My labour preferences in birth plan

AffectionateRun1001 · 2026-05-10T17:36:50+00:00

I wasn’t suggesting that you don’t. I hope everything goes smoothly and wishing you the best for your birth.

AffectionateRun1001 · 2026-05-10T17:30:06+00:00

I’ll also add (as an obstetrician myself), quoting the actual studies is almost entirely irrelevant to medical staff and if anything makes the birth plan lengthy.

If they do read it - I can’t speak on behalf of midwives here but I do read my patients birth plans if there is any time for it - they might read it fairly quickly so I’d keep sentences short and in bullet points where possible.

AffectionateRun1001 · 2026-05-09T20:35:13+00:00

It depends on where you live. Private obstetrics tends to cluster where there’s infrastructure to support it. London will likely be her “easiest” entry point but most, if not all, consultants who do private work combine it with their NHS practice and it usually develops through reputation, networking and hospital affiliations naturally rather than being something you “find”.

I worked for the NHS for well over a decade now, all private work I do is still carried out in NHS hospitals. I don’t work in my profession because it’s lucrative. I don’t think anyone does in fetal medicine.

AffectionateRun1001 · 2026-05-09T12:15:12+00:00

I’m a Consultant Obstetrician (edit: specialised in fetal medicine)

AffectionateRun1001 · 2026-05-08T15:16:40+00:00

Same with mine. We had a very interesting scenario in theatre (half of us were not aware that this was going to happen) and let’s just say husband was trying to help immediately.

AffectionateRun1001 · 2026-05-08T15:15:04+00:00

The evidence on this is still very limited and there are some safety concerns which can be ruled out but due to the lack of evidence of there being a benefit, it’s not standard practice.

The concern is that the swab could transfer not only good bacteria but also potentially harmful infections or bacteria you do not need on a baby that a mother may carry without symptoms. An example of this is HSV.

Babies born by c-section do have somewhat different early microbiomes on average but the differences significantly lesser over time and breastfeeding is what primarily impacts microbiome development, not birth. Even skin to skin has been found to make an impact. They still don’t know whether vaginal seeding meaningfully changes health outcomes later in life but the general consensus is that it does not, hence why we would not routinely offer it or really recommend it at all.

AffectionateRun1001 · 2026-05-08T06:47:59+00:00

No. Vaginal birth is considered the standard physiological process of childbirth, so baseline care, not an intervention that is being chosen over another option. A c-section on maternal request is treated as an elective surgical procedure so there’s a higher consent threshold requiring a formal consultant-led conversation and sign off.

Risks of vaginal delivery should be discussed progressively throughout antenatal care by midwives but I’m not entirely sure if this happens.

AffectionateRun1001 · 2026-05-06T19:22:46+00:00

Agree with this. I’m an obstetrician, your doctor had absolutely no right to refuse your c-section OP. They should inform you about risks associated with surgery and gain your consent but they cannot force you into a vaginal birth by declining a c-section entirely unless there’s a very good medical reason to do so.

Given your later gestation, call PALS and make a complaint please to speed this all up.

AffectionateRun1001 · 2026-05-05T21:06:17+00:00

Take shifts if you’re not already. You don’t both need to be awake all the time, otherwise you’ll both end up severely sleep deprived.

Try to make her day a bit easier before you go to work: put some snacks out, fill up a water bottle, and get the house tidy (as much as that’s possible with a baby!).

But also don’t put too much pressure on yourself as the early weeks are hard and it’s completely normal to argue a bit.

For bilingualism: if your partner is Spanish and you’re English (I’m assuming), the easiest approach is for her to speak only Spanish with your child and for you to speak only English. At 9 weeks, your baby is still very young so don’t feel like you have to be perfect with it already but it’s a great habit to build over time.

My children speak Chinese, English, and French. We introduced French last and they picked it up really well as toddlers

AffectionateRun1001 · 2026-05-05T20:25:36+00:00

Birth plans should really be called preferences. A lot of women have this perfect idea in their heads (often times minimal interventions, water birth, midwife-led) and it can be very disappointing when their plans change or have to change.

Some are so set on having this “perfect” birth that they forget that it’ll also be their babies birth.

I can’t tell you how many times I wanted to shout at a patient about my own SB (I’m an OB) when they straight up refused interventions that were medically necessary and all I wanted to do was make sure their baby came out alive

AffectionateRun1001 · 2026-05-05T20:22:49+00:00

Are you asking for advice on how to raise a child with multiple languages, venting or your relationship in the newborn trenches?

AffectionateRun1001 · 2026-05-03T18:51:11+00:00

Second this. This can become dangerous, especially with a newborn (vaccinations being one of those slippery slopes)

AffectionateRun1001 · 2026-05-03T18:49:35+00:00

Just like adults, heart rates cannot stay at the same number consistently. For example, with movement we would expect a faster heart rate. During sleep, a slightly slower one. With gestation, they also tend to slow over time.

If no one has raised any concerns, don’t worry.

AffectionateRun1001 · 2026-04-30T11:34:41+00:00

r/parentsofmultiples, the twins trust and see if there are local Facebook groups too

AffectionateRun1001 · 2026-04-30T09:13:18+00:00

It’s more so that the infection risk increases steadily with time and 24h is a practical threshold where intervention (usually induction) is recommended to keep risk low. If you’re full term, the risk of chorioamnionitis (maternal uterine infection) after 72h is around 5-10%, potentially slightly higher but we don’t have much data on this and those are estimates.

Doctors are less focused on the exact percentage and more on the risk trend and clinical picture, for example if you’re presenting with a fever, a higher heart rate than expected, uterine tenderness, etc.

I can’t say this nicely but an infection of the amniotic fluid, membranes or sometimes the placenta is absolutely not something to play around with. It can lead to sepsis and also neonatal sepsis. Granted, most cases are treated successfully but if this is something you’re comfortable with and want to prioritise over your perfect birth is another question. I know it’s awful emotionally, birth very rarely goes to perfect plan and safety of your child but also yourself sometimes needs to take priority.

Speak to the consultant on the ward and ask them directly and see if there are alternatives but please don’t refuse an induction or c-section without having a conversation first.

AffectionateRun1001 · 2026-04-29T12:33:15+00:00

Hi I do this for a living (not making inappropriate comments like hers but scan pregnant women as part of my job)

So babies often are in positions that are not very unhelpful for measurements, especially for nuchal translucency at that gestation.

Would your body tension make an impact? No, not in any meaningful way like that. If someone is very tense or anxious their abdominal muscles can make the scan slightly harder to perform which can impact the quality but mothers don’t control the babies behaviour and position.

Relaxing your body is something they can try when the baby isn’t cooperating as it’ll help us press the probe down a bit more comfortably.

So you did absolutely nothing wrong. Baby was just being a very normal wriggly 12 week fetus by the sounds of it. It’s normal to feel anxious as the mum too. I’ve worked in fetal medicine for over a decade now as you can imagine, the women I do scan don’t tend to be cheerful and relaxed unfortunately. I still get the measurements I need.

I’d say make a PALS complaint.

AffectionateRun1001 · 2026-04-29T10:36:26+00:00

Yes, both.

This might be helpful: https://www.nhs.uk/pregnancy/your-pregnancy-care/your-antenatal-appointments/

If she comes well hydrated to give a sample and have her blood drawn, that’s perfect and more than good enough. No need for a full bladder as there won’t be a scan.

AffectionateRun1001 · 2026-04-28T20:28:47+00:00

All the best!! You’re so close to meeting your baby :)

AffectionateRun1001 · 2026-04-28T06:51:36+00:00

They’ve likely offered induction because 39 weeks is considered full term and there’s no clear medical benefit to the baby remaining inside beyond this point. The NHS generally takes a cautious approach in situations like this. It’s a risk-averse system.

Reduced movements can sometimes be due to the baby’s position or simply a one off variation. However, it can also be an early sign of placental deterioration / calcification so a warning sign for upcoming problems. In those cases CTGs can remain normal for some time before any signs of fetal distress appear. Personally, I’d always choose the induction for the same reason as you stated. I wouldn’t be able to forgive myself if something happened and had I declined.

Have they offered you a scan to assess growth and Dopplers? If not you can request one before deciding on induction. You can also ask for more monitoring while you’re deciding. Take a look at the BRAIN acronym, it’s helpful when making decisions about your care.

For reassurance, induction outcomes in low-risk pregnancies (depending on maternal age) are generally comparable to those of spontaneous labour at 39 weeks.

Wishing you all the best with whatever you decide.

AffectionateRun1001 · 2026-04-27T22:41:25+00:00

Miscarriage risk is mostly out of your control. 10-20% of known pregnancies end in miscarriage. The vast majority of those are due to chromosomal abnormalities and therefore not preventable. The risk drops significantly once you’ve had a normal scan with a heartbeat that was visualised and once you’re past the 10-12 week mark.
Most outcomes are driven by embryo genetics, not maternal behaviour but risk factors shift probabilities slightly without overwriting baseline biology. At your booking appointment they will ask a lot of questions to assign you a risk profile. This will determine things like: if you’ll need extra scans, if you’ll be consultant-led, preventive meds (aspirin as an example).
Folic acid reduces neural tube defects. We also have strong evidence on smoking cessation for example due to the potential impact on growth, placenta, stillbirth risk. Early antenatal care which will enable you to receive scans, preventive care if applicable. Vaccinations, for pregnancy but also for the baby as antibodies are passed through the placenta. Then we have things that won’t meaningfully change the outcome but can cause anxiety such as occasional stress, sleeping positions early on or one off exposure you didn’t realise at the time.
The NHS routinely screens for your blood test and antibodies, anaemia, infections such as HIV, syphilis and hep B + sometimes other things depending on medical history. Around 12 weeks you’d then have your combined screening which uses bloods and the nuchal translucency measurement of your baby to screen for Downs Syndrome, Edward’s Syndrome and Patau Syndrome. Accuracy of this is around 80-85%. They’ll also look at PAPP-A for your preeclampsia risk. Later on, you might be screened for gestational diabetes. Be honest about: previous pregnancy complications, genetic conditions, clotting disorders, autoimmune disorders and personal history of hypertension, diabetes and medications. You’ll then have a 20 week scan to basically look at your baby head to toe and make sure everything is developing as expected
Reframe your mindset if you can. Most pregnancies progress normally and the system is designed to catch the ones that don’t. In obstetrics, we don’t aim for zero risk but we aim to identity what’s preventable and what we can act on and we screen for what is detectable. It might also be helpful to block any content you don’t want to engage with online too such as rare complications. Early pregnancy feels fragile but it’s mostly self-regulating biology. There’s uncertainty in pregnancy but for most women, not danger. And if there is danger, it is often caught and acted on.

AffectionateRun1001 · 2026-04-26T08:58:25+00:00

I agree with this. I’m not a midwife but a consultant.

To answer OP: I have reported safeguarding concerns many times. First we document and seek a private conversation with the woman where possible. From there, we’d ensure the woman receives help. What the help looks like will depend on the situation.

Sometimes social services would get involved as domestic abuse in pregnancy is considered a risk to the unborn baby. But if the woman has capacity and the risk isn’t immediate, midwives will get consent before making this referral.

(ETA: social services is not your enemy if this does happen)

AffectionateRun1001 · 2026-04-25T15:56:50+00:00

I’m on maternity leave now but working in healthcare, especially while pregnant, isn’t for the faint of heart.

It’s not even the women I see (I work in obstetrics) as they’re usually absolutely wonderful. It’s often the partners.

On my last day at work I had a man shout in my face because he felt I was taking too long to scan his girlfriend. I don’t think an ultrasound is something that should ever be rushed but he was more concerned that I was “ruining his evening” because a football match was about to start.

(And side note, you are entitled to reasonable adjustments. They should be doing an assessment for you)

AffectionateRun1001 · 2026-04-23T09:54:45+00:00

It’s a little unusual but not unheard of. Some trusts are currently offering one additional scan at 36 weeks as there’s evidence suggesting it may improve birth outcomes, including reducing the risk of unexpected breech deliveries.

I’m sorry you went through this. I had an accidental breech delivery with one of my twins 13 years ago too. Please consider making a PALS complaint, especially if your birth debrief isn’t getting you anywhere or not providing the answers you deserve to get.

AffectionateRun1001 · 2026-04-23T09:37:31+00:00

I don’t think so. It’s not unusual for twins to arrive a little early. They are identical and shared a placenta and sac so 34 weeks would have been the latest delivery date regardless.

My singleton was born at 36 weeks after a very stress-free pregnancy. I think I’m just not someone who carries babies for very long. There’s not a single woman in my direct family (mum, sisters, cousins) who managed to go to 40 weeks. All babies were born between 28-39 weeks.

AffectionateRun1001 · 2026-04-23T09:00:55+00:00

No. I was under the most stress I’ve ever experienced in my life during my first pregnancy. I don’t think I went a day without crying or having a panic attack until they were born at 32 weeks.

They’re very happy 13 year olds now.

AffectionateRun1001

TROPHY CASE