Birth choices and birth plan

When I was working in India in a topmost research organisation, we had a fun day debating about the growth of technology. We, the scientists, were given a topic to talk for and against “the technology development”. Head of our computer section talked against the technology development. “gyara number ki gaadi thi, mein bada kush tha” (hindi) was his catchy line. He meant that when he had to walk to his school, he was stress free and happy but his troubles and worries only increased as he moved on to cycle, scooter, bike and then to car then.

I agree choices are good,  but sometimes they just confuse us. I love choices. I love getting confused. I love selecting the one I want. It makes me feel good about my decision making skills and about my freedom to choose what I WANT to choose. I do not like to go with what every one does method. I have to know everything about what I am choosing. If anything goes wrong I know it was all my fault. It was my choice. I am fine with that.

Birth Choices:

1. Home birth
Some people prefer to have home birth as it gives the feeling of comfort at a familiar surrounding.

What equipment do I need?
Very little – a few weeks before your due date, your midwife will bring round a “birth pack” containing all the bits and pieces she needs. All you may be asked to provide is an angle-poise lamp or desk lamp, which can be used to check your perineum (the muscular area between the vagina and the back passage) after the delivery, and perhaps a portable heater.

says the babycentre.co.uk site. Read more on home birth. And read on the considerations you have to think about before choosing this one.

2. At the hands of the specialists.

2.a) Birth Centres or Midwife-led maternity units

They offer a comfortable, low-tech environment where birth is treated as a “normal” process rather than a medical one 

You are unlikely to have the full range of pain relief on offer — you probably won’t be able to have an epidural, for example. There is also no special care baby unit on hand in the event of an emergency. However, midwives are generally skilled in life-support and resuscitation techniques and in managing emergency situations. You may not be able to have an assisted delivery with forceps or ventouse, although some birth centre midwives are now trained to use ventouse.

You also won’t be able to have a caesarean at a birth centre. If you do get into difficulties during labour, you will be transferred to hospital by ambulance with your midwife. Despite the lack of medical facilities, evidence shows that giving birth in a birth centre is just as safe for you and your baby as having your baby in hospital.

2.b) Consultant units

A consultant unit is usually part of a general hospital, staffed by obstetricians (specialists in birth where there are complications) and midwives (specialists in normal birth).

All sorts of facilities offered by that NHS trust are generally available at consultant units. (NHS trust and its policies, facilities and choices offered are different for different counties. For example, they had withdrawn antenatal classes in our county until last month. I was going to go private, but luckily they have reintroduced it. Saves me some money.)

2.c) Community units

Community units are another birth option for women who do not want a home birth but do not feel comfortable with a hospital environment, or live a long way from their nearest hospital. They tend to have a “home-from-home” atmosphere giving many of the benefits of home birth.

Because epidurals and Caesarean sections are not usually available at these units, they tend to be suitable for women expected to have a good chance of having a straightforward birth (“low-risk” women). This can include first-time mothers. In GP units, a GP specialising in birth is available for interventions such as forceps deliveries. In some community unit, a doctor may be available to carry out Caesarean operations in an emergency. 

Read more on birth units.

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See what type of birthing unit is available near you and there are (in the same site) some statistics about each unit available for the public to view.

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Birth Plan

1. Select your companion. Not always your husband is the best companion. I am still wondering whether to let Balan in or not. He has his rights as a father, but I want the situation to be comfortable for me. If I say something and if he doesn’t get it before even I open my mouth, it might irritate me. But at the same time, he is the best person I feel comfortable when I am in pain. So, I think he is going to be in.
Absolutely NO to my mother.

2. Positions for labour is another thing one has to read about and select. I haven’t thought a lot about it yet.

3. Pain relief:
One Indian woman acquaintance of mine claimed that she didn’t want any pain relief at all, as she wanted to be a perfect mother. Well, it is just the reason is absurd, but if one is willing to bear the pain, without pain relief is also an ok choice I guess. Some might think they are brave, but might change their mind halfway into labour, as the woman I have mentioned above did as well that she went for epidural when she realised that she couldn’t bear the pain.

There are a range of pain relief options available. Waterpool birth method is also one method of dealing with pain. Read more on how to use a birthing pool and on how to plan a waterbirth. There are some additional pain reliefs available and at the same time some of the pain reliefs such as epidural are not suitable to be coupled with water birth. Read more on that and on monitoring the baby in a birthing pool.

Pain relieving drugs:
Epidural seem to be a choice a lot of women are going for. I am all for the complete pain relief offered by epidural. But I do not like the following disadvantages.

• Epidurals can increase the length of labour, especially the pushing stage.

• There’s a greater chance of needing to have a forceps or ventouse delivery because epidurals often prevent the baby moving into the best position to be born. 

Read on the advantages and disadvantages of using epidural before deciding on to have it.

There are some reported after effects of spinal that I do not like.

SilentOne used TENS machine and pethadine. TENS seems to be alright.

Here are the advantages and disadvantages of use of pethadine. The disadvantages I do not like about pethadine are, it is spinal, and it may slow down the labour.

Read on all pain relieving methods and drugs before deciding.

4. Assisted delivery:
Forceps or Ventouse is used to assist the delivery if there is any problem or if the labour is too long or if the mother is too tired to push.. Read on the advantages and disadvantages of assisted delivery. Ventouse is popular than forceps these days, though the woman I have mentioned few paras above delivered her baby with the assistance of forceps. I do not want either of these.

5. Third stage of delivery, delivering the placenta:
I will go for managed third stage.

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Read on writing a birth plan down so that midwives and consultants can follow your instructions. BirthChoiceUK takes you through a check list to help you take decision.

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Info file on my choice /plan

Natural birth is fine too,  but I am little scared now. Antenatal classes will help me to understand it better and will take the fear off me, says my midwife. I strongly believe I will end up having emergency caesarean. I do not want epidural. I might end up having it, if I have to go for emergency caesarean. I do not know whether they can give me general anesthesia for emergency C, as they may not have enough time to do that. I am trying for elective Caesarean. I may not get it. I also prefer to have general anesthesia if I get elective C.
I have been under the knife before. I have had major surgery before. So, I know what I am getting myself into when I am asking for elective C. Yes, I agree there will be added issue of having to handle the child, breast feeding etc.. Don’t know what I am going to do.

TENS machine looks fine too me. I do not want ventouse or forceps. No pethadine or epidural. I might change my mind about the drugs.  

The hospital near to us has consultants as well, but it is mostly midwife led. It has all the facilities and is part of a general hospital. I have heard good reviews about this hospital from women who have delivered their babies there. Here is the statistics for caesarean delivery at our hospital. Elective C in the statistics does not mean just the C sect by choice, but also includes C sect indicated by the consultant when a complication was detected well before the beginning of natural labour.

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7 Comments (+add yours?)

  1. Vidya
    Nov 13, 2007 @ 18:23:35

    Hats off for your research Prema. I love the way your mind works on an issue. 🙂

    Reply

  2. Trackback: www.learnhypnosiseasily.info » Birth choices and birth plan
  3. Premalatha
    Nov 14, 2007 @ 19:58:23

    Thanks Vidya. Wealth of information is available and provided to all pregnant women. Also, many buy books and read. So, I am embarrassed to take the credit fully as many do more research than I do perhaps.

    Thanks anyway. 🙂

    Reply

  4. desigirl
    Nov 17, 2007 @ 11:24:13

    hmm, you know what they say about too much science??! chill, girl, you’ll be fine. just relax, take it easy.

    and yeah, i’d plump for roping Balan in – always good to have a strong male to latch on to when the pain hits. i almost fractured sundeep’s hand – or so he claims! and bully to position. who gives a shit as long as you get the job done. i tell ya, by then, u’d be ready to pop the baby out anyhow and not give a rat’s ass about the birth plan, position or whatever rubbish they throw at u.

    I had an assisted delivery – ventuose – as the brat’s head was (and still is!) massive. i kind of felt like a blocked drain. but they gave me an injection and i was flying high.

    Reply

  5. the mad momma
    Nov 19, 2007 @ 22:07:28

    hey Prema,
    I am sure you will be fine. Administered properly, the spinal doesnt do harm. that and you need to stay flat on your back for 24 hours and not disturb the fluid or something like that. fingers crossed that you will not need it. all the best. we’re all cheering from the sidelines… though err.. that doesnt make you feel any better i am sure!!! hang in there and you will be fine.

    Reply

  6. the mad momma
    Nov 19, 2007 @ 22:10:18

    btw.. i notice you have the bean’s birth story up.. here’s the brat’s in case you are interested http://themadmomma.blogspot.com/2006/06/let-record-state.html

    Reply

  7. Premalatha
    Nov 20, 2007 @ 14:52:48

    DG and MM,

    Thank you.

    Reply

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