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  1. #1
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    Default 'Natural' birth - communicating in your birth plan

    Hoping for some opinions/advice on how to communicate in my birth plan that I want to avoid epidural and pain medication where possible.

    I find myself getting very annoyed at some people's responses to my desire to go without an epidural and other pain medications during labour. I have done so much reading up and feel it's the best option for me but every time I mention that to someone who asks, they smirk and say 'just see how you go when you're actually in labour because you'll probably change your mind'. They seem to assume that I am underestimating labour, which is not the case. I just believe that it can be done without drugs and that it will likely be very very painful but that I can get through it with the right preparation. Another comment I get is that you can't truly prepare for labour, which I strongly disagree with. I'm not saying I can do anything to make it a breeze, but there are proven techniques to help get through it.

    My OB said that although it's good to be flexible on my birth plan because things don't always go the way you want, it's important to communicate my wishes while in a sound frame of mind because you don't really want to be making these decisions in the peak of labour. Basically, I don't like the idea of putting it in my birth plan with a disclaimer as such, like 'unless I ask for it' or 'unless labour is slow in progressing'. Everyone says you kind of forget the pain once it's all over and some of my friends who put on their birth plan that they wanted to avoid epidural but ended up opting for one and were told it was too late, were actually glad it worked out that way and they think it was actually deliberate delaying from the midwife because of their birth plan wishes.

    I cannot stand when someone says 'don't be a hero' because that implies those who choose pain medication are weak. I'm trying really hard not to pay attention to people's responses as if I'm naive and like they're waiting for me to come out of labour saying 'ok you were right I needed an epidural'. I have no shame in getting one, but I'm feeling a bit confused if I should just commit to no drugs or if I should prepare for any exceptions and how to communicate this clearly.

    Thanks!

  2. #2
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    I personally don't believe in a birth plan, so didn't write one with my daughter

    But I would say, it's not like your birth plan is legally binding, so put in there exactly what you want, and don't think about the other comments like 'unless things stall', 'unless I need it' etc. if at the time of labour, you decide you need something, you can ask for it then, but at least your initial wishes are known

    If you are planning any kind of hypnobirthing or calm birth courses, the person running the course should be able to help with birth plan preparation

  3. #3
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    When I was in labour with DD as soon as I arrived the midwife said if you want an epidural you'd better organize it now because the anaesthetist goes home at midnight (was 11.30pm). Of course I panicked & said give me the epidural! All was fine & DD was born 2 hours later with no major issues (although the epidural was patchy & didn't give me complete pain relief).
    This time around my instructions are for staff not to mention pain relief - I will ask for it when/if I want it. If it's too late then too bad.
    There's no harm in having a birth plan with clear instructions for pain relief, but I also strongly believe that a lot of plans go out the window when you're actually experiencing labour so be prepared to be flexible.

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    I was aiming for a drug free labour & did so 3 times. I like to call it my birth preferences, rather than birth plan, because I thinkit's important to remember we cant always plan it. That being said, my birth preferences were simple and to the point -

    - Preference for water for pain relef: 1. Bath or 2. Shower if bath isn't possible
    - Don't offer epidural, peth or gas, I will ask for it if I need, but would prefer to try other methods of pain relief first.

    This is very direct, there's no 'unless', & they know not to offer, only for you to have the option to ask. IME, midwives are extremely more than happy to help you find other ways of pain relief if needed, such as offering the fit ball, changing positions,water, etc. I havent had one who is 'drug happy' yet.

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    WaitRose  (30-09-2016)

  6. #5
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    I had in my plan that I didn't want them to even mention the word "epidural" and that I would ask if I needed. I have a needle phobia, and the idea of them suggesting it made me anxious. The midwife offered it to me 3 times. And almost made me lose the plot. I was in transition and couldn't tell her to shut up. If you do your wording as @cheeeeesecake has suggested, make sure your support people are aware of how strongly you feel, so that they can tell them to be quiet if they look like they are going to offer. My DH told her off after the 3rd time, and asked to speak to the anaesthetist for alternatives, just to get her to be quiet.

  7. #6
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    I wanted a drug free natural birth with both my children. The first ended up with an emergency c section (after 20+ hours of labor), the second birth was a drug free VBAC.

    I didn't have a birth plan with my first - although I had let my DH know I wanted to avoid drugs etc and I was in a birth centre so they were very supportive of my decision (I tried for a water birth). My baby had other plans, and it took me a long time to get over the whole experience as I saw it as a failure (it wasn't of course, that's just how I felt).

    With my 2nd I had learned a lot from my first experience and TBH I think it crucial to have some kind of written birth 'preferences' (better to call it preference rather than plan, because afterall it's your preference - what happens on the day is largely out of your control). This may also help to alleviate some of the negative comments you're getting - by saying 'it's my preference to have a natural birth, and please do not offer me pain relief' etc.

    My OB was very supportive and suggested the only reason she would suggest an epidural to a woman that requested no drugs was as a last ditch effort to avoid a c-section (ie if things turned ugly). I was happy with that - avoiding a c-section was absolutely my #1 preference!

    Because I had a very clear 'birth preferences' (which should also include a page on 'my preferences in the event of an emergency c-section' - just in case), I was never asked once whether I wanted any pain relief by the midwives or OB or my DH. They all respected my wishes and worked together to give me every chance of having the birth I wanted (and thankfully I got my drug free VBAC). I was thanked by a midwife for having such a great birth plan - they like it, it saves them having to interrupt you and ask questions.

    I think it's also important to express how you plan to deal with labor. For example, you might plan to manage the pain through use of hypnobirthing techniques, use of the shower/bath if available, use different positioning to help maintain an active labor, etc. Do your homework and familiarise yourself with different ways of managing the pain (or 'pressure' as you may prefer to call it). If you have your preferences listed, it's much easier for the midwives to work with you and offer appropriate support on the day. Because you will most likely not be in a headspace to communicate effectively!

    For this reason also ensure your support person (your DH/DP or other) is 100% understanding of your preferences and ready to be your voice on the day. I even went as far as to write my DH a list of 'what to say' and 'what not to say to me' - sounds ridiculous but he was so appreciative and it worked wonderfully! (I did this after he said the 'wrong thing' during my first labor. Partners can really struggle to know what to say or do).

    Best of luck. A drug free birth is totally possible (unless an emergency arises), but I do think it's crucial to prepare.

  8. #7
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    Quote Originally Posted by cheeeeesecake View Post
    I was aiming for a drug free labour & did so 3 times. I like to call it my birth preferences, rather than birth plan, because I thinkit's important to remember we cant always plan it. That being said, my birth preferences were simple and to the point -

    - Preference for water for pain relef: 1. Bath or 2. Shower if bath isn't possible
    - Don't offer epidural, peth or gas, I will ask for it if I need, but would prefer to try other methods of pain relief first.

    This is very direct, there's no 'unless', & they know not to offer, only for you to have the option to ask. IME, midwives are extremely more than happy to help you find other ways of pain relief if needed, such as offering the fit ball, changing positions,water, etc. I havent had one who is 'drug happy' yet.
    I would suggest this, and just making sure your birth support (DH? doula?) knows how strongly you feel and will object on your behalf if you are distracted.

  9. #8
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    I didn't have a birth plan as such but my hospital asked about my preferences when I had my pre admission interview. I just told them that I wanted to see how things went, I'd like to keep things as low intervention as possible but wasn't ruling anything out. They noted it on my paperwork so it was in my file.

    I ended up being induced and while I went in armed with a TENS machine and tried gas, neither were enough for me and I ended up getting an epi/spinal block. It was absolutely the best decision for me and the instant relief from the spinal was what I needed at that time. Having said that, if I went into labour by myself rather than being induced, I may not have needed the epi. I couldn't move around, get in the shower etc because I had monitors and a drip attached to me so I couldn't actively do much to help with the pain apart from breathing.

    I think just tell the hospital you would like to try with as little pain relief as possible, but will ask for it if/when you feel you need it. I don't think there's a need to write a big plan, because you can't plan for everything that might happen anyway. Just keep it to a few bullet points of your preferences then see how you go when the time comes. Good luck

  10. #9
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    I didn't have a birth plan eithèr time. I suggest talking to your care provider about what you want.

    First time I had gas/morphine. Second time I went through the midwife group practice and had a great relationship with my MW. I went on to have a drug free, intervention free water birth.

  11. #10
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    I agree with others sentiments. Have birth preferences rather than a plan.
    Births without pain relief are absolutely possible. My first 3 births had no pain relief (2 were induced). My 4th I had a bit of gas during transition (also induced). I said to the midwife I was rely struggling and she said "do you want to try the gas?" And so I did. She knew I wanted to go with no pain relief again but that I was open and accepting. I think biting on it and concentrating on the bubbly sound is what helped more than the gas tbh.

    I think the most important thing to do is tell your birth partner (husband, mum, best friend, whoever) what your wishes are and have them be your voice when you are in the throws of labour.


 

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