Who else has written their Birth Plan?

[Heather Marie]

My DH and I finally wrote a Birth Plan today. It seems so long, 3 pages. Do you think that is normal? I am going to give it to the MW for review and change anything I might need to and make final copies.

[sorteep]

ohhh I MUST do this..I need to and besides our MW's require us to.. really really must do this.......so glad yours is done (3 pgs is not weird, I don't think//)

[maisiedotes]

I am pretty psyched- I was talking to my OB the other day about birth plans and everything I said, she said was standard hospital procedure. I am still writing one though, just in case... I love our hospital. They are awesome.

[meisterfrau]

Our hospital actually has a birth plan to download and print on their website, so I printed it out and filled it in. Two of them, actually...one for the VBAC and one for a C-section if the VBAC doesn't happen.

[Valerieg]

I am using the same birth vision as I used with DD. It worked well, was succinct and to the point, and nothing has changed in what I'm looking for with this birth.

Personally, I think anything over one page (bulleted) is too long. My thought is, it won't get read by anyone besides your OB/MW on the day you discuss it. It is slightly impractical and typically says more than it has to.

I'm willing to share mine with anyone that wants to see it.

[Heather Marie]

Sorry about the typo in the subject. I can't figure out how to edit it.

Valerieg-That would be great if you would share your birth plan.

[Googy]

Yes, please share! DH and I are working on ours this week, and we would love some ideas!!!

[LittleBrownDog]

Originally Posted by Valerieg

My thought is, it won't get read by anyone besides your OB/MW on the day you discuss it.

Actually, I was pleasantly surprised when I met my nurse at the hospital with DD and she had already read my birth plan! The student MW who was with my MW had also read it, and each nurse that came on duty (I labored through a few shift changes) read it before coming into the room to introduce themselves to me! So I think it varies a lot from place to place.

I agree, though, that short and simple is best. Mine is about a page and a half long, but it includes some "extra" info that my MWs asked for, like contact info for my labor support people. The second page is info for a hospital transfer.

[LittleBrownDog]

Here's mine (still subject to editing, I'd love input!)

In General: Ideally, if all goes smoothly, I hope that the midwife who attends me in labor will support and encourage me, using her experience to guide me through labor and offer suggestions as needed or requested.

The labor: I would like to remain active and use whatever position I find comfortable. I may wish to move throughout the house and to use the bath or shower from time to time. I would like to avoid internal examinations. I am willing to have one internal examination to check presentation if it seems necessary, but would like to avoid them otherwise.

Please do not offer to break my waters, and please be very careful to avoid doing so during any internal examinations. If the baby appears to be poorly positioned or labor is not progressing well for some reason, I would appreciate it if you could suggest changes of position or movements which might help.

Birth Companions
The following people may come to my home during the labor or birth:
My husband, Tim cell:
My daughter Allison, who will be 2y 10m old
My mother in law Pat, (cell)
My friend Kim who will be taking pictures and helping to look after Allison. Kim:

I have purchased a birth pool and will use it if it helps me. It is important that the pool temperature is comfortable for me so, unless it is outside normal safety limits, I will choose the temperature myself. I understand that I would probably want a cooler temperature during the first stage of labor, and warmer for the second stage. I intend to use the pool for the first stage of labor, but have no fixed ideas about where to manage the second stage. I will decide on the day.

Pain relief: I intend to use no drugs for pain relief, and would appreciate your encouragement to use other methods.

The birth: I would prefer for you to examine me to let me know when I am ready to begin pushing my baby out only if I spontaneously begin pushing.

Please keep the room as quiet as possible during the second stage. I would like to minimise distractions at this time. If you need to discuss matters with someone, please do so very quietly and preferably out of earshot!

I would like to give birth wherever seems right at the time. I would like to give birth in an upright, kneeling, supported squatting or all-fours position to give the baby maximum space to descend through my pelvis. I do not want to be on my back or semi-reclining unless that position seems right for me on the day, having tried alternatives.

I would like to avoid perineal damage and would appreciate your guidance in giving birth gently to accomplish this. However, I would rather tear naturally than have an episiotomy. I would like to see or feel the head as it crowns, and my birth partner will have a hand mirror available for this.

I would like the lights dimmed when my baby is born, and for the minimum amount of noise to be made. I hope that it will be a gentle entry into the world.

When my baby is born, I would like to bring her to my belly/chest myself, if possible. Or, please pass her straight to me.

Please do not suction mucus from the baby's nose and mouth 'just in case' - only suction if necessary.

Third Stage: I would like a physiological third stage with the cord clamped and cut when it stops pulsating. I wish no drugs to be used unless specifically indicated. Please do not pull on the cord or use fundal pressure unless there is a specific indication to do so. I would like to cut the cord myself.

If I give birth in the pool, I would like to get out of the water for the third stage, but that may change on the day- please remind me that my intention was to get out of the water, but know that I may choose to stay in.

Care of the baby: I would like to breastfeed my baby as soon as possible after the birth. I would like to keep the baby unclothed and close to my skin immediately after birth, to maximize skin-to-skin contact.

(Page Two)
In case of transfer to hospital: If transfer by ambulance becomes necessary, please do not strap me in on my back - I would prefer to be on my side, to make contractions easier to deal with.

I would like to keep an open mind about my pain relief options; please suggest anything you think would be appropriate.

I would like to avoid a caesarean section if it is at all possible. I particularly would like to avoid a caesarean just for slow progress. If labor is simply taking a long time but my baby is not in immediate danger, please encourage me to keep going and perhaps to try changes of position or movements which might help. Please do not offer a caesarean unless my baby is in danger.

If a caesarean section becomes necessary, I would prefer to remain awake with epidural or spinal block anaesthesia. I do not want my arms restrained in any way. I would like my husband to stay with me at all times, and would like to hold and breastfeed the baby as soon after birth as possible, ideally immediately.

If there are problems after the birth: If I suffer a severe post-partum hemorrhage, please do not perform a hysterectomy unless it is the only available course of action. Please do not admit my baby to the NICU simply for observation, but only if there is a specific reason for concern.

Baby Feeding: Please do not give my baby supplements of glucose water or formula milk without my permission. I would expressly like to avoid having any formula supplements unless it is unavoidable, and certainly not in the first two days in any event. Under no circumstances is my baby to be bottle-fed. If supplements are necessary, please give them by spoon or other method, not by bottle. Also, please do not give my baby a pacifier. If I have trouble breastfeeding, I would like the help of a lactation consultant who is fully supportive of breastfeeding.

Going Home: I would like to go home as soon after the birth as I am physically able, unless I or the baby have health problems which require hospital treatment.

[Momma Aimee]

when i wrot my first one with Theo it was over 6 pages

they say one page -- our was with theo one page front and back and i know all the nurses read it -- and heck the anisialogist (sp????) even read it before putting in my Epdural (course he was waiting for scott to fill out forms and was jsut standing ther) but he did read it.

in 2005 The nurse assinged to us had read ours before we got there -- it went to the hosptial in our chart and once we called we were on our way and the CNM went to the hosptial to meet us, the nurse assinged to her / to us read our chart. all 3 of our nurses had read it before coming into our room, or when they got there.

I took mine in to our OB last week -- we are going to discuss it and he will sign off on it and add it to my chart for the hosptial.

you will be able to shorten it -- no doubt -- after you talk to the MW and tour your birth location... cuz some of it won't apply -- i had in our first one i wanted ot wear my own clothes -- well that is SOP anyway so i removed it. see what i mean. I have remvoed things this time, since i know they won't be an issue birthing int he same hosptial.

I think bullet points are easier to read -- and look back at -- but that is my PO.

if you are birthing in a birth center or at home, with the MW, then it doesn't matter how long or short it is -- it is just a communcation device, or a conservation starter for the two of you -- the shorter idea is jsut to encourage nurseing staff, and techs and whoever, to read it in a hosptial setting. at home or at a BC you would expect them to read it even if it is 10 pages long.

I know one mom -- birthing ina hosptial but with a MW -- who had a 4 page one and the MW still wantd more details about some parts -- so it could have been longer and the mw would have been happy.

here is ours, as it stands now.

I for theo had 2 plans -- one fore induced (as we had an induction date set) and one for natural on-set labor.

Also what i did with Theo is had the Master copy -- in our birth binder for the doula and scott, that was much more detailed and for scott sited WHY for each of the preferences .. then the short copy that was bare bones for the hosptial staff.

Packard Birth Preference and Goals
Packard 2nd child EED 11/6/07

General
We are seeking a natural, gentle birth with no medications or interventions.
My support people are Scott Packard (Husband) and Amelia (Doula) they will be with me at all times.
Our son Theodore might visit the labor room with his Grandmother as we, the parents, see fit.
We are seeking a calm and peaceful birth, with low stress and no rushing or conflict.
I would like time to discuss any interventions (monitions, labor augmentation, medications, etc) with my husband and Doula privately.
We will control the lights and music in our room, as well as the tempitture.

Labor
I would like to be totally mobile during labor, free to walk or change positions at will.
I would like to shower or soak in a tub to aid in relaxation.
I would like to be able to have food and drink by mouth throughout labor.
I would prefer to keep the number of vaginal exams to a minimum.

Monitoring
We will not have continuous fetal monitoring unless it is required by the baby’s condition -- we would really like to avoid this.
We will not have any internal monitors (baby or contractions) unless the baby has shown some definite, repeated, or unchanging signs of distress.

Labor Augmentation/Induction
We do not wish to augment labor and delivery or alter the natural process in anyway.
We prefer only natural methods of encouraging labor.
We do not wish to have the amniotic membrane ruptured artificially.
We prefer to strip (sweep) the membrane and try other non-drug interventions in place of medication.
We refuse Cytotec which has not been approved by the FDA for use on pregnant woman, nor for labor induction, and has been proven dangerous.
We would like to give labor a good opportunity to re-start if stalled before Pit is administered.

Anesthesia/Pain Medication
We realize that many pain medications exist — We’ll ask for them if I need them.
We strongly prefer not to have any pharmaceutical l pain management suggested.
We prefer to utilize a short acting pharmaceutical such as Fentanyl first to try to regain natural management.
We prefer to try a slightly longer acting narcotic pain relief (Nubain, Sublimaze, Stadol or similar) next.
We prefer to save Demerol as a final option.
We intend to avoid an epidural unless medically necessary.

Cesarean
Unless absolutely necessary we would like to avoid a Cesarean
We would like to attempt forceps, again, or vacuum before a surgical birth.
Please see separate Cesarean Preference Sheet

Episiotomy
I prefer not to have an episiotomy; I prefer to tear naturally.
I prefer local anastia for any repairs.

Delivery
I would like to be allowed total freedom to choose the position in which to give birth, and the freedom to change positions frequently.
Scott and Amelia will offer physical support.
I prefer to push only spontialus and as hard or for as long as I feel the need (avoiding purple pushing).

Immediately After Delivery
Scott will cut the cord.
The cord should be allowed to pulse until it naturally stops before being clamped and cut.
I will hold the baby while I deliver the placenta and any tissue repairs are made, if not possible Scott or Amelia will hold the baby.
We would like to view the placenta.
ALL evaluations of the baby are to be done on my abdomen (or beside me on the bed), not the warming table.
Scott will take the baby to be weighed and return the baby to the mother.

Postpartum
I will shower ASAP with our doula and change clothing, while Scott holds the baby.
We would like all medical equipment put away or removed ASAP and the bed remade so our son can join us and see his new brother or sister as soon after the birth as medically possible.
Unless required for the health of the baby, the baby is not to be removed from the mother for any reason.
The baby will stay in my room -- all tests and exams will be done there. If the baby must be removed from the mother for the hearing and PKU test the father will be in physical contact with the infant at all times (we prefer these tests be done in the mother’s room),
If the baby must be removed from the mother for any medical reason, the father or another adult designated by us will be with and in physical contact with the baby at all times.

Baby Care
We refuse the eye ointment.
We refuse a routine Vit K shot.
The baby is to receive NO vaccination at the hospital.
The baby is to receive NO medication or tests without prior written consent of the parents.
The baby does not need to be bathed immediately, mother will bath the baby with a nurse attendant after a time of rest and calm.
We prefer to hold the baby – mother or father – skin to skin rather than have the baby artificially warmed.
We do not want our baby admitted to a special nursery merely for observation,

Breastfeeding
I will exclusively breastfeed Our Baby and will begin nursing immediately after birth.
Our baby is not to receive a bottle for any reason.
If our baby is unable to nurse she/he should receive only mother’s milk (or medication) via a nasogastric tube.
We do not want Our Baby to be given a pacifier, other any other artificial soother.
We do not want any formula or anti-breastfeeding materials brought into our room, no gift packs, no promotional material, nothing.

Circumcision
We do not want our son circumcised.

After the Birth

•We may choose to leave at the 24 hours mark, rather than the 48 depending on recovery of the mother and time of day, so to avoid unnecessary time away from our older child.
•Our 24 month old son, Theodore will visit as soon as reasonable to see his new sibling…the length of his stay will be determined by the parents.
•Theodore will stay with us as we feel best for the family as a whole, including possible spending the night with his mother, father and new sibling.

hey littlebrowndog -- you should edit out the personal data posted, this is apublic board and not everyone can be trusted

PS if you want to edit the title -- choose EDIT then choose GOD ADVANCED and you can edit the title. no big deal

[LittleBrownDog]

Originally Posted by Momma Aimee

hey littlebrowndog -- you should edit out the personal data posted, this is apublic board and not everyone can be trusted

Oh sheesh! Thanks! When I posted it on my other board I remembered to do that, but it totally slipped my mind when I copy/pasted last night! Thank you!

[brooklyn_warbler]

since i am doing a homebirth and my m/w and i talk at length about my wishes at every appointment, i did not feel the need for a birth plan. i did, however, write an emergency c-section plan. i didn't want to put myself in the kind of headspace that made think about that even happening, but i figured it was worth it since in an emergency andy might be distraught and not have the clearheadedness to make sure everything happened the way we want/need it to.

i only did an emergency plan though because i will not transfer for any other reason. i am pretty pleased with mine, and i also kept it to one page.

[maisiedotes]

I have GOT to get my birth plan done. And I have to nail DH down to a time to go over it- I don't want the OB or nurse to ask him anything that he answers something I don't want. Time is ticking away and I keep putting it off...

[Curlita]

I modified my birth plan from Dylan, took out some stuff that was unnecessary (things that the hospital doesn't do anyway), and added a lot for the possibility of C-section. I worked on mine early, when I was diagnosed with the previa, because I was thinking a lot about what I would change if I needed another section.

Mine is two pages, separated into sections for VBAC, C-Section, and post-delivery.

At my last midwife appointment, my MW actually asked if I had a copy ready yet, which was really nice. I mean, there are five people on the midwife team so I think it's entirely possible that the one on duty when I go into labor will only have time to skim it. Mostly I think of it as being something for my doula and labor partners to read so that they can advocate for me.

[Momma Aimee]

I met with our OB regarding our birth prference sheet -- and he was supportive. we went though it item by item -- it is posted in a few posts abover here --

here it is as he and I agreed on --

Packard Birth Preference and Goals

Packard 2nd child EED 11/6/07

These preferences assume a normal pregnancy and labor. They assume a healthy mom and baby. We fully understand, and trust Dr M, that should any emergencies arise these preferences will have to be altered.

General
We are seeking a calm, natural, gentle birth with no stress, no medications and no interventions. We are willing to take the time necessary.
My support people are Scott (Husband) and Amelia (Doula) they will be with me at all times.
I would like time to consider and discuss any interventions (monitions, labor augmentation, medications, etc) with my husband and Doula privately.

Labor
I would prefer a hep-lock upon admission, not a full IV unless it becomes medically necessary.
I would like to be totally mobile during labor, free to walk or change positions at will.
I would like to shower or soak in a tub to aid in relaxation.
I would like to be able to have food and drink by mouth throughout labor.
I would like to be reminded to stay hydrated by mouth.
I would prefer to keep the number of vaginal exams to a minimum.

Monitoring
We expect intermediate monitoring of the baby’s heart, however we really wish to avoid continuous monitoring.
We will not have any internal monitors (baby or contractions) unless the baby has shown some definite, repeated, or unchanging signs of distress.

Labor Augmentation/Induction
We do not wish to augment labor and delivery or alter the natural process in anyway unless there is a true emergency. We would rather be patient and allow my body to do its job.
We prefer to employ natural methods of encouraging labor first.
We do not wish to have the amniotic membrane ruptured artificially.
We prefer to strip (sweep) the membrane and try other non-drug interventions in place of medication.
We refuse Cytotec which has not been approved by the FDA for use on pregnant woman, nor for labor induction, and has been proven dangerous.
We would like to give labor a good opportunity to re-start naturally, if stalled, before Pit is administered.

Anesthesia/Pain Medication
We realize that many pain medications exist — We’ll ask for them if I need them.
We prefer to utilize a short acting pharmaceutical such as Fentanyl first to try to regain natural management.
We prefer to try a slightly longer acting narcotic pain relief (Nubain, Sublimaze, Stadol or similar) next.
We prefer to save Demerol as a final option.
We intend to avoid an epidural unless medically necessary.

Cesarean
Unless absolutely necessary we would like to avoid a Cesarean
We would like to attempt forceps, again, or vacuum before a surgical birth.
I would like the cape placed low on my stomach and lowered so I can see the actual birth.
I would like the incision closed in such a way to promote a VBAC.
I would like to hold the baby on my chest immediately after the delivery while I am closed; if not possible the baby should be given to Scott – not placed on a warming table or the nursery or given to a nurse.
Please see separate Cesarean Preference Sheet

Episiotomy
I prefer not to have an episiotomy; I prefer to tear naturally.

Delivery
I would like to be allowed total freedom to choose the position in which to give birth, and the freedom to change positions frequently.
Scott and Amelia will offer physical support.
I prefer to push only spontialus and as hard or for as long as I feel the need (avoiding purple pushing).

Immediately After Delivery
The cord should be allowed to pulse until it naturally stops before being clamped and cut.
I will hold the baby while I deliver the placenta and any tissue repairs are made, if not possible Scott or Amelia will hold the baby.
We would like to view the placenta.
ALL evaluations of the baby are to be done on my abdomen (or beside me on the bed), not the warming table.
Scott will take the baby to be weighed and return the baby to the mother.

Postpartum – dependant on time of day
I will shower ASAP with our doula and change clothing, while Scott holds the baby.
We would like all medical equipment put away or removed ASAP and the bed remade so our son can join us and see his new brother or sister as soon after the birth as medically possible.
Unless required for the health of the baby, the baby is not to be removed from the mother for any reason.
The baby will stay in my room -- all tests and exams will be done there. If the baby must be removed from the mother for the hearing and PKU test the father will be in physical contact with the infant at all times (we prefer these tests be done in the mother’s room),
If the baby must be removed from the mother for any medical reason, the father or another adult designated by us will be with the baby at all times.

Baby Care
We refuse the eye ointment.
We refuse a routine Vit K shot.
The baby is to receive NO vaccination at the hospital.
The baby is to receive NO medication or tests without prior written consent of the parents.
The baby does not need to be bathed immediately, mother will bath the baby with a nurse attendant after a time of rest and calm.
We prefer to hold the baby – mother or father – skin to skin rather than have the baby artificially warmed.
We do not want our baby admitted to a special nursery merely for observation,

Breastfeeding
I will exclusively breastfeed Our Baby and will begin nursing immediately after birth.
Our baby is not to receive a bottle or soother for any reason.
If our baby is unable to nurse she/he should receive only mother’s milk (or medication) via a nasogastric tube.
We do not want Our Baby to be given a pacifier, other any other artificial soother.

Circumcision
We do not want our son circumcised.

After the Birth
•We may choose to leave at the 24 hours mark, rather than the 48 depending on recovery of the mother and time of day, so to avoid unnecessary time away from our older child.
•Our 24 month old son, Theodore will visit as soon as reasonable to see his new sibling…the length of his stay will be determined by the parents.
•Theodore will stay with us as we feel best for the family as a whole, including possible spending the night with his mother, father and new sibling.

he did note that it is SOP as part of the vitals taking for the nurses to ask about pain levels and management -- which i know my mom has to as an RN too -- but pointing out i will have one nurse for the whole shift, he said she will likely either not ask, as she will be there so much anyway, and / or won't make teh offer of medications after she realizes i am educated as to my options and that i will ask if i want them. he did point out, at teh start, she will likely want to run though the options with me, just so she knows i know what is avaiable to me .... that is fine, i rspect tehy have a job to do, i just don't want them "pushing" medication and last time i birthed int his hosptial they did not.

the hosptial SOP is "light food" and "clear stuff". she said a couple of teh anistialgists (misspelled) are rather grumpy about people eating anything, or drinking anything, but he went on to point out that THAT is silly cuz you can't treat each laboring mom as pre-sugery, and labor and delivery are physcally demanind and the mom needs SOMETHING.

but he notes there is a fridge in teh room and Scott or anyone else can bring in THEIR food too -- Last time, byt the time i got there, all i WANTED was popcicykles and grape jucie and stuff -- i didn't want a bagle or a muffin or anyting like a cheese burger -- so we'll play along. he told me what he was supposed to tell me, and we'll all smile about it.

we discussed situations where he would like to suggest more active management of the birth ... generally just the expected 'emergencies' of broken water for a long time and a fever starts... type thing ... but he notes that there are very few "EMERGINCES" where there is not room for discussion and compermise in most cases....

just thought i'd share