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Birth Plans

post #1 of 11
Thread Starter 
Alright, let's see 'em.

I've been going back and forth over whether to even bother with making one, since last time I forgot it at home and ended up not even needing it. But I think I'm leaning towards making a short one.

What do all of ya'll have in yours?
post #2 of 11
My birth plan has been altered since I will be going in for an induction on Thursday morning. Originally, I had points about stating no IV fluids or Hep lock, but that's necessary since I'll be having an induction and will require Pitocin. I also had only intermittent monitoring, but again, continuous monitoring is necessary with a VBAC Pitocin induction and I'm ok with that. Other than that, everything stayed the same. I have a detailed Cesarean plan because of my horrific cesarean with my daughter - I want things to go MY way this time if I have to have another section.



BIRTH PLAN

I am planning a vaginal birth after cesarean. As labor can be unpredictable, I understand that I may need to deviate from this plan at times. Please discuss with me all procedures for myself and my baby so that I can make an informed decision.


LABOR

• I would love to utilize the hospital's doula program.
• Routine vaginal exams to be kept to the absolute minimum. I prefer not to know my progress unless I ask.
• No artificial rupture of membranes. Please allow my water to break on it's own during labor.
• My goal is a natural, drug free labor. Please don't offer me pain medication. If I ask for pain medication, please remind me of my goals and encourage me. If I am adamant about pain relief, please offer me IV pain medication before an epidural.
• Freedom to move and change positions as monitoring allows.


BIRTH
• I prefer to push in any position I'm most comfortable rather than flat on my back.
• Please do not immediately clamp and cut the umbilical cord. Please allow the cord to stop pulsating and become silver/gray to ensure the baby receives his full blood supply and valuable stem cells before the cord is cut.
• I plan on taking my placenta home and would like it placed on ice as immediately as possible after birth. Please let me know what I will need to do in order for that to happen.


CESAREAN DELIVERY
• Please do not place a urine catheter until anesthesia is placed and in full effect.
• Please do not begin surgery until my husband has been allowed into the OR.
• Please make sure the uterine incision is closed with a double layer of sutures rather than a single layer.
• Please leave my arms free so that I am able to touch and hold my newborn.
• Please place baby skin to skin on my chest and cover us both with a blanket if needed.
• Please conduct all newborn assessments either directly on me, or at my bedside so that my baby is in full view.
• Baby is not to leave the OR until I do. He is not to be taken to the nursery (unless there are medical issues) or to my room before my surgery is complete. Both my husband and child to remain in the OR until I am ready to be taken back to my room.
• Please follow all newborn wishes as outlined in the next paragraph.


POST PARTUM & BABY
• Immediate skin to skin contact with the baby during delivery of the placenta and any repair procedures that need to be done.
• APGARS and any other newborn assessment to be done while baby is being held by me.
• Please delay all non-emergency procedures until we have had time to bond.
• I plan to breastfeed and would like help in doing so immediately after birth.
• I do NOT consent to the administration of eye ointment.
• I do NOT consent to the administration of vitamin K injection.
• I do NOT consent to the administration of the HepB vaccine.
• I do NOT consent to circumcision.
• Please do not bathe the baby, we prefer to do it ourselves.
• Baby is not to leave my side. Only in the case of extreme medical necessity, baby is to be accompanied by my husband or myself at all times.
• No bottles or pacifiers to avoid nipple confusion during the early days of breastfeeding.
post #3 of 11
Thread Starter 
That looks pretty good...

You're swaying me to make one just to have some c-section points. Because while I don't anticipate having a c/s, you never know... and it would be nice to feel a bit in control if that ends up happening.
post #4 of 11
Quote:
Originally Posted by Kelly1101 View Post
That looks pretty good...

You're swaying me to make one just to have some c-section points. Because while I don't anticipate having a c/s, you never know... and it would be nice to feel a bit in control if that ends up happening.
I would definitely, definitely do that. I wish I would have just considered the possibility of a section with my first and written out a plan.

EIGHT, yes EIGHT people touched and held my daughter before I did. Both my husband and daughter were ushered out of the operating room while I was still on the table - not even stitched up yet. All of my family, plus the OB, pedi, and two nurses held Ava before I even got to touch her - my arms were strapped down to the table.
post #5 of 11
Amber that's a good looking birth plan. Good luck with the induction - I will be thinking of you on Thursday.

We haven't written up our birth plan, and I don't quite know what to do as far as one goes. We don't plan on needing one for at home, as we are planning a homebirth. But I am a worrier and want to plan for the possibilities. I want to make one up for in case of transfer to the hospital, but I don't know how likely it is that I will transfer and not end up with a c-section. First timers have a 20% chance of transfer, usually due to exhaustion, so I'm not sure what to include in a plan other than c-section info. I'll have to tell DH this needs to get done this weekend - we have a prenatal with the doula on monday and can have her look it over with us.
post #6 of 11
I had this posted in the other thread, but am happy to share.

Birth Plan for [My Name] (baby girl!)

Mother: My Name
Father and Support Person: Dh's name
Last name of baby girl: Dh's last name
Practitioner: Dr. J----- -------
Due Date: September 9, 2010

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 fifth child. Our first birth (full term twins) was a natural vaginal birth, as was the birth of our son. (Our daughter is adopted.) 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 and nipple stimulation 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 a spinal rather than general anesthetic
•Partner present and able to take photographs
•Free one or both of my hands to touch the baby
•Partner to cut the cord
•Baby stays with partner, in-room, unless there is evidence of distress.
•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.

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 daughter.
post #7 of 11
Amazing birth plan cinderella08! I like the way it sounds with please at the beginning of each statement.....so much softer.
post #8 of 11
this is mine in case it's helpful to anyone, a doula online friend used it as hers:
Birth Hopes

In General:
Ideally, if all goes smoothly, I know that (our midwife's name) will support and encourage me, using her experience to guide me through labour. Please offer suggestions when necessary, but otherwise to remain in the background, taking observations to check on the baby's and my safety, but not directing my labour, unless I request otherwise. I believe that I know how to give birth on my own, but appreciate the security of having you there to help with the unexpected or emergency situations.
The Labour
•I would like to remain active and use whatever position I find comfortable. Please encourage me to stay off my back.
•I may wish to move around and to use the bath or shower from time to time.
•I would like to minimise internal examinations as much as possible.
•I would prefer not to have my waters broken, unless it is previously agreed to in order to encourage active labour in the case of going overdue.
•If the baby appears to be poorly positioned or labour is not progressing well for some reason, I would appreciate it if you could suggest changes of position or movements which might help.
•I may wish to use aromatherapy/herbal remedies/homeopathy during the labour
Birth Companions:
The following people may come to Genesis Clinic during the labour or birth:
(insert name/s)
Pain relief:
•Please do not offer any pain relieving drugs unless I ask for them, and even then only if necessary.
•Please do not offer me Pethidine, I had a bad experience using it with my previous birth.
•I hope to manage using no drugs for pain relief, and would appreciate your encouragement to use other methods. For example, I might use movement, massage, relaxation, or water
The birth:
•I would like to give birth in the water, or wherever seems right at the time.
•I would prefer to not have my waters broken artificially, unless it is completely necessary. Please discuss this with us beforehand.
•I would like to give birth in the position that feels right to me at the time, I hope it to be in an upright, kneeling, supported squatting or all-fours position to give the baby maximum space to descend through my pelvis. I hope to not be on my back or semi-reclining unless that position seems right for me on the day, having tried alternatives. If I am too tired to maintain an upright position, then please encourage me to lie on my side instead of my back, to allow maximum mobility in my pelvis.
•Ideally I would like either dh or myself to 'catch' the baby. I’d like (midwife) to observe and to be on hand in case of emergency. Otherwise when my baby is born, please pass him or her straight to me.
•I would like to avoid perineal damage if possible and would appreciate your guidance in giving birth gently to accomplish this. However, I would rather tear naturally than have an episiotomy.
•I may like to see or feel the head as it crowns, and my birth partner will have a hand mirror available for this.
•I would like the lights dimmed when my baby is born, and for our ‘birth CD’ to be playing, with a minimum amount of noise to be made. I hope that it will be a gentle entry into the world.
Third Stage:
•I would like to not use drugs, unless specifically indicated,
•Please clamp the cord only AFTER it has stopped pulsating unless you need to take emergency steps which preclude this.
•Please offer dh the opportunity to cut the cord if possible (after it has stopped pulsating)
Care of the baby:
•I would like to breastfeed my baby as soon as possible after the birth
•I would like to keep the baby unclothed and close to my skin immediately after birth, to maximise skin-to-skin contact
General
•No Pethidine please 
•Please do not offer any form of pain relief medication unless I specifically ask for it.
•If pain relief becomes necessary, I would like to use the following methods before we resort medication:
oBirthing From Within Techniques (please encourage me to use these)
oMassage
oBirthing Ball
oEntonox
oTENS machine if available
•If an assisted delivery becomes necessary, I would prefer the use of forceps before the use of a ventouse.
•I am very keen to avoid a caesarean section if it is at all possible. I particularly would like to avoid a caesarean for ‘slow progress’. If labour is simply taking a long time but my baby is not in immediate danger, please would you encourage me to keep going and perhaps to try changes of position or movements which might help. Please do not offer a caesarean unless my baby is in danger.
•If a caesarean section becomes necessary, I would prefer to remain awake with epidural or spinal block anaesthesia. I would like a skin to skin caesarean. I would like my partner to stay with me at all times, and would like to breastfeed the baby as soon after birth as possible

Thank-you for your care and understanding
post #9 of 11
To my Health Care Providers: Thank you for taking the time to work with us and our birth plan. These are our preferences; however we are open and flexible to any medical intervention that may become necessary in the case of a medical emergency .I am hoping to have a natural labor and would like to not use any interventions. If any interventions are suggested I want the time to review them with my Doula. I will have a labor support person and my husband with me

Before Labor

If I go past my due date and the baby and I are fine, I prefer to go into labor naturally rather than be induced.

As long as baby and I are healthy I would like to be given 2 weeks past my due date to go into labor naturally

I don’t mind NSTs after my due date to make sure everything is ok

If induction becomes necessary, I would like to try natural induction techniques first

Labor

I would like to labor at home as long as possible

Please only offer pain medications if I ask for them

I want to be able to walk around and move as I wish while in labor

I would like intermittent to allow for as much mobility as possible

I do not want an IV unless absolutely necessary a heplock is ok depending on how far into labor I am when I arrive

I would like to use the shower or birth ball if needed for pain relief

I would like no time limits on labor

Second Stage Labor

As long as the baby and I are healthy, I prefer to have no time limits on pushing.

I would like to push in whatever position feels right at the time

It's important to me to push instinctively. I do not want to be told how or when to push.

I prefer to have no episiotomy and risk tearing

To prevent tearing please apply hot compress and perineal massage

As long as my baby is healthy, I would like my baby placed immediately skin-to-skin on my abdomen

We would like to discover the baby’s sex ourselves

Please wait for the umbilical cord to stop pulsating before it is clamped. Wait at least 5 minutes to cut and clamp.

Please do not separate me and my baby until after my baby has successfully breastfed and we have had time to bond

Please delay all essential routine procedures on my baby until after the bonding and breastfeeding period (i.e., bathing).

Ceserean

If a caesarean became necessary I would like to remain conscious and have my partner present. I would like to have contact with the baby as soon as possible and to be able to breastfeed as soon as possible. If I must be separated from the baby my partner will take them. I like to try all other options before a C-section and only have one if it is absolutely medically necessary.

Third Stage Labor

I would prefer for the placenta to be born spontaneously without the use of pitocin, and/or controlled traction on the umbilical cord.

Baby procedures

If the baby is a male he will NOT be circumcised.

If the baby has any problems, I would like my partner to be present with the baby at all times, if possible

I would like to have routine newborn procedures delayed until bonding and breastfeeding have occurred

I would like all newborn routine procedures to be performed in my presence
We are not getting any vaccinations in the hospital

My baby is to be exclusively breastfed. Do not offer any artificial nipples, formula or sugar water. If baby is having difficulty latching I would like to see an LC

I would like to room in with the baby

I want to leave the hospital after the baby is cleared and have a short stay
post #10 of 11
I've got my name, my husband's name, and my doula's name at the top followed by:

We have planned and prepared for a peaceful and natural childbirth. We would like to allow labor and delivery to unfold naturally, with as few interventions as possible. We would like to be informed about all procedures and tests before they are performed. We want to be aware and informed of all of our options in the event of an unexpected emergency.

Preferences During Labor
No medications. Please do not offer pain relief.
No IV fluids
Intermittent electronic fetal monitoring, external only
No stripping of membranes or breaking of bag of waters
No use of Pitocin or other drugs to induce, speed up, or strengthen labor

Preferences After Baby Is Born
Immediate contact between mother and baby: baby placed on mother’s chest, breastfeeding encouraged, mother and baby left undisturbed for one hour following birth, and any newborn procedures performed afterward
Delay of clamping and cutting umbilical cord until blood stops pulsing
Placenta delivered spontaneously; Pitocin injection to assist placental delivery is acceptable.
We do not consent to administration of eye ointment (signed waiver is already on file) or hepatitis B vaccine.
Vitamin K injection is acceptable.
All baby examinations done with the permission, and in the presence, of a parent
We prefer to give baby her first bath ourselves.
If baby and Jenifer must be separated for any reason, Tim will accompany baby wherever she needs to go.
No artificial nipples for baby; no fluids by mouth other than breast milk.
Early hospital discharge, assuming healthy mom and baby.

Last thing on the page is baby's ped info.

It fills about 3/4 of a page and is in a nice big font with bullets to make it easy to read and therefore likely to be read.
I debated including so many of these, but figured they were the most important to me, so I put them on. My midwife confirmed today that they're almost completely standard issue for birthing with them, but that it was good to include things for the nurses just in case. She particularly said it was helpful to include a request not to offer pain meds and the part about not consenting to ointment and vax. She also said that early discharge is pretty common if mom and baby are healthy, so that was good.

One thing that surprised me, though, was she thought the ped would draw blood for the newborn panel before we left the hospital even if it was before 24 hours, then I'd have to go have it done again at the ped's office since the original test would be worthless. I'm not loving the idea of having my baby's blood drawn twice within a few days, especially when one is completely pointless. Will look into how difficult it is to opt out of that, but it's a state mandate, so not sure if I want to fight it . . .
post #11 of 11
We plan to have present at this birth our doctor, a nurse, the father and one friend for support. We ask that ALL other visitors and unnecessary staff be turned away until we (the parents) have had time alone with our new son.
-The birth environment is very important to us. For that reason we ask that the lights be kept dim, noise be avoided and the door closed for privacy.
-This is our first child, and we are attempting to have a natural birth, which we believe to be birth without medical and/or chemical intervention. We do understand that there are procedures which may be necessary. Except in the case of an extreme emergency, we ask that we be given the opportunity to accept or refuse any procedure. We also request that the least invasive or restricting versions of procedures (i.e. walking epidural, external monitor) be used, if necessary.
-Except in the case of severe dehydration or the necessity of an IV antibiotic (in the case of a GBS+ lab result), we would prefer that no prophylactic IV fluids be used and that the mother be allowed to eat and drink as desired.
-We would prefer to avoid hourly vaginal exams during the laboring process.
-If induction becomes necessary, we ask that non-chemical induction methods (walking, castor oil) be tried before chemical methods. If chemical methods do become necessary, we prefer to use the cervical cream before trying Pitocin.
-We plan to handle pain with meditation, relaxation, massage, and water. Please do not offer chemical pain relief.
-We plan on pushing in any position that seems comfortable to the mother. The mother would like to push at her own pace. If time permits, the mother would like to feel our son's head as he descends. We prefer to not have an episiotomy.
-After the birth, we wish to nurse our son immediately. We ask that any evaluations be done while the mother is holding him.
-If Cesarean becomes necessary, the mother would like to be conscious, the father would like to be present at all times and we still prefer for our son to be nursed immediately.
-We ask that the father and our son both room in for the duration of the hospital stay.
-We ask that the father or the mother be physically present with our son at all times during our hospital stay.
-We request that no rubber be used/given to our son during our hospital stay (i.e. pacifiers, bottles, any artificial nipple.) in order to help prevent nipple confusion.

We thank you for taking the time to help us achieve a natural birth for our son in the safe environment of your hospital.
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