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Birth plans
Useful or not?


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#1 F.E.B.E

Posted 17 June 2012 - 09:41 PM

Today Mia Freedman coined the term 'birthzillas' for people 'more interested in the birth experience than the baby'.

In response Tara Moss has written a piece for us on why birth plans can be useful.

http://www.essentialbaby.com.au/birth/birt...0617-20idn.html

QUOTE
Women have the right to control what is done to their bodies, always, including during the intense process of birth when the body is arguably most out of our individual control. Informed consent is important in birth, as it is in our sexual experiences, in breastfeeding, and in the sadder times when illness and death take over. During these times it pays to be particularly clear about our wishes and requests, to ourselves, but most importantly to those who will be in that experience with us – our carers, our partners, our doctors, our families, our friends.  

Clearly communicated requests about what we would or would not like to have done to our bodies is important, which is why birth plans are recommended by many obstetricians and midwives.


Did you have a birth plan? Why/why not?

#2 EsmeLennox

Posted 17 June 2012 - 09:49 PM

Ds1 no, DS2 and 3 yes, pretty much for the reasons stated by Tara. It was really more for me to be clear about what I did and did not want (within reason of course, any complications and all bets were off so to speak, but even with that I had noted how I would prefer things if it were possible, depending on the circumstances). I also discovered when I had DS1 that I was pretty shocking at actually speaking while in labour, so a plan was useful that way too!

It is not at all about being more interested in the birth than the baby, in fact most women I know who used birth plans do so with specific outcomes for their baby in mind, not so much themselves. I know that the birth plan I used for my second and third child had their well-being as the key objective.

I also think it is rather insulting to dismiss all women who might like to be clear and articulate about what they want done with their body and their baby as somehow having a bit of a 'screw loose'. No woman would walk into a hairdresser and say 'go crazy do what you like,' why on earth would they do that when having a baby?

Edited by Jemstar, 17 June 2012 - 09:54 PM.


#3 follies

Posted 17 June 2012 - 09:52 PM

Nope, just no epidural and try not to poo.

Everything else I wanted was standard practice at my hospitals mid wife center.

I was a little huh.gif at the whole placenta birth plan. When my placenta came out I was too busy holding a newborn to care. In fact I don't even think I gave it a thought prior.

ETA I think my birth plan was my hospital. Instead of researching what kind of birth I wanted I researched what hospital would give me the best experience in line with what I wanted/expected. I went out of my way to make sure I could use that hospital including making my official address my parents house. My experience at that hospital was amazing.

Edited by follies, 17 June 2012 - 10:36 PM.


#4 Anna_in_Canberra

Posted 17 June 2012 - 09:53 PM

I think birth plans are useful for getting you to think through your preferences, but since those preferences can't always be accommodated - birth being the unpredictable thing it is - it's best not to be too rigid about them.

I had a written birth plan first time around, but just discussed my preferences with my doctor and husband second time around, and will do the same this time.

#5 liveworkplay

Posted 17 June 2012 - 09:55 PM

I read Mia's article today and, as with most of her stuff, I thought it was glossy tripe. She fails to understand what a birth plan actually is. I think Tara understands a lot better. It is not saying I want x, y and z done to the letter with no variation, it is saying what you would prefer ie I would like to be told why  x y z is necessary before it is consented to, or I would prefer x orver y over z if appropriate etc.

I had a birth plan for my second and third births (VBACS) and was glad of them and my care providers respected my requests and, as my birth plans did not set out what I wanted the births to be, my births were very positive experiences even when things went a bit pear shaped.

Edited by liveworkplay, 17 June 2012 - 10:12 PM.


#6 EsmeLennox

Posted 17 June 2012 - 09:56 PM

And yes, I agree pp, a birth plan actually needs to cover all contingencies, you can't be absolutely rigid about it, but it makes you think through the possibilities and what your preferences are in a range of situations.

#7 F.E.B.E

Posted 17 June 2012 - 09:57 PM

I'll answer the question too, as I was just speaking to my husband about it.

He found the process of putting together a birth plan to be really  useful for him, as he'd done less research than me and it was a good chance to discuss some of the options we might have.

Also, as my only advocate in the room (like many women, I didn't have a private OB) it was important that my husband and I were on the same page so if I was too zonked on gas he could confidently speak on my behalf.

I don't see why you can't care about the birth AND THE baby, particularly when a mother's wishes are not potentially detrimental to a baby and in many cases (skin to skin, delayed cord clamping etc) may be beneficial.

#8 CherrySunday

Posted 17 June 2012 - 09:59 PM

I think that having an idea of what you would like to happen is important.
I wrote out birth preferences, and have discussed them with my care providers - however, I'm going through the birth centre, which promotes & accommodates pretty much everything I was after anyway.

Why shouldn't women & their partners have a list of things that are important to them during the birth of their child?
I imagine they would be immensely helpful to husbands/birth partners as a reminder of what they should be advocating for if the care provider doesn't know/care/remember.

And as for people being 'more interested in the birth experience than the baby' - rubbish.Most of the things in Birth Plans/preferences are things that are known to be beneficial to the baby, like immediate skin-to-skin contact, the preference not to use drugs or to have the clamping of the cord delayed.
Everything in my birth preferences is for the best interests of my baby.

MF really needs to start keeping her mouth shut if she can't get it to link to her brain...

Edited by *Browncoat*, 17 June 2012 - 10:01 PM.


#9 F.E.B.E

Posted 17 June 2012 - 09:59 PM

With the placenta  birth plan, I imagine that would be whether you want a natural or managed third stage, if you want the cord cut, the placenta put aside etc.

#10 Pooks Combusted

Posted 17 June 2012 - 10:00 PM

I wish I'd done one.

#11 AliasMater

Posted 17 June 2012 - 10:03 PM

Nah, none of the events that took place in my births I would have thought to plan for in a million years anyway. I just went in each time with an open mind with the goal to bring home a live baby. By not having a rigid plan meant I didn't set myself up for disappointment.

#12 F.E.B.E

Posted 17 June 2012 - 10:03 PM

Can I just add, that I would like to keep the discussion about the articles rather than the authors - fair comment is allowed but keep it reasonable.

#13 Moo point

Posted 17 June 2012 - 10:04 PM

QUOTE (Jemstar @ 17/06/2012, 09:49 PM) <{POST_SNAPBACK}>
It is not at all about being more interested in the birth than the baby, in fact most women I know who used birth plans do so with specific outcomes for their baby in mind, not so much themselves. I know that the birth plan I used for my second and third child had their well-being as the key objective.

I also think it is rather insulting to dismiss all women who might like to be clear and articulate about what they want done with their body and their baby as somehow having a bit of a 'screw loose'. No woman would walk into a hairdresser and say 'go crazy do what you like,' why on earth would they do that when having a baby?



QUOTE (EBeditor @ 17/06/2012, 09:57 PM) <{POST_SNAPBACK}>
Also, as my only advocate in the room (like many women, I didn't have a private OB) it was important that my husband and I were on the same page so if I was too zonked on gas he could confidently speak on my behalf.

I don't see why you can't care about the birth AND THE baby, particularly when a mother's wishes are not potentially detrimental to a baby and in many cases (skin to skin, delayed cord clamping etc) may be beneficial.


Agree with both of you 100%.

The midwives at my hospital asked for a birth plan, and there is also a checklist of things to consider in the books that were provided by the hospital's own birthing class. The midwives really liked that we headed it "birth preferences". Although very supportive of active and natural birth, it was good for them to see what DH and I want (in an ideal situation) and provide points of discussion.

We have discussed our birth preferences (I am now 40 weeks along) with our midwives. One of the main things I included was requesting a delivery room with a bath - as only 5 of the 7 delivery rooms have a bath - so by putting that there it means that they will allocate one to us if there is one free. And IF everything goes ok then we can try for a waterbirth. If we hadn't written that, we may not have the option. Does that make me a birthzilla? Um, no. Baths are suggested as a good way of dealing with pain, and waterbirths can be a positive thing.

We were also able to include things such as preferring skin to skin contact afterwards; not allowing anyone else in the delivery room, and not even informing us if any family turned up to the waiting room (as I know it would make me anxious); and being given the chance to labour with no medical pain relief unless requested. All of our preferences are based on the research we have done on what is best for both the baby and the mother (I have a masters in public health degree so I've read actual research, not just natural birthing information).

We only had about a half page document of dot points, and the disclaimer to everything was unless there is a medical emergency. It is stapled to my hospital record on the first page.

I don't see how advocating for your wants/needs in labour means you care more about the birth than the baby - every decision we made from our IVF journey to the birth preference list and beyond has been made thoughtfully with the baby at the centre.

#14 suline

Posted 17 June 2012 - 10:10 PM

I think they are a great way for the woman to research what may or may not happen, and how she feels about them - things you wouldnt normally think about.

It can often just be a way of sorting out your thoughts.

#15 follies

Posted 17 June 2012 - 10:11 PM

QUOTE (ange_75 @ 17/06/2012, 10:04 PM) <{POST_SNAPBACK}>
We have discussed our birth preferences (I am now 40 weeks along) with our midwives. One of the main things I included was requesting a delivery room with a bath - as only 5 of the 7 delivery rooms have a bath - so by putting that there it means that they will allocate one to us if there is one free. And IF everything goes ok then we can try for a waterbirth. If we hadn't written that, we may not have the option. Does that make me a birthzilla? Um, no. Baths are suggested as a good way of dealing with pain, and waterbirths can be a positive thing.


I tried waterbirth on suggestion of the midwives and hated it. After getting out every 15 minutes to use the toilet I realized the contractions were less intense out of the water.

If I had paid for it I would have asked for a refund. Very disappointing.

#16 EsmeLennox

Posted 17 June 2012 - 10:11 PM

QUOTE (Bek+3 @ 17/06/2012, 08:03 PM) <{POST_SNAPBACK}>
Nah, none of the events that took place in my births I would have thought to plan for in a million years anyway. I just went in each time with an open mind with the goal to bring home a live baby. By not having a rigid plan meant I didn't set myself up for disappointment.


With all due respect if you think a birth plan is about having a rigid plan then you don't really understand the intent of them. I completely agree that a genuinely rigid plan could well be a recipe for disaster.

#17 Moo point

Posted 17 June 2012 - 10:16 PM

QUOTE (follies @ 17/06/2012, 10:11 PM) <{POST_SNAPBACK}>
I tried waterbirth on suggestion of the midwives and hated it. After getting out every 15 minutes to use the toilet I realized the contractions were less intense out of the water.

If I had paid for it I would have asked for a refund. Very disappointing.


Oh I know that it's not for everyone, and I may end up hating it too! I just like the idea of having the option, as I have heard a few positive stories from friends and colleagues. We are going public so there is no extra cost, the midwives said if I don't like it then don't use it original.gif

#18 follies

Posted 17 June 2012 - 10:18 PM

QUOTE (Jemstar @ 17/06/2012, 10:11 PM) <{POST_SNAPBACK}>
With all due respect if you think a birth plan is about having a rigid plan then you don't really understand the intent of them. I completely agree that a genuinely rigid plan could well be a recipe for disaster.


Unfortunately there are many women that do want to adhere to a rigid plan and I think those are the ones MF is mainly talking about.

#19 AliasMater

Posted 17 June 2012 - 10:19 PM

QUOTE (Jemstar @ 17/06/2012, 10:11 PM) <{POST_SNAPBACK}>
With all due respect if you think a birth plan is about having a rigid plan then you don't really understand the intent of them. I completely agree that a genuinely rigid plan could well be a recipe for disaster.


Your right... remove the word rigid.

However, although not written on paper, I did say to the midwives before being induced with DS1 that I didn't want drugs. (That was my birth plan!!) I wish I had never even said that much though. After 12 hours of contractions I was begging for them but they were respecting my initial wishes. Doh!!


#20 Oma Desala

Posted 17 June 2012 - 10:28 PM

QUOTE (Jemstar @ 17/06/2012, 09:49 PM) <{POST_SNAPBACK}>
No woman would walk into a hairdresser and say 'go crazy do what you like,' why on earth would they do that when having a baby?

^^^ that pretty much sums it up for me.

A birth plan or list of birth preferences is merely that - a list of preferences and wishes that are written down so that whilst in labour you do not have to worry about answering various questions regarding how you would like to proceed providing all is going well. If birth starts to deviate from the norm then have the discussions on how to proceed next. However if all is going well, why mess with the groove with unnecessary thinking and speaking?


#21 YodaTheWrinkledOne

Posted 17 June 2012 - 10:40 PM

I didn't have a formal list or even anything scribbled on a piece of paper.  As my pregnancy progressed, I just discussed issues with my doctor(s).  DH and I were on the same page as well.  And thankfully, during both pregnancies, there were no complications or anything unexpected, so that made it easy to follow my "birth plan".  In any case, there was nothing particular extreme about my preferences anyway.

QUOTE (*Browncoat* @ 17/06/2012, 10:59 PM) <{POST_SNAPBACK}>
Most of the things in Birth Plans/preferences are things that are known to be beneficial to the baby, like immediate skin-to-skin contact, the preference not to use drugs or to have the clamping of the cord delayed.

Agree.

QUOTE (Bek+3 @ 17/06/2012, 11:03 PM) <{POST_SNAPBACK}>
By not having a rigid plan meant I didn't set myself up for disappointment.

I went in with no expectations (apart from expecting/hoping to come out with a living baby).  I think that helps in terms of reducing your risk of disappointment.  

QUOTE (follies @ 17/06/2012, 11:18 PM) <{POST_SNAPBACK}>
Unfortunately there are many women that do want to adhere to a rigid plan and I think those are the ones MF is mainly talking about.

that's what I gather as well.  Than again, MF seems to like the extremes.  Gives her something to write about.

#22 Pandorasbox

Posted 17 June 2012 - 10:47 PM

I used to quite like Mia Freedman but she has really started to put me off.  For someone who professes to want an end to Mummy wars she seems hell-bent on starting them.  I thought Tara Moss was far more compelling, informed and useful.  Mia clearly hasn't met or heard from anyone who has anal incontinence or PND as a result of traumatic births  - the concept that these severe outcomes could affect ongoing parenting/relationships with the child's father/ability to breastfeed, etc, hasn't occurred to her with her casual, sarcastic manner.  I am quite shocked at her comments.  She sounds entirely b**chy and I'm surprised...she did a piece defending whatshername on TV as well a while back and that was very one-eyed.  I am starting to wonder if she has some issues in her life that are making her look negatively at everything, perhaps??

The idea behind a birth plan, and planning for what SHOULD be the most important day of your life, is to ensure that the baby is healthy, that your bonding isn't affected, and that you feel in control enough to avoid the risk of PND and associated breastfeeding and bonding issues with your child.  Some women are fine with a c-section and even book one, some women never recover from one.  And those in the latter category need a birth plan so they at least feel in control as far as possible.  How and where you have the baby is not important, not feeling disempowered by the birth is.  

For you, and your child.  I am surprised at how ignorant her comments are.  Loved the hairdresser remark...so true!  It's a very important day and it has the potential to seriously affect your child and yourself for better or worse - so for goodness' sake give it some thought!


#23 anon1071

Posted 17 June 2012 - 10:50 PM

I had an idea of what I would have liked to happen but at the same time I knew that I couldn't plan for the unknown.

I was quite happy to go with the flow and make decisons based on how I felt at the time.

#24 JAPNII

Posted 17 June 2012 - 10:58 PM

I didn't have a written birth plan.

I had a great OB and we talked about options. He was clear and so was I - I chose him because we both thought the 1st was breech and I wanted a VB. He would deliver a breech VB under certain conditions which he explained in detail. In the end my 1st turned.

I was pretty happy with all 3 births, the last of which was breech.

I think the need for a birth plan depends on the type of person you are, the OB you have (if private) and the staff in the hospital.

#25 coco100

Posted 17 June 2012 - 10:59 PM

I used to like her but lately she is getting on my nerves.. I suspect she writes articles like these to get more hits on her website. This article has generated over 600 comments since mid morning.

She proclaims to be an all out feminist but isn't the whole point of being a feminist being free to make your own choices and also be supportive of other women?

Making such a big fuss over a very clear minority of women just seems attention seeking to me.




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