Birth Plan

[frisbar]

DH surprised me this morning and said we should work on our birth plan over dinner tonight. As this is literally the first time he has ever voluntarily discussed birth planning, I feel like I need to take advantage of the opportunity...does anyone have a good source for a sample or a copy of their birth plan they might be willing to share?

[DeChRi]

I dug out mine from out last baby, last night, and went over it with DH. I will post it up here when LO goes down for a nap. We are keeping it mostly the same. Although DH recommended I add "I prefer Taco Bell within 2 hours following delivery, but my husband should be able to handle this". We are super healthy food freaks, but there is a Taco Bell right next to the hospital, and even though both my last kids came in the middle of the night, I was suddenly DYING for Taco Bell after each kid, lol. Was maybe the best food I have ever eaten!

And I hear you about taking advantage of DH's willingness....will be a fun project!

[frisbar]

Thank you so much - and a serious giggle here about the taco bell. DH and I were driving to our hospital the other day and saw a taco bell around the corner...and...I had the same reaction. DH said "won't you want something healthier after you're just finished with labor??" and I thought...nope, pretty sure I will just want about 6 tacos, pronto.

[MaerynPearl]

thats funny i wanted tacos too with both mine... with DS they brought me spaghetti (ugh i did not want spaghetti!) and with DD we ordered the free pizza the local pizza place delivers to the birth center. But I made it a taco pizza and that helped some lol.

[RedOakMomma]

This was our birth plan for our second pregnancy. We tried to trim it down a little from our first birth plan (twins), partly because we were really impressed with the nurses following the first birth plan and an effort on our part to make our wishes clearer for them.

Plus, with our plans to stay home as long as possible before birth, there just wasn't time for the poor nurses to read a long birth plan! The poor woman was trying to read it while she was getting me undressed (in transition no less) and give me an IV. Bravo for effort, labor nurse!

Birth Plan for -----[my name]----- (baby boy!)

Mother: -------
Father and Support Person: -------
Last name of baby boy: -------- (I have a different last name than our kids)
Practitioner: Dr.
Due Date: March _st, 200_

We have prepared this Birth Plan to help you understand our philosophy and the kind of care we hope to have for the birth of our third child. Our first birth (full term twins) was a natural vaginal birth. We again wish for as natural a birth as possible, avoiding all unnecessary procedures and medications. However, if medications or procedures become necessary, we ask that you discuss them with us in advance so we can participate in the decision-making. Thank you!

First Stage (Labor):
•Dim Lights and Quiet
•Would prefer to have a minimum of people in the room (no students/observers)
•NO IV, but Heparin Lock is OK. (If for any reason an IV must be connected, I do not want any medications administered through the IV without permission from my husband or me.)
•Maintain mobility (walking, rocking, up to the bathroom, etc.)
•I will drink water if I need fluids—no routine IV infusion.
•Intermittent fetal monitoring rather than continuous EFM.
•Eat lightly and drink to comfort (fruit juices, tea, toast, etc.)
•Please do not offer me pain medications. I will ask for them if I want them.
•NO augmentation with pitocin.

Induction:
•I would prefer to use natural methods to start labor.
•I would like for my labor to proceed at its own pace, and would therefore like to avoid measures such as rupture of membranes, stripping of membranes, and/or pitocin unless a specific medical need arises.

Augmentation:
•If necessary, I would prefer walking, nipple stimulation, and rocking to speed labor.

Second Stage (Birth):
•Would prefer to have no students or observers in the room.
•Prolonged length of labor (longer than 3 hours) allowed if progress is being made and baby is not stressed
•Spontaneous bearing down rather than directed pushing, especially as baby is crowning.
•NO Episiotomy:
•I would prefer to tear than have an episiotomy, but please use compresses, massage, perineal support, and positioning. Please remind me to slow my pushing as baby crowns to allow for gradual stretching of the perineum.
•In the case of severe fetal distress, an episiotomy may be necessary. I would like to be informed of the episiotomy before it is performed.

In the case of a Cesarean Birth:
•I would prefer an epidural rather than general anesthetic
•Partner present and able to take photographs
•Free one of my hands to touch the baby
•Partner to cut the cord
•Two-layer stitching repair of uterus, rather than a single-layer closure
•Breast feeding in recovery room

Baby Care:
•Baby to be set immediately on Mother's chest/abdomen after birth (observed/checked in parents' arms)
•Would prefer, if delivery is normal and healthy, to wait 2-3 minutes before clamping umbilical cord.
•Father cuts the cord
•Delay the eye medication for 1 hour
•Vitamin K shot okay
•Delay all routine examinations of baby for 1 hour post-birth to allow for bonding
•Breast Feeding Only, no pacifiers or glucose water
•Mother or Father with baby at ALL times
•Rooming-in
•NO Hepatitis B vaccine; no vaccines without permission from Mother and Father.
•NO circumcision.

In the Case of a Sick Baby:
•Breast feeding as soon as possible. Mother's expressed milk to be used until then.
•Please consult us before formula is considered or administered.
•Handling of the baby (Kangaroo care, holding, care of, etc.)
•We would like to be very involved in the care of our son.

.

[rootzdawta]

Moved from I'm Pregnant to Birth and Beyond.

[Zoeanne]

I am planning on a homebirth, but made a birth plan specifically in case I have to transfer to the hospital. It mostly focuses on what I DONT want to happen!

There is a nice birth plan tool here: http://www.earthmamaangelbaby.com/free-birth-plan

CESAREAN BIRTH

If a Cesarean birth must be planned ahead of time, it should be scheduled to occur after labor has begun on its own.

Robert and Nancy or Stacy should accompany Zoe into the operating room.

If possible, please play Zoe’s CD during the procedure. Those present should refrain from extraneous conversation. It would be appreciated if a doctor “narrates”, explaining events as they occur.

I do not consent to any pre, peri, or postoperative medication without prior verbal consent from myself, or my spouse if I am incapacitated. I wish to discuss the complete anesthesia protocol with the anesthesiologist prior to any medication administration. I do not consent to general anesthesia except in the case of extreme medical emergency.

I do not consent to placement of a urinary catheter until after regional anesthesia is in place, unless it has been discussed with me in advance.

I do not consent to having my arms strapped down unless I am physically unable to control them. I am familiar with surgical fields and understand the necessity of maintaining a sterile surgical field.

The incisions should be a “bikini cut” and a low transverse incision; I do not consent to a vertical uterine incision.

The screen/curtain should be lowered to allow Zoë and Robert to view the birth unobstructed. If not possible, a mirror or curtain with a window should be used to allow the parents to view the birth.

I do not consent to the umbilical cord being clamped/cut until it has stopped pulsing.

I wish to take the placenta home.

The baby should be placed immediately on Zoe’s chest after birth, with a warm blanket covering her, unless medically impossible. We would like to make physical and verbal contact with the baby as soon as possible. The baby should remain on Zoe’s chest during checks for baby’s health and repair of the incision. Breastfeeding will be initiated as soon as the baby shows interest.

The double-suturing method should be used for closing the uterus.

I do not consent to the removal of the baby from my arms or the room unless a medical emergency requires it. If the baby needs to go to the nursery or intensive care for emergency medical reasons, Robert will stay with the baby at all times, and Nancy or Stacy will stay with Zoe.

The considerations/requests for care listed below should also be honored during a Cesarean birth as much as possible.

VAGINAL EXAMS

I do not consent to any vaginal exams without my request/agreement.

I do not consent to having my membranes stripped during a vaginal exam.

GROUP B STREP

I decline testing for Group B strep. I do not consent to antibiotics during labor except possibly in the following cases: Labor or rupture of membrane before 37 weeks, rupture of membrane 18 hours or more before delivery, fever during labor.

PRIVACY

I do not consent to residents or students attending my birth.

I would like for people entering the room to speak softly.

Please keep my door always closed during labor.

SECOND STAGE OF LABOR

I do not consent to an episiotomy.

I not consent to the use of forceps or vacuum-assisted birth.

NEWBORN/RECOVERY:

I do not consent to the separation of my baby and myself at any time unless there is a medical emergency. In the case of medical emergency, Robert will stay with the baby at all times.

I would like my baby to be placed immediately on my abdomen following the birth, skin-to-skin with a warm blanket over her.

I do not consent to having the baby’s airways suctioned unless it becomes absolutely necessary.

I do not consent to the umbilical cord being clamped/cut before it has stopped pulsating.

Please delay all essential routine procedures on my baby until after the bonding and breastfeeding period.

I would like all newborn routine procedures to be performed in my presence/sight, and preferably in my arms.

I do not consent to anyone other than myself/my partner giving the baby a bath.

I do not consent to eye drops for my baby.

I do not consent to vitamin K to my baby.

I do not consent to any immunizations for my baby.

I do not consent to circumcision for my child.

I do not consent to the heel prick for PKU testing; we would like to wait, and delay the PKU testing until our first pediatrician visit.

I do not consent to newborn hearing screening unless one of the following risk factors is present: NICU admission for 2 days or more; syndromes known to include hearing loss; congenital infections (e.g., toxoplasmosis, bacterial meningitis, syphilis, rubella, cytomegalovirus, herpes virus); or craniofacial abnormalities (especially morphologic abnormalities of the pinna and ear canal).

I do not consent to my baby being given any of the following: formula, sugar/glucose water, artificial nipples (pacifiers/bottles/etc)

If the baby must be cared for in the NICU, we will use kangaroo care, and would like to be with the baby as much as possible.

THIRD STAGE OF LABOR

I would prefer for the placenta to be born spontaneously; I do not consent to the use of pitocin, and/or controlled traction on the umbilical cord.

I would like the option of taking home the placenta.

VISITORS

I would like my other child (Logan) to be allowed to visit with me for as long as he wishes or as long as hospital policy permits.

I would like my husband and child to have the option of rooming in with my baby and me.

[BetsyS]

Mine is pretty simple:

Please don't count while I'm pushing.
If I need a c-section, please do a double layer closure.
No erythromycin for the baby.

[MegBoz]

Mine is very similar to RedOakMomma, except at my doula's suggestion, we titled it our "Birth Wishes." - I know, so PC!!! Since some HCPs think, "You can't plan birth." So it's less insistent, more passive & polite.

My doula also put it into a GREAT format with 4 boxes w/ an intro at the top: Labor, 2nd stage, baby care & c-section - so with the bullet points, it fit into one page!! Which was great.

I also excluded mention of induction since that's not something I'd need to be discussing with HCPs when I arrive at the hospital in labor.