And here's my birth plan too...

[Joyzerelly]

Home Birth Plan

Briefly:
· We plan to use a TENS machine for early pain relief.
· We plan to use a warm birthing pool from about 6cm dilation.
· We do not wish for my waters to be artificially broken.
· We would like the baby to be born into the water if that is where I am still most comfortable.
· We would like the cord to remain unclamped and attached until it has stopped pulsating, if the baby requires special attention/resuscitation, please do this as closely as possible to me so that the cord can remain attached. Please do not clamp the cord without asking me first.
· I would like my baby to remain unbathed, and unclothed and to be passed naked to me for initial skin-to-skin contact, with a warm towel over the top to keep him/her warm.
· We do not want the baby to receive vitamin K.

In General:
Ideally, if all goes smoothly, I would like for the midwives to generally remain in the background and not get involved in my labour unless I ask them to.

The labour:
I would like to remain active and use whatever position I find comfortable.
Please encourage me to stay off my back – particularly for the second stage!
I would like to minimise internal examinations and, if possible, have them done in a position other than lying on my back.
I do not want my waters broken.
Monitoring of the baby’s heartbeat should be done as unobtrusively as possible and in whatever position I am in at the time.
If the baby appears to be poorly positioned or labour is not progressing well for some reason, I would like to try different positions and movements that might help.
I would like the birthing room to be quiet and to have my hypnobirthing CD playing when I feel its necessary during the labour.


Birth Companions
Only my partner, Olly and the midwife/wives may be present during labour and birth. I do not want to be contacted by friends and family asking ‘is it out yet’. Olly can tell these people to ‘bugger off’ or better still, unplug the telephone.

Pain relief:
I intend to use a TENS Machine and the warm birthing pool to aid me in pain management, along with using hypnobirthing breathing exercises for which I will require a quiet atmosphere. I would like Entonox to be available. However I do not want it to offered unless I specifically ask for it.


The birth:
Please keep the room as quiet as possible during the second stage.
I do not want to be coached through the birth unless it seems as if I need some help, and if anyone calls me ‘mum’ instead of using my name I may hit them over the head with the gas and air!
I would like to give birth in the dining room of Br************Suffolk, N****R.
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. If I am too tired to maintain an upright position then please encourage me to lie on my side instead of my back, to allow maximum mobility in my pelvis.
I would like our baby to be born in the birthing pool and the cord allowed to stop pulsating before it is clamped and cut. When the baby is born, please give me the choice of picking him/her up out of the water myself, if I choose not to please pass him or her straight to me.
Please only administer an episiotomy if the baby needs to be born quickly as a matter of absolute emergency.
I would like the lights dimmed when my baby is born, and for the minimum amount of noise to be made.
I would not like mucus suctioned from the baby’s mouth and nose unless 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 I specifically request them. It is important to me that you do not clamp the cord until it has stopped pulsating. If the baby needs to be resuscitated it is important to me that the natural oxygen supply coming through the cord is not severed before the baby is breathing unassisted. **Please do not pull on the cord or use fundal pressure unless there is a specific indication to do so, as I have read that this is contra-indicated in drug-free third stages**.
I would like my midwife to set up her resuscitation equipment as close as possible to the place where I give birth, so that if my baby needs resuscitation, this can be done with the cord still attached - thus giving him/her the benefit of all the oxygenated blood which is transfused from the placenta to the baby when the cord pulsates.
Please offer my partner the opportunity to cut the cord if possible.
We would like to keep the placenta for encapsulation (or to plant under a sapling).

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 maximise skin-to-skin contact. A warm towel can be used to cover the baby if necessary.
I would prefer that my baby is not given Vitamin K at all.

In case of transfer to hospital:
I do not wish to be transferred to hospital unless my or the baby’s health are at risk.
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 prefer student doctors/nurses/midwives not to be present during my treatment.
I am very keen to avoid a caesarean section if it is at all possible, as I do not want to enter future labours with a scarred uterus. I particularly would like to avoid a caesarean just for slow progress. If labour is simply taking a long time but my baby is not in immediate danger, please would you 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 would like my partner to stay with me at all times, and would like to breastfeed the baby as soon after birth as possible.

If there are problems after the birth:
If I suffer a severe post-partum haemorrhage, please do not perform a hysterectomy unless it is the only available course of action.
Please do not admit my baby to Special Care 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 as this could lead to nipple confusion and hinder breastfeeding. If supplements are necessary, please give them by spoon, sipping cup or other method, not by bottle.

 

[milkmachine]

it looks good there is alot to it though have you thought about condensing it a bit, just because they (hospital staff) wont have time to go thru it all in case of an emergency...they need to beable to tell at a glance what you want if you know what i mean? x

 

[Joyzerelly]

it looks good there is alot to it though have you thought about condensing it a bit, just because they (hospital staff) wont have time to go thru it all in case of an emergency...they need to beable to tell at a glance what you want if you know what i mean? x

That's why I've done the In Brief bit at the top, that bits supposed to be a quick version of the important points. My midwife has read through it and seems to be quite happy with it so fingers crossed she'll be the one who comes on the big day...

 

[bklove]

sounds good, good luck with it. I think your midwife and hubby will be the best ones to know the plan and help advocate for you during labor

 

[milkmachine]

it looks good there is alot to it though have you thought about condensing it a bit, just because they (hospital staff) wont have time to go thru it all in case of an emergency...they need to beable to tell at a glance what you want if you know what i mean? x

That's why I've done the In Brief bit at the top, that bits supposed to be a quick version of the important points. My midwife has read through it and seems to be quite happy with it so fingers crossed she'll be the one who comes on the big day...

 

[JenStar1976]

Sounds like a lovely birth plan - almost exactly how my birth turned out in fact! When Alex was born in the water, I was the only person to touch & hold him and I announced the sex too (you could add that if you wanted?). When I was having the skin-to-skin, the midwives just asked that I kept his body in the water and that he had a hat put on just to stop him losing any body heat.

Fingers crossed for you - shouldn't be too long now! x

 

[madasa]

It sounds lovely, very well thought out.... I think you've covered everything . Mind you I would say that... It looks a lot like mine!! I'm going to be a bit blunt (sorry). Please don't think I'm being mean!

You do repeat yourself a little tho. I can think of a couple of ways to condense it... One thing I did was head each section like: "The Birth -Preferably, I would like:". This makes sure that that your requests are positive ones and it also means you don't have variations of I want a dozen or do times throughout... I just think this makes it easier to keep to one page and easier for them to read

just an example, I would change this:
//I would like to remain active and use whatever position I find comfortable.
Please encourage me to stay off my back – particularly for the second stage!//

to this:

- have complete freedom of movement throughout, but please do encourage me to stay off my back

and then when it comes to pushing:

- to remain upright, or sidelying if upright is not possible

I would go over the plan in detail with your birth companion so that if yr mws object on the day then dh can argue the reasons (helps baby descend, allows yr pelvis to open). You'd hope a decent mw would know this stuff, so putting it in yr plan is like telling your granny how to suck eggs, dyswim?

Id also change:
// Only my partner, Olly and the midwife/wives may be present during labour and birth. I do not want to be contacted by friends and family asking ‘is it out yet’. Olly can tell these people to ‘bugger off’ or better still, unplug the telephone.//

to:

Birth companions - Partner: [name]. No one else to be in the room other than the mws unless I have asked/consented for them to be there.

The rest of that stuff is stuff that you need to brief your oh about before the big day... About telling people to go away, or heading them off at the door so he can forewarn you of their arrival, unplugging the phone etc. That's not stuff for your HCPs IMO I found I could pare my plan down by writing a to do list for dh

 

[Joyzerelly]

I found I could pare my plan down by writing a to do list for dh

Hehe, I've done this too, and I've put certain parts in order of when they should be done... He did ask for this though, so that he would know his role. I also didn't want him asking questions when I'm in labour and distracting me...

It looks like this:

Birth tips for Olly

In Advance:

~ Read the TENS MACHINE instruction booklet.
~ Read the NCT notes several times.
~ Find out how to keep the hot water on all day.
~ Be shown where to find towels, etc.
~ Bring plenty of antihistamines. (He's allergic to my cat)
~ Remind me to charge the video camera.
~ Know that the baby’s mini suitcase with first clothes/ nappies etc is upstairs in my bedroom.


On the day:

~ When setting up the birthing pool, place bath mats around the perimeter of the pool to absorb splashes and to give me something firm and dry to stand on if I get in and out of the pool.

~ Fit low wattage bulb into a lamp (Lamp is by my bedside - Bulb is in birthing box).

~ Look after the candles, light them, keep an eye etc.

~ Once midwives have arrived, close main front gates and attach notice – not giving too much information to the neighbours but basically saying ‘Bugger off!’ ‘Do not disturb/ enter’ etc.

~ Also put a ‘DO NOT UNDER ANY CIRCUMSTANCES DISTURB’ sign on the front door.

~ If it is a cooler day/night, pre-warm the baby’s towel either by wrapping in foil and placing in oven on very low heat or put in the tumble dryer.

~ Know where the ice cubes are kept, have some waiting in the kitchen icebox.

~ Be chef for the day, offer and make tea and toast for the midwives etc.

~ Ensure sofa bed is made up with a waterproof sheet and bed sheet, a waterproof sheet on top, and then a fresh bed sheet and bedding on top of this. (So that top sheet and waterproof sheet can be stripped off if necessary, leaving a clean sheet ready to use underneath).

~ Ensure water is constantly being heated in the household tank.

~ Prepare clary sage oil for massage:
Massage: Blend 5 drops essential oils with 10mls (two teaspoons) carrier oil (sunflower or rapeseed oil).
(Clary sage (salvia sclarea), one of the oils you are strongly advised to stay away from during your pregnancy due to its labour inducing properties. It can however be extremely beneficial to you on the big day. It has a narcotic effect and can be used either blended into a carrier oil which your birth partner massages into your lower back, or in a warm compress pushed onto the lower abdomen or lower back – basically, where it hurts most. Another way to use it is to dab a couple of drops onto a face pad or tissue to hold to your nose/mouth when you need some relief. A good combination is clary sage with rose oil. This might be a substitute for gas and air. Just before you feel a contraction coming, breathe in deeply from your face pad, then after the contraction has passed, breathe in gently and rhythmically from the face pad).

~ Place the well-wrapped placenta straight into the bottom of the garage freezer as soon as possible.

 

[madasa]

I went through the birth box with oh beforehand so he knew where the first nappy/sleep suit was, where the fan and tennis ball and lip balm was etc... He still got a bit flustered on the day because of my transfer.

My to do list looked a bit like this:

inflate the pool, fill it, keep it to the right temp
look up Light Touch Massage so you can use it on me in labour (he didn't do this! Git, it might have helped)
press a tennis ball into my lower back
bring me drinks of water
remind me to go to the loo approx hourly
hold my hand
keep the cat out/away from the pool!
Make snacks and drinks for the mws
TAKE TOO MANY PHOTOS

In fact I thought there was too much for him to do, and I wad concerned that he might be doing other stuff when I needed him. So I arranged for someone else to be there to help...

So my mum came along to be an extra pair of hands to do any little things that dh couldn't do because he was with me... Also, distract ds if necessary and stay with him if I transferred and be ready with the camera when lo slipped out. I picked my mum because I knew she would be able to stick up for me if the mws tried to pressure us into anything we didn't want to do... I knew we had the same sort of mindset about it all, minimal intervention etc. Like an unofficial doulas if you like. In the end the most important thing she did was photos - dh and me were too overwhelmed and wouldnt have got anywhere near so many and such nice ones. She also looked after ds when I transferred, but if she hadn't have been there he'd have gone to his nans... It was the photos I will be eternally grateful for!! I'd definitely have a photographer again

 

[KandyKinz]

Birth plan looks good. Only issue I see is the request to leave the cord attached in the event baby requires a resus. Umbilical cords can be long but are usually quite short leaving the only available space to perform the resus on your belly or right between your legs... Both would be very difficult in water! Also, the area should be completely flat (not on a belly) in order to position the baby to allow for optimal air entry and it should also be flat (not on a bed) if god forbid chest compressions are necessary (the michael jackson cpr lawsuit comes to mind.....) Also, the area of resus should be easily accessible by atleast two care providers... one to do the bag and mask and one from compressions if necessary.

Just keep in mind that most babies DO NOT require any resus and transition just nicely on their own!

 

[Joyzerelly]

Birth plan looks good. Only issue I see is the request to leave the cord attached in the event baby requires a resus. Umbilical cords can be long but are usually quite short leaving the only available space to perform the resus on your belly or right between your legs... Both would be very difficult in water! Also, the area should be completely flat (not on a belly) in order to position the baby to allow for optimal air entry and it should also be flat (not on a bed) if god forbid chest compressions are necessary (the michael jackson cpr lawsuit comes to mind.....) Also, the area of resus should be easily accessible by atleast two care providers... one to do the bag and mask and one from compressions if necessary.

Just keep in mind that most babies DO NOT require any resus and transition just nicely on their own!

While the baby is attached to the pulsating cord, he/she is getting a natural and essential supply of oxygenated blood. To sever that oxygen supply in order to give oxygen to the baby orally would be utterly nuts. The midwife has said that they can set up an area right next to the pool should they need to give oxygen but fingers crossed, the cord will provide all the oxygen baby needs until he/she takes the first breaths.