Valerie Gommon Midwife’s Blog

Archive for the ‘birth plan’ Category

This is a guest blog, written by one of my clients.

My name is Donna and I am a mother of three.  Two year old Grace and nine week old fraternal twin girls Olivia and Faith.

My husband Paul and I had always agreed that we didn’t want a big age gap between our children so when Grace was one year old, we decided to begin trying for baby number two.  I fell pregnant fairly quickly but unfortunately suffered a miscarriage at 5 weeks which was very upsetting.  After a few weeks we were ready to try again and as before, I fell pregnant within a couple of months.

I was very anxious during the first few weeks hoping that this time I would hold onto the baby.  At 12 weeks it was time for the scan.  I was feeling quite relaxed as the pregnancy was going well and I was feeling extremely sick which I thought was a good sign.

The last thing on my mind was the fact that I could be carrying twins.  When the ultrasonographer casually told us ‘oh, you have two in there’, we knew that our lives were going to change forever.  I didn’t know whether to laugh or cry – so I did both!  Everyone in the room was so excited for us but my husband and I were just stunned.  His face was a picture.  They told me that the reason why I had felt so sick was due to the additional hormone racing round my body. They also told us that the twins were fraternal and each had their own placenta and were in their own sac which is the safest type of twin pregnancy.

The first feeling I had once I had calmed down was that of being pregnant for the first time.  My pregnancy suddenly went from having a singleton baby and feeling confident that I had done this before so it will be ok, to all the anxieties of a first time pregnancy.

I knew that I had to do my research so as I could make some informed decisions about my pregnancy and birth.  When I told the ultrasonographer that I was planning a home birth, her reaction was ‘oh, you won’t be able to do that with twins’.  I had a fantastic pregnancy with Grace and had her at home in a birthing pool.  The thought of having to follow a medical route and have my babies in hospital filled me with dread.

As with my first pregnancy, I chose to take on an independent midwife.  This was my preference as I knew I would be less likely to end up with a hospital birth.  I made sure I looked after myself by eating well, getting plenty of rest (as much as Grace would allow me!) and exercised regularly.  I found swimming was great for keeping me fit and taking the weight off my bump.  I had regular scans to check on the twins’ development and position.  Throughout the pregnancy, Olivia (first born) remained head down and Faith was breech.  I knew that this wasn’t ideal but also knew after doing some research that as long as Olivia remained head down and although a little more risky, I could still safely deliver Faith as breech.  At 38 weeks I went for my final scan and to my surprise, Faith had done a full turn and was now head down along with Olivia.  The perfect combination for birth.

We had put together a birth plan that covered every eventuality if I needed to be transferred to hospital at any stage.  Two days after my last scan; my waters broke at 9.30pm when I was lying in bed.  I felt a pop and then a head drop down.  I walked into the bathroom and called downstairs for Paul saying ‘I think my waters have broken!’  He chased upstairs and I told him to call the midwife.  My contractions started almost immediately after my waters broke.  I spoke to my midwife and she told me to go back to bed as things may not start to happen until the morning and I would need my rest.  Olivia was not going to wait until morning.  I came downstairs and stood in the bathroom leaning over the toilet with my contractions coming fast and furious.  I tried the TENS machine but that didn’t really work for me.  Paul was in the dining room putting together the birthing pool which I got into as soon as it was ready.  The relief was immense.  I had heard that water was the most effective pain relief next to an epidural – I can well believe that.

I had four midwives looking after me and the babies and they all arrived at my house in time.  It was all happening so quickly and Olivia was born in the pool at 11.55pm.  She shot out and I heard her crying straight away.  I stood up and held my baby; I was elated and also amazed that my babies would have their own birthdays.  One of my midwives held my stomach to make sure that Faith fell and engaged in the right position.  We knew she was head down so we needed to make sure she stayed that way.  We decided to wait for my labour to progress naturally however, it slowed down.  I got out of the pool to walk around and see if I could get it started again.  Four hours passed and a decision was made to break the waters around Faith as the midwife discovered they were still intact.  As soon as the waters were broken, Faith was born on the sofa, again extremely quickly.

She cried straight away and the midwife placed her on me so as I could give her a cuddle and have skin to skin contact.  Another of the midwives was looking after Olivia.  Both my babies were born healthy and I couldn’t have been happier than I was just then.

The down side was that I now had to deliver the placentae.  I was so tired but knew I had to keep going.  One of my midwives helped to keep me relaxed with hypnobirthing techniques and control my breathing.  The placentae had fused together and were not budging.  With a combination of experience from my midwives and a hot towel placed across my stomach, the placenta moved and came away.  If it hadn’t been for the determination and skill of the team of midwives, I think I would have ended up in hospital with a retained placenta and that would have been disappointing after going through the entire birth at home.

So all was well.  I was in good health and although extremely tired, felt elated and proud that I had accomplished the birth I wanted.  My husband Paul was fantastic during and after the birth and I couldn’t have asked for a more supportive birthing partner.

A home birth is not for everyone and if there had been a health issue with either myself or my babies, I would have chosen hospital care.

I wanted to share my story so as other women can see that you do have choices during pregnancy even when you are having twins and you can make decisions that are right for you.  For more information about twin and multiple pregnancies visit www.tamba.org.uk

Donna has also set up a website which offers information about homebirth; she offers a free ebook at www.happyhomebirth.com

I have just “appeared” on 3 Counties Radio to discuss a local news item.  A Sainsbury’s employee refused to sell local woman, Janet Lehain, unpasteuried cheddar because she was pregnant!

Whilst applauding the employee for pointing out the recommendation that pregnant women do not consume unpasteurised products I have to say that I believe they overstepped the mark by refusing to sell her the cheese!  The woman could have been buying the cheese for her husband and whatever happened to freedom of choice? 

I am a firm believer in Informed Choice, we are very cautious where pregnancy is concerned because although the risks are very low there could be serious implications for the baby SHOULD the mother contract food poisoning.

The Department of Health guidance in early pregnancy is to be extra careful with hygiene; food poisoning is bad news for your baby. They suggest that women don’t eat any unpasteurised foods – most food is pasteurised, but some speciality milks, cheeses/diary are not.

The recommendation is to avoid moulded or veined cheeses and pate/salami. Eggs should be well cooked not runny. Fruit and vegetables should be washed prior to eating. It is suggested that you don’t eat swordfish or marlin and limit the consumption of “oily” fish to twice weekly. Sea food should be cooked not raw. Liver is not recommended for pregnant women.

Whilst pregnant the current recommendation is not to drink alcohol at all, and it is better to limit the amount of caffeine you take (tea, coffee, cola and fizzy drinks), and obviously it would be wise to stop smoking and avoid any “recreational” drugs prior to getting pregnant.

We are still evaluating the evidence regarding eating peanuts in pregnancy – the best current advice is that if you have nut allergies in the family it may well be best to avoid eating nuts in pregnancy; it there are no nut allergies then use your own instinct and judgement as to whether you feel safe to eat nuts (bearing in mind they are a good source of protein, particularly if you are vegetarian or vegan).

Having made a huge list of foods to avoid, you are encouraged to eat plenty of fruit and vegetables (aim for at least five a day), plenty of protein (at every meal if you possibly can) and plenty of iron rich foods (red meat, pulses, green vegetables).

You can read articles I have written at:

www.birthindex.co.uk/Planningababy.pdf and www.birthindex.co.uk/SOYOUAREPREGNANT!.pdf or

https://midwifevalerie.wordpress.com/wp-admin/post.php?action=edit&post=59

https://midwifevalerie.wordpress.com/wp-admin/post.php?action=edit&post=64

A birth plan is optional – it enables you to devise your own personal plan of care if this is your wish, and can be helpful to health professionals in knowing your thoughts.

It is also an opportunity to make a decision about your care on the basis of informed choice.  By compiling a birth plan, it does not imply that you want a ‘natural’ or ‘alternative’ labour and a birth plan can be changed at any point, it is just an indication of your wishes.

Whether you decide to make a birth plan or not, your care should be discussed with you and no treatment or procedures performed without a full explanation and your consent.

The following are some suggestions of things you might like to include in your birth plan:

Who you want with you for the birth (e.g your partner, a friend or both)

Pain relief (you may be keen to manage without drugs or keen to have as pain free a labour as possible, do you plan a waterbirth)

Positions for labour and birth (you may wish to be able to move around during labour and encouraged to try different positions for the birth)

Monitoring of the baby’s heartbeat (e.g. using a hand-held sonicaid to monitor the baby intermittently or being monitored continuously)

Students (whether you are happy for students to participate in, or witness your birth)

After the birth (do you want pick up the baby yourself/be given the baby or do you want the baby wrapped, do you want to discover the baby’s sex yourself, would your partner (or you) like to cut the cord)

Management of the third stage or placenta (do you want a ‘natural’ third stage or to be given the drug syntometrine

Vitamin K (do you wish your baby to receive Vitamin K either by injection/orally/not at all)

A Birth Plan is just that – a plan, it can be deviated from according to your wishes at the time!


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