natural birth plan in QMH

Hi

I would like a natural birth for my second child.

I will deliver in Queen Mary Hospital


Anyone to help me to make my birth plan ?

Thanks a lot in advance

Did you attend their class on writing the birth plan? (at Tsan Yuk) It gives you a general idea what should go into the birth plan.

I will, I will, but they have only 2 sessions for the first 6 months of 2007. I will attend end of March. I sow the form they have but I don't know what is acceptable for them or not... That's why I would like to talk with someone who had a birth all natural in QMH.

I have the feeling that when you talk to them they smile at you and tell you that what you want is possible and the reality is all different. A lot of friends of mine said that they didn't care about the birth plan because they always find a good medical reason to scare you and to do the contrary of what you wanted. I went to visit my friend who delivered yesterday and she had to fight a lot to deliver naturally without any medication...

I had a pretty simple birthplan and I know the nurses and midwife went through it a couple of times. I did not want an episiotomy but ended up getting one (rather than risking a tear). Either my perineal massage was not that effective or they tricked me!!!!

Keep it very very simple...


Vaginal Birth, no C-Section (unless medical emergency)


No Epidural, or whatever your request is...


Breast Milk Only, No Formula or bottled


Husband to stay with baby at all times (ie, when they take it away to get weighed, washed, etc..)


You could even have a billingual version for further clarity.


Good luck!!

Thank you for your advice Cri :-)

Better if you can fill in your birth plan after attending the class at TYH so that you know what's possible and what's not. Also fill it in after the tour of the hospital where you can ask lots of in situ questions. For my 1st one, birth plan with epidural, episio if necessary etc... ended up in C-section after 10 hours labour, no foetal distress, just baby wasn't coming out and I have never questioned their medical decision to do so.

2nd one, birth plan no epidural, no episio, no IV, no monitoring, no lying down etc,asking for eating and drinking whilst in labour. They accomodate the no medication, no episio, but I had to have the IV. When I arrived I could not stand anymore anyway so I lied down ! But for pushing the baby I asked on the birth plan not to have the feet in the stirrups but instead support my thights with my arms, and since I couldn't do it because pain/exhaustion they actually did it for me with my husband. I had a small tear although they tried their best to avoid but quite big baby. Despite I've requested no injection for placenta delivery, they insisted and I gave in.


Very important to have your husband making sure they understand the birth plan. Everytime they were asking me a question about the birth plan, my husband would answer rather than me (better things to do).


Keep it simple, know what you want, make sure in advance what they can't and what they can do (no delivery in water, no pushing stage on 4s, no eating or drinking in labour), and take it into account when writing your birth plan, involve your husband as much as possible, and be humble with the midewives.

They are professionnal, very experienced and although they worked in a quite 'rigid' structure, some are really willing to assist for something a little bit 'different'.

Thank you very much for your good advices Suzie. As I keep thinking about it, I just wanted to do it a bit in advance even if I adapt it after the class in TYH. I already visited the QMH but the nurse was not able to answer my questions she said I have to attend the birth plan class.

Sorry my english is very poor

Could you tell me what is a IV ? and what is no pushing stage 4s please?


And why do we need an injection for placenta delivery is it artificial oxytocine ?


"be humble with the midewives" yes I can imagine that we "break" their habbits and if that's not easy for us to deliver in a foreign country, that is not easy for them to allow things they are not used to...

Thanks again

Sorry I don't know how to send a PM...

In QMH you need to have the IV (Intravenous) drip, and they will not let you deliver the baby in other position than lying on the back, ie no squatting or on 'all fours' positions.


For placenta delivery and helping the uterus to contract they do an injection of oxytocine yes. At 1st I wanted to avoid that, based on my preparation with the Bradley method, but they look so bothered by this request ('We always to that, it's better for u etc') and since it wasn't any more about delivering the baby, I eventually agreed.


I you know how to send a PM, please do not hesitate to contact me !

Hi Suzie

No I don't know neither but you can email me at this address vvvvv9999 on hotmail.com I will give you my real email address in private :-))

Thanks a lot

sorry it can be confusing when you read it so it's the letter v (5times)...and 9 (4times)and then @hotmail.com

I would keep the birth plan simple. I for example didn't want an episiotomy - this is where your partner is important - because you could be in any state it is important that your partner is firm about your wishes (in case you're in no state to cope) - if you are not firm they will do whatever they are comfortable with e.g. episiotomy.

You also need to realise that what they tell you in the antenatal classes can be absolute rubbish eg the mobile baby monitor (sorry don't remember what it's called - the machine they use to monitor the baby before you give birth) - I was told emphatically that they had a mobile one where you could walk around but when I asked for it at the hospital they stared blankly and told me they'd never heard of it.

Also I wanted an epidural but there was no anaethestist available - they kept telling me that he was on his way but that was absolute rubbish - he never showed. They will offer you pethadine in the ward but that was the one thing I didn't want - if you want gas you need to be in the labour room - be forceful if they won't take you there - I found a huge amount of screaming and swearing did the trick in the end!

Maybe I just had a bad experience but don't expect any favours - my birth plan was a waste of paper - I was lucky to have a midwife at my delivery - the nurse wouldn't believe that I was giving birth so quickly - they were still setting up the bed as I was pushing my son out!

Hi Blitzing,

Yesterday while attending the antenatal classes I realised that what they say can't be done in the reality. My friend gave birth a few days ago I went to visit her and actually I could see the real conditions. My friend told me they dit all the contrary of what they tell us during the antenatal classes.

They say your husband MUST assist you in any case but he is not allowed in the ward! You have to go out in the lobby. Honnestly I can't imagine myself on 'all fours' positions, or making "pelvic rotations" in the lobby !!!!! They say you can use a chair to begin the labour in the ward, but their is not enough space near your bed and the chairs they have are not suitable for that, they hurt. When I told kindly to the physiotherapist yesterday that what she said was not really possible she suddenly took it personnally (Although I said it in a very very respectfull way)and she didn't want to tell me more and continued her lesson...

My friend also told me (like you) that she kept telling them she was giving birth but they didn't believe her and when they realised that the head of the baby was coming out they rushed her in the labour room they paniqued and forced her to change the pink clothes for the ones for delivery but poor thing she couldn't move anymore. They finally gave up with the clothes to concentrate on the birth...(they did well).

She said they have been nice during the delivery.


Well I don't feel really confortable when I think what will happen for my (second) child delivery :-( I think I will have to fight for what I want. Or an other solution is to arrive at the hospital at the last moment even if I stay outside the building.... well I keep thinking about all those things..

Thanks for you email Blitzing :-)

Well the main problem of QMH is whether the relevant medical staff will be available for you at the time you need. There are only a few anaethestists for the whole hospital, so if they are busy in operation theater or with other patients, they might not make it on time for you. For my 1st one I requested the epidural as soon as they took me to the labour ward, and I had it an hour later. And when they decided to take me for C-section 6 hours later, the anaesthetic was there immediately and stayed throughout the whole operation (over 40 min) so I guess at the same time some other ladies in labour pain couldn't receive any epidural. The other issue is the usual habit of never saying 'no' so they will just tell you he's on the way although he's just not available...

They do have a lot of procedures, when you arrive you still need to give a urine sample, and they weight you, change gown as you mentioned etc... They did all of that for my 1st one, and it made me quite upset since I had pain and I just wanted this to be dealt with.

But for the 2nd one I showed up as late as possible, very close and long contractions, we left home just when I thought it was my last chance to stand and walk, and I arrived at the hospital at 7 cm, so they took me straight into the labour room where my husband could stay by my side.


I think timing is important and there's probably a fair amount of luck for the midwives and nurses on duties that day, some are more open-minded than others. It also depends how many patients are already there (for my 1st one, the wards where over-crowded, for my 2nd one only 2 beds were occupied in my ward !).

Unfortunately you have to leave it quite a lot to fate for the comfort of your delivery when you deliver in public hospital.

My labour was close to blitzing's way & worse as time passed by. I delivered 30 hrs later, with me unconscious & the baby in distress. Decision: to never have another baby at QHMS.

I agree with ' shouting & screaming' works the best there. I was polite & ended up tortured. Advised my friend on being ' loud' & she said it worked spot on!

Well, yesterday at the antenatal class they said : we recognize if the delivery is close when the women loose her self control. So I understand by what you say that if you don't scream they don't believe that the baby is coming and they leave you in the ward separated from your husband...

To FCB,

I had 2 kids at the POW hospital (as a private patient) although the delivery is the same for both private and public. During my antenatal checks I was given a list of the normal procedures for the hospital,. which included giving birth in the Lithotomy position (flat on back with legs in stirrups), a routine episiotomy, IV etc. I went in ready to do battle with my doctor and told him I wouldn't agree to any of that, he told me that the list was aimed at their 'local' mothers. Anyway, I wrote a birth plan, which was actually looked at in the delivery room and followed. Gave birth well propped up for the first (actually the 4th), and on my side for the 2nd, no episotomies, and no IV's. The aftercare was OK, a bit basic, but only stayed in 1 night with the 1st and came out the same afternoon with the 2nd. But at least the special care was on hand if needed.ts

Thank you for your feedback cd. May be in QMH they could accept to let me deliver laying on my side...

My first QMH labour was terrible, all the same bad stuff as the above, but the second one 6 weeks ago was much better - basically, you want to keep the doctors away as much as poss as they are the mean ones, the midwives are nice. Also your partner needs to know exactly what you want, and to be prepared to deal with the staff so you can concentrate on having a baby. Also, if you don't want drugs you need to INSIST that they don't offer them to you, as you will be tempted to accept. If you need pain relief you can ask for it. Be firm. They are bossy there, but will be a bit flexible if you are definite about what you want.

I would point out that even if you arrive with contractions <3 minutes apart (like I did), it took them 1.5 hours before they took me to the delivery room (and that was only because I was swearing so much (trying to convince the nurse that I was going to have the baby) that I think I was scaring all the other patients and they had no choice!). The reason why they wouldn't take me to the delivery room earlier was because there were no midwives available to take me - in the end the head nurse took me there herself. If you end up having your baby on a weekend/holiday you should expect similar understaffing. On the bright side, my partner was allowed to stay with me in the ward (we were there from 1-2.30pm) - I don't think they were game to suggest that he stand outside.

You might also want to have your husband on guard duty - i don't remember how many old Chinese ladies (those ones who seem to be there to "help") I had to tell to "go away" - it was like a sideshow - "come and poke your head around the curtain and look at the moaning gweipor". I couldn't believe it. My baby was out 1/2 hour after I walked into the delivery room.

I probably sound like a right b*tch but the incompetence I experienced was shocking - after 2 trainee doctors had a few pokes around to try and insert the IV needle I once again had to scream and demanded they get me a "proper" doctor - they did and he got it in first time.

After I gave birth they tried to attach the ECG bits - I spoke up when I saw him attach the cords with the big "L" on them to my right foot - I mean it's hardly rocket science is it??? It would have made great reality tv - you couldn't have scripted it better.

I guess the point I'm trying to get across is that whilst no-one likes coming off as a completely demanding b*tch, it is absolutely essential for you to stand you ground and demand what you need - in my QMH experience trying to be nice and get your own way is a complete waste of time. You will be duly ignored.

I would also strongly recommend that for any of you having their first child that you do private antenatal classes so that you know what to expect during the birth process eg how to recognise transition - I was in transition (I only know this because of the private antenatal classes I'd done) and the nurse still wouldn't believe that I was going to give birth any time soon. Thank goodness I knew that I shouldn't push without someone there to check me. It was only when the sac came out between my legs (my water hadn't broken) that the nurse suddenly panicked and found some midwives.

The hardest things for me to cope with were 1) lying to me about people/things being "on their way" - they should have just said that no anaesthetist was available for eg; 2) not believing me at all when I said that the baby was on its way - I have never felt so frustrated in my life.


Rant over.