27 weeks: best laid birth plans
This week’s Baby size as fruit or vegetable: Cauliflower
Pregnancy symptom of the week: Random nosebleeds!
Aside from my nose randomly erupting at various points over the last few days (I’ve had three unprovoked nosebleeds now), I’ve had an uneventful pregnancy week. Bump continues to grow and wriggle and I continue to heave myself around, and we’re all getting on quite nicely. Having not experienced nosebleeds in my first pregnancy, although I understand they are common, I am wondering how much effect the low-dose aspirin I’m taking for pre-eclampsia prevention might be having to cause them. Next week sees another trip to the consultant and my first additional growth scan, so I’ll mention it then and hope they don’t become more frequent!
Following some brilliant discussion on Twitter about birth plans – or to be more accurate, birth preferences – this week I’ve decided to start gathering some of my thoughts on what I would like for my labour and delivery in an ideal world, being only too aware that often things are far from ideal in the maternity world but I have to be positive! I’ve taken the headings from prompts in my hospital maternity notes, where there is space to write in my thoughts to discuss with the midwife. I also found some great little visual icons online, which are American so weren’t all relevant to the UK experience, but I’ve added a few which I felt applied to my preferences.
I’d love to hear your thoughts about my preferences, and birth ‘plans’ in general. I hope that in making my feelings clear, I will be able to be an active partner in my care during labour and maintain some of the control that I crave, almost regardless of how the whole thing eventually pans out. As long as I have a midwife and/or obstetrician who involves me in what’s happening and my wishes are sought and respected, that’s all I really want.
My birth preferences
My ultimate preference is for an unassisted vaginal delivery with minimal intervention, but should the circumstances dictate otherwise, I will consider other options so long as I am fully informed and any alternative course of action is explained and discussed first. I would like to be addressed directly and involved in all decision making. I have a strong wish for this birth experience to be less medicalised and frightening than my first, although the safe delivery of my baby is my main priority.
Place of birth
If my pregnancy continues to be straightforward, I would prefer to deliver in the Birthing Centre rather than on Delivery Suite [for clarification here, the Birthing Centre at my local hospital is an alongside MLU, situated in the same block as the main maternity unit]. The consultant has indicated that even with my previous history of pre-eclampsia, if it does not develop again I should have the option of using the Birthing Centre. If it proves necessary to labour on Delivery Suite, I would still like as many of my preferences to be fulfilled as possible.
I wish for my husband to remain with me at all times throughout labour and birth, including during any examinations or procedures. I am happy for medical students or student midwives to be present at any time.
Monitoring baby’s heartbeat
I would like fetal monitoring to be kept to a minimum using intermittent auscultation unless there is a cause for concern. In the event that continuous fetal monitoring is considered necessary, I would like to be able to stay as mobile as possible and not confined to the bed.
Options for labour and delivery
I would like the freedom to find my own comfortable positions throughout labour, using any birthing equipment available such as birthing balls or mats. I would like the option of using a birthing pool for pain relief and relaxation and would like to consider delivery in the water if all is straightforward. I would appreciate gentle support and guidance, and advice will be welcome, especially if intervention is needed. I do not wish to have an episiotomy unless it is considered vital.
I would like to keep pain relief to a minimum in the early stages, trying TENS, being in water and remaining active. I would like to manage on Entonox for as long as possible before considering anything stronger. I am open to considering other pain relief options if necessary but I would like to avoid an epidural if at all possible.
I would like the baby to be delivered onto my stomach for immediate skin-to-skin contact. I would like to delay cord clamping until it has stopped pulsating. If a managed third stage is necessary, I am happy for this to happen but would like to delay cord clamping for a minute or two if this is safe to do. I would like my husband to cut the cord. I would like to attempt breastfeeding as soon as it is appropriate. If stitching is necessary I would like a local anaesthetic first. I am happy for the baby to receive vitamin K.
Slow progress in labour
If labour is progressing slowly, I would like to be kept informed and able to make decisions about any change of plan or interventions required.
I would like to discuss options for induction if this becomes necessary.
In the event that an assisted delivery is necessary, I would like to have all options fully explained to me and will take the advice of my care providers in making a decision.
In the event that a caesarean section is necessary, I would like my husband to stay with me unless a general anaesthetic is required. I would like to be awake and alert if possible. I would like skin-to-skin contact to be facilitated in theatre after delivery.
Have you got a pregnancy post to link up to #BlogBumpClub this week? I love to read your updates and I’d especially like you to share any posts about your birth preferences too! Link up here:
I’m linking up with Ghostwriter Mummy’s Maternity Matters