Candyfloss & Dreams

Tag: birth plan

  • My Birth Plan for Baby Number 2

    My Birth Plan for Baby Number 2

    I’ve talked before about why I think writing a birth plan for every pregnancy is important. Lots of comments said that so many women didn’t bother for subsequent children, especially after a straightforward first birth or they just had a few preferences. I think birth planning becomes a bit more of an obsession when you’ve had a traumatic birth because you want to avoid the same thing happening and ultimately reflect more positively on the situation.

    I do agree that birth can be really unpredictable and it is wise to consider options B and C however I personally can not just accept “going with the flow” as it is likely I’ll always be at risk of another c-section for this and future births. It’s very hard for me to just go with the flow when major abdominal surgery will always be part of the plan.

    36 Weeks Pregnancy Bump High BMI

    I wanted to share my birth plan for my ideal birth and touch on how I’m trying to turn it into a positive experience however I am also going to share my plans for a hospital transfer and in the case of needing a planned or unplanned c-section. My hope is that you can pick up some of these to add into your own birth plans or there might be some considerations that you hadn’t thought of yet. I’m also currently writing a book on having a high BMI and being pregnant and why individualised care is absolutely key when you’re in that situation.

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    Creating Birth Plans A, B & C

    So birth plan A is a home upright, forward and open VBAC Waterbirth using hypnotherapy and gas and air.

    Plan B is an active and upright vaginal birth with or without assistance following a transfer to hospital for whatever reason. I’m still happy for gas and air, Hypnobirthing and might consider pethidine or diamorphine if I feel it’s needed however I want to avoid an epidural.

    Plan C is the planned c-section with spinal block at 42 weeks if I am not already in labour or the unplanned c-section with spinal block or general anaesthetic in an emergency following any difficulties and where the safety of myself and my baby are compromised.

    Risk of Scar Weakening or Rupture

    The risk of scar rupture is around 1 in 200 so it is not common place and the scar is more likely to weaken or slightly open than actually rupture. I need to be aware of:

    • Pain in between contractions
    • Referred pain in my shoulder
    • A sense of feeling of something being wrong or not feeling right
    • Vaginal bleeding

    Any of these will mean a direct transfer to my booked in hospital. The risk here from home is the transfer time of course and is a risk I acknowledge which is why the midwife attending me at home will be looking for these symptoms closely.

    Things that help avoid scar weakening

    • Length of time between pregnancy – 8 years
    • Placenta away from the scar site – mine is no where near my old very neat scar
    • Shorter labours – something I can’t control but as my uterus has done it before there is no reason why my labour should drag on and I should labour just like any other second time mother.
    • Positioning – being upright with gravity on my side
    • No hormonal/syntocinon/epidural induction.

    There aren’t many home birth vbacs in my hospital trust area, especially those with a high BMI so it’s really hard to know what my chances are of a successful vbac however the evidence does suggest that women that do plan a Home birth are more successful at having one and those that plan for a vbac at home are more successful at having them at home or at hospital.i therefore have had three lengthy discussions with a consultant midwife who has put a midwifery care action plan in place for the midwife attending me at a home birth and to help with making my labour positive in hospital.

    Guidelines recommend that a VBAC woman comes into hospital for continuous monitoring but if they want to birth at home they can and the transfer threshold to hospital should be lower. In the case of Home births with a high BMI around 58% of women are transferred into hospital at some point either at their own request, prolonged labour or in an emergency. This is why it’s even more important for me to have a birth plan.

    preparing for birth hospital bag

    Birth Plan A – Home VBAC Waterbirth

    Pros – in my own environment, feel safer, no need to rush to and from hospital, can labour and birth in water if I want to.

    Cons – transfer time to hospital or waiting for an ambulance.

    At home I will have access to water, gas and air, TENS, food and drink. I have bags packed just in case of a transfer and so Adam knows where everything is. We will have shower curtains and tarp to protect furniture. Large TENA pads for the bed and sofa. I will have a fan and portable heater to adjust the temperature in the room. We will have plenty of space in the bathroom to birth the placenta – apparently using a pan and sitting on the loo is a perfect place to do this for a physiological first stage.

    Early labour signs that the plan is to have a whole grain carb meal for energy, inform labour line that things are beginning, get adam home and arrange childcare for Evie if needed and inform my Doula, a warm bath, take two paracetamol and go to sleep – labour will wake me up!

    Continue to inform labour line whilst contractions progress, watch funny comedy videos on Netflix and build a Lego set. Trust me there is a method to my madness here – anything that makes you feel good will make you labour better. Eat what I want and drink isontonic drinks for energy.

    When I need to focus on contractions use birthing ball, TENS and hypnobirthing tracks remain in an upright and active position. Consider filling up the pool at this point and when contractions are three in ten minutes lasting a minute ask for a midwife to attend. Avoid getting in the pool until midwife arrives and allow a cervical examination.

    Try and wait until 8cm/transition to get into the pool and remain in active, upright position. It is estimated that a second time mum will dilate from 5cm to 10cm within around five hours or one hour for 1cm.

    Birth Plan B – Following Hospital Transfer

    Pros – emergency equipment available if needed, no need to wait for transfer time

    Cons – unfamiliar, sterile environment, likely to have more interruptions and midwives I’ve never met

    If I transfer to hospital I am asking for intermittent monitoring to continue as I feel being strapped to a bed will really limit my ability to labour the way I want as I plan to remain mobile, upright and active. Transferring to hospital usually means no eating in case of an unplanned c-section, so drinking for energy is going to be key. I’ll be bringing isotonic drinks, chewable glucose tablets and honey as well as some chocolate for after birth. I have requested wireless monitoring if continuous monitoring is required and a room with a large shower so that I still have access to water for pain relief. I have also rejected having a cannula inserted as a precaution and do not want an epidural. I am happy to use gas and air and might consider pethidine or diamorphine if labour is taking a long time.

    When it comes to assisted delivery I believe remaining upright, forward and open will be the best position for me and my hospital has floor mats and birth balls available. However, if baby needs to be born then I will accept methods of assisted delivery offered.

    Birth Plan C – C-Section Birth

    Pros – baby is delivered. 

    Cons – major surgery, more scar tissue, more risk of rupture for subsequent pregnancies, theatre environment, lots of people. 

    In the event of a c-section I am still requesting the following:

    • Optimal cord clamping
    • Skin to Skin in theatre
    • Delay weighing and measuring until first breastfeed
    • Second APGAR on my chest
    • Baby born slowly and gently

    General Birth Plan and Preferences

    1st Stage of Labour – Dialation.

    Consider the environment for the best possible production of Oxytocin and base this on my senses. Create space for the birth pool and a birth nest. This can also be transferred into labour ward as much as possible.

    Smell – favourite aromatherapy oils

    Touch – water, soft textures

    See – low lighting, family photos, birth affirmations

    Taste – favourite treats, frozen grapes, warm lemon and honey drinks, isotonic drinks

    Hear – hypnobirthing track, hushed, empathetic voices

    2nd Stage of Labour – Pushing

    Breathe Baby Down

    No coached pushing

    Upright position, preferably in water for buoyancy and most comfort

    Skin to skin after birth

    3rd Stage of Labour – Physiological (if all is well)

    • Birth placenta without injection unless excessive bleeding
    • Optimal cord clamping – wait until the cord has changed colour and stopped pulsating
    • Golden hour of skin to skin contact, breastfeeding and delay weighing and measuring

    birth plan a b c

    For more pregnancy content please head to my hub post which contains links to all my relevant pregnancy based blog posts. My second High Bmi Pregnancy.

  • Why You Should Write A Birth Plan for Every Pregnancy

    Writing a Birth Plan to some people might seem completely pointless and I totally get that. Birth is unpredictable. You might be given a due date but that baby could turn up anytime really from 38 weeks when you’re considered full term. Sometimes it even happens before that and sometimes you’re left their waiting until 42 weeks after hanging on to your due date for so long. You don’t know how, where or when labour will spontaneously happen either. If having a plan sounds a bit too much then think about it as your birth preferences. Think about a plan A, your ideal birth experience and then have some things in mind for a plan B and C just in case things do become a little more unexpected. People have said to me just “go with the flow” but I really can’t do that. I’m not that sort of person. I like knowing what type of pain relief is available and thinking ahead of the type I would prefer to have. I like working things out in stages and even if things change I know exactly what course I would like to follow after a particular change. Having a high BMI also makes me more at risk and makes monitoring harder and the type of monitoring I want to have isn’t something I want to think about whilst I’m trying to let my body do what it should know what to do!

    no guilt pregnancy plan, birth plan
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    My first pregnancy was really straightforward however with an induction and then failure to progress during pushing which then lead to an unplanned c-section so this time around I am hoping for an at home VBAC birth but I also have an idea of how I’d like to have a planned c-section. In all fairness, I really don’t want to have a c-section at all. The idea of having another round of surgery whilst being overweight and the longer recovery period is making me feel increasingly worried, however, on the flip side, being induced increases the chance of scar weakening and rupture. It’s really hard when you’re a high risk pregnancy but that’s why I think it’s even more important to have a birth plan or birth preferences in mind. I’ve put together a list of books that I think are must reads when pregnant which could really help with planning a positive birth.

    The benefits of a birth plan for me have been:

    • Helped with my anxiety. I feel I’ve ironed out every detail in my mind of how I’d like to birth and I feel really positive about labour.
    • A plan A, B and C has allowed me to think of best and worst case scenarios for the birth and where it will happen
    • I have made my preferences clear to my midwife, consultant, doula and consultant midwife – all of which are being helpful, positive and supportive
    • I understand a lot about the risks and benefits of the type of birth I want as well as what might happen if things don’t go to plan
    • I feel more connected to my body and baby
    • Midwives can easily see exactly what I want and expect from the birth as well as my newborn preferences
    • In the throws of labour I shouldn’t need to answer lots of questions about what I want as it’s clearly marked out and I am hoping easy for my midwife to be really in tune with
    • It has taken away a lot of the overwhelm and helped me come to terms better with my previous birth

    I wanted to share some top tips when it comes to writing a birth plan and how I’ve made some of the decisions I have for having a positive birth experience as well as explaining some of my choices for this birth and my baby.

    1. When writing a birth plan, put the most important information at the top so it’s clear. For me, I have put that I have anxiety, that I’ve been in an abusive relationship and that my consent for internal examinations is important. I feel this really sets my birth plan off in the right way and will hopefully eliminate the issues I had with my previous pregnancy and the lack of communication and empathy I had from my previous birth and hospital.
    2. Add names of your birth partners and the location in which you are planning to give birth. I have named myself, my partner and my doula as well as what we like to be called. This makes it nice and easy should I be transferred to hospital during labour and for any midwives handing over to know who we are and what to call us. I know it sounds obvious but it just makes it nice and straightforward.
    3. Try and keep it to one page. Think of it as an overview for the birth. Mine is two pages because I have one for a VBAC and another for a planned c-section should it get to that stage. I have laid it all out in sections from staying at home, first stage of labour, transition to hospital, second stage of labour, the placenta and my newborn preferences. These are headings you might want to consider.
    4. If you’re a planner, like me, you might want to consider writing everything down in list form and then condensing down. My birth plan was originally eight pages long and went into a lot of detail which I’ve managed to hammer out after writing letters to my consultant and talking through with my doula. I now feel like my notes and my birth plan represent exactly the type of experience I want.
    5. If you prefer visual birth planning I strongly recommend the Positive Birth Book which will direct you to free images to use to create a visual birth plan. Or you can get really creative and draw your own visual birth plan if that helps! It should be an experience that makes you feel good and prepared.
    6. Make time to talk through your birth plan with your health care team when you approach the third trimester.

    Writing a Birth Plan for every pregnancy #birth #birthstory #birthplan #positivebirth #positivebirthplan #writingabirthplan #pregnancy #thirdtrimester

    For more pregnancy content please head to my hub post which contains links to all my relevant pregnancy based blog posts. My second High Bmi Pregnancy.