I'm working on our birth plan and even though it's only one page I feel like it's "too long". Can you guys help me refine it? Our hospital is pretty mother/baby friendly and most of what I am hoping for is "standard practice" but I want to make sure it's in writing anyway. "Purple Sheet" is the hospital's version of a special-care-plan for a specific concern, in my case it is to try to prevent me from passing out if I need an IV or during a cervical check (which I have done in the recent past).
Medical Directive: In case a decision about my medical care must be made while I am unconscious, I grant the authority for making that decision to my husband.
Labor and Delivery Goals: My husband and I are choosing to have as natural of a birth as possible, with as few medical interventions as necessary and being sensitive to my medical history of passing out w/injections and vaginal exams (see Purple Sheet). We understand that we must be flexible, but the following is a guideline of our wishes and desires for the birth of our child.
Fully Informed Consent: Before any procedure is performed, I will want to hear and understand the reasons the procedure is being offered, any possible alternatives, and the risks and benefits involved.
Labor Environment: Please keep the door closed for privacy, and the atmosphere as restful as possible. Please introduce yourself by name to myself and DH or Doula. Please no staff-in-training.
· Vaginal Exams: I prefer that vaginal exams be done only in the case of a medical emergency or at my request; I have a history of vasovagal reactions following Pap smears/IUD insertion.
· IV: I am strongly interested in avoiding IVs as much as possible. I have a history of passing out w/injections – see Purple Sheet. I will need reminders to drink clear liquids throughout labor to remain hydrated.
· Episiotomy: Tearing is preferred over an episiotomy. In order to reduce the risk of tearing, I would like warm compresses applied to my perineum and be given time to stretch gradually.
· Pain Management: Please do not suggest pain medication to me or my husband unless we ask. Non-medicated suggestions for pain relief would be welcome. During labor, I would appreciate encouragement to get in the shower or tub, massage from my support team, suggestions for different upright positions (including hands/knees or use of birthing ball), and reminders to relax my body especially my shoulders.
· Labor Positions: I do not wish to be on my back during labor and delivery and would welcome suggestions for different positions, such as a bar, ball, kneeling, squatting, etc.
Progress of Labor: Except for an emergency, I do not wish for my labor to be augmented. If there is a need to induce or speed labor, I would like to try natural methods first, including walking and breast stimulation. If medication is warranted, please discuss this with me, including the type of medication you recommend. “Failure to Progress” will NOT be considered a valid reason to use Pitocin or get a Cesarean. Please allow time for my body to follow its natural course without being rushed.
Cesarean: If making the recommendation for a cesarean, please help us to fully understand the reasons and options. My husband and Debra will accompany me during the surgery. If a Cesarean is necessary I would like to be informed throughout the procedure and allowed to watch if possible. As long as our baby is doing well, I would like her to be placed on my chest skin to skin while my incision is being repaired. Otherwise, my husband will take the baby and/or accompany her wherever necessary.
Pushing: It is my belief that the body knows when to push and to what degree. Please do not rush this stage of the delivery. Instead, please keep me informed about the baby’s progress which will encourage me in my efforts. If I have an epidural, please allow me to “labor down” before pushing.
Third Stage Preferences: Please offer my husband the opportunity to “catch” the baby and cut the cord after it stops pulsing. I would like her to be placed on my chest immediately after birth for skin-to-skin contact and warming. All exams and procedures should take place on my chest or in our presence (please check with me before giving her injections – see Purple Sheet). I plan to exclusively breastfeed. If the baby needs special care, please involve us as much as possible in her care, including feedings and kangaroo care. My husband or doula will accompany the baby if she must be taken to the NICU.