Top Tips on Writing Birth Preferences

Writing your birth preferences is important to do for a number of reasons:  
1. It gives you time and space to think about what you want for your birth
2. It opens communication between you and your birth support team
3. It helps you to familiarise yourself with hospital policies
4. You have time to compare policies with national guidelines, international guidelines and evidence based research.
5. It gives you a tool to remain in control and make informed decisions
 

Key points when writing your birth preferences

Woman taking notes.jpg

Keep your language open and positive. You have a chance to create the atmosphere you wish to birth in. Positivity is key and opens on a good relationship with your team.

Know your chosen hospitals policies. Each hospital has different policies around key factors in labour and birth. You are free to question these and even change hospital if you feel better suited to a different standard of care.

Know the HSE (national) and international guidelines / best practice / evidence. This is key. If you know what the evidence says then you can make an unbiased informed decision, rather than being swept along with a phrase such as “that’s the way we have always done it here”

Keep it to 10 points, or less. Anything more will negate the things that are important to you.

Don’t bother putting things in that are already policy in your chosen hospital (ie drinking water during labour) Again if you are familiar with your hospitals policies then you can avoid this.

Think about the atmosphere you want to birth in. Would you like the lights dimmed, music playing, limit the number of people in the room etc Or are you happy to have lights on, student midwives and doctors in the room etc?

Be firm on the points that are non negotiable for you once all is OK with baby (i.e. if you absolutely do not want an episotomy and would rather have a natural tear if it came to it). Some decisions need to be made in a split second and having discussions around the really important issues before hand are vital.

Create birth preferences for a Caesarean Birth preferences as well. This is a good idea for all the same reasons that are mentioned here. You can have the discussions, make informed decisions and then ‘park it’ to one side. You have your just in case covered, remaining in control. Then you can shift your focus back to the birth you visualise. It can be on the next page so your focus is not necessarily on this outcome if you are not planning to have an elective Caesarean, but it does mean that if things don't turn out as you had hoped you have something written up to help you create a dialogue with staff. 

Create your birth preferences with your birth partner. This is important as they will be your advocate for the day. Being aware of what you want and why will help them be a better advocate for you. 

Bring multiple copies so you have them for shift changes. Make sure your partner is aware they need to ask the team caring for you to read through them and discuss them with you both. 

Finally knowledge is power as they say - but trust in the process is also important. All the above are important and give you the knowledge to discover what you want for your birth. It gets the discussion out of the way before labour begins, as during labour it's important to park the conscious brain as much as you can. You body and your baby know what to do, they are an awesome team, made to work together. Let your advocate voice your preferences and allow yourself to go with your labour journey.

Here at Doulacare Ireland we will always helps our clients draw up their birth preferences after meeting with their birth doula for an antenatal visit. We listen to what is important for our clients and offer information on evidence based care that will enable them to be aware of what they might want to include in a birth preference sheet. We would always encourage clients to have some birth preferences to facilitate improved communication between clients and staff. 

Jen's Pregnancy Diary: Week 29

This week I had my first appointment in the Semi Private clinic. The midwife, Ann, was absolutely lovely. She saw I was a doula on my chart and was full of questions. She was so warm and showed genuine interest in my pregnancy. She mentioned there was protein in my urine but was not concerned as everything else was fine. She ran through my GTT and said I had absolutely no markers for gestational diabetes which was a relief. She did say my iron was a little low – but after 6 months of sickness I’m not too surprised. I said I would up my iron intake to build up stores. 

I met my doctor, Claire, who was a similar age to me I think. She was nice but very clinical. I mentioned all the Braxton Hicks (which had continued all through this week too – making me feel pretty drained). She popped me up on the bed and lo and behold baby has flipped again! She is now almost head down (slightly diagonal) in OP position (facing out). The doctor mentioned she would expect baby to be getting into position around now but they are not overly concerned until 34 weeks. 

While going through my chart she said my EDD was now 22nd of March and I nearly dropped off the chair. I said my date has been fip flopping from 30th, 31st march and 1st April but I have not heard 22nd march. She told me that at my 21 week scan the sonographer changed the date to match babies size. I had a long discussion with her about how my early scan is the most accurite. My babies size has nothing to do with how mature her lungs or brain function are. That her gestation is most important. I said from my first early scan and my dates my EDD should be 1st April. I told her both my boys went post dates (40+8 & 40+14) and I would really appreciate as much time as possible to avoid unnecessary intervention at the end of my pregnancy.  She was very helpful and went to speak to a senior consultant, who was happy to change me back to 1st of April. I was very relieved with this as it gives my body that bit more time at the end to go into labour undisturbed. 

Of course I was told all the usual hospital policies. It was mentioned that I would “not be allowed go past 41 weeks”, that I would be monitored very closely during labour and at the first sign of any issues I would be “straight to section”. I decided to just nod as I had one win for the day and didn’t particularly want to have written across my notes “this one is trouble”. So I left knowing I would need to have those conversations at a later date. 

Certificate of Attendance for my Training Day with Cuidiu 

Certificate of Attendance for my Training Day with Cuidiu 

I attended a weekend of training for Cuidiu Antenatal Teachers course. I haven’t been at tutorials for over 6 months as I have been so sick but I have 2 to attend in order to qualify. On the Sunday there was a Study day on Loss, Grief and Disappointment. It was facilitated by the Rotunda Bereavement Midwife, Trish and a Cuidiu Tutor, Niamh. It was the second time I attended this day but I always think these kind of days are so valuable. It was a heavy day but I felt better knowing what is available to parents suffering deep loss such as the death of their baby either in pregnancy or soon after birth. I also appreciated touching base with my own emotions and reactions around the subject and having time to reflect on how to support families in this situation. In my role with Irish Premature Babies, I supported many families who lost their little babies and it is a privilege to be part of that journey with them. 

This week the tightening/Braxton Hicks are continuing so I am resting as much as I can, while still being a mum and running a business. Our cat Shadow is showing me so much love – like over the top. He just wants to be on me all the time, kissing my face and rubbing off me purring. I am thinking he can sense the Braxton Hicks perhaps? Any cat people out there have a similar experience?

My mother in law was admitted to hospital with a terrible gastric bug and is on a drip. I would normally be the first to run around and be by people's side but as they are unsure of the cause I need to avoid just in-case. Plus with all the Braxton Hicks I’m not sure I would be up to it. I do feel really wiped this week. Hopefully this will all pass soon! 

Next week Mary is coming up for an important meeting (for DoulaCare Ireland) We are so excited to spend some time together in person! Then we will have our Team CPD day in Portlaoise, which again I am so looking forward to.

Until next time....Jen x

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Week 29: What Is Happening  To Your Baby

  • Your baby is now approximately the size of a butternut squash and they are continuing to get plumber over the next few weeks as they lay down body fat. 
  • Their head is getting bigger to make room for their ever growing brain 
  • At this stage if baby were to be born early they would have a much better chance of survival (however, the closer to full term they can get the better for their mental and physical well being and development). 
  • There is such a huge increase in brain activity from this week on it is thought that your baby may be capable of dreaming now. 

 

 

 

 

Week 29: What Might Be Happening To your Body

  • If you have been suffering from heartburn or consitpation you may find it worsening now for the rest of your pregnancy until baby arrives 
  • Some women find they get headaches 
  • Your belly may be itchy as your skin here continues to stretch and expand. Drink lots of water and use a good moisturiser to support your skin. Do let your GP know if the itching is severe just in case it's a sign of something more serious
  • You may have pain in your back, legs and/or hips as your body manages the extra weight. As well as this your body is also producing the hormone Relaxin to help soften the ligaments and joints in preparation for your birth. Some women find they are in extreme pain with SPD and will need some extra help like a support belt, regular visits to a physio or maybe even crutches. Being in water can be a huge relief so regular visits to the pool might be on the cards to help. 
  • You may find you are leaking breastmilk as hormones in your body start to produce colostrum- so stock up on breast pads to help. Washable pads are much better for the environment and in the long term cheaper on your pocket. 
  • The hormone that is responsible for producing milk (prolactin) can also make you feel sleepy. So don't be surprised if you need to take naps again. 

Week 29: Pregnancy Tip

You should be looking into applying for your Maternity Benefit payment around now (or the equivalent payment for the country you are living in). Citizens Information is a very helpful place to read up on this payment. You can read if you are entitled to it and when you should apply (at least 6 weeks before you intend to take it). The form may take a bit of time to fill in so it's useful to get started around this point in your pregnancy. The Maternity Benefit Section of the Dept of Social Protection are usually very helpful if you are unsure of anything in particular.  Your local Citizen's Information Centre can also help you fill in the form if you need this support. Your partner can read up on Paternity Benefit on the Citizen's Information website so they are prepared and understand how to apply for their entitlements. 

 

 

Jen's Pregnancy Diary: Week 28

This week was very busy with lots of meetings, both with more potential agency clients and with other birth professionals - building relationships. I am such a people person and love to have these chats. I also had a few short shifts with some clients needing some extra support with breastfeeding. 

On Sunday we went to our local Panto “Beauty and the Beast”. We brought my Nan and she really enjoyed herself. It was fantastic. This is one of my favourite childhood films. Leon loved it, and got really into the spirit with the interactions. Seth is getting a little too old and too cool, so did not quite enjoy it as much (this may be the last year I’ll be able to convince him to go!) Afterwards we ordered a take away and chilled out together. 

I had terrible Braxton Hicks that night. To the point I started timing them. For 2 hours they came every 6-11 minutes and some were very uncomfortable. I got down on all fours and did some gentle stretches and some spinning babies excerises. Paul rubbed my back and got me a hot water bottle. I texted Mim and Mary to bounce ideas off them. After about 3 hours things settled down. As they were much more intense that anything I have experienced before.  

I called my GP the next day and went to her just to check all was ok. I told her baby had been tranverse (side lying position) during them and I felt she may now be OP (facing outwards instead of toward my back). My GP had a good feel and broke the news baba was not only facing out but she was also now Breech (or head up). She confirmed this with the doppler. I was a little gutted as none of my babies have been Breech at this point in my previous pregnancies, but I also know she still has lots of time to flip. GP thought perhaps it was the big movement that sent my body into spasm. She told me if I experienced them that intensely and regularly again to go into the Rotunda.

We ended the week with a wonderful 3d scan of our baby girl. I had a meeting with a client in the morning so I headed in ahead of Paul and the boys. We went to The Ultrasound Suite on Grafton Strret. It was a very professional set up and the sonographer was so warm and friendly. She did a full health check first, which was so reassuring. Baby is measuring a week more than dates but this is to be expected with my history of big babies. 

Our little baby

Our little baby

She then started the scan in 3d. Baby was putting her arms up over her face and hiding. She also wouldn’t stay still and every time the sonographer tried to take a picture it was blurred as baby was moving so much. After a little while though we did get some lovely pictures. We watched our little girl play with her feet and hands, suck her thumb and move around. The boys loved seeing her as she looked like a ‘real baby’ rather than the normal scan photos. We confirmed baby is a little girl and skipped out on a high. 

After the scan we got a treat (Leon got ice cream, Seth a Waffle and myself and Paul a crepe) and pottered around the shops a little. It was such a lovely day. 

Next week I have an appointment in the Rotunda. It will be my first in the Semi Private clinic so I am eager to see their reaction to me wanting a VBAC, with a ‘big’ breech baby!

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What is Happening To Your Baby This Week 

  • Your baby is the size of a aubergine this week 
  • Your baby is starting to develop more fat on their body 
  • They may be able to see light as their eyesight is developing.
  • This week your baby starts to settle down into the position they will be in when you are in labour with them (ideally this is with head facing downward,). 

 

 

 

 

Week 28: What Might Be Happening To your Body

  • Can you believe you are 6 months pregnant this week!
  • You are starting into the third trimester this week 
  • You may have aches and pains this week - stretching, swimming, yoga and walking can all help. If it is really bad you could try wear a maternity support belt. 
  • You may notice Braxton Hicks this week. While this is perfectly normal, if they get stronger and more regular make sure you let your GP know 
  • Your breasts may start to leak this week as your body is preparing your baby's first food (colostrum). 

Week 28: Pregnancy Tip 

It is usually recommended to start counting kicks from this week. This is a very helpful way to ensure all is well with your baby. This website has really useful and up to date information about how to do this as well as a really helpful video: 

Jen's Pregnancy Diary: Week 27

This week I am on call for a birth client. One of our doulas in our agency is sick at the moment and  so I have taken over until she feels better. That is the one of the many benefits of the agency model, as we ensure our doulas can take time off if needed and our clients always feel supported. 

For New Year's Eve I watched Free Willy with Seth (and cried A LOT!!!) 

For New Year's Eve I watched Free Willy with Seth (and cried A LOT!!!) 

On Sunday it was New Years Eve. We normally all go to our neighbours for a party but this year we were all wrecked. I was feeling sore and Paul had a cold (plus he was due up at 6am for work!) So Leon and Paul went to bed together at 10pm. Seth wanted to stay up so I stayed up with him. We watched Fee Willy and I of course bawled my eyes out even though I have seen it a good few times.  Then we turned on the National Countdown. We listened to the music and watched the fireworks. The guys on the drums were epic (they played at our friends wedding last year and really got everyone going before the DJ started). Myself and Seth chatted about things we are looking forward to for the year ahead and had a cuddle. Then we both went to bed around 12.30am! Not exactly the rock and roll life but perfect for us this year just the same! 

We had our antenatal with one of my lovely doulas Mim this week. I love her so much and just feel so relaxed in her company. Mim was my mentor over the years and has taught me so much, in my role as a doula, antenatal teacher and breastfeeding counsellor. She is such a warm and calm person and one of the most experienced doulas in Ireland. Between her and Mary we will be well nurtured during our pregnancy, labour and birth! Their combined experience hits nearly 30 years!! We are so lucky to have these two wonderful ladies in our lives. 

The antenatal meeting was really fab as Paul has been a bit in denial about the birth. With both the boys things did not go as planned and both Paul and I carry a lot of trauma. Through all my courses, CPD and training days I am lucky to have worked through a lot of this trauma and have had space and time to debrief. Paul on the other hand has not. So Mim spent a good bit of time giving him room to talk and share his feelings. She pulled more out of him than I have ever managed, but in a very gentle and respectful way. Before this visit, Paul was unsure if he wanted to be at the birth this time, which I would have supported if he truly felt uncomfortable. Now he feels happy in the knowledge he will have either Mim or Mary there as a supporter. 

Mim brought her youngest daughter Juno over to play with Leon while we chatted. I do believe they might be soul mates! They are both cute as a button with innocent little faces, but absolute divils and mad hatters. They had great crack for the few hours and had to be dragged apart when Mim was leaving. 

I then logged on to do a Google Hangouts call with our DoulaCare Ireland doulas on supporting parents with premature babies, as we have a client with preterm twins starting this week. 

I have been getting lots of regular Braxton Hicks this week. Very tight tummy, a little uncomfortable but nothing concerning. I am wondering if my magnesium is low – as this can be a cause of more frequent BH. I also am making sure to drink plenty and rest when I can (again dehydration and doing too much can also be a reason for them as well). 

On Wednesday I had a few client interviews with potential birth and postpartum clients for the agency. I had a lovely evening with the boys and a relaxing shower. I was just about to head to bed and I got the call that our client was in labour. She was a second time mum and had been having surges on and off for days so I had a feeling she would experience a fast labour. Once I heard it was her husbands voice I knew it was time (as mum was unable to talk over the phone). With my bag ready, I made a sandwich for the car on the way, got dressed and headed out the door. It was a stormy night but I made good time. When I arrived 30 minutes later she was ready to go to the hospital. We were only there a few hours and baby was in arms after a beautiful, unmedicated, fiercely strong and positive VBAC. I stayed with them for the first breastfeed and to take some family photos etc. I got home around 6am and fell asleep on a high, feeling so privledged to be part of such a wonderful birth. 

Next week we have our 3d scan booked and are so excited to see babies face!

Until next time....Jen x

Week 27: What Is Happening to your Baby

  • This week your baby is the size of a head of cauliflower
  • If your baby were to be born now their lungs would be capable of functioning (though they would still not be fully mature). They are inhaling and exhaling amniotic fluid practising for life outside your body. 
  • Baby is also showing brain activity this week and will keep developing over the coming weeks becoming more and more complex as the weeks go on. 
  • Your baby's taste buds are very developed now 
  • If you feel light spasm like sensations in your body - this could be your baby hiccuping 

 

Week 27: What Might Be Happening to your Body

  • Many of the symptoms you have been experiencing will still be around (and stay until baby arrives!). Leg cramps, constipation, backache and haemorrhoids can all be experienced during pregnancy. There are things you can do to help (drinking water can be a huge help with leg cramps and constipation), so it's good to see what might bring you some relief and help make your pregnancy more enjoyable. Some women will sail through pregnancy with none of these issues - let's hope you are one of the lucky ones! 
  • If you have managed to escape leg cramps or backaches up to now they may start from this week on as your baby gets bigger and puts pressure on your back and legs. 
  • Tying your shoes and bending over is going to become more difficult as that bump expands

 

Week 27: Pregnancy Tip 

Think about buying a birth ball or exercise ball for yourself this week. They are great support for your pregnancy and during your labour. A birth ball is really just an exercise ball and can be bought in places like Argos, any sports shop and occasionally Lidl and Aldi stock them. During pregnancy they are great to sit on. You can't slouch on them so your posture is improved and they can help balance the ligaments, tendons and muscles in your pelvis. Doing this helps baby as it can give them more room in there and thus encourage them into an optimal position for birth. If you sit in work all day ask can you swap the chair for a birth ball instead. They can help relieve lower back pain

This is a great position to be in on the birth ball both during pregnancy and in labour (some Mums like to have some more support so will add a few pillows for under their knees and on the ball). 

This is a great position to be in on the birth ball both during pregnancy and in labour (some Mums like to have some more support so will add a few pillows for under their knees and on the ball). 

During labour they are a fantastic tool for making you more comfortable. You can use them to sit on and do gentle hip circles or figures of 8 in early labour. They are also great for leaning over when the surges get more intense. This can help encourage baby into a more optimal position if they are posterior, but it also allows your partner access to your back - and so they can give comfort measures to help make your labour more manageable for you (they will learn these tools at a good birth preparation course like GentleBirth or Cuidiu). Having a birth ball with you also helps to keep you upright and off the bed (much better for labour). 

Do make sure you choose a ball that is anti burst (which would mean they deflate slowly if they burst) and you will also need one that suits your height. Your hips should always be higher than your knees when sitting on the ball. Recommendations are: 

Under 5ft 4 inches: 55cm ball

5ft 4 inches - 5ft 9 inches: 65cm ball

Over 5ft 9 inches: 75 cm ball 

Any questions about using a birth ball do let us know here at DoulaCare. Our email is: info@doulacare.ie 

Jen's Pregnancy Diary: Week 26

Christmas morning excitement - Santa came!

Christmas morning excitement - Santa came!

Well this week was Christmas :) It was full of excitement and last minute wrapping. The boys were so excited and it’s just so lovely to share in their joy. Paul had this Christmas off so we really got time to relax and celebrate as a family. 

We host Christmas dinner in our house every year and both myself and Pauls family come down. Then we do it all over again on Stephen's Day to use up the left-over Turkey and Ham. The kids help to set and decorate the table and enjoy choosing a place for everyone to sit. I love being surrounded by family and spending that special time together. The boys are so special to everyone as they are the only grandchildren on both sides so they got lots of attention! Of course everyone is over the moon about their new granddaughter on the way and excitement is building!!

I always find the few days after Christmas to drag a little. The boys were on their best behaviour playing with their new toys so on the 27th I had a nice day of tidying up and resting. We went to see the new Star Wars movie, which was brilliant! The boys loved it, as did Paul and I. We all stuffed ourselves with popcorn and nachos and chilled then for the evening. 

Paul and the kids at Swords on Ice 

Paul and the kids at Swords on Ice 

Later in the week we went to Swords on Ice. I didn’t chance skating myself but loved watching the lads and Paul having fun. Leon flew around and was a natural! He is always so brave and just throws himself at a new experience. Seth was a little more wobbly and had a few falls but enjoyed himself all the same. Paul did very well, while holding the lads up in parts. He only had one fall which was very funny :) 

I have been so busy these last few weeks, it only dawned on me that I am in my last week of the second trimester! I am not ready for the third trimester to begin!! I feel I have not enjoyed this pregnancy as much as my previous pregnancies as with this one I have been so sick for so long and experienced lots of cramping etc. Also factoring in running a business, working with clients, finishing off my Antenatal Teacher course (after 3 years) and being a wife and a mam..... I just want to feel I enjoyed it. I feel so bad for this little baba as I loved every second with my first two pregnancies and savoured every moment. I feel like I’ve kind of ‘got through’ this one so far. It makes my heart hurt as I love this little baby so much already and smile every time I feel her move. 

As  a result I have decided I need to slow down a bit more. I need to take at least 10 minutes out each day to just be with my baby and feel my bump. I love my pregnant body. It’s strange to say but I always feel most comfortable with my body when I am pregnant. I love my bump and feel it’s my happy place ;) Hopefully things will slow down a little so I can enjoy the end of my pregnancy. It’s such a special time. 

Until next time.....Jen

Week 26: What Is Happening  To Your Baby

Photo by Jez Timms on Unsplash

Photo by Jez Timms on Unsplash

  • Your baby is the size of a courgette this week (both in length and weight). 
  • Your baby is soaking up your antibodies - and by doing so is preparing their own immune system 
  • Your baby's eyes are starting to open this week and they have eyelashes
  • If you are having a boy - his testicles will start to descend very shortly into his scrotum (and this will take a few months)
  • Your baby's lungs are developing 'surfactant' - this allows them to inflate and keeps the lung tissue from sticking together 
  • Your baby's hearing system is now complete and fully formed 

Week 26: What Might Be Happening To your Body

  • You are probably having some trouble sleeping (and we have some tips to help with that on this blog post)
  • You may be experiencing swelling and puffiness. While this can be normal, it is also something to keep an eye on in case it is a sign of something more serious. 
  • You may have headaches. While these can be due to changes in hormones it could be that you are dehydrated. So be aware and drink plenty of water throughout the day. 
  • Pregnancy brain - yes it is a thing! Mary was on Cork's 96 FM chatting about this recently. 

Week 26: Pregnancy Tip 

It's probably a good idea to start stocking up on baby items now. There is such a wealth of items to choose from and many Mums find they buy items that they don't really use. Ask other Mum's what their most important buys were and what they ended up passing on or taking up space. It's important of course to have a safe and secure car seat and this should be bought new. Lot's of other purchases however, can be sourced second hand. There are a number of fab baby market's around Ireland where you can pop along to and source items that have been pre-loved. Check out The Baby Market to see when the next one is in your area. If you prefer to buy new there are lots of lovely local Irish shops around. One of our favourites is Pip and Pumpkin. They have a physical shop in Mullingar but they will also have a website coming soon and you will be able to order online. They are extremely competitive (they do their best to price match) and shipping is only €5 for orders under €75 and anything over €75 is free. And you are supporting a local homegrown small Irish family run business. Elaine the owner is hugely helpful and will answer any questions you may have about products. I don't know about you but when I was a first time Mum I hadn't a clue what half the baby stuff was for, so it's always great to be able to chat to someone who can guide you through your purchases. You can connect in with them on their Facebook page at the moment (and keep an eye out for the website). They are also on Instagram