Birth plan question

[guitarmama]

I'm doing a birth plan even though I'm planning a home birth. I figure that things would have to be pretty bad for me to actually have to be transfered to a hospital, so I want to include something in there about if a c-s was necessary. Does anyone have any suggestions as to what I should include? I got the easy ones like dh to be in opperating room and holding and breastfeeding asap, but I'm sure there are things I'm missing in there.

[damyen's mommy]

Hi, I'm having a hospital birth, not really by choice but that is another story, but here is the birth plan I used, it is pretty complete. Some things I left out when I made my own but I think it pretty much covers everything http://www.earthmamaangelbaby.com/birth_plan.html I love this site for other stuff too. I hope this helps.

[musemor]

This is an article about a "gentle" caesarian.
http://www.guardian.co.uk/family/sto...656246,00.html

I think it may have some ideas for your birth plan. I was really impressed that it's possible (doctor willing) to have a beautiful and "natural" experience, even if the baby can't be delivered vaginally.

[EllasMama]

Those sites should be helpful. Also having your doula/midwife as your advocate at the hospital will help you stick closer to your intentions.

Regarding cesareans: should that occur, besides hoping for a "gentle cesarean" and wanting to breastfeed as soon as humanly possible afterward, I've asked my doula and DH to insist that I'm given double-layer suturing when my uterus is sewn up. The research I've read indicates this is preferable, but not all hospitals/surgeons do it.

Carol

[BakingMama]

Ellasmama: Could you talk more what double layer suturing is, benefits of this and why this isn't routine. Do you have any links to the research on it you mentioned. Thanks. I'm not planning to have a C-section but just in case.....

[MAMom]

I too am having a homebirth (HBAC). I actually wrote 3 birth plans - one for homebirth, one for hospital vaginal birth, and one for cesarean birth.

I have my home visit with my midwife, her assistant, my doula and friend who will be attending my birth next week. I think a birth plan is useful (it was really empowering to write it) even for homebirth, since in reality unless you've delivered with the same midwife before, you don't *really* know what she will be like during your actual delivery.

For me it's really important that we're all on the same page (including DH) and I've found that putting my wants/hopes/preferences down on paper that I think that will be accomplished vs. just relying on the conversations we've had over the past 8 months.

Anyway, here is the wording from my c-section part of my birthplan:

In the event of an emergency c-section:
• Please remain respectful of my wishes as outlined above (in hospital vaginal birth plan)
• If a c-section is needed, spinal anesthesia is preferred if time permits. [dh], [midwife] and [doula] to be present in the operating room.
• [dh] would like to take pictures and/or videotape of birth
• I wish to be kept fully informed of all my options in the matter, and kept abreast of what is happening to me and my baby at all times
• I do not want my arms strapped down
• Please use a double-layer suture to close the incision on my uterus
• Please do not use staples to close the outer incision [I had staples before & had 18 months of everyday pain - want to try just stitches this time, which friends have had better luck with]
• Please take measures to ensure that adhesions are not formed as a result of the surgery, including but not limited to the use of adhesion prevention product(s) near the incision site
• If possible, I would like baby evaluated, tested, and cleaned while laying on my chest before I am taken to recovery
• [mom] and/or [dh] prefer to hold baby immediately after c-section if baby is doing well and baby to stay with parents for first feeding (breast feeding ONLY)
• Delay all routine procedures until after [mom] has regained consciousness

We thank you in advance for your support and attention to our choices. We look forward to a wonderful birth.

and also:

If the baby is ill:
• I would like to nurse if possible and give the baby pumped milk if not. Bottles of formula, sugar water, water or pacifiers are NOT to be given without our consent.
• We plan on staying with the baby as much as possible.
• We plan on practicing kangaroo care.

[EllasMama]

BakingMama, I'm not aware of concrete evidence one way or the other, but I feel more comfortable with double-layer repair (where they sew up under layers of tissue, then separately sew over layers, rather than sewing through both in one). I read an article sent to me by a friend that cited what seems to be a lower infection rate with single-layer suturing, but a higher rate of future uterine rupture with single-layer suturing, esp. if a VBAC is attempted in less than 24 months following the cesarean. So it seems there may be pros and cons to each. I haven't done much research, I just feel like the main reason they changed to single-layer suturing is that it saves time and money. And that IMO is not an acceptable justification for changing methods. It should be studied in a randomized, controlled fashion, and until then, two layers just sounds better to me than one. Wish I could be of more help with info.

Carol

[BakingMama]

Thanks for the info. Was more than what I knew about C-sections-- which isn't much.