in January just the two of us. I know some people couldn’t bear to be apart from their babies, but we’ve been pretty good at having the odd night away and I think it’s essential to our sanity and marriage! We realise we really like each other when I’m not moaning at him for forgetting to put the bins out.

Have you got any advice for mamas-to-be/new mamas?

I recently wrote a list for Clemmie Telford’s blog which just about covers everything!

What’s do you reckon the most essential item mamas-to-be need to pack in their birth bag?

Snacks! I was very disappointed by the post-birth food on offer at hospital!

What’s been your best baby product?

The IKEA high chair. Forget your fancy ones, for about a tenner this thing wipes clean and has NO primary colours.

What’s your ultimate mum product?

OBVIOUSLY a thoughtful gift package from Don’t Buy Her Flowers… but also a changing bag from Tiba + Marl. Practical AND good-looking. And a buggy hook because you always have too much stuff to carry.

Steph Douglas and kids

Huge thanks to Steph for taking part – be sure to check out her blog, it is well worth a read! And of course if you know somebody who needs a little TLC – Don’t Buy Her Flowers!

I’d love to hear from any other Mamas out there who’d like to feature as part of my ‘In the (mother) hood’ series – just drop me a line: thedoublemama@gmail.com