Birth Plan

[Kellz]

Can't remember who I said I'd find and post this for
I used a template from the pregnancyandbaby website and edited it to suit me.

Birth Plan for Kelly B
Date: 21st September 2007

Due Date: 7th November 2007
Patient of Dr ...

We are looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate you reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labour and birth a great experience. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments. Thank you!

Please Note
My bloodtype is A Rh- (Rhesus Negative)
Partner is also an A Rh-

Labour
Please perform no routine prepatory tasks (shaving, enema, etc.), unless requested.
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to wear my own clothes, rather than a hospital gown.
I prefer to eat and drink throughout labour, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
Please do not administer an IV/etc unless there is a clear medical indication that such is necessary.
I would like a quiet, soothing environment during labour, with dim lights and minimal interruptions.
I would like to play my own music.
Please limit the number of vaginal exams.
I wish to labour freely in the birthing tub or shower.
As long as Harvey is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler, even if the membranes have ruptured.
If fetal distress is suspected and time permits, I would like confirmation of this with a fetal scalp blood sample before proceeding with other interventions.
Please allow me to vocalize as desired during labour and birth without comment or criticism.
Please do not permit observers such as interns, students or unnecessary staff into the room without my permission.
To preserve my privacy and dignity, I would prefer that everyone knock before entering.


Labour Augmentation/Induction
I would like to avoid induction unless it is medically necessary.
As long as Harvey and I are healthy, I do not want to discuss induction prior to 42 weeks.
If my pregnancy progresses past 40 weeks, I would prefer to base the decision to induce on the results of Harvey's biophysical profiles, not on my own personal discomfort or impatience.
I would like to try alternative means of labour augmentation, like walking or nipple stimulation, before oxytocin or artificial rupture of membranes is attempted.
If induction is necessary, I would like to attempt it with prostaglandin gel or another means before oxytocin is administered.
If induction is attempted, but fails, I would like to come back at another time rather than pursue further intervention (assuming my membranes are intact and that waiting presents no danger to Harvey or myself).
Please do not rupture my membranes artificially unless medically indicated.


Anesthesia/Pain Medication
Please do not offer anesthesia/analgesia unless I ask for it.
If I ask for pain relief, please feel free to offer non-medical choices for coping and/or remind me how close I am to the birth.
I would like to avoid all narcotics, if possible.
If pain relief is considered, I would like to try a narcotic before an epidural.


Cesarean Section Delivery
I feel very strongly that I would like to avoid a cesarean delivery
If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like my mum to be present during the surgery.
Please explain the surgery to me as it happens.
I would prefer general anesthesia in an emergency only.
I would like to have a respectful atmosphere without chatter during any part of the surgical procedure.
If possible, please do not strap my arms to the table during the procedure.
If conditions permit, I would like to be the first to hold Harvey after the delivery.
If possible, I would like to breastfeed Harvey immediately after the birth.
I would like our plans outlined here for after the birth to be followed as closely as possible.
Please lower the screen just before delivery so I may see the birth of the Harvey.


Perineal Care
I prefer not to have an episiotomy unless it is medically indicated.
To avoid episiotomy or tearing, my labour assistant will perform perineal massage with oil and apply hot compresses.
I would rather tear than have an episiotomy.
Please administer local anesthesia when repairing any episiotomy or tear(s).
Please suture tears only if necessary.


Delivery
Even if I am fully dilated, and assuming Harvey is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.
I do not want to use stirrups while pushing.
I would like the freedom to push and deliver in any position I like.
I would appreciate help from staff supporting my legs as I push if I request it.
I would like to deliver in a birthing pool and have made arrangements for one for the birth.
I would like to have a mirror available and adjusted so I can see Harvey's head crowning.
I would like the opportunity to touch Harvey's head as it crowns.
I would like a soothing environment during the actual birth, with dim lights and quiet voices.
I would like to help catch Harvey.
I would like to have the birth recorded with photographs, video tape and/or tape recording.


Immediately after the birth
Please place Harvey on my stomach/chest immediately after delivery.
I would like to breastfeed Harvey immediately.
My partner would like the option to cut the cord.
Please allow the umbilical cord to stop pulsating before it is cut.
I prefer to wait for spontaneous delivery of the placenta and do not want a routine injection of oxytocin.
Please show me the placenta after it is delivered.
Please remove my IV/catheter/etc as soon as possible after delivery.


Newborn Care
I would like to hold Harvey skin-to-skin during the first hours to help regulate Harvey's body temperature.
I would like to hold Harvey through delivery of the placenta and any repair procedures.
If possible, please evaluate Harvey on my abdomen. Otherwise please evaluate and bathe Harvey at my bedside.
I would prefer to bathe Harvey myself, at my discretion.
If Harvey must go to the nursery for evaluation or medical treatment, someone I designate, will accompany Harvey at all times.
I would like to waive the administration of eye antibiotics.
Please delay eye medication for Harvey until we are well past the initial bonding period (if I am unable to waive the adminstration of).
If available, would prefer erythromycin eye treatment or other antibiotic eye drops instead of silver nitrate (if I am unable to waive the adminstration of).
I would like to waive the administration of routine Vitamin K, unless medically indicated.
I would prefer to have Vitamin K administered orally (if I am unable to waive the adminstration of).
I would like to defer the PKU screening.


Postpartum Care
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.
If available, I would prefer a private room.
I would like to have Harvey room-in with me at all times.
I would like my partner to room-in with me.
Assuming I feel up to it and Harvey is healthy, I would like to be released from the hospital as soon as possible following the birth.
I would like access to my chart and Harvey's chart.


Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.
Please do not give Harvey supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
Unless I am unable to give my consent, please do not give Harvey any supplements without first informing me of the reason(s) and seeking my consent.
Please do not give Harvey a pacifier.


Additional notes
I would like to take still photographs during labour and the birth.
I would like to make a videorecording of labour and/or the birth.
I am not planning to have Harvey circumcised.

 

[tinytoes]

oh gosh so much to think about!!!

I would rather tear than have an episiotomy....wow!

good luck.

 

[Kellz]

tears repair so much quicker and are usually smaller, require less stitches (if any) than an episiotomy.
Of course there's always exceptions but I'd much rather tear a teeny bit than be cut with surgical scissors - owwies

 

[Margerle]

tears repair so much quicker and are usually smaller, require less stitches (if any) than an episiotomy.
Of course there's always exceptions but I'd much rather tear a teeny bit than be cut with surgical scissors - owwies

ditto

Great birth plan!

 

[vickilouise]

bloody hell i thought a birth plan was where i wanted to deliver and refusal/acceptance of epidural i had no idea it was that detailed.

 

[marley2580]

You should have seen mine, it was 8 pages long! I'm glad I wrote it though as I ended up with a c-section.

 

[tinytoes]

tears repair so much quicker and are usually smaller, require less stitches (if any) than an episiotomy.
Of course there's always exceptions but I'd much rather tear a teeny bit than be cut with surgical scissors - owwies

haha, i'd rather the opposite - I'd rather a nice neat cut rather than a rough messy tear. But each to their own. All the best to you!

 

[Kellz]

tinytoes - those neat cuts often split further during the delivery and the slidy straight edges require more stitches and take longer to knit together.
Often you'll tear less than what they'll cut you anyway and if you do perineal massage for a couple months before delivery the chances of tearing are really small.
It also reduces your risks of tearing if you wait until you actually want to push (a lot of hospitals/midwives will tell you that you are fully dialted and so must push) between dilation and wanting to push you release loads of hormones that cause your ligaments and muscles in your pelvis to relax and makes stretching the birth canal much easier.

But yep each to their own =) my biggest fear is some doctor coming at me weilding a scapel saying I have to have a c-section.

 

[Firsttimer]

IM SO SCARED OF LABOURRRRRRRR

that birth plan was great im going to print it off and use some of it in mine. i might do my birth plan next week when i go see my midwife

 

[Tilly]

My birth plan was a small A5 page, lol. Sounds good.

 

[Linzi]

Thats really good, I might use that template as well.

I thought I had it all sussed til they closed the birthing pool down at the hospital Im delivering at and now I haven't got a clue, Im really frightened now.

xxx

 

[Pearl]

thanks for posting this ... its really useful ... if anyone else wants to share their birth plans, please do !!

 

[marley2580]

Home Birth Plan

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 to have music playing during the labour, and I want to be in charge of the iPod.
I would like for the clocks in the house to be covered or removed as I do not want to be clock watching.

Birth Companions
Only my mother, Laurie and my partner, Barry may be present during labour and birth. I do not want to be contacted by friends and family asking ‘is it out yet’. Mum or Barry can tell these people to ‘bugger off’.

Pain relief:
I would like Entonox and Pethadine to be available. However I do not want them to offered unless I specifically ask for them.
I intend to use baths and a TENS Machine to aid me in pain management.

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 my bedroom
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.
When my baby is born, please pass him or her straight to me.
Please only administer an episiotomy if the baby needs to be born quickly.
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.
Please do not announce the baby's sex as we would like to find out for ourselves.

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. It is important to me that you do not clamp the cord until it has stopped pulsating, unless you need to take emergency steps which preclude this. **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 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 do not wish to keep the placenta

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
I would prefer that my baby is not given an injection of Vitamin K, but would like him/her to have oral Vitamin K instead.

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 agree to student doctors being 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 or other method, not by bottle.
If I have trouble breastfeeding, I would greatly appreciate the help of a midwife who is fully supportive of breastfeeding, and would also like to be given contact details for local breastfeeding counsellors.
Going Home
I would like to go home as soon after the birth as I am able to move, unless I or the baby have health problems which require hospital treatment.

 

[Margerle]

tinytoes - those neat cuts often split further during the delivery and the slidy straight edges require more stitches and take longer to knit together.
Often you'll tear less than what they'll cut you anyway and if you do perineal massage for a couple months before delivery the chances of tearing are really small.
It also reduces your risks of tearing if you wait until you actually want to push (a lot of hospitals/midwives will tell you that you are fully dialted and so must push) between dilation and wanting to push you release loads of hormones that cause your ligaments and muscles in your pelvis to relax and makes stretching the birth canal much easier.

But yep each to their own =) my biggest fear is some doctor coming at me weilding a scapel saying I have to have a c-section.

Yes imagine taking a scissors snipto a piece of fabric. Once you make that first snip in the fabric, it's easier to tear the fabric all the way.

 

[Sara]

Home Birth Plan

Hey Marley, I know where you got most of your plan!
Mine's really similar, it can be found here.
I keep feeling like I'm missing something though...