I'm planning a VBAC, according to the following:
The Roche Family Birth Plan - Baby #4 (VBAC)
Name: Analisa Roche
Midwife or OB: Dr. Yolanda Lawson
Pediatrician: Dr. Daniel Moulton
Professional Labor Assistant:
Birth Center or Hospital: Baylor
Approximate Due Date: 03/06/2006
We understand that birth can be unpredictable. We are presenting this birth plan to encourage dialogue and to help us achieve a safe and satisfying birth. Our baby's health and well being is of utmost importance to us. We look forward to working with you, and appreciate your cooperation in helping our family to achieve our personal birthing goals.
BEFORE LABOR BEGINS:
* I expect, and trust, that my practitioner will seek my opinion, and that of my partner, on all issues that may affect my birth experience or that deviate from this plan.
* If the baby and I are fine, and if I go past my estimated due date, I would like to wait until I go into labor naturally.
* If my water breaks at the onset of labor and there are no signs of infection, I would ideally like to wait at least 24 hours before induction is considered.
* If my baby is overdue, prior to induction, I would like to try the following techniques first (with the guidance and supervision of my doctor or midwife):
o Breast stimulation
o Sex (assuming waters have not broken)
FIRST STAGE OF CHILDBIRTH: LABOR
First Stage, Phase I - Latent Labor:
* Upon entering my hospital or birth center, it is crucial for me that I will not be separated from my partner(s) at any point during labor or birth.
* While I understand and can appreciate the need for training and teaching, I may prefer not to have residents or students walking in and out during my labor and delivery. Please respect my wishes as I state them while laboring and delivering.
* Ideally, I would like my environment to:
o have dimmed lights
o to have voices respectfully lowered
o to be at a cool temperature
* I would like the hospital or birthing staff to know that I may have my own personal style to birthing -- from walking, moaning, or grunting. I would be grateful for the personal space to do this comfortably without feeling hushed or rushed.
* Upon being admitted, I would like to avoid a routine enema.
* I am uncomfortable having my pubic area shaven unless it becomes medically necessary to do so. Please explain such a procedure beforehand.
First Stage, Phase II - Active Labor - Getting to 10 cm:
* I would like to keep internal vaginal exams to a minimum.
* I understand that I will be working REALLY hard. Therefore:
o If hospital rules do not allow food, I would like to insist on access to clear fluids, like water, Recharge®, Gatorade®, and/or ice-chips.
* If an IV prep becomes necessary I would like a heparin/saline lock to be considered. A heparin/saline lock is ....
* Since mobility is important to me, I would like Intermittent Monitoring (ACOG Standards), using:
o External electronic monitor
* My birth partner and I would like to take a few moments to privately discuss my pain-relief options before a decision is made.
o Ideally, I'd like a drug-free birth. Only offer medications if I ask.
* I would like the opportunity to try non-medical, non-invasive pain-relief methods. Some therapies I feel would be useful for me include:
o Guided relaxation
o Water (shower/bath)
o If bath or shower, I would like my partner to join me.
o Change in position
o Hot/cold therapy
* Ideally, I would like to be allowed freedom of movement -- to walk, rock, use the bathroom and move as my body dictates.
* I am interested in having access to certain birthing equipment. If available, I would like to use:
o Birthing stool
o Birthing pool/tub
First Stage, Phase III - Transition:
* I understand that transition is unpredictable. I may throw-up, my water may break if has not already, and/or I may expel other bodily fluids. I am appreciative of help that reduces my anxieties and my sense of vulnerability.
* At this point, my body may be most sensitive. If I am feeling that my support person's or staff member's voice and/or touch feels too much, I will indicate so.
SECOND STAGE OF CHILDBIRTH: PUSHING AND DELIVERY
* I have the following coaching preferences:
o I do not want to be coached how or when to push. When I am fully dilated, I trust my body's instincts to push my baby out naturally.
* As long as it is clear that my baby's heart tones are good and that she/he is receiving sufficient oxygen, I would like to be free of time limits on pushing. It is important to me to allow my body to operate in its natural rhythm and time-table.
* If my doctor or midwife feels that pushing may not be progressing efficiently, I would like to be reminded that sometimes changing positions helps. Because I may be very internally-focused, I would like to be encouraged to try one or more of the following delivery positions:
o Side-lying position
o Standing upright
o Hands and knees on floor
o Kneeling, resting arms on bed/chair
o Semi-reclining on bed, knees pressed to chest with support person behind me, providing counter-pressure
o Whatever feels right in the moment
* Ideally, I would like to avoid an episiotomy. To that end, I would like my practitioner or birth partner to support me with:
o warm compresses applied to my perineum
o sterile olive oil to massage and stretch my perineum
o encouragement to breath with my urge push, allowing me to move with the flow and force of my uterus.
* I would like local anesthesia for repairs (stitches).
* I would like to be given the option to view my baby's entry into the world by using a mirror.
* I would like to catch my baby, or have my partner catch the baby, as he or she descends.
* I would like for my baby to hear our voices first.
* I would like my baby to be placed on my abdomen immediately following the birth.
* If warming is necessary, please allow baby to be warmed on my abdomen, covered by blankets.
If Complications Lead to a Cesarean Delivery:
* Please keep communication open. If, at all possible, please wait for my express consent, or that of my partner, before initiating any procedure.
* It is important to me that my partner(s) be present with me at all times during the birth.
* Ideally, I would like to remain awake and aware, avoiding general anesthesia if possible.
* Please discuss anesthesia options with me.
* Please use a low-transverse incision on my uterus and abdomen.
* Since I have had a cesarean, please use the same incision, if possible.
* I would like the screen to be lowered, or be able to use a mirror, so I can witness my baby's entrance into the world.
* Please leave at least one of my hands free so I may touch my baby when he or she is born.
* Assuming the baby is well, I would like to hold my baby on my chest and/or nurse my baby as soon as possible.
* I would like the opportunity to see and/or photograph my placenta.
* Please remove my IV and catheter as soon as possible following my baby's birth.
* Please discuss options for postpartum medication, if needed, with me.
* Please provide me with nutritious food and drink as soon as possible.
THIRD STAGE OF CHILDBIRTH: DELIVERY OF PLACENTA OR AFTERBIRTH
* Ideally, I would like to deliver the placenta unassisted -- without Pitocin, uterine massage or cord traction. If a procedure is necessary, please explain it to me.
* I would like the opportunity to see the placenta. I understand that the placenta has been my baby's life support system, providing him or her with daily nutrients, warmth and eliminating his or her wastes. Assuming both baby and I are well after the delivery, I would like the opportunity to see the placenta. If possible, I would like my doctor or midwife to show me the maternal and the fetus' sides.
* I would like my partner to have an opportunity to take a picture of the placenta.
IMMEDIATE NEWBORN CARE:
Suction and Cord Care:
* I would like my baby not to be suctioned unless medically necessary.
* In my ideal world, my healthy baby will be immediately placed on my chest. If this is the case, he or she will be above the placenta and I would therefore like to wait until the cord stops pulsating before it is clamped and cut.
Eyedrops, Vitamin K and other Procedures:
* I understand that it is routine to administer antibiotic drops or ointment, such as erythromycin, to newborn baby's eyes to protect against gonorrhea and chlamydia, as well as other more common bacterial infections.
o I prefer not to have my baby undergo this treatment at all.
* I understand that in the United States, it is routine procedure to give newborns a one-time injection of vitamin K.
o I would like vitamin K to be given to my newborn.
* Ideally, with either a vaginal or cesarean birth, I would like to postpone routine newborn procedures until I have had a chance to bond with my baby.
* I would like to have any additional newborn procedures thoroughly explained to us.
* I would like for my birth partner(s) or me to be present during all newborn procedures.
* I would like to postpone any immunizations until a later time.
Bathing and Circumcision:
* I prefer that the baby be gently wiped down to remove fluids, and wrapped in a receiving blanket. Please do not bathe, to allow my baby's natural vernix to continue to soften and protect skin.
* If the baby is a boy,
o please do not circumcise.
Rooming-In and Feeding:
* My preference for in-hospital infant care is:
o Full rooming in -- no separation.
* Please do not offer my baby the following:
o Sugar water
o Artificial nipples
* My feeding preference is:
o to breastfeed exclusively.
* I would like the assistance of a lactation consultant to help me with nursing.
* I would like my older children to visit with my newborn and me as soon as possible.
Sick Baby and Postpartum Care:
* If my baby is not well, I would like to:
o accompany my baby, or have my partner accompany the baby if transported to another facility.
o breastfeed, or provide my expressed milk for my baby.
o have unlimited visitation for my partner and myself.
o hold, rock and care for my baby, if possible.