Last time around my midwife did review my plan and talk to me about it, but who knows if the midwife who was actually on duty when he was born had a chance to look at it. I really counted on my doula, sister, and husband to know what was in my birth plan and advocate for me. I tried to keep it short and focus on what is absolutely important to me. I think that it's shorter this time around, but more specific in some areas because I know more about what to expect.
Here's my plan; I also have a section of information that is just to serve as reminders to myself and my birth team, etc.
Name: Erica M
Due Date: November 2007
Primary Caregiver: UW Midwives
Birth setting: UW Medical Center
My support people will be:
Jonny, husband
Michelle, sister
Jodilyn, doula
•I would like them to be with me throughout labor and delivery.
•I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.
•Our pediatrician is Will Van Cleve, UW Physicians, Roosevelt Medical Center
IMPORTANT ISSUES AND CONCERNS
•I was diagnosed with vulvar vestibulitis (chronic pain and inflammation of the vulva) seven years ago. I am concerned about minimizing trauma to the vulvar area so as not to aggravate this condition. This includes avoiding an episiotomy and doing everything I can to avoid or minimize tears. I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch, as well as warm compresses, pressure, or any other measures to help maintain an intact perineum.
•I have three prescription medications that I take on a daily basis (Singulair, Flovent and Zoloft). I would like help remembering to take these medications while I am in the hospital.
IN THE CASE OF A VAGINAL BIRTH
Coping with Childbirth Pain
•I plan to use breathing techniques, hot or cold compresses, bathing, and other comfort measures and relaxation techniques to cope with childbirth pain.
•I will have a labor tub in the room for use during labor, provided by Labor Tubs Northwest.
First Stage of Labor
•I would prefer to keep the number of vaginal exams to a minimum.
•I do not want an enema, an episiotomy, or shaving of my pubic hair.
•I wish to be able to move around, change position and/or take a bath at will throughout labor.
•I would like to be able to have fluids and snacks throughout labor.
Labor Augmentation/Induction
•I would like to avoid induction by chemical means, as it has been contraindicated for women attempting a VBAC.
Episiotomy
•I do not want an episiotomy.
•I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch, as well as warm compresses, pressure, or any other measures to help maintain an intact perineum.
Delivery
I would like to have the baby placed on my stomach/chest immediately after delivery. He can be cleaned up after I have “met” him and later bathed after his first nursing session.
Immediately After Delivery
•I would like my husband Jonny to cut the cord.
•I would like to hold the baby while I deliver the placenta and any tissue repairs are made.
•I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.
•If the baby must be taken from me to receive medical treatment, Jonny will accompany the baby at all times.
•I would like to delay the eye medication for the baby until an hour or more after birth.
•We do not want the baby circumcised.
•I plan to breastfeed the baby immediately after birth.
•If I receive antibiotics after the delivery, I would also like to receive prophylactic doses of oral flucanazole to prevent developing a yeast infection. Yeast infections, in addition to be unpleasant, also exacerbate vulvar vestibulitis.
IN THE CASE OF A CESAREAN
Cesarean
•I would like an epidural as opposed to a spinal block. In my previous Cesarean delivery, use of the spinal caused me a great deal of anxiety because I could not feel myself breathing. I would also like to be able to touch my baby after he is born, something that was not possible for me last time due to the spinal block.
•I would like to be catheterized after receiving the epidural.
•My arms are not to be strapped down unless general anesthesia becomes necessary during an emergency.
•I would like the option of viewing the birth either by lowering the screen or positioning a mirror.
•I would like my husband Jonny present at all times if the baby requires a Cesarean delivery, and for him to be able to watch the delivery.
•I would like to have our midwife or another person in the room take pictures of the birth.
•If the baby is not in distress, the baby should be dried off and given to Jonny immediately after birth.
Immediately After Delivery
•I would like my husband Jonny to cut the cord.
•I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done in the same room.
•If the baby must be taken from me to receive medical treatment, Jonny will accompany the baby at all times.
•I would like to delay the eye medication for the baby until an hour or more after birth.
•We do not want the baby circumcised.
•I plan to breastfeed the baby as soon after birth as possible.
DURING MY HOSPITAL STAY
•My husband will stay with me.
•If I receive antibiotics after the delivery, I would also like to receive prophylactic doses of oral flucanazole to prevent developing a yeast infection. Yeast infections, in addition to being unpleasant, also exacerbate vulvar vestibulitis.
•If I have delivered by Cesarean, I would like to receive clear care instructions on scar massage, and any medications that might be recommended after the birth (stool softeners, pain relievers, etc.)
•I will breastfeed the baby. He is not to receive formula, sugar water, or any other substitute.
•I would appreciate help from the UW lactation specialists, but would prefer not to receive assistance from staff who are not specifically trained in lactation.
•In the event that there is a delay in my milk coming in, I would like access to a breast pump to help encourage lactation.
Special Circumstances
In the case of a sick or premature baby:
We would like to practice “kangaroo care” and to feed and care for the baby as much as possible. We would like to be involved in decision-making regarding medication and treatment.
In the case of a stillbirth:
I would like to recover in a room separate from the maternity wing. I would like to see and hold the baby, and to obtain mementoes. If the cause of death is not apparent, we would like an autopsy. We would prefer for the baby to be cremated.
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: I just had a whole big rant about them written out here, but decided not to post it.
