[AmityD]

So as the final weeks of my pregnancy creep by it’s time to pack my bags and contemplate going through labour again. But this time one part of my preparations will be missing. I won’t waste my time writing a birth plan. Because I know now the idea that I have any control over how my labour goes is an absolute crock.

I’m not sure when birth plans came into vogue but it seems that most books and birth classes now advise you to do one in the final weeks leading up to your baby’s birth. In your plan you can write about how you would like your labour to go, whether you would like to use drugs or not, if you’d like to utilise the bath or shower to help with labour pains, what position you’d like to deliver in, how you’d like the cord cut, whether you’d like music playing or essential oils burning and if you’d prefer a peaceful environment to give birth in. You are then advised to hand your neatly typed plan to your midwife and obstetrician during labour, while they try not to look like they too think it’s a total crock.

I’m sure it’s all part of us modern mums wanting to feel like we’re in control when it comes to our bodies and our labours. After all, we’re in control of everything else in out lives these days, so why not our deliveries? Gone are the days where we were expected to quietly do as we were instructed by our male obstetrician, putting up with the pain without complaint, while our husbands dutifully waited outside with the cigars ready. And that is undoubtedly a good thing. But have we gone so far the other way, where we think we can control something that is actually in Mother Nature’s hands?

With my first pregnancy I wrote a birth plan and had specific ideas about how I wanted to give birth. I wanted to be in the bath or shower when possible, to have candles burning and listen to my favourite music to help me focus. I even had two ipod playlists ready, Labour Relaxing and Labour Pushing. The relaxing one was to calm me during the early stages and then the pushing one was made up of inspiring songs to help motivate me when the time came. Kind of like an athlete getting pumped up before a big race.

I didn’t have a strong opinion either way about drugs, with the expectation that I would try to do it without them but was not opposed to using them if it got too hard. And of course all my plans were excellent in theory, except that here is how my actual labour went.

At 37 weeks, after experiencing what I thought were Braxton Hicks on and off all day, I was lying on the couch at 6.45pm (whinging about how uncomfortable and over it I was) when my waters broke in a sudden and dramatic fashion. Now, firstly, they said in the classes that it rarely happened like this, like it does in the movies. I was told that in most cases your waters will be broken in hospital after you have been in early labour for a while. Secondly, I was expecting hours and hours of early contractions, with most first labours reportedly taking at least 8 hours. Hours where my husband would rub my back, I would lie in the bath and we would excitedly anticipate the eminent birth of our child in between 15 minute apart contractions.

What I was not expecting was to go from nothing to 3 minute apart contractions, accompanied by an Oh-My-God-This-Is-Bad kind of pain. A call to the hospital confirmed that I needed to get there as quickly as possible, seemingly giving my stricken husband permission to run red lights where needed. I don’t know which was more stressful in that mercifully quick journey, the thought that I’d die from labour pains or from a car accident.

When we arrived at the hospital the contractions were coming about a minute apart and rather than heading for the bath I went straight for the toilet. The desire to stay there was so strong I would have happily given birth over the loo, which wasn’t exactly the birthing position I had planned.

After my midwife coaxed me to the bed I asked her how dilated I was, expecting that she would know by looking…in my eyes? It never occurred to me the method they would use to find out, making me feel slightly foolish in hindsight! I promptly told her that if she said I was something ridiculous like 2 centimetres I was going to kill someone. She replied that my labour had only just started so it may be a while yet. At this point my darling husband tried to insert my ipod headphones in my ear, to stimulate the calming effect I had so wisely planned. However, rather than being soothed the music annoyed me, the headphones hurt my ears and I yanked them out angrily as he tried to remind me that this was what I wanted.

All through this, my neatly typed birth plan remained in my unopened bag, along with my candles and birthing outfit that I had lovingly folded in anticipation.

Then, after my examination, things got a little crazy. My midwife proclaimed that the head was crowing to which I screamed “I TOLD YOU IT HURT” and my obstetrician rushed in just as I started pushing. By now I was screaming for an epidural, knowing full well I wouldn’t get one but feeling better for asking anyway.

Twenty minutes of pushing later, at 8.15pm my beautiful son was born. There was nothing calm about any of it, it didn’t go at all to plan, but I wouldn’t have changed a second of it.

So, this time there are a few things I know for sure.

1. My labour is likely to be quick, so be ready!

2. There is no planning in labour so it’s best to go into it with an open mind and go with the flow. There is nothing wrong with having an expectation of how you would like it to be, but it can often fall out of your control and holding on too tightly to those expectations can make the experience more stressful.

3. Trust both your body and your caregivers to know what they are doing.

4. From the moment that labour starts and for the rest of your life, you are no longer in control. It’s better to accept it now and go with it!

5. While labour will be a huge focus for you during your first pregnancy, with subsequent children you know that it is just a tiny moment in the monumental scale of their lives. And whether they arrive through a drug free birth, with an epidural or with a c-section it doesn’t really matter, no way makes you a better mother. It just matters that they are safely in your arms at the end of it.

What was your birth like, did it go to plan? Did you write a birth plan and did you find it helpful or a waste of time?

[dogsbody]

Sure I had a birth plan - that I would try to make it to hospital before the baby was born LOL! More seriously, I did plan to try a natural birth, but I would follow my midwife and doctors advice as required..... As it turned out I did manage the whole thing drug-free (but only because I refused the pethidine until it was too late!!!)

[Obesa cantavit]

With my first I had no plan. I had no idea how labour would be and, as informed as I thought I was, I really wasnt. I ended up with a planned c/s anyway and had 2 weeks to get my head around that, which was enough in itself.

DD2 I did have a birth plan, or maybe preference would be better. I had ideas on what I didnt want more then what I did. For example I wanted to be the one to ask for drugs, not have them ask me. I also had a list of preference if intervention was needed ( ie vaccume over forcepts, tear over episeotomy) Most importantly for me, I wanted the reason for a recommendation explained to me, my OB and midwife hapily obliged. I also did not want the cord clamped until it stopped pulsating.

All of these wishes were adhered too and I had a successful VBAC. She was posterior and I required an assisted delivery, but it was not with keeping with my preferences.

With DD3 I also had a similar birth plan, which in hindsight, was not really needed as the hopital I gave birth at was very pro active birth and a lot of what I asked was hospital policy. I had a drug free 5 hour VBAC.

SO I do not think they are an " absolute crock". Birthplans are not about stipulating how you want the birth to go, any fool knows that labout and birth are unpredictable and out of anyones control, however I think that it is silly to go into it without clearly stating your clear preferences. If you wish to rely on hospital policy, policy that is put in place to create the least risk to the hospital, client and baby, and also be most convienient financailly and administrative ie staff levels, not necessarily what is best for the client and baby then go for it. Some of us and well informed ( I have worked in a hospital setting for over 15 yrs) in what we want but more importantly what we DON'T want.

ETA: my Private OB actually added some points to my birth plan. She also signed it and it was placed in my hospital file before I went into labouor. The midwives on duty must have read it as there were a few things like wanting minimal noise and minimum number of people present, that were strictly adhered too, to the point of actuallly asking me if someone could come into the room and staff leaving the room to speak.

This post has been edited by Obesa cantavit: 18/05/2010, 10:08 AM

[namie]

I didn't bother with a birth plan. I had no pre-conceived ideas of what labour was like so I didn't feel I could really plan anything. I mentioned the idea of a birth plan to my OB at around 38 weeks as other mothers-to-be I'd spoken to had asked if I'd written one and I hadn't. My OB rolled her eyes, shrugged and said I could but as she prefers the natural approach as far as possible there wasn't really much point.

I'm not one for inspirational music, I hate baths and I was happy to just go with the flow.

And I didn't once wish I'd had one to follow. I had 2 fantastic midwives at the hospital who helped me through the various stages of my induced labour and my DP was also fantastic! I had an epidural due to hideous back pain and gave birth, forceps-assisted, after 11 hours.

I'd do it again exactly the same way.

[Eight.years]

So, this time there are a few things I know for sure.

1. My labour is likely to be quick, so be ready!

2. There is no planning in labour so it’s best to go into it with an open mind and go with the flow. There is nothing wrong with having an expectation of how you would like it to be, but it can often fall out of your control and holding on too tightly to those expectations can make the experience more stressful.

3. Trust both your body and your caregivers to know what they are doing.

4. From the moment that labour starts and for the rest of your life, you are no longer in control. It’s better to accept it now and go with it!

Sounds like a birth plan to me!

I think it's a bit hasty to call them 'a crock' when the phrase birth plan encapsulates such a wide range of practices.

You seem to be talking about the type of four page detailed document, rich with ideas about aromatherapy and affirmational phrases drawn up by an optimistic first time mum. And they probably are more likely than not to be thrown away at the first strong contraction. But a birth blan could also be something as simple as a mental list of what you want to happen if the baby has to be whisked away immediately after the birth (partner to stay with baby, consent to be given for vitamin K injection etc), or a few points about how to make a scheduled caesarian more mother/baby friendly.

I have never written a birth plan myself, but I certainly have gone into both labours with some firm ideas - including the idea that I would need to be flexible about what is to come. But I also had researched and thought about things like whether or not to have the syntocinon injection, how I felt about continuous monitoring and the like.

I didn't always get my way, but at least when the issues came up I had already thought about them and I knew for sure that what was going on was a matter of necessity rather than just being an issue of hospital policy/care provider preference/whatever.

[RatbagBob]

I didn't have a birth plan - the first I heard of these strange beasts was at the pre-natal classes when they were discussed at length and DH and I looked at each other, somewhat non-plussed. My birth plan, if it could even be called that, was simply to get drugs when I thought I needed them and just go with the flow.

I had a healthy baby, no hang ups that I "failed" the birth and like the PP, I'd do like that again.

[beatrice11]

I can't say I agree Amity. For my first birth I completely subscribed to the birth plans are for foolish women who believe that they can control Mother Nature theory. I was going to go with the flow knowing that my caregivers knew what they were doing and that the best way to be disappointed with your birth was to have a particular expectation about how it all turned out. I assumed I would have a vaginal birth (why in a hospital with a 50% c-section rate I don't know) and that I would try without drugs but be open to taking them if needed.

I ended up with a completely unnecessary c-section as my obstetrician told me that my pelvis was too small to fit my baby through. Bub wasn't in distress and I'd only been at hospital for an hour. I had no plan and no knowledge and ended up going along with what my trusted careprovider was telling me. Also because I'd given no thought to what I wanted to happen after the birth I was also unnecessarily separated from my completely healthy child for the majority of her first 12 hours.

Second time around I had a pretty extensive birth plan. It actually meant something because I wrote it with the 2 midwives who attended my birth and we were all behind it. I had a particularly detailed plan to deal with what I wanted to happen if I needed to have a c-section. There was no way I was missing those early hours with my second child. End result was a much bigger baby born through my pelvis just fine in an empowering vaginal birth. It didn't go exactly as I planned of course but knowing how I wanted it to go and what I needed to do to get there was a massive part of having the birth I got. The other big part was choosing careproviders who respected my choices and genuinely wanted me to have a fulfilling birth experience.

For me the birth experience for both my children was not a tiny moment. Birth experiences matter - they set us up for motherhood. Until I had my son I did not realise how important the birth was. Its not a simple matter of c-section bad, drug free vaginal birth good but that whatever happens we feel that we are given the information we need to make good decisions and that our wishes are respected, that we are not given c-sections for flimsy reasons and that we are not separated from our babies after birth.

If I go for no. 3 I will be taking that birthplan. Even if it stays in the bag it represents my hard-won knowledge and my determination to give my kids the best start I can in their lives however that pans out.

[BucketONuts]

What was your birth like, did it go to plan? Did you write a birth plan and did you find it helpful or a waste of time?

Hmm this is a nice blog..I'm due with #2 too..and while I still have a while to go..I laugh now at all my so called plans...I too had a nice bag packed..While I was due 4th feb, i was in labour on and off from 27jan..Was horribly uncomfortable all day 30Jan and then at 2am on 31Jan I had a bloody show..freaked out of course but the middies at the hosp told me to time it and wait at home. From then on I couldn't sleep as the contractions were 15-10mins apart...continued all day 31Jan.
Then around 8pm it got reaaaaaaaaaaallly bad and we headed to the hospital at about 2-3 mins apart..They checked and I was only 2cms..Of course from the middies checking my water burst so there was my only chance to labour in the bath/shower gone.. From then on the pain was awful but I refused the pain meds..then around 3am on 1Feb I gave in & begged to have an epidural..had it around 4am but after 1hr of peace I started feeling everything again..so I'm one of the few epidural's don't work on... ..
THEN my labour slowed nearly to a stop...so I was given something to get it started again.. the rest was a blur of pain , pain & more pain...until finally around 11:40am on 1Feb I was fully dilated..so then I pushed for about 2 hours..My fantastic OB suggested a vaccuum/ forceps delivery and I was past caring at that point..
The decision was taken out of my hands though as my baby's heart rate dropped and I had a high fever from an infection..I was taken to the OT so quickly (some kind of Code One?) I bumped a booked twin Ceaser out too . She was stuck so bad that the OB couldn't get her out frm my tummy easily. The middie had to shove her back into the womb between my legs and then she was out..I was taken in at 2:20pm and DD ws out at 2:33pm. So that was my fantastic labour..
This time i'm booking to have a C-sec...can't take a risk with one at home personally & don't want to ...

[BucketONuts]

ETA: my Private OB actually added some points to my birth plan. She also signed it and it was placed in my hospital file before I went into labouor. The midwives on duty must have read it as there were a few things like wanting minimal noise and minimum number of people present, that were strictly adhered too, to the point of actuallly asking me if someone could come into the room and staff leaving the room to speak.

Hey quick question....did you go to a public hospital? My OB mentioned that I would need to go public (as a private patient) if I wanted a VBAC..and I just wanted to get my facts right...
TIA

[AmityD]

Good to read the replies so far. I knew everyone wouldn't agree with me, but that's ok, it makes for an interesting discussion!

I should clarify that I don't believe you should go into labour without any opnions or preferences on how you'd like it to go. I will still be telling my OB and midwives to leave the chord til its stops pulsating and what I'd like re Vitamin K and Hep B, etc. But I do think there is so much pressure on us mums now to have this perfect birthing experience and then if things end up going differently it can lead to feelings of disappointment and failure. And there are some things you can't possibly know how you will react to until you're in the situation. I was also 'against' eps before labour but when the time came I would have happily agreed to my OB cutting my leg off if it got my baby out faster!!

And Beatrice11 - I agree that giving birth is not a small moment, for me it was a huge, life changing moment. What I was trying to say is that for your first pregnancy it is your sole focus and once you've had a child you realise that how you birth is not a reflection of how strong you are or what kind of mother you will be. Kind of like focusing on the wedding instead of the marriage!