Anyone want to share their hospital VBAC/VBA2C birth plan?

[Lyss]

My OB is part of a midwife clinic, and she's willing to let me do a TOL after 2 c/s.   I'm excited, walking regularly, and doing Hypnobabies. 

I lost my first two birth plans when I lost my hard drive.  I'm not sure where to start - I would need one for a VB and also provisions for a C/S.

I will not have a doula - we thought about it and looked into it, and even met with some people and am going to forgo a doula (please, L.A. doulas, don't message me).  We're lucky because we've heard wonderful things about the nurses at our hospital being very supportive of natural births.  I understand they can be helpful, but I don't really want someone in there with me and they cost more than we can spend.

Anyone want to share their plans?

[alyrie]

I removed my personal info, but this is mine. I had my OB sign off on it at my last appointment (36 weeks) :) 

[NaturalMama311]

I created mine here:  http://www.birthplan.com/  It was super easy and promted you for everything so you won't leave anything out. 

Here is my birth plan, I had a successful VBAC on Jan 9th but totally forgot my birth plan.  Luckily I remembered most of it so just told the nurses everything and DH made sure everything was done per our wishes. 

Good luck!!!

Labor

• I would like to be free to walk around during labor.

• I wish to be able to move around and change position at will throughout labor.

• I would like to be able to have fluids by mouth throughout the first stage of labor.

• I will be bringing my own music to play during labor.

• I do not want an IV unless I become dehydrated.

Monitoring

• I do not wish to have continuous fetal monitoring unless it is required by the condition of the baby.

• I do not want an internal monitor unless the baby has shown some sign of distress.

Labor Augmentation/Induction

• I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.

• If labor is not progressing, I would like to have the amniotic membrane ruptured before other methods are used to augment labor.

• I would prefer to be allowed to try changing position and other natural methods (walking, nipple stimulation) before Pitocin is administered.

Anesthesia/Pain Medication

• I realize that many pain medications exist. I'll ask for them if I need them.

Cesarean

• Unless absolutely necessary, I would like to avoid a Cesarean.

• I would like my husband present at all times if the baby requires a Cesarean delivery.

• If the baby is not in distress, the baby should be given to my husband immediately after birth.

Episiotomy

• I would prefer not to have an episiotomy unless absolutely required for the baby's safety.

• I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch.

• I would like a local anesthetic to repair a tear or an episiotomy.

Delivery

• I would like to be allowed to choose the position in which I give birth, including squatting.

• I would like my husband and/or nurses to support me and my legs as necessary during the pushing stage.

• Even if I am fully dilated, and assuming the baby is not in distress, I would like to try to wait until I feel the urge to push before beginning the pushing phase.

• I would like to have the baby placed on my stomach/chest immediately after delivery.

Immediately After Delivery

• I would like to have my husband cut the cord.

• I would prefer that the umbilical cord stop pulsating before it is cut.

• I would like to hold the baby while I deliver the placenta and any tissue repairs are made.

• I would like to hold the baby for at least 15 minutes before (he/she) is photographed, examined, etc.

• I would like to have the baby evaluated and bathed in my presence.

• I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.

• If the baby must be taken from me to receive medical treatment, my husband or some other person I designate will accompany the baby at all times.

• I would prefer to hold the baby rather than have (him/her) placed under heat lamps.

• I would like to delay the eye medication for the baby until a couple hours after birth.

• I do not want baby given the Hep B shot at the hospital.

• After the birth, I would prefer to be given a few moments of privacy to urinate on my own before being catheterized.

• I would like to bank the umbilical cord blood, and have made arrangements to do so.

Postpartum

• Unless required for health reasons, I do not wish to be separated from my baby.

• I would like to have the baby "room in" and be with me at all times.

Breastfeeding

• I plan to breastfeed the baby and would like to begin nursing very shortly after birth.

• Unless medically necessary, I do not wish to have any bottles given to the baby (including glucose water or plain water).

Circumcision

• I would like the baby to be circumcised before we check out of the hospital.

Other

• My support person(s) is/are (support people) and I would like them to be present during labor and/or delivery.

• I would like my other children to be able to visit me and the baby in the hospital.

• I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.

[neveraim]

Mine was simple, unwritten...when asked, I said "I just want a VBAC".  I finally got my VBA3C.  GOOD LUCK!

[kltroy]

Here's mine, with my own comments in red about why I asked for specific things:

(FWIW, I had a really nice intervention-free hospital VBAC!)

BIRTH PLAN – [mom’s name]

Birth attendants: 

 **   (physician)

 **   (husband)

 **   (mother)

I wish to be treated as if my uterine scar does not exist. I am planning an intervention-free and natural birth.  Residents/students are welcome to come in but please be respectful of my privacy by knocking and not turning on lights or making unnecessary noise.  Assuming there are no medical complications, I request the following:

1ST STAGE OF LABOR

·         In general, please leave me alone as much as possible.  My body knows what to do.  I thought this, and the intro bit, was good for setting up expectations

·         No complete IV line, heplock only  easy enough to ask, you may be able to refuse this altogether, but I didn’t think that was worth the fight.

·         If required, telemetered EFM so that I can move around as needed  this was the one thing I didn’t end up getting b/c it was broken.  Still, the birth ball worked well for me

·         Pain relief and vaginal examsby my request only 

·         I do not consent to artificial induction or augmentation of labor  Probably not necessary to put in a birth plan, but I wanted it down just for the record

·         All interventions consented to ONLY after a full verbal discussion of risks and benefits (rather than simply offering me a form to sign)  This too.  I think this one is more about the questions you ask at the time and probably doesn’t need to be in the plan.

2ND STAGE OF LABOR

·         No directed pushing, please

·         Birth in any position I would like

·         I would like to catch my own baby if I am in a position to do so  This was so special.  Obviously doesn’t work if you end up on hands and knees, but it was very cool.

·         Please offer Dad the opportunity to dry off the baby

3RD STAGE OF LABOR and POSTPARTUM

·         Delay cord-cutting for 5 minutes.  Offer Dad the opportunity to cut the cord.  I specified a time rather than “until it stops pulsating” because a time is not subjective, which means it’s more likely to actually be followed I think.

·         No active management of 3rd stage of labor unless medically necessary  This translates to “no routine pitocin to deliver the placenta”.  Obviously if I hemorrhage I would take the pitocin. 

·         Delay routines, APGARS to be performed while baby is held by me  Unless baby needs to be resuscitated, there’s no reason they can’t honor this one

·         I have tested negative for chlamydia; no erithromyocin in my baby's eyes please

·         We will do the first bath, not the nurses  We ended up letting the nurses do it, but not until later.

·         If baby is a boy, he will not be circumcised

·         Other parents may wish to put things about hep B vaccine etc.  Honestly though, once the kid is born your mind will be back in the real world, so I think cluttering birth plans with things that are easy to ask for is not productive.  Still, if you’re using your plan as a note to yourself and think you might forget, write it down.

[Lyss]

Thanks so much for sharing with me, ladies!!!  I really appreciate it.  My old OB hated my birth plans and told me the nurses would hate me (and they did).  This time, I don't care.  I'm going to write down what I want.  Hopefully I'll have time to make some cookies or cut up some fruit or something first to soften the blow.  :)

[sweeetpea]

May I suggest that you use the terminology "Do not clamp or cut the cord for xxx minutes".  I had a client who specified that she did not want the cord cut, which the OB agreed to, but the OB had a clamp on the cord within seconds after the birth, cutting off all blood flow anyway.

[Lyss]

Thanks!  Great point!

[porttack]

kltroy, thank you!