Help with my Birth Plan - - Update p 2 Is it rude?

[modo]

My doula has emailed me a template birth plan. Please can you make any recommendations on what it needs? Any suggestions?

Version 1

Spoiler

Birth Preferences for VBAC:

LABOUR

My husband Ben and my doula Lucy will be present.

Please do not offer me pain relief. I know what is available and will ask for it if I need it.DO NOT ask me if I am in "pain" or if I "hurt".

Help us keep the atmosphere right for my birth: dimmed lights, quiet voices, as much privacy as possible. If my eyes are closed, do not interrupt me.

I will be eating and drinking freely.

I do not consent to having a cannula fitted.

My temperature and blood pressure may be monitored please be unobtrusive and please do not limit my actions.

I will have as few vaginal exams as possible. Do not tell me the dilation unless I ask.

Please remind me to go to the loo every hour.

I will have freedom of movement throughout.

I would like to try to rest between contractions.

Monitoring of the baby to be kept to a minimum unless there is cause for concern. Please use a hand-held sonic aid and not continual monitoring. Do not place monitors in my baby's head.

I do not want any interventions (e.g. breaking waters) unless a medical emergency precipitates them. No pitocin or augmentation.

I do not want any medication administered without discussion: the purpose, potential side effects on me/the baby and options on timing e.g. before or after the baby is born.

I will use hypnosis/TENS/water/massage/gas and air during my labour.

I would like to use the birthing pool, staying in the pool until the baby is born.

SECOND STAGE

I will find an upright, comfortable position. DO NOT pressure me to push the baby out, I will breath the baby out. Please do not pressure me after one hour has passed my baby will come when ready. Please use calm tones.

Use of a birthing stool or bed for squatting if not in water.

I do not wish to have an episiotomy unless medically vital or I agree to it.

Please use a suctioning device, no forceps, if assistance is medically necessary.

THIRD STAGE

I will pick up the baby and discover the sex myself. I will have skin to skin contact and to put our baby to my breast as soon as possible, ideally to find the breast itself. I would like any help in positioning the baby for breast feeding you can offer.

If I have had a natural birth, I would like a physiological third stage.

the cord to remain attached until it stops pulsating.

I will cut the cord.

I want to keep my placenta however I have given birth.

If a tear occurs I want to be advised whether or not I need to be stitched and I will then choose whether or not I need a local anaesthetic. I wish to be stitched by an experienced midwife or doctor.

The baby should receive Vitamin K orally rather than via injection.

Emergencies

My husband and I will discuss all eventualities as they arise. Please share any concerns with us as soon as they arise. It will help us to know the answers to these questions:

1. What is wrong?
2. What do you suggest and why?
3. What would be the best possible outcomes with and without this intervention?
4 How much time do we have to make a decision?
5. Are there any other courses of action open to us?
6. What are the benefits and risks of this intervention?
7. What are the alternatives?

In the unlikely event that a caesarean section is necessary I my husband will be present, I will be told what is happening at each stage and the curtain will be dropped at the moment of birth. Please do not tell me my baby's gender, instead hand them over to me. Do not separate my baby for a long time from us. Any checks can be preformed quickly and my baby must be returned for skin to skin ASAP. If I am unable to hold the baby, please let my husband have skin to skin contact as soon as possible and for him to stay with the baby if we are separated.

Version 2

Birth Preferences for VBAC​

LABOUR

My husband Ben and my doula Lucy will be present.

Please do not offer me pain relief. I know what is available and will ask for it if I need it.DO NOT ask me if I am in "pain" or if I "hurt".

Help us keep the atmosphere right for my birth: dimmed lights, quiet voices, as much privacy as possible. If my eyes are closed, do not interrupt me.

I will be eating and drinking freely.

I do not consent to having a cannula fitted.

My temperature and blood pressure may be monitored please be unobtrusive and please do not limit my actions.

I will have as few vaginal exams as possible. Do not tell me the dilation unless I ask.

Please remind me to go to the loo every hour.

I will have freedom of movement throughout.

I would like to try to rest between contractions.

Monitoring of the baby to be kept to a minimum unless there is cause for concern. Please use a hand-held sonic aid and not continual monitoring. Do not place monitors in my baby's head.

I do not want any interventions (e.g. breaking waters) unless a medical emergency precipitates them. No pitocin or augmentation.

I do not want any medication administered without discussion: the purpose, potential side effects on me/the baby and options on timing e.g. before or after the baby is born.

I will use hypnosis/TENS/water/massage/gas and air during my labour.

I would like to use the birthing pool, staying in the pool until the baby is born.

SECOND STAGE

I will find an upright, comfortable position. DO NOT pressure me to push the baby out, I will breath the baby out. Please do not pressure me after one hour has passed my baby will come when ready. Please use calm tones.

Use of a birthing stool or bed for squatting if not in water.

I do not wish to have an episiotomy unless medically vital or I agree to it.

Please use a suctioning device, no forceps, if assistance is medically necessary.

THIRD STAGE

I will pick up the baby and discover the sex myself. I will have skin to skin contact and to put our baby to my breast as soon as possible, ideally to find the breast itself. I would like any help in positioning the baby for breast feeding you can offer.

If I have had a natural birth, I would like a physiological third stage.

the cord to remain attached until it stops pulsating.

I will cut the cord.

I want to keep my placenta however I have given birth.

If a tear occurs I want to be advised whether or not I need to be stitched and I will then choose whether or not I need a local anaesthetic. I wish to be stitched by an experienced midwife or doctor.

The baby should receive Vitamin K orally rather than via injection.

Emergencies

My husband and I will discuss all eventualities as they arise. Please share any concerns with us as soon as they arise. It will help us to know the answers to these questions:

1. What is wrong?
2. What do you suggest and why?
3. What would be the best possible outcomes with and without this intervention?
4 How much time do we have to make a decision?
5. Are there any other courses of action open to us?
6. What are the benefits and risks of this intervention?
7. What are the alternatives?

In the unlikely event that a caesarean section is necessary I my husband will be present, I will be told what is happening at each stage and the curtain will be dropped at the moment of birth. Please do not tell me my baby's gender, instead hand them over to me. Do not separate my baby for a long time from us. Any checks can be preformed quickly and my baby must be returned for skin to skin ASAP. If I am unable to hold the baby, please let my husband have skin to skin contact as soon as possible and for him to stay with the baby if we are separated.

 

[aliss]

It looks really great! Are you birthing in the hospital? (I assume maybe if it's a VBAC?). Ina May's best advice is, if you write a birth plan, make sure you give the doula a copy well before labour begins so that she can study it and enforce your birth plan choices when the time comes. Good job!!!

 

[modo]

Thanks hon. Yes it's a hospital V-bac

 

[NickyNack]

All looks good to me

If it helps, my midwife uses the BRAN analogy for labour interventions -
B - benefits ie what are the benefits of this suggestion?
R - risks ie what risks are associated with this procedure etc?
A - alternatives ie are there any alternatives?
N - nothing ie what would happen if we done nothing and just waited?

In case it helps you articulate your thoughts any better (not that yours aren't clear!!)

 

[madasa]

It's a great plan! I love it when women have a firm idea of the kind of care they want in labour

I would change a couple of small things:

*Please* remind me to go to the loo.....

I think shorter is better. For ex. this part: "I will remain as active as possible, finding the best positions for me and changing these as I wish." - I'd probably put "I will have freedom of movement throughout."

The husb and doula - I would probably move that to the top and I would include their names

I would probably put the part about the dimmed lights like this: "Please help us keep the atmosphere right for my birth: dimmed lights, quiet voices, etc."

You've mentioned about not offering pain relief more than once - I'd just keep the first one, the second one seems redundant...

I was a bit confused - you said you wanted to stay in the pool until the baby was born but you also want them to not disturb you too much and you also want them to tell you when the head is crowning - that seems a little contradictory? If you stay in the pool they will want you to lift up so they can see when the head is crowning, or even get out and lie down so they have a great view and coach you through this part of labour. There are other things you can do to guard against tearing, and I am unconvinced that coached pushing is that great, tbh.

The part about emergencies - I'd probably want to include "What are the benefits and risks of this intervention? What are the alternatives?"

Do you have any other children?

Good luck

 

[Lina]

Good birth plan but it is a bit long. In situations like these you need shorter more concise sentences as midwives quickly glance over your birth plan.

I would draw a small table and have (do's) and (don'ts).

 

[modo]

Do you have any other children?

Good luck

Thanks or the advice I have made the changes you suggested.

I do have a 23 month old, I am hoping for my vbac. I remember you from when you were pregnant on the trimester forums

 

[modo]

Good birth plan but it is a bit long. In situations like these you need shorter more concise sentences as midwives quickly glance over your birth plan.

I would draw a small table and have (do's) and (don'ts).

Thanks hon. I'll try and make it shorter when going through it with my doula.

 

[modo]

Updated

 

[tinytabby]

Just stalking this thread for when the time comes. I hope you dont mind! Thank you for posting it.

 

[modo]

No problem

 

[madasa]

I've heard of BRAIN. Same as BRAN except the I is for Intuition. Never ever ignore or under estimate the mother's intuition!

 

[modo]

Ok I think I am done with it. Copied and emailed to my doula

Thanks for your help everyone x

 

[modo]

I just got an email from my Doula suggesting I put some pleases into the birth plan and get rid of the capitals.

Can I just suggest an adjustment to the tone? Can you try to take out anything that looks like a demand?

the occasional "Please" may help this. For example: Please do not offer me pain relief. I know what is available and will ask for it if I need it. Please do not ask me if I am in "pain" or if I "hurt".

You can put the backs up of a midwife if she feels you are shouting (block capitals) or demanding.

What do you girls think I should do?

 

[tinytabby]

I'd take her advice - she's got experience of what midwives will respond well to.

 

[NickyNack]

Agreed, I would follow her suggestions

 

[modo]

Ok. I guess I will do that,

Thanks

 

[Lina]

It wouldn't hurt no, but I would emphasise the points that I feel are important to me. If not capital, perhaps use colour.

 

[disneyleanne]

I agree with your doula. You want your wishes to be met but at the same time you want to maintain a friendly atmosphere with your midwife.

 

[fifi-folle]

I agree with keeping it to the point and having a positive tone.

Your birth plan is possibly rather different from what the m/ws are used to and some things may be out of their comfort zone (having a doula, not talking about dilation, pain etc) so they might be on the defensive. I would try to preempt this by adapting how you write it. For example "I do not consent to having a cannula fitted." I would write as "I do not wish a cannula fitted (unless medically necessary.)"

One tip my friend gave me was:
• Please allow my husband and myself 5 minutes alone to discuss any changes to the plan unless danger to life (mine or baby’s) is imminent

I hope you get the birth you want this time! I am aiming for a hbac this time!!!