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Bells

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Friday, March 3rd 2006, 1:00pm

***Birth Plans***

Bagpuss mentioned in another thread that she needs to think about her birth plan and 'my goodness', so many of you are pregnant now!!! ..... so I thought we could have a thread dedicated to birthplans.

Your birthplan should cover everything that you want during labour, delivery and the immediate hours after birth. It's important to remember that you may be rushed into hospital with fast contractions and may be unable to hold a conversation with a midwife, also you may have midwives that you've never met before.

It's also important to remember that your midwife may not have time to read your birthplan if things happen quickly or if she comes onto shift while you're in th elatter stages of labour and although hopefully your wishes will be passed on during handover it's not always the case.

Your birthplan should therefore be to the point, easy to read and state clearly what you do and don't want.


For example.....

Do you wish to remain active during labour? Do you want to use a ball, pool, baths etc?

Do you want vaginal examinations to tell you how far along you are or would you prefer not to know?

Are you opposed to intervention, do you feel strongly about medicalisation of childbirth?

Do you want gas & air, pethadine and an epidural or are you dead against it. Do you want it offered to you or would you prefer that they make no mention of it and wait until you ask?

Do you want the baby delivered into your arms/onto your tummy or do you want baby cleaning up and wrapping?

Do you want syntometrine to deliver the placenta or would you prefer a physiological 3rd stage?

Do you want Dad to cut the cord?

Do you want to breastfeed? Do you feel strongly that no-one should give your baby a 'supplementary' formula feed?


.............. While it may seem clear to you what you want you must remember that some women are perfectly happy to go into hospital and lie on a bed while midwives and doctors administer drugs and give orders, (which is the easiest way to be as hospital is absolutely geared up for this type of person).... some women like the complete opposite and would feel angry at being treated as such. You have the chance to let them know how strongly you feel about the issue in your birthplan.

Maybe some of you guys could post your birthplans as examples.

(Lucky for you I can't find my birthplan to bore you with, I think it's on DD's computer :D )

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Friday, March 3rd 2006, 1:44pm

Thanks for this Bells. There are some things on there I hadn't thought about!! And here's me thinking I'm organised!!!!!!!! :D

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Friday, March 3rd 2006, 1:59pm

Oh Bells, my midwife is going to be very cross with you, I'm going to see her onTuesday for the first time and I'm going to be there for HOURS because of all the questions I've now got to ask her!
The only thing I'm certain of is that I don't want some junior anaesthetist who's been awake for 50 hours doing an epidural. So if it's 3am and they haven't got someone who's at least a registrar, I'll do without thank you very much.

Bells

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Friday, March 3rd 2006, 2:16pm

Lol.... that's what they're paid for :D Write down a list of questions so that you don't get sidetracked, after all, if you forget to ask something you'll be kicking yourself until your next appointment.

I know that birth plans can't always be followed and sometimes go straight out of the window if circumstances change but if every single thing changes from your original wishes and only one little thing happens because you wrote it down (like having Dad cut the cord) then it's worth it.

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Friday, March 3rd 2006, 2:27pm

After years of planning, nephews and niece arrivals I've already made up my mind!!

I want lots of pain relief, and the option of
Want the baby cleaning before handing to me
Will try breastfeeding and see how it goes
Would be nice for dad to cut the cord

secrets

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Friday, March 3rd 2006, 2:40pm

Perfect plan Jenny - sounds like how mine ended up....apart from the cord cutting as it was wrapped around DS neck twice.
xx

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Friday, March 3rd 2006, 2:41pm

Think my DH would have a fit if he had to cut the cord. 8o Not really his cup of tea... In fact he's not even allowed near the business end for fear of sarcastic comments (where I'd have to kill him! 8o), fainting or never coming near me again!! :D. Not really his thing but its all fine with me.

I'm really really determined to breast feed so will be trying & doing that unless something major happens. Not really sure about cleaned / or not baby just yet. ?(

As far as pain meds I'm going to try to cope myself as long as possible (prob about oooohhhh 10 mins!!) and then see how it goes. Would really like to avoid an epidural but have a feeling I'll definitely change my mind on the day. ;)

This post has been edited 1 times, last edit by "Tigger" (Mar 3rd 2006, 2:42pm)


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Friday, March 3rd 2006, 2:44pm

That's true - will have to see how we feel at the time, might be too engrossed/flat out on the floor/stunned to 'go down there' (and you're right, it might pose too many comments!!)

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Friday, March 3rd 2006, 2:51pm

Mine was completely disregarded!! I'm not complaining as it all turned out ok 8)

I had planned to just have gas and air, pethidine if it really got too much, and to stay mobile. I ended up having an epidural due to back labour and generally being exhausted! I'd been in since the monday afternoon, and didn't go into established labour until late tuesday night as they left too bigger gap between drugs.

Lauren was supposed to cleaned, but I started bleeding heavily after the birth so she was just plonked on my chest.. she wasn't cleaned actually until thursday! DP was supposed to cut the cord, but chickened out!!

But what really mattered is that I still felt in control of the situation and I had a lovely midwife (from tuesday night anyway, after another nasty one had gone home!!)

xxx

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Friday, March 3rd 2006, 2:52pm

Oh and don't look down!! Not a horrid sight, just a little weird!!

xxx

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Friday, March 3rd 2006, 2:56pm

I can only imagine!!

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Friday, March 3rd 2006, 3:40pm

I put a brief outline of mine on one of the other threads, but basically..

Gas and Air, but pethidine if really, really REALLY necessary. I definately don't want an epidural.

Waterbirth (hopefully), or at east very active.

Rhiannon born onto my tummy.

DH to cut cord.

When she has been cleaned up, I want her passing to her dad not me.

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Friday, March 3rd 2006, 4:29pm

Ok me-

Homebirth

waterpool possibly (Bec that website you posted was really a reasonable price thankyou!)

Gas and air

I don't really want to be examined unless they really have to and don't want my waters broken!

So don't want alot then!

manged to get an appointment with my MW on the 17th (double appointment) to tlak about my birth plan.

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Friday, March 3rd 2006, 5:16pm

DRUGS, DRUGS, DRUGS!!! thats what you need gals
xxxx

Bells

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Friday, March 3rd 2006, 5:41pm

Quoted

Originally posted by secrets
DRUGS, DRUGS, DRUGS!!! thats what you need gals
xxxx


No no nooooo!!!! ;(

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Friday, March 3rd 2006, 5:51pm

Bells do you have any advice or opinions on episiotomy or tearing naturally? It's one of the things I'm not sure about ?( & there doesn't really seem to be much advice in the books 8o

I would like a water birth (active as possible before hand) with gas & air but not ruling out any other form of pain relief. I'd like baby to be put on my tummy before being cleaned but not sure about DH cutting the cord (will have to discuss that one!) & breast feed straight away if possible.

I def DON'T want to have my waters broken or be induced if it can be avoided. I don't mind being examined as needed but would prefer not to be lying on a bed to be monitored every few minutes.

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Friday, March 3rd 2006, 6:23pm

Quoted

Originally posted by Bagpuss
Bells do you have any advice or opinions on episiotomy or tearing naturally? It's one of the things I'm not sure about ?( & there doesn't really seem to be much advice in the books 8o


Episiotomies are usually done as a last resort. When the baby's head is being born the skin between the anus and the vagina (perineum) gets stretched to its limit. Sometimes the pressure of the baby's head is too much and the skin can begin to tear in the middle of the perineum, this looks like a buttonhole appearing. If this happens the tear may go towards the anus and so the choice is made to cut the skin at the vagina to stop the tear from going the 'wrong way'.

In other cases it is the skin around the vagina that is too tight effectively 'stopping' the baby's head from being born, sometimes an episiotomy is needed to simply provide more room.

In both cases it's imperative that an episiotomy is performed as it is preferable to tearing for two reasons. 1) a cut is easier to control whereas a tear can go the wrong way or too far towards the anus. 2) It's easier to sew together the layers of muscle and skin when there has been a neat,clean cut.

If you find yourself in these circumstances then you wont have a say in it, it will be done and for good reason. But it's important to listen to your midwife and do as she says. While the widest part of the baby's head is being born it's essential that you do exactly as she says which will be to pant and NOT push. The skin needs time to stretch and any sudden pushes can lead to a tear.

There is some research to say that if a midwife touches your perineum then some of the elasticity is lost and the skin effectively 'tenses up', another reason for a 'hands off' approach to delivery.

If you tear then you may be given a choice about whether you want stitches. If you have a bad tear then it will require stitching as the muscle AND skin will need repairing. If you have a small tear you may be given the choice. An unstitched perineum heals better and more 'naturally' than a stitched perineum so if you remember to ask it might be worth questioning whether your tear can be left alone.


Tearing ISN'T as bad as it sounds, I know I know.... :D but there's so much going on down there and you do feel quite numb too.... it's really not 'that' bad. I didn't realise that I had aquired a small tear with my second at all until they asked me if I wanted stitching afterwards ?(

Quoted

I would like a water birth (active as possible before hand) with gas & air but not ruling out any other form of pain relief. I'd like baby to e put on my tummy before being cleaned but not sure about DH cutting the cord (will have to discuss that one!) & breast feed straight away if possible.

I def DON'T want to have my waters broken or be induced if it can be avoided. I don't mind being examined as needed but would prefer not to be lying on a bed to be monitored every few minutes.


Sounds lovely :))

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Friday, March 3rd 2006, 6:38pm

Thanks Bells - that's the bit I am most frightened about, the bit where the baby's head comes out. I think I might be able to cope with the muscular type of pain but the stinging pain in such an intimate place terrifies me. Its good to hear that its not THAT bad

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Friday, March 3rd 2006, 7:17pm

Some people describe it as a burning sensation and you will hear midwives saying "push past the burn", my (childless) midwife said that to me and I remember thinking "it's not burning ?(, it just feels like someone's parked a car in my pelvis! :D"

In some hospitals they pour warm water over your perineum while the head is crowning, this is supposed to alleviate the burning sensation.

As I said before, listening to your midwife is the best preventative measure there is. A very slow, calm and controlled delivery of the head is the perfect way to avoid having a bad tear.

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Saturday, March 4th 2006, 3:16am

I would recommend that you be open to suggestions, even at the last minute, even if they arent in your plan.

I REALLY didnt want a c-section, but ended up having one, and it was for the best given the circumstances.

I also didnt want an epidural but preferred general because I have a phobia about backs. In the end the anaethetist pleaded with me to have an epidural because (a) I had only eaten a few hours ago and (b) a general would have made the baby anaethetised as well. So I changed my mind, and I am glad I did.

I would also recommend reading up about ALL procedures - for me it was a huge shock to find out I would have to be catheterised for 24 hours afterwards just before the c-section - it was horrible anyway, but the worst was not knowing that I would have to have - it was sprung on me by surprise. Also finding out just as I entered the operating theatre that the hospital would not allow DH to be there with me was traumatic for both of us. I was determined I wasnt going to have a c-section so much so that I didnt read up about it. I wish I had now.

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Saturday, March 4th 2006, 7:53am

Thanks for the info re the perineum!! I would never have thought of that until it happened 8o!!

I forgot to put that I also want a hands of delivery if possible, that is as active as it possibly can be!!

Bells

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Saturday, March 4th 2006, 11:44am

I agree Sun, I found my first birthplan yesterday which said that I wasn't having any drugs and wanted to remain mobile. I ended up with every drug in the hospital, flat on my back and like you, had a catheter in which was a total surprise for me :(

When I wrote that birthplan I was young and a first time Mum, I had read that it was good to have an active labour and that drugs were bad but I didn't actually understand why. I had been drip fed information from magazines and parentcraft classes but had no idea why these things were 'good' or 'bad', just that it was best if you walked about and didn't have an epidural. After spending a few years researching the practices and proceedures I finally felt that I understood why these things were best and it was this understanding that reinforced my decisions so that they weren't based on what other people suggested but based on what I knew, believed and understood.

My second birthplan was a much more accurate representation of what I wanted and it was clear that it wasn't a list of suggestions or preferences, more of an instruction manual with very definate do's and don'ts which were to be followed to the letter.

*rambling now (or rampling :D )* While I was completely open to being rushed into hospital for a section if the need arose, it was very important to me that IF things went as planned, they should be on my terms. I required the midwives expertise to deliver my baby and to ensure that we were safe but it was my house, my body, my baby and my birth.

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Sunday, March 5th 2006, 5:23pm

I would like to try to do it without epidural or caesarean. Not cos I am into the natural thing or anything, just cos it would be nice to do it on your own.

However, I am a big fat wimp. Everything hurts me, my body is so sensitive to all pain in every possible way.

I aim to use a TENS machine as much as possible and gas and air in hospital, then just see how it all goes really, I want to stand to help baby come down for as long as poss too as this can help a quicker birth. But I am open to whatever is suggested that I need really, I will listen to my body and to the midwife.

I DO NOT want to tear or be cut and I would rather not have forceps and ventouse used. But, who knows what will happen.

I am open minded really, and what will be will be.

I am not sure about having baby delivered onto my tummy, I am squeamish and hate the sight of blood and gooey stuff, but as its my baby I probably wont bat an eyelid. DH will defo be cutting the cord and re the placenta, I want it out asap. So whatever they have to do to get it out is what I will go for. I will just want to get on with healing down below and spending time with my new baby.

This post has been edited 1 times, last edit by "LadyLuck" (Mar 5th 2006, 5:26pm)


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Monday, March 6th 2006, 11:38am

Quoted

Originally posted by Vickimarie
I am not sure about having baby delivered onto my tummy, I am squeamish and hate the sight of blood and gooey stuff, but as its my baby I probably wont bat an eyelid.


After all you've been through delivering her, you won't even notice the goo, let alone mind it. :D The overwhelming emotion of meeting the baby is likely to make you want to meet her as soon as possible rather than not see or touch her for a minute while they clean her.

Just a quick point about active births. I'm all for it (as you know I'm into exercise in a big way) and put it in my birth plan with my DS. However, your body can react to labour in a way you can't foresee. My legs were trembling and I was weak all over because of the effort of coping with the contractions, so although I had vowed to walk around throughout, I simply couldn't. However, I had insisted in my birth plan that lying down was NOT an option, and the halfway house I had was to sit on a gym ball for the entire time (apart from about 5 internal exams) which meant I was upright which was good for the baby's position. I could roll the ball (by wriggling while sitting) around during the contractions which helped the muscles cope. However, come the time of the birth when it was time to push, I felt I had to stand, and gave birth standing up. The midwife was fantastic and was crouched on the floor as a result. She caught the head and enlisted my DH to catch his bottom!

I can't say if I'll feel like being in those positions this time, but my birth plan will give the outline of wanting to be active and NOT wanting to lie down, but we'll work round how things feel at the time.

My choice seems to be the opposite of some - I wanted no pain medications at all, and that's what I got. No pain medication. It was ridiculously painful, but I was glad to feel that I was in control of my body (even though I probably wasn't). If I would have to suffer pain that bad when ill, I wouldn't be able to tolerate it, because the pain is telling you that something is wrong with your body. This is one of the few occasions in your life where pain is positive - your body is doing something amazing to allow a baby to come into the world. There's nothing wrong with you, and it's only going to last for a (relatively) short length of time, so you may find you can put up with it more than you thought you could. I think I managed better than I thought because I had been preparing myself for some weeks that the pain would not be because anything was wrong.

Bells - I'm rambling too just to keep you company! 8)

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Monday, March 6th 2006, 12:03pm

:D Perhaps we should start a support group... 'ramblers annonymous!"

I too stated that I wanted an active birth but found that standing and walking made my contractions unbelievably more painful so I spent the first part of labour on my ball and the second part straddling a kitchen chair ?( NOT what I had anticipated. I also found that having to lie down for examinations was absolute torture, I couldn't get up fast enough! I pushed while kneeling but was flipped over onto my back at the last minute by the midwives to give baby a bit more room.


Very strange and quite different to how I imagined but goes to show that you can't plan these things you just have to do what your body is telling you.

Pacing corridors may work for some women but not for me, too painful... which makes you think as lots of midwives send Mums out to walk around during their contractions, no wonder those Mums say it's too painfull! My ball, chair, kneeling and leaning were all great for me but a trip upstairs to the loo was a killer.

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Monday, March 6th 2006, 8:16pm

Can I just say I went to the hospital today to be checked over as I'd fallen down the stairs (I've had a terrible couple of days ;() I was really reassured because the M/W read my birth plan and said how clear and easy to understand it was. She said that it totally fitted in with the ethos of the ward and was very sensible and realistic. (I had put down amongst other things that I wanted minimal intervention, water birth, allowed to use my CD, bring in floor cushions etc but to have epidural if can't cope with gas and air!!!). Felt like I'd got an A in my homework - but it was so nice to feel like I am on the same wave length as them.

I keep thinking I should start massaging my perinium but I can't be bothered! Does anyone else know if it really works in helping to avoid episiotomies/tears?

PS Also from the monitor I am having very strong braxton hicks apparently 8o - which I mostly didn't feel, as I left they said they expect to see me back in the next day or two!

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Monday, March 6th 2006, 8:23pm

Well done on your A! Ohh not long now :)

I am trying to be realistic regards labour I think it's because i have no idea at all what to expect so I can only go by what my MW tells me, still want the homebirth though someone said I was very brave the other day which put the wind up me! And my DH and my dad decided the birthing pool wasn't a good idea 8o 8o I over heard them discusing it yesterday...ummmm think I will ignore what they think is right or wrong - Dh has never seen a delivery and my dads last experience was 30 years ago next week (I am old!!)

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Monday, March 6th 2006, 9:02pm

Thanks LOL!
don't listen to them - I'd love a homebirth. LOL re: your dad - my dad was sympathising with me re: how uncomfortable I am and I could hear my mum in the background shouting 'how the bl**dy hell would you know what it feels like?!" (she never swears usually!) I'd ask them if they were off the birthing pool idea because they were scared they didn't have the DIY skills to errect it? (My DH would never be able to resist that challenge!)

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Tuesday, March 7th 2006, 8:03am

Quoted

Originally posted by Chilli
Well done on your A! Ohh not long now :)

still want the homebirth though someone said I was very brave the other day which put the wind up me! And my DH and my dad decided the birthing pool wasn't a good idea 8o 8o I over heard them discusing it yesterday...ummmm think I will ignore what they think is right or wrong - Dh has never seen a delivery and my dads last experience was 30 years ago next week (I am old!!)


I've had people say oh aren't you brave about the homebirth thing (in fact it just happened three times in a row right after writing that from the cleaning staff here!). I know that I've never expereinced it before but to tell you the truth I'm just not interested in that kind of comment, its so unproductive. If all goes well and I ever have a second pregnancy and someone says oh aren't you brave to me I'll say I think their brave going into hospital and see how they like it. Alternatively if it all goes tits up I'll keep my trap shut LOL!

REgards your dad. Mine said he htought I was wrong to want a homebirth as the hospital was safest. I told him he wasn't allowed an opinion. Besides his last expereince of childbirth was 30 years ago AND he didn't even attend so has no clue whatsoever. My sis has tried to scare me off but now seems to have given up. I hope it does go ok. Its not a competition after all and in the end if going into hospital is the right thing at the time then thats what i will do. It woul dbe so nice to be able to curl up in my own bed with my husband and our new baby on the same day though!

DH is 100% behind me and oddly enough so is my brother in law who has become the biggest softy towards me since I got pregnant. Must be strange for him actually as he is about 10 years older than me and has known me since I was about 9.

This post has been edited 1 times, last edit by "Rivka" (Mar 7th 2006, 8:21am)


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Tuesday, March 7th 2006, 9:12am

excately Bec we can go into hospital if needs be. I know my dad is NOT happy about me having a home birth but as my mum said to him it is my choice, my baby, my pg, my labour and DH is 100% behind me as is my mum. My MW is more than happy and the MWs in the labour ward all said "wonderful, if you have a good pg there is no reason not to be at home good for you!" Which made me feel really confident about it, like Geoge said in another post re her birth plan "I felt like I had been given an A!"

But again I am not against going to hospital if either myself or my baby are at risk, I can be quite earth motherish at times (piscean!!) but if I was advised to go to hospital I would without a doubt be up and out that door!

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Tuesday, March 7th 2006, 9:15am

I think the words 'Birth Plan' is an oxymoron, LOL

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Tuesday, March 7th 2006, 9:27am

lol - how about "birthing wishes"?!

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Tuesday, March 7th 2006, 9:27am

mmmmm that would be more like it lol

Bells

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Tuesday, March 7th 2006, 11:16am

Geogie, this is no time to be chucking yourself down the stairs!!!! :D Glad you're ok, how long do we have left.... umm... 4 days? Well come on woman, hurry up!!! or as the usual comment is "have you not had it yet???" :D



Chilli and Bec, my hubby was really against a homebirth, he only came around at about 38 weeks after listening to me drone on about it for a couple of hours every day.... but he still had reservations. My Dad was mortified about it until he got a lecture from my sister on just exactly how safe it is. My Dad's a bit pig headed in the way that he believes what he believes and he's always right :rolleyes: By the time she had finished telling him about hospital and home births he was absolutely aghast at the thought of me going into hospital. Such is the evidence to support the safety of a home birth compared to a hospital birth. It was the graphic explanations of needle happy doctors, drugs galore, strangers rooting about inside me, lack of care, lack of midwives, dirty wards etc.

That's not intended to put anyone off going into hospital, if you feel safer then a hospital birth is great, psychologically I feel safer at home so it worked for me the opposite way. Imagine of you wanted to go to hospital but were forced to stay at home against your wishes, that's how I feel about going to hospital.

I had and still have people saying "homebirth? You're brave!!!!" I always answer that actually I think they're far braver going into hospital. I base my opinions on my own personal experience of having one hospital birth and one home birth... and for me I feel quite confident in stating that anyone who chooses to have a baby in hospital is a much braver person than me.


Edited to add: I always thought that I would 'end up' in hospital due to complications, I was open to this as I would be going for a reason. I was still convinced that I would end up in hospital when the midwife brought in the weighing scales from her car and put them against the radiator to warm. I was totally shocked that she 'believed' that I would be delivering at home. An hour later I had a baby in my arms. Keeping an open mind is the key to a succesful homebirth. The important part for me was being able to labour at home for as long as possible

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Tuesday, March 7th 2006, 12:04pm

Quoted

Originally posted by Bells
My Dad was mortified about it until he got a lecture from my sister on just exactly how safe it is. My Dad's a bit pig headed in the way that he believes what he believes and he's always right :rolleyes:


Sounds like my dad!! :D he never says it to me but my mum gets it in the ear!

Too be honest I have got it in my head I will end up in hospital but want to be at home for aslong as i can, blimey i still can't believe I am actually having a baby let alone delivering one!!!!!!!!!!!!!!!!!!!!

My DH is very laid back and just goes along with whatever - don't know if that is considered lazy or under the thumb i prefer to call it - WELL TRAINED myself. He is very "whatever you think is best" as if I have done this all before and am the expert he forgets it's both our first time! anything for an easy life - why he married me I have no idea LOL!

mrsjasper

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Tuesday, March 7th 2006, 7:01pm

I saw the midwife for the first time today. We didn't get as far as birthing plans but she said if I want a home birth she will support me, unless she's in the boozer! This is a woman I can get on with. Also she had a student midwife who wants me as a case study, this means she will be at the scans and also at the delivery (unless it's at 2am), which is quite nice, someone else to swear at!

Bells

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Tuesday, March 7th 2006, 7:19pm

Mrs Jasper, when my sister was training she had to do case studies on ladies and absolutely LOVED it. She would go to their scans and chat on the phone, when the birth was imminent she was always ready for the phone call.

She had spent loads of time with her ladies during pregnancy and was thrilled to be able to be there at the births of their babies. It always ended in hugs and tears of emotion as she was so involved with the families. Your student will always remember you too, especially if you manage a homebirth as it will probably be her first one and her friends at uni will be SOOOOOO jealous :D

I had a student with while I laboured with my first baby, she had gone off shift before the birth and so came up to see me the following day. When she saw my baby she burst into tears :D :D Snivelling she said "I'm so sorry, she's so perfect!!!" :D :D

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Tuesday, March 7th 2006, 7:34pm

When I was a student I saw a birth. It was amazing. I cried. The baby was a little girl called Jessica. It was about about 10 years ago now. It would be lovely to give someone else that opportunity.

I am now really keen on a home birth. I love the idea of being in control. I've printed a load of stuff off the NCT website and I'm going to do a bit of reading and see what I can find. I don't mind if I can't have the baby at home but I'm going to bloomin' well try!




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