Birth Plans

[turtlemama77]

Anybody interested in sharing birth plans? I really like reading them, and always get good ideas.

[~pi]

Mine isn't done, but I plan to start discussing it with my MWs and peri next week, so I've started drafting up a rough list:

Environment

I would like to make the environment as comfortable and relaxing as possible for me. This could include:
- dimming the lights
- playing music
- lighting candles
- keeping unnecessary noises (machines) off

Labour

I would like to labour at my own pace as much as possible. This could include:
- eating and drinking if I wish to
- walking, moving around and showering
- bringing and using a birthing stool
- pushing instinctively rather than being coached

I would prefer to avoid:
- continuous EFM (intermittent is fine)
- IV or heparin lock (emergency IV is fine)

Please don't offer me pain medication. I'll request it if I need it.

Blood Sugar Management

I would like me and my husband (who is trained in the use of my test meter and insulin pump) to manage my blood sugar so long as we feel that it is within our control. This could include:
- eating and drinking as needed
- continuing to wear my insulin pump
- testing my blood sugar frequently (we will bring our own meter and are happy to also provide blood samples for the hospital's meter for my chart at whatever interval is deemed necessary)
- no IV insulin/dextrose drip

Vaginal Delivery

I would prefer:
- to view the birth using a mirror
- to touch my baby's head as it crowns
- the room to be as quiet as possible
- to risk a tear rather than have an episiotomy
- to catch the baby myself or to have my husband catch him/her

C-section

If a C-section is deemed necessary, I would prefer:
- my husband present at all times during the operation
- to see as much as possible of the procedure, especially the baby coming out
- spinal anesthesia rather than general

After the birth

I would prefer to have the baby with me as much as possible. If s/he needs medical attention, I would like my husband to be with him/her at all times.

I would like to:
- hold the baby skin to skin immediately after birth
- breastfeed the baby as soon as possible
- have all heel prick tests performed while the baby is with me

In the case of neonatal hypoglycemia

If my baby becomes hypoglycemic, my preferences for treating it are, in order:
1. colostrum via breastfeeding
2. pumped colostrum (provided by me ahead of time) via dropper or syringe
3. glucose solution
4. TRIGR formula

[Miss Juice]

I haven't started on this one - but here's the one from our last DD's birth. I think I'll reword some things this time and try to make it a little shorter, without leaving anything out. So it's a work in progress, but here it is:

Birth Preferences for (me)
Due Date: June 8, 2004
Patient of (my midwife)
Scheduled to deliver at UH MacDonald Women's Hospital

May 15, 2004

Dear Midwives, Doctors, Nurses and Staff,
We are looking forward to a positive birth experience, and are extremely glad that you will be there to aid us in the birth of our second child. We had a wonderful birth experience with our daughter here two years ago, and are hoping for another uncomplicated, natural childbirth. In an effort to ensure complete and open communication we have written down some of our specific preferences for labor and delivery. Thank you for your care and consideration in these matters.
Sincerely,
(myself and DH)

Labor
I would like to be free to walk around during labor and to move around and change position at will throughout labor. I would like to have a birthing tub available for use during labor and/or delivery, if conditions allow.

I would like to be able to have fluids by mouth throughout the first stage of labor.

I would like the environment to be kept as quiet as possible and for the lights in the room to be kept low during my labor. I will be bringing my own music to play during labor if a stereo is available.

I would prefer to keep the number of vaginal exams to a minimum.

I do not want an IV unless I become dehydrated. If IV access is absolutely necessary, I will accept a heparin lock, though I would prefer to avoid this if possible.

Monitoring
I do not wish to have continuous fetal monitoring unless it is required by the condition of our baby. I do not want an internal monitor unless our baby has shown some sign of distress.

Anesthesia/Pain Medication
I would not like to be offered pain medication unless I specifically ask for it.

Cesarean
Unless absolutely necessary, I would like to avoid a Cesarean delivery. If my primary care provider determines that a Cesarean delivery is indicated, I would like to obtain a second opinion from another physician if time allows.
If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.
I would like my husband present at all times if our baby requires a Cesarean delivery.
I wish to have an epidural for anesthesia.
If our baby is not in distress, s/he should be given to my husband immediately after birth and brought to me for breastfeeding as soon as my condition allows.

Episiotomy
I would prefer not to have an episiotomy unless absolutely required for the baby's safety. I would prefer a tear over an episiotomy.
I am hoping to protect the perineum. I am practicing ahead of time by squatting, doing Kegel exercises, and perineal massage.

I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch.

I would like a local anesthetic to repair any tear or an episiotomy.

Delivery
I would like to be allowed to choose the position in which I give birth, including squatting.

I would appreciate having the room as quiet as possible when our baby is born.

I would like to have our baby placed on my stomach/chest immediately after delivery.

Immediately After Delivery
I would prefer that the umbilical cord stop pulsating before it is cut, and then we would like for my husband to cut the cord.

I would like to hold our baby while I deliver the placenta and any tissue repairs are made. I do not want a routine injection of pitocin after the delivery to aid in expelling the placenta.

I plan to keep our baby near me following birth and would appreciate if the evaluation of our baby can be done with our baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.

We do not want our baby to receive a vitamin K injection or prophylactic eye antibiotics. We will sign a release to this effect.

If our baby must be taken from me to receive medical treatment, my husband or some other person I designate will accompany our baby at all times.

Postpartum
I would like a private room, if available.

Unless required for health reasons, I do not wish to be separated from our baby.

I would like to have our baby 'room in' and be with me at all times.

Breastfeeding
I plan to breastfeed our baby and would like to begin nursing very shortly after birth.

Unless medically necessary, I do not wish to have any bottles given to our baby (including glucose water or plain water).

I do not want our baby to be given a pacifier.

Circumcision
We do not want our baby circumcised.

[AidansMommy1012]

I'm still working mine up. When I wrote it, I thought I was going to have to deliver in a pretty old school hospital (the lactation consultant gave us formula at DS1's birth), but Tuesday night we have an appointment to attend an open house at a birth center in Indianapolis, where they don't even have pain meds on hand and I would be able to give birth in a Jacuzzi (not just water, but water with bubbles! I think my labor is going to like water jets). It's not totally official yet (DH still needs to feel a little bit better about driving a laboring woman 80 miles into a major city, possibly negotiating with traffic depending on the time of day--here's hoping for another labor starting at 2 a.m.), but he knows I really want it and in the end, I think he'll like it better, too.

[luckymama]

i had one for my son's birth ... but i knew i was going into a potentially unfriendly environment, wasn't sure my OB and i were on the same page, and so i was being really specific about everything i could think of ... so that at least our L&D nurses could see where we were starting from.

i haven't done one yet ... i plan to talk to my m/w about what do put on paper, but i know that her practice and my philosophy are in line ... i just want to cover specifics with her at some point.

anyway, i'll try to find our last birth plan ... and i'll come back and post whatever my m/w and i talk about ...

:love

[lotus.blossom]

These are great guides to help me make up my birth plan! Thanks for sharing.

I just have to make an appointment to tour my birth center because my midwife said that a lot of women add things to their birth plan that are already routine (or non-routine) procedure at the birth center.

The one concern I have is that it is an attached birth center (to a hospital) so I want to have some kind of clause in there stating at what point if any I would be willing to be transferred to labor and delivery.

[Max'sMama]

Don't forget the power of a plate of cookies or brownies or a angel food cake to be delivered to with your birth plan to the nurses (if delivering in a hospital). Since the nurses spend way more time with you they are the ones to make happy when you want things to go your way:thumb

[turtlemama77]

Max'smama, that's a great idea!! :) We didn't give the hospital a copy of our birth plan ahead of time, we just brought it with us. Should we send a copy along with our registration forms?

Here's my rough copy...I did already give a copy to my OB, but we haven't toured the hospital yet (I'm thinking I might want to do this with our doula, who we're in the process of hiring) and there may be more things to add. I do know that in this hospital, they like to take the babies to the nursery for "observation" and I know this won't fly with me or dh. We want our baby with us unless there's some medical emergency.

To Whom It May Concern:


The following are some considerations we desire to have a satisfying birth experience. Of course, we are open to other options should the need arise. Clear communication is very important to us, especially if problems arise.

As far as the environment, we would like the following if they are possible:
• Lights dimmed
• To be able to film and/or photograph the delivery
• If the following birth equipment is available, we would like to try: a squatting bar; a birthing ball

During the first stage of labor:
• I would prefer not to be separated from my partner at any stage of labor
• If my water breaks at the onset of labor, I would prefer to wait at least 12 hours before inducing, if my and my baby’s health permits
• If inducing should become necessary, I would like to use pitocin as a last resort. Instead, we would like to try stripping of membranes, walking, or cervical gel first.
• I would prefer not to undergo internal exams during labor unless they are necessary medically
• I would like to stay hydrated by drinking clear fluids and using ice chips and to eat at any time I am feeling hungry
• I prefer to be able to walk and move freely as I choose during labor
• If baby needs to be monitored, I prefer external monitoring
• As long as baby and I are fine, I would like to be free of time limits and not have my labor augmented




Pain Medication:
• I am interested in pain medication only if I request it. I would prefer it not be offered.
• If I request pain medication, please wait 15 minutes (to see if I ask again).
• I would like to handle pain in the following ways: massage by partner or nurse; relaxation; breathing techniques; hot/cold packs; bath/shower; changing positions; walking


Second Stage Labor
• Unless I’m having a medical emergency, I would prefer not to have an episiotomy. I would prefer to use perinial support/massage and controlled pushing.
• I would like to try whatever positions feel right at the time during delivery, using gravity in my favor.
• I would like to push instinctively, but with support.
• As long as baby and I are fine, I would like to be free of time limits on pushing.

In the event a cesarean section is necessary:
• I would like my partner present at all times during the operation.
• I would like to be conscious
• I would like to have one hand free to touch the baby.
• We would like to videotape/photograph the operation and baby coming out if possible.
• I would like immediate contact with the baby if the baby is in good health


Post Birth:
• I would like to hold the baby immediately after birth
• My partner would like to cut the umbilical cord
• I would prefer not to receive pitocin after birth (to help with the delivery of the placenta)
• I would like to deliver the placenta unassisted if possible, and would like to allow 30-45 minutes at the minimum before interventions
• I would like to postpone newborn procedures until I have had a chance to bond with my baby
• I would like newborn procedures to take place in my presence
• If I can’t be with my baby during newborn procedures, my partner would like to stay with the baby at all times
• I plan to breastfeed my baby, and would like to do so as soon after birth as possible
• I would prefer 24 hour rooming in with my baby, with feeding on demand.
• Absolutely no pacifiers, supplemental bottles, or other nipples for my baby, please!

[AidansMommy1012]

The one concern I have is that it is an attached birth center (to a hospital)

Buildings! In slings! :laugh: Man, I'm tired. This really shouldn't be that funny. :coffee

[ksjhwkr]

Mine is pretty simple...go into labor, call the midwife when it gets serious, get into the tub as soon as possible and labor there! The baby will be born in the water I am sure, I loved it so much with Seth. My midwife is great about letting us decide when to cut the cord and such. We didn't do it with Seth until after I delivered the placenta. I plan on then going into my room and snuggling up with my new babe and the old one too! :lol
Since my midwife caught Seth, she knows me and knows what I like and don't like. So, that is really nice that I don't have to worry about that this time! :D I am just so excited to give birth again...I know it sounds funny, but I really love it!

[Quagmire]

Hmm...

This thread has me thinking. I had a birth plan for my first (hospital) birth, and by the time I got there I had forgotten what was on it. I knew I didn't want an episiotomy... that was about it.

This time is sooooo sooo soooooo different since it's a midwife who in practice is probably ready to let me do things I haven't even thought of asking about! :lol But I'm wondering if I should have a birth plan as back up for the hospital in case I transport. Anyone BTDT? Is it a moot point since transport probably means some sort of horrible intervention I don't want?

[tsk_mum]

I need to get started on mine! I will probably use some of these as a guideline:wink

[lotus.blossom]

( Anna you are so silly! Now I'm giggling about that! :lol )

[momsmyjob]

Mine is pretty simple...go into labor, call the midwife when it gets serious, get into the tub as soon as possible and labor there! The baby will be born in the water I am sure, I loved it so much with Seth. My midwife is great about letting us decide when to cut the cord and such. We didn't do it with Seth until after I delivered the placenta. I plan on then going into my room and snuggling up with my new babe and the old one too! :lol
Since my midwife caught Seth, she knows me and knows what I like and don't like. So, that is really nice that I don't have to worry about that this time! :D I am just so excited to give birth again...I know it sounds funny, but I really love it!

That's about like mine :love