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Anyone want to post your birth plan?

post #1 of 9
Thread Starter 

I'd love to see it!  I worked on mine today and need to type it out.  I stuck to the things that are most important to me, but I'd like to get some ideas in case there is anything big I have forgotten.

 

I really didn't think a huge detailed plan would be necessary this time.  I am being delivered by a midwife in a hospital with another midwife as my doula.  My doula delivered my last and is the crunchiest midwife I know and just wonderful!  She and the midwife who is delivering this time worked together for years in another clinic and are great friends.  Can't wait!!!  But the more I think about it, I would like to have a good plan in case I end up being delivered by someone else, plus the hospital staff needs to know my plan.

 

So what are your biggest concerns drawn out in your birth plan?

post #2 of 9
Great idea! I just created mine, and I used a couple of birth plan templates I found to make sure I wasn't forgetting anything. Here they are in case you're interested:

http://www.childbirth.org/interactive/ibirthplan.html

http://www.earthmamaangelbaby.com/free-birth-plan

I'm going to be in a hospital with a regular OB. I was very upset about that, but after showing my doctor my plan, which even included hubby catching the baby, and her being totally gung-ho, I'm feeling much more optimistic!! I don't have the plan on my phone, so I'll post it tomorrow when I have computer time.

I stuck to the things I cared most about and things I felt really needed to be discussed rather than mentioning every little thing, like dim lights, music, my own clothes, etc. that I want. I figure I'll just do those things when I walk in! My main goal was to keep it to a page long. I skipped the explanations, too. I'm not trying to justify myself or change anyone's mind, so I'd rather not risk anyone not reading it or mistaking my intentions for trying to tell them how to do their job.

I'll be back tomorrow! Hope this helps in some way...
post #3 of 9

I wasn't planning on writing a birth plan out at all (homebirth with a midwife I'm very comfortable with), but I wonder if I should just in case I have to transfer...though my only reason to transfer would be for a true emergency (cord prolapse/hemmorage/etc.) so a "birth plan" would likely be thrown out the window anyway.  Hmm.

 

If I were going to a hospital the most important things to me this time would be ABSOLUTELY DO NOT CUT THE CORD EARLY, any suctioning can be done on my body, and no erithromycin (eye ointment), hep B vaccination, or vitamin K after birth. If I was going in early I'd also demand only intermittent fetal monitoring, as that was truly one of the worst parts for me last time (besides the pitocin...).  I think between those things and having my midwife as my doula (as she will be if we have to go to the hospital) we'll be okay.

post #4 of 9

Okay, here is my birth plan:

 

If post-date, I prefer trying natural induction methods first, only considering other options after 42 weeks

I prefer not having any students, interns, etc. in the room to observe the birth

I would like to keep vaginal checks to a minimum- once upon admittance, once to confirm complete dilation (if I have the urge to push)

I would prefer a hep-lock instead of IV during labor

I would prefer intermittent monitoring throughout labor

I want freedom of movement during labor

Please do not break my water

Please do not offer any type of pain medication during labor

Please do not offer Pitocin to speed up labor

Please do not perform an episiotomy-

I would prefer natural perineal support such as hot compresses, oil, or message

I would rather tear than be cut

I would like to avoid being sutured unless tearing is severe

I would like to choose the position I push in that feels best to me at the time

Please no coached pushing or hurried pushing

I would like to feel my baby crown and support my own perineum if desired

I would like for myself or my husband to catch the baby

I would like to delay cord clamping until after all the blood has gone to my baby, and the cord is white and limp

I do not want the cord to be forcibly tugged in order to separate the placenta

Please do not give me Pitocin to contract my uterus unless hemorrhaging is obvious

I want my baby immediately on my chest, skin to skin

I do not want my baby bathed, only thoroughly dried while on my chest

I do not want any eye ointment, vitamin k, or vaccinations for my baby

If baby is a boy, I do not want him circumcised or his foreskin retracted

I prefer all examinations be done while baby is on or next to me

I would like to delay weighing baby until we have had plenty of time to bond

Baby will be exclusively breastfed, so I do not want any pacifiers, sugar water, formula, etc, introduced

I do not want my baby to leave my side- if any emergency arises, my husband will accompany him/her

 

 

 

post #5 of 9

I haven't made one this time, though I still have my plan from the birth of DS2 and nothing has changed in it so I'll just use it again.  

 

 

 

Statement of Purpose



My partner and I have planned and prepared for a peaceful and natural childbirth. We would like to allow our 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.



The Labour


-- I would like to remain active and use whatever position I find comfortable. Please encourage me to stay off my back!

-- I am happy to have one internal examination to check presentation, but would like to avoid them otherwise, unless there is a particular reason why you think one is necessary.

--  Please do not offer to break my waters, and please be very careful to avoid doing so during any internal examinations

-- 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 would like to be able to eat and drink freely and will have what I need on hand.  I have also made a list of food/drink and where they are located.  

-- I would like my environment to remain as quiet and calm as possible.  

I may prefer to labor completely alone. If I have gone in the bathroom or our bedroom and shut the door, this is probably the case – in this situation, please come in one at a time for the sake of my privacy and concentration.



Birth Companions


I prefer not to have anyone (other than those listed below) present during labour/birth.  Surprise visitors should be turned away.  [I do NOT plan to notify anyone that I'm in labour other than those listed below and will have a sign outside of my door indicating that visitors should CALL first before knocking.] 

-- Midwife and her assistant(s)
-- Husband
-- Children

 

(Back up person for helping with children, if necessary, will be Kayla)
 

 


Pain Relief


I plan 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, the shower/tub



The Birth


I agree to an internal exam when feeling the urge to push to insure that I am fully dilated and not pushing through a cervical lip

Please keep the room as quiet as possible during the second stage. I would like to minimise distractions at this time

I would like to give birth wherever feels right to me at the time.  

I would prefer not to have an episiotomy unless absolutely required for the baby's safety; I am hoping to protect the perineum.  

Even if I am fully dilated, and assuming 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 rather not be told how to push, or guided in the second stage, unless there is a particular reason to suppose that I need assistance, or unless I ask for assistance.


I would appreciate having the room lights turned low for the actual delivery.




Third Stage/immediately after birth:


I would like to have baby placed on my stomach/chest immediately after delivery and wish to commence breastfeeding immediately after birth.

I plan to have a fully natural (physiological) third stage, and to cut the cord only after the placenta is delivered. I want to allow the placenta to turn up in its own time. It is important that the cord is not clamped or cut until the placenta is delivered and the cord has stopped pulsating. Please do not administer any drugs unless you feel there is a real need. I would appreciate your advice to help me deliver the placenta naturally. Please do not pull on the cord or use fundal pressure unless there is a specific indication to do so, as I have read that this is contra-indicated in drug-free third stages. I wish to keep the placenta and will provide an appropriate receptacle for it to be retained in.

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

Please do not suction mucus from the baby's nose and mouth 'just in case' - only suction if necessary.

Please do not bathe baby.




Repair of the Perineum, if necessary

I would prefer to avoid having stitches if possible, so if you think any tear will heal of its own accord, without stitiches, please let me know.




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 (as this may help bonding, be reassuring to the baby, and help your 'breastfeeding hormones' flow)

Please do not administer prophylactic Vitamin K after the birth. If the birth is traumatic for the baby or there is some other risk factor for HDN, I will be happy to discuss this with the midwife and allow vitamin K if we both decide it is appropriate.

Do NOT circumcise baby




In case of transfer to hospital:



I am aware that due to conditions beyond anyone's control, it may become necessary to transfer to hospital; should that be the case, the following are my wishes in the event of a hospital delivery.

Possible reasons for transfer:

I don not wish to be urged into a hospital transfer simply for “failure to progress” unless there is clear evidence that baby is in distress and a transfer is urgently required.

Should meconium be found in the waters, I wish to discuss fully the options dependant on the appearance of the meconium and fetal heart rate.

If transfer by ambulance becomes necessary, please do not strap me in on my back - I would prefer to be on my side, to make contractions easier to deal with.

Do not offer pain relief unless I specifically request it; likewise I wish to avoid any “routine” use of IV, etc and therefore do not consent to having a Venflon inserted.



 

Labour/delivery in hospital


As above, I intend to have an active birth and prefer to be allowed to move freely and give birth in the position that best suits me. I do not wish to be given an episiotomy; nor do I wish for the lithotomy position to be used. 

I do not consent to having student doctors present, during birth or afterwards.




Immediately after delivery


As above, I wish to have a physiological third stage, and to cut the cord only after the placenta is delivered. I want to allow the placenta to turn up in its own time. It is important that the cord is not clamped or cut until the placenta is delivered and the cord has stopped pulsating. Please do not administer any drugs unless you feel there is a real need. I wish to retain the placenta and will wish to take it home; I would appreciate it if it could either be kept refridgerated until I go home, or else given to my husband is aware of my wishes in this regard.

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

I would prefer to hold baby rather than have her placed under heat lamps.

As above, I do not consent to the administration of Vitamin K after the birth, unless the birth is traumatic.  In the case of a traumatic birth, I would like to discuss this and give my consent PRIOR to it being administered 

Unless required for health reasons, I do not consent to separation from baby.

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




Feeding


As stated above, I intend to breastfeed and wish to do so as immediately after birth as possible. I do not require "hands-on" assistance with regards to breastfeeding.

Please do not give my baby supplements of glucose water or formula milk without my permission. I would expressly like to avoid having any formula supplements unless it is unavoidable, and certainly not in the first two days in any event.
Under no circumstances is my baby to be given a pacifier or be bottle-fed as this could lead to nipple confusion and hinder breastfeeding. If supplements are necessary, please give them by spoon or other method, not by bottle.




Caesarean


I am very keen to avoid a caesarean section if it is at all possible, as I do not want to enter future labours with a scarred uterus. I particularly would like to avoid a caesarean just 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 my primary care provider determines that a Caesarean delivery is indicated, I would like to obtain a second opinion from another physician if time allows.

If a Caesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.

I would like my husband present at all times if baby requires a Caesarean delivery.

If baby is not in distress, s/he should be given to my husband immediately after birth.




Post-partum complications


If I suffer a severe post-partum haemorrhage, please do not perform a hysterectomy unless it is the only available course of action. 

Please do not admit my baby to Special Care simply for observation, but only if there is a specific reason for concern.




Going home


I would like to go home as soon after the birth as I am able to move, unless I or the baby have health problems which require hospital treatment.



I understand that circumstances may change due to events during labour and birth and that matters may not necessarily proceed as I would wish dependant on any medical intervention I and/or baby may need and accept that I should be prepared to be flexible with regards to this birth plan as a result. I am fully aware that a birth plan can only be a guide to my wishes; however I prefer that all medical treatment and any changes to this plan be discussed fully with myself and my husband and expect to be consulted fully prior to any treatments being carried out on either myself or baby.


Edited by itsajenism - 12/13/12 at 12:46pm
post #6 of 9
  • I had a very difficult time verbalizing anything during my past labors, even answers to simple yes or no questions.  (I have Asperger’s; this might be a factor.)  I trust that my husband knows me well enough to speak for me if I am unable to.  For this reason especially, I hope not to be separated from him at any time, barring an emergency.

 

  • My husband is a disabled veteran.  When under stress, his demeanor can sometimes appear to those who do not know him as brusque, rude, or possibly even aggressive.  I can assure you (as can his doctors) that he is not a threat.  Please bear with his manner.  J

 

  • I respectfully decline any and all cervical checks that are not absolutely medically essential.

 

  • I labor best in quiet and low light.  If the staff could facilitate that, it’d be awesome!

 

  • I would prefer to push on instinct - both on when to push, and in which position.

 

  • I do not want an episiotomy.  And if we could avoid routine suctioning of the baby, that’d be great.

 

  • If a C-section is needed, my husband will probably not want to attend.  This is fine; please don’t try to talk him into it.  He would prefer to accompany the baby to the nursery if this is possible.

 

  • Please do not announce if it is a boy or a girl before we get to check it out ourselves.

 

  • Barring medical emergency, I want the baby to stay with me at all times – preferably skin to skin.  (I have never been separated from my infants before.)

 

  • I would like to avoid routine fundal pressure or manual removal of the placenta.  If I am bleeding too much, feel free to go all out. J

 

  • We are not circumcising if it’s a boy.  Also, please do not retract the foreskin during any exams!

 

  • I am planning on breastfeeding.  If the baby needs to be separated from me at any time, please do not give him/her a routine bottle unless medically indicated.

 

 

*******

 

Still have to talk to the doctors about whether constant IV's  are needed, and the whole freedom in pushing positions.

post #7 of 9
Thread Starter 

Thank you, ladies!  I am going to look over mine again, tweak and add a couple things, and I will share as well.

post #8 of 9

Mine is below... just a note first, though.  I was a doula for several years before becoming a teacher.  A friend of mine who worked in L&D mentioned to me one time that when they see a really long and detailed birth plan, they automatically think "c-section."  I was advised to help my clients develop a plan that was short and sweet, because L&D nurses just don't have the time to read those long birth plans in detail.  With that said, I've used the same plan for my last birth, and will for this one as well, with a few changes.  It's only one page (but that's because I use large font so they can read it more easily).

 

Birth Goals for Julie and Eric

Labor

  • We would like to be informed of all of our options at all times.
  • We would like to be as mobile as possible, only using intermittent monitoring.
  • We will request medication if and when it is needed.  Please do not offer us medication.
  • We would like to use the tub and shower as much as possible.
  • We ask for patience for Julie’s body to work on its own.  Her labor history has shown a pattern of hours with few contractions and little cervical progress.  Once labor picks up, however, a baby is born very quickly.

Pushing

  • I would like to be in the position that is most comfortable for me.
  • I would like to push as I feel the urge- no extended breath holding or counting, please.
  • I do not wish to have an episiotomy unless forceps are required or if my baby must be delivered quickly due to fetal distress.
  • My daughter Liberty would like to assist in the “catching” as long as there is not an emergency situation.

Immediate Postpartum

  • We would like to have and hold our baby immediately after the birth for as long as we wish.  We do not want our baby removed from the room for a bath, measuring, footprinting, etc.
  • We would like to wait for the umbilical cord to stop pulsing before it is cut.  Eric would like to cut the cord himself. 
  • We decline the administration of the Vitamin K shot and eye drops for our baby.
  • Julie will be breastfeeding the baby exclusively- this means no sugar water, pacifiers, or artificial nipples of any kind, for any reason, without our explicit permission.
  • If the baby needs to go to the nursery, Eric will go with the baby and stay with the baby the entire time. 
post #9 of 9
Thread Starter 

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Edited by rebeccajm - 12/21/12 at 8:43pm
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