Homebirth Mamas: Your Birth Plans?

[flyingspaghettimama]

Do you have a "Plan?" Is it in bullet format that I can easily steal from you? What's out, what's in?

Can I make my birth plan look like a Glamour magazine OUT/IN table? That would be easy to read, n'est pas?

My midwife asked me to make one...I assumed that since I was having a homebirth and wouldn't have people all over me ready to cut me open at a moment's notice, that I would not need one!

[mamaharsh]

No help here, 'cause I'm having to do the same thing and having the same problem. I totally was not expecting to have to do one. Hope someone has some ideas for us...

[flapjack]

I've been asked to do one this time: it goes something along the lines of:
During labour:
-My children would like to be there. They will be supported by a member of our family, and have been thoroughly prepared, through discussion, books and videos.
-I wish to labour and birth in any position that feels comfortable to me, but keeping upright and moving as much as possible.
-No vaginal exams
-No AROM (either intentional or accidentally during an exam.)
-In all my previous labours, I have had a period of time where no contractions were felt. Should this happen again, we will be using (self-administered, with support) homoeopathy and changes in position to stimulate stronger contractions. I will not push until feeling the urge.

At and after the birth
-Please don't tell us the baby's gender- let us find out for ourselves!
-Due to confusion over the amount of blood lost following Isaac's birth, I will probably choose to have an actively managed third stage. Please do not clamp/cut the cord or administer syntometrine until our new baby is breathing well and independently, and please respect me by asking my permission before clamping or injecting.
-We would like Isaac to cut his new sibling's umbilical cord, if this is possible. If not, I (mummy) will do it.
- Steve and the boys would like to give baby their first bath and dress them.
-Please keep the towels baby is initially wrapped in separate, to help us accustom our dog to the scent of the new baby.
- Please leave our new baby's placenta with us, for us to dispose of with grace and dignity.

Plus a bit of waffle, and directions to the tea, coffee, toast and biscuits.

[flyingspaghettimama]

Due to confusion over the amount of blood lost following Isaac's birth, I will probably choose to have an actively managed third stage. Please do not clamp/cut the cord or administer syntometrine until our new baby is breathing well and independently, and please respect me by asking my permission before clamping or injecting.

Can you explain this part - how does the clamping effect blood loss? If you don't mind educating me... I imagine syntometrine is a British word for pitocin? I'll look that part up.

[spughy]

Love the Glamour "out/in" table idea. :LOL

My midwife went over everything that will happen during the birth and I didn't have anything to argue with so I don't know that we'll do a formal birth plan. They are as non-interventionist as possible and I know they will consult with me before they do anything.

[Gunter]

I would like to have a rough guide to follow about things that I may or may not be comfortable with but it's hard to know all of those things as this is my first birth. Hard to know how I will act/react and hard to know all the little things that I see you all listing but have not thoughts as much about. I am still reading and discussing though to become more well-informed.

DH just read some interesting advice about birth plans in "Birthing From Within" and he seemed to agree with the author about them being unneccesary or something. But I would like some details written down just in case they come up and I am unable to respond while birthing.

[flapjack]

Cool- now I know I need to reword that bit. What I'm trying to say is, I probably want an actively managed third stage but for any intervention to be delayed until baby is breathing independently. It seemed like a compromise.
The clamping of the cord wouldn't address any blood loss, but as I understand it, once it's done it's done. We know the placenta continues to oxygenate the baby until it separates or baby breathes for itself, but we think I'm at risk for another borderline haemorrhage, because it's a fourth birth, I'm overweight and I did with Isaac. Baby's lifeline continuing until independently breathing is more important to me than avoiding something that may or may not happen, especially as I'm planning on handling second stage very differently and avoiding a "tired uterus". (literally, my contractions stopped after my waters were broken. I had two hours, then was given the choice of push or hospital. I pushed- in retrospect, I should have gone for a long walk or run up and down stairs or something to get the head descending)
Syntometrine is a combination of syntocinon (Brit term for pitocin) and ergometrine, a synthetic form of a herbal preparation that encourages the separation of the placenta and contracting down- so the risks of a retained placenta in an actively managed third stage are lower than with syntocinon/pitocin alone.

[MelW]

I don't have a birth plan, but am working on a kind of household instructions list. Info like how to use our phone to let people into the building, where to put garbage/compost/recycling, supplies for tea/coffee/snacks, laundry info, etc. Stuff that I think would be totally annoying to field questions about during labour.

My midwives and I are pretty much on the same page about interventions, and they keep a mini log on my prenatals of specific requests (third stage management, newborn procedures, etc.).

I'm also making a phone list for people to call during labour, after the birth and support/resources if I need them. Not really birth plan related, but a convenient thing to have around.

[willemsmamma]

I pretty much copied mine off www.unhinderedliving.com in their online childbirth class section and then modified it to meet my needs accordingly. I think it's well worded and includes lots of things I would not have put in the plan had I thought it up myself (esp. hospital interventions in case transfer is necessary.)
I really need to sit down and write up a home list more tailored to this birth... detailing what labor support items I have available and how I would like them used.


flapjack- I hadn't thought about the dog thing. Are you just going to hold the towel and let him/her sniff it or lay it down where the dog sleeps? Wow, I can't believe I hadn't thought about that at all.

[BensMom]

Very interesting. I had assumed I would not need a birth plan since I am having a HB.

As an aside, I highly recommend them to my clients who are birthing in a hospital (not sure what BFW says) as a way to discuss some of these issues with their OB/CNM at a visit *before* the birth. That way, they are fully imformed when a provider balks at things like Intermittent Monitoring, no IV, etc. As opposed to being surprised by the attitudes when they are in labor. For that, they serve a (IMHO) valuable purpose.

I think I will discuss prototcols with my MWs at my next visit and work up a plan for the 36w home visit. Next visit is DH's turn to ask questions, since he has not been to a pre-natal yet, so I dont want to steal all of his time.

I know they agree with me on things like delayed cord clamping, birthing in any position. But I guess it would be good to mention things like no VE, not mentioning the gender, etc etc. Thanks guys!

[bec]

I'm not doing a birth plan for this baby. I have spent the last 9 months talking to my midwife and doula about how I want things to go. If they haven't gotten it by then, I doubt a piece of paper will make any difference! :LOL



Bec

[flapjack]

flapjack- I hadn't thought about the dog thing. Are you just going to hold the towel and let him/her sniff it or lay it down where the dog sleeps? Wow, I can't believe I hadn't thought about that at all.

It's a suggestion that came from my big cousin- apparently, after his son was born he brought the dirty washing home from the hospital the morning after and put it in the dog basket. Baby came home four days later (c-section following an induction for pre-eclampsia, I think- I know they had problems), Jake had a very good sniff and then got on with things- they've had no problems since.
Then again, this is the man who reckons his dog is so well-trained, he's learnt not to wag his tail as he walks past the cruising baby, so I'm taking it with a pinch of salt. I'm sure the constant wagging is why so many springers are docked...

[flyingspaghettimama]

I'm not doing a birth plan for this baby. I have spent the last 9 months talking to my midwife and doula about how I want things to go. If they haven't gotten it by then, I doubt a piece of paper will make any difference! :LOL
Bec

Yah, I was kind of thinking along the same lines - that's why I was surprised when they (MW and assistant) asked me to do one. They are very non-to-low interventionist (rumored to be the MOST so in my town). I suppose they might just want some things to help remind them, specifically: who we want (and don't want) there, what protocol we want to follow with the newborn (i.e. yes to the panel screening, no to eye drops, I dunno about vitamin K?), and any other special requests. I guess I just don't know what the other special requests might be? Thanks for the good ideas that some of you all have provided.

I trust their judgement, I guess. My birth plan was highly important at my last birth, at a hospital - but only because everything I wanted was totally against the hospital's protocol or required compromise on their part.

[flyingspaghettimama]

. I think it's well worded and includes lots of things I would not have put in the plan had I thought it up myself (esp. hospital interventions in case transfer is necessary.)

eek. I hadn't thought about that. And I do know of three women who transferred without birth plans and ended up with some negative experiences.

[Feathere]

My mw hasn't asked for one, but I wrote a hb plan, and then I wrote a hospital birth plan, just in case. I have to print it out and find a place to put it in the event that it is needed. Since i don't anticipate a transfer, I don't have a bag packed, but I guess I could put it on the infant seat after we install it in the car. The plan for the mw is just a review of my needs and wishes, a service to her because she is busy, and to her assistant, who might not be as aware of my desires.

lots of good ideas on this thread!

[gonnabeamom]

I am writing up some thoughts for my midwives, about my own feelings about birth and things I liked from childbirth class as comfort measures. That's just because it will help me clarify my own thoughts.

I am also stealing a "in case of transfer list" I got at my Childbirth class to cover things like avoiding separation, bathing, etc.

[flyingspaghettimama]

I did find this homebirth birthplan website. http://www.homebirth.org.uk/plan.htm

If nothing else, it made me think more carefully about what I want and possible issues and outcomes for different choices. It even has a rather detailed section on laboring in tubs and explains all that "actively managed third stage" stuff that I didn't really understand before. Because I hemorraged (sp?) last time, I'll have to ask my MW more about the options.

[flapjack]

The homebirth UK site and list is brilliant- there's also the Association of Radical Midwives site that has a lot of good stuff about birth plans. Angela Horn (the woman who runs homebirthUK) is evangelical about homebirth and obsessive about research, which is a useful resource to have when you're short on time.