Anyone else reference their birth plan?

[Celesse]

Currently writing my birth plan and adding a few references in.

Has anyone else referenced their birth plan?
Did you use full Harvard referencing for every fact you included, or take it that some things are given and only reference facts which may be lesser known or disputed?
Or did you just include links, web page references without "proper" references?

I don't want to come across as condescending to the consultant, but I also don't want to come across as unintelligent. My birth plan will be going against some "standard" care, but I understand the risks, have researched them to death and want to demonstrate this in writing.

 

[OurLilFlu]

As a nurse who has worked labour and delivery.. ill tell you that yes we read birth plans but tbh i think putting references might be laughable, making you 'that lady'... this is not my opinion but it is generally how some of those 'out there' birth plans are seen... I hope this doesn't come across the wrong way. I fully understand you want evidence to support yourself and want others to know its not just a shot in the dark request. On the other hand, not many nurses etc will have the time to look up an article or check out a website so your hard work might be a waste.

I'm not sure about how busy / open your consultant is to your choices but I would do your general birth plan without references and have a list of sources or main points separate that you can bring up in the discussion or give to him/her if there are certain topics you wanted more input on or to solidify why that is your preference...

May I ask which choices you feel might be debatable? Many of them are well supported in more natural streams but the resistance sits more on a personal practice level with some physicians... Stubbornness really

 

[Eleanor ace]

Is this a joke? I don't mean that in a rude way, I just don't want to reply seriously and look like an idiot if it is a tounge in cheek joke comment about some peoples attitudes to birth plans (I've seen it many times on here, in-depth birth plans are often ridiculed).
If you're serious, I would say that referenacing probably isn't necessary and might be counter productive as it would probably seem to the consultant that you are being a bit condescending (even though you are in fact only trying to be informative) which would probably make him less likely to be "on your side". I would have your research ready to hand over if he questions your decissions, and would think that referencing would only be necessary for those points which you know are likely to be disputed, as it is those he will be focusing on. I think when people reference every little thing it makes it seem as though they are just parroting other peoples ideas, following the train of thought from one journal/article/study to another without being able to determine which ideas are worth discussing and which are just well known facts.
I hope you get the birth that is right for you and your LO. I had to petition my consultant for the birth I felt was right for my LO and I last time and I went to my appointment prepared to fight hard but was pleasently suprised with my consultants support; fingers crossed you recieve the same!

 

[tristansmum]

I agree. I don't think putting in references is necessary. Is this a birth plan just for your consultant or are you taking it to the birth too? I think birth plans for the midwives are best to be kept straightforward and almost bullet points. Too much details and too long risk them not reading it all together. They are busy and can't be spending their time reading an essay when they need to be looking after you

 

[Celesse]

No not a joke.

By the time I reach the labour ward I'll have a bullet pointed non referenced version for the midwives that has been agree with the consultant, or senior midwife, or if not agreed they have in advance discussed the risks with me. But in advance of my consultant appointment, I want to have everything written down so she can see my wishes and the thinking behind it.

I had a previous c-section, then a VBAC, which was a forceps delivery and PPH. I'm planning on declining CTG, Canulla, VE's and having to option of labouring in water. So I need to be able to demonstrate I understand the risks that I am taking against medical advice. Chances are they are going to give me a load of facts and figures regarding VBAC's and why I need to be monitored so I need my counter argument prepared.

And if she isn't open to my birth plan I'm discharging myself from consultant led care.

 

[tristansmum]

No not a joke.

By the time I reach the labour ward I'll have a bullet pointed non referenced version for the midwives that has been agree with the consultant, or senior midwife, or if not agreed they have in advance discussed the risks with me. But in advance of my consultant appointment, I want to have everything written down so she can see my wishes and the thinking behind it.

I had a previous c-section, then a VBAC, which was a forceps delivery and PPH. I'm planning on declining CTG, Canulla, VE's and having to option of labouring in water. So I need to be able to demonstrate I understand the risks that I am taking against medical advice. Chances are they are going to give me a load of facts and figures regarding VBAC's and why I need to be monitored so I need my counter argument prepared.

And if she isn't open to my birth plan I'm discharging myself from consultant led care.

Good luck. I had a vbac too although I did have ctg and wanted ve lol. I hope you get a lovely experience this time x

 

[Rhi_Rhi1]

Wouldn't filling in the generic one from the nhs website be just as usefull ? I'm sure they wont really "care" what evidence you have for your answers and nor does it matter... If you put NO next to forceps delivery for example.. surely that is all you need to say on the matter. By that I mean, you don't need to explain yourself

Or if you would rather be cut then let tear etc ? Simple yes and no answers ?
because at the end of the day... you get what you get ? you can say "no I don't want" (which is fair enough) but if you need it in an emergency situ.. surely u will end up with it anyways ?

 

[Celesse]

It's not so much about explaining myself. I want it recorded that I understand the risks so I don't end up with midwives trying to have those discussions during labour. If I go in during labour and say I'm not having a CTG they are going to start with the explanations of why I need one. I want those discussions before labour, when its not going to slow down labour and when I have the capacity to offer informed consent.

 

[OurLilFlu]

The thing is celesse, if you're planning on signing off AMA on these things anyways, the nurses, midwife and consultant won't really care what your reasons are, nor will they battle with you over them at that appt. it's your right to refuse and as long as its on paper, they're in the free and clear. And surely they won't look up the articles etc to find flaws to argue about or something like that. It's like them coming to a Jehovah's Witness with a bunch of facts about blood products, he/she still won't believe in it or sign the consent. Yes the example a refusal based on religion, but all I'm saying is they can't make you believe their way is best and most won't waste their breath trying to convince you if they know you'll be signing off AMA.

Anyways, these are kind of standard things to refuse, but given your history/ case it does make them a bit more risky. and as long as youre aware of the risks and as long as their butts aren't on the line, aka you've signed that you're refusing xxx it doesn't matter if your reason is well supported or not, they are legally off the hook, which is really why those policies and protocols are in place. The risk of putting in an IV early is peanuts compared to the risk of not administering a medication or blood in an emergency... So in their minds, why not? Same with monitoring etc. plus it all serves as support in court if need be.

All this said, if it is an emergency or if there are indications that it may be beneficial for you to have these things don't be surprised if they mention it even if it is written explicitly or already signed off on... Ex. If through intermittent fetal heart auscultation they're hearing decels, I would expect they might want to hook you up to the monitor... If you're in the middle of another pph and don't have an IV, they'll probably bring it up... I hope you understand this, I know you want to be in a calm, organized state to make these decisions but in certain circumstances this is impossible. And I would hope that you would want to be offered xyz if the situation really called for it.

All in all I don't think your refusals are way 'out there' it's just your history that makes you a person they'd deffijitely would want to have extra monitoring, IV access etc just in case. Yes it will be against their policies and protocols but I wouldn't imagine the evidence behind your decision is much different than anyone else who doesn't want those interventions, yes maybe an extra study on vbacs or pph management etc but I imagine its nothing extraordinary... Ykwim? They still all impede the natural progress of labour, lead to more interventions etc...
Anyways I hope they are understanding and truly I hope you get the experience you want since it hasn't been that way in the past. But again, I hope you are informed enough to accept their offer in the moment if need be... You know it's serious when they want to reconsider something that's signed off AMA, yes they're not legally obliged to but they are there to keep you and babe safe...
Cheers!

 

[josephine3]

Out of interest what are VEs and CTG? Is ctg the continuous monitoring? I had a previous pph also and tbh i thought the idea of having a canula in place this time ready for meds so i dont black out again was a good one! Can i ask why ur against this? Also just to add i had a water birth and still had a 3rd degree tear it was an awful experience its not always all its cracked up to be!
Anyway in response to your question i do think it may be going a bit far, but i suppose it wouldnt hurt to take a copy of references with you, just not hand them out to everyone you give your birth plan to.

 

[proudparent88]

I printed a birth plan off of the internet and I am not adding anything extra other than if there is something not listed in the section I want. But I think they will get the idea if you just write out your basics that you want and then if they have questions explain your answers to them. I think it's easier to for your point to get across when asked questions about it anyway because they can see your emotion behind your reasoning.

 

[EmmaFTM]

I was able to speak to a senior midwife who explained all the facts and figures to me and I was able to show that I had done my research. She translated our conversation into a letter which is now in my notes and to be referred to by the midwives when I am in labour. This letter states the things I am happy to have e.g. cannula only in an emergency and shows that I am aware of the risks etc. Maybe you could also get in contact with a senior midwife who can do the same for you. It supports your birth plan and reinforces that you have done your research and taken the time to talk through your hopes and wishes with a professional. Xxx