or Connect
Mothering › Groups › August 2013 Due Date Club › Discussions › Birth Plans- share yours here

Birth Plans- share yours here

post #1 of 9
Thread Starter 
Hi guys, I was working this weekend on my birth plan, mostly because I was excited to pull together some of the thoughts in my head about how I want this birth to go in the hospital. I gave birth to our DD 3.5 years ago in the same hospital and had a pretty simple birth plan, but there were some things I hadn't thought to put in my plan- like routine pitocin for delivering the placenta. :-(

I thought we could share our birth plans here as we are working on them and get feedback/ideas. I came up with a pretty detailed plan that I will probably edit down, but I need to talk to my doula and OB about the things that don't need to be stated for my very mom/baby-friendly hospital. Anyway, here goes (names taken out for privacy):


BIRTH PLAN- **** HOSPITAL
Parents: ****
Attended by: ****
Doula: ****
Obstetrician: ****

**** and I are anticipating an unmedicated vaginal birth for our second child. We value your encouragement and support in making this possible!

FIRST STAGE:
--Freedom of movement is very important to me as I plan to employ a variety of natural pain management techniques. I appreciate your assistance in making this possible through the use of intermittent fetal monitoring. (I will add in my preference for a hep-loc here if I am GPS+)
--I prefer to avoid routine vaginal exams.
--I do not wish for my water to be artificially broken unless I request it.
--Please wait for me to request pain medication.

SECOND STAGE:
--I intend to follow my natural urge to push with freedom of position. Please do not count.
--I welcome your support in preventing a tear but prefer a natural tear over an episiotomy. I do not consent to an episiotomy.
--Please refrain from pulling/maneuvering baby's head before shoulders are born. If positioning is a problem, help me change to hands/knees position.
--Please remind me to touch my son’s head as he is being born.

AFTER THE BIRTH:
--Please place my son directly on my chest/stomach after birth.
--**** would like to cut the cord once it stops pulsating (5-10 minutes after the birth).
--I prefer to deliver the placenta once it has detached on its own. I do not consent to traction, gentle or otherwise, on the cord.
--We would like to see the placenta after it is delivered. Please save the placenta for us to take home.
--I do not consent to a pitocin shot after birth unless I am hemorrhaging.
--I do not consent to manual removal of clots from my uterus.

NEWBORN CARE AND FEEDING:
--We prefer for the initial bath to be done in our room with our assistance.
--We will be breastfeeding and do not consent to the use of artificial nipples or supplements (including glucose solution and/or formula).
--We prefer that newborn exams be delayed for at least one hour after birth.
--We will not be circumcising our son.
--We do not consent to the eye ointment or Hepatitis B vaccination for our son.

I feel like this birth plan is rather assertive/bossy- is it just me or do I need to soften some of the language? Is there anything I've forgotten?
post #2 of 9

Thank you for this!  I haven't written one before, but really feel like it is necessary this go around (mostly because of how things went with DS's birth and a general lack of communication with our midwife then).  I asked one of our midwives if I could share a birth plan with them and get their help, but then realized I didn't even know where to start. 

 

I don't think your plan is bossy, just factual.  I would suggest going over it with both your doula and your OB and see what they think.  Maybe different wording would be better received in a hospital, but maybe not (cut and dry, no room for interpretation could be exactly what you want).  I just Googled birth plan template and found this link http://pregnant.thebump.com/pregnancy/pregnancy-tools/articles/tool-birth-plan.aspx  It is like a checklist and has a few more things/areas covered on it.  I think I am going to look at some more before I start mine, but I look forward to reading others and eventually sharing and getting feedback on mine! 

post #3 of 9
I think your tone is good. I prefer is a good phrase. You say please lots too.
Know that episiotomies are used by competent OBs mostly with vacuum or forceps so if you find yourself there your plan may change.
I would write a if then c section part. I have one in my home birth plan, just because I don have some preferences and sometimes sections are needed. I also have a daddy stays with baby bit.
I would add an I prefer no pain meds, but if I change my mind I will ask, don't offer.
What about vit k?
Do you want a parent to go with baby for the hearing test. In our very baby friendly hospital last time that was the only routine out of room thing, but we were welcome to come.
Note if you tear, as I always seem to, about local anesthetic for stitches. I had not thought about it with my first and stuipdly just said no. It hurt so much I could not hold my baby.
Do you want to go home early if everything is alright?


Last, do you have any preferences to remind your doula, etc of. I don't like being naked, being called mommy, get super hungry after, and I just noted them in mine.
post #4 of 9

I try to keep mine as short as possible...  This was mine from last time (though it will likely be different this time as I have differing concerns, a different hospital, and different care providers:

 

Birth Preferences (“plan”) for: Susan *******
Due date: January 15, 2012
Support persons: Chris *******(husband), Barb *******(mother)

 

We’re hoping to achieve the birth of our son John with as few interventions as possible.  We plan to labor without use of painkillers.


In addition, to help accomplish this, we would like the following:

·         Freedom of movement/positioning during labor, pushing, and delivery

·         Saline Lock instead of IV

·         Intermittent Auscultation as long as baby is doing well

·         Please discuss use of interventions like Pitocin, AROM, etc with us prior to use

·         Limit checks to admission and upon patient request

·         Self-directed pushing

·         Chris would like to cut the cord and we would like it to stop pulsating before being cut

·         No cord traction or uterine massage, no post-partum pitocin or cytotec unless bleeding is severe

·         Immediate skin-to-skin contact/breastfeeding

·         Delayed eye ointment/vitamin K shot for the first hour while we bond

·         No Hep B shot, no bath for baby

 

Cesarean:

In the event a cesarean is necessary, we would like to keep the spirit of our original “plan”

·         Only essential conversation related to the surgery/delivery

·         Lower sterile drape or use a mirror so I can see my baby immediately

·         Chris would like to cut the cord

·         Pictures allowed

·         Baby to stay with me unless needed for medical treatment

·         Breastfeed in the recovery room

·         Delayed eye ointment/vitamin K shot for the first hour while we bond

·         No Hep B shot, no bath for baby

·         Most senior anesthesiologist possible to administer the anesthesia (due to prior issues with anesthesia not taking fully, scoliosis)

post #5 of 9
One note I will make after observing hospital births as a doula... It's not just CUTting the cord, it's CLAMPing the cord. You can wait an hour to cut but if they clamp right away, there's no point. So you may want to specify no clamping, specifically.
post #6 of 9

Thanks for the reminder to do this! Since I'm likely birthing at our women's hospital rather than at home I need to make sure I have a very detailed, very clear birth plan.

post #7 of 9
Most of what is in our plan is standard procedure at our hospital, but we're leaving the state for over a week (I'll be 34-35 weeks), and I wanted our wishes to be very clear in case I go into labor while we're on vacation.


Our Birth Plan
Name:
Husband:
Midwife:
Practice:
Hospital:
Due Date: August 11, 2013
Baby’s Gender: It’s a GIRL!
Baby’s Pediatrician:

The following is our preferred birth plan. We understand that situations may arise in which not all of our choices will be possible. We would like to be informed of all decisions and procedures in advance, and be allowed the chance to give informed consent. If you have any questions or comments, please feel free to discuss them with us. Thank you!

Prior to Labor/Labor Augmentation:
As long as the baby & I are healthy, I would like to have no time restrictions on my pregnancy.
I would like to avoid induction, unless medically necessary.
I would like to try alternative means of labor augmentation, like walking or nipple stimulation, before pitocin or artificial rupture of membranes is attempted.
If induction is necessary, I would like to attempt it with prostaglandin gel or another means before pitocin is administered.
If induction is attempted, but fails, I would like to come back at another time rather than pursue further intervention (assuming my membranes are intact and that waiting presents no danger to the baby or me).

Environment:
I would prefer…
• a private delivery room with a tub.
• a quiet, soothing environment during labor.
• to play my own music.
• the option to take pictures.

Support People:
• my husband
• any immediate family members I request, according to hospital policy
• only essential medical staff

Labor:
I would prefer…
• to labor at home as long as possible.
• to have a heparin lock so I can be as mobile as possible. Please do not administer an IV or heparin lock unless it is medically necessary.
• to labor freely and use any birthing equipment available: tub, yoga ball, squatting bar, bed, etc.
• the option to wear my own clothes.
• to eat and drink throughout labor, as desired.
• to avoid a catheter, unless medically necessary.
• to forgo routine preparatory tasks (shaving, enema, etc.), unless requested.

Pain Relief:
Please do not offer any medical choices for pain relief, unless requested.
If pain relief is considered, please offer nonmedical choices for coping and/or remind me of how close I am to the birth.

Cesaeran:
I would prefer…
• to avoid C-section, unless medically necessary.
• for myself or my husband to be fully informed of all procedures and actively participate in decision-making, if possible.

Monitoring:
I would prefer…
• to be monitored intermittently with external devices.
• to limit the number of vaginal exams.

Perineal Care:
I would prefer…
• not to have an episiotomy, unless medically necessary.
• perineal massage with oil and hot compresses to avoid tearing or episiotomy.
• to be guided in my pushing & breathing efforts to help my perineum stretch.
• to have local anesthesia administered when repairing any episiotomy or tear(s).

Delivery:
I would prefer…
• the freedom to push and deliver in any position I like.
• help supporting my legs as I push.

Extraction Devices:
I would prefer none to be used, unless medically necessary.

Immediately After Birth:
I would prefer…
• the baby to be placed on my stomach/chest immediately.
• the umbilical cord to stop pulsating before it is clamped or cut.
• the option to deliver the placenta naturally, without medical intervention.
• the remaining cord blood to be donated publically, if possible.
• the IV/Heparin lock/catheter to be removed as soon as possible after delivery.

Newborn Care:
I would prefer…
• all essential routines procedures to be delayed until after a period of bonding/breastfeeding.
• myself or my husband to be present during all testing and procedures.
• to waive the administration of eye antibiotics.
• to waive the administration of routine Vitamin K, unless medically necessary.
• to waive the administration of any immunizations, including Hep B.
• for the PKU testing to be delayed until after a period of bonding/breastfeeding.
• the baby to be circumcised, if it happens to be a boy.
If my baby has any complications, I would prefer…
• for myself or my husband to be transported with the baby, if possible.
• to be allowed to breastfeed or express milk for the baby.
• to have as much physical contact with the baby as possible.

Feeding:
I plan to breastfeed.
Please do not give the baby supplements (including formula, glucose, plain water, or a pacifier) without my consent, unless there is an urgent medical necessity.
I would like to meet with the staff lactation consultant.

Post-Partum/Recovery:
I would prefer…
• the option to have the baby stay in my room.
• the option to have the baby go to the nursery if I need to rest.
• the baby to be brought to me for feedings on demand.
• to have access to my chart and my baby’s chart.
• information on pain management and the healing process.
• to have my husband stay with me for the duration of my hospital stay.
• to have visitors, according to hospital policy.

Again, we understand that not every aspect of our birth plan may be possible, but we want to thank you for supporting and respecting our decisions.
post #8 of 9

I'm kind of lazy, so I googled for birth plan checklists.  You check off the stuff you want, and they email you a link to a custom birth plan:

 

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

post #9 of 9

With this being a homebirth (my first, I am very excited) my notes look a bit different than the first two times. I found I actually had more to say, but it was true preferences, my experiences of how I labor, and notes on the set up. It is written for me, my husband, and the midwifes.

 

Birth Note

Midwives (lists all their numbers)

 

My husband is

Baby is a girl and is called Iggy (Wigglesworth) until she is born

My parents are (Nanna) and (Grandpa).

The kids are Monkey (4) and Bee (2).

My neighbor X may also be here.

My Mum is welcome in the birth room as she is comfortable

My Dad  would very much like not to be around and will be on kid patrol. My kids will also not be around the birth.

 

overnight parking please call XX.

CVS is open from 7 am to 10 pm

Duncan Donuts is open 24 hours

 

Stage One

I have a La Bassine and plan on living in it. I could have married the tub at hospital with Bee.  It takes 10 minutes to blow up and filled pretty fast. Unscrew the shower head (it is hand tight) and the adaptor is already on the hose.

When I get down to work in labour I tend to check out and not be engaged. I don’t need active participants. Unless I have a specific request, which must them be immediately met.

Please have someone beside husband near me so if I have a question or need, you can answer/meet it.

I may waddle off to the toilet, but otherwise I think I will want to stay put in the bedroom.

I don’t concentrate on my breathing, it just messes me up

I find having concrete progress markers helpful and would like to be told how many centimeters dilated I am.

I don’t notice the atmosphere.

I have no idea how I feel about dimmed lights, at night if I am sleepy they sound nice.

Stage Two

I seem to wake up a bit at transition

I prefer not to be told when to push

I caught Bee and would like to catch this one if that works in the moment.

Stage Three

If it is between 11am and 9pm call Jimmy Johns () or give me the iPad. I need a BLT (extra tomato and cucumber). If they are closed, bring me food soon.

I was very cold after Monekey and would like to have the flannel sheet available this time.

Please offer to let Husband cut the cord, but he may choose not to.

We do not wish to keep the placenta

If I need stitches again, I would love some pain relief

She will have the Vit K shot

I don’t see the need for her to have eye ointment

I would love to be tucked into some dry clothes in a clean bed pretty quickly so the kids (and grandparents) can come and meet the baby. They can hold her while I eat.  PJs and nursing tanks are in the top drawer of my dresser (the one on the right)

We have a footprint kit and I would love to get some prints.

Both by earlier births were at 11 something at night and I could never sleep for hours. Husband wanted to crash almost immediately.

Rogam is in the fridge, top right at the back

Please use the green hose to empty the pool (send someone to get it from the side yard if needed) to keep the clean hose clean

Z is our pastoral care person. She sees clients most days so might not answer immediately, but will be able to check messages throughout any given day. Her cell phone number is .

 

Transfer Plan

Home address

home phone

Kids will stay home or go to : cell:  home: address

 

My first choice if we need to transfer is X hospital

I would like my midwife to stay with me as a support person

I will ask for pain relief if I feel I need it.

Please offer to let husband  cut the cord, but he may choose not to.

If I need stitches again, I would love some pain relief

Please make sure to feed me as soon after the birth as possible. It makes me very very very hungry.

 

If a caesarean section becomes necessary:

            My husband will be at least a bit faint.

            I would like to nurse as soon as possible.

            I would like my midwife to stay with me as a support person

 

Newborn Care

My baby will be exclusively breastfed. Do not give her formula.  If I am not in a position to nurse, please use donated milk.

If she can not be with me, all my kids so far have loved pacifiers.

She does not need to have eye ointment or a Hep B vaccine.

She will have the Vit K shot

If she needs to be separated from me, her Dad will go with her

I would prefer to give her a bath as needed.

We would prefer to leave early, subject to circumstance.

  Return Home
  Back to Forum: August 2013 Due Date Club
Mothering › Groups › August 2013 Due Date Club › Discussions › Birth Plans- share yours here