I'm slightly bored this evening so browsing the net and came across an extravagant birth plan where it is stated, 'no stitches under any circumstances'. There is also refusal of all drugs for 3rd stage management on there.

Now this is all fine and well if everything goes perfectly but what consequences could there be of not repairing a 3rd or even 4th degree tear, surely this isn't even an option? The thought of it scares me.

What about in emergency circumstances, PPH say? in the 3rd stage, is any attention paid to the 'rules' laid out in the birth plan?

Is it the responsibility of the midwife attending this birth to notice these details and discuss it with the woman prior to these circumstances arising.

(I should add it has apparently been OK'd by the community midwife, as I realise ideally it should be picked up during antenatal appts).

Anyone have thoughts on this?

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