Home Birth Plan
This is the birth plan of Amanda. The birth will be supported by my husband. I am happy for student midwives/student nurses to accompany my midwives to and participate in the birth.
The baby is due 27/02/2010. The birth is planned to take place at home.
Preferred birth equipment: Birthing ball, heat pack, aromatherapy, TENS, massage, music.
I would like to try my bath for pain management.
I want an active birth; please remind me to try different positions, such as: kneeling, lying forward, leaning against partner, lying on side, sitting on birth ball, supported squat, standing, perhaps sitting on the toilet. I do not want to be lying on my back.
I want to use the following pain relief: breathing and relaxation, adopting comfortable positions, water during labour, massage, TENS, possibly gas and air.
Please do not offer me Pethidine – I am not convinced of its efficacy. Also, I do not want to risk my baby being sleepy and not wanting to breastfeed as a result. (I also react badly to codeine and am unsure how I would react to this opiate.)
I do not want an episiotomy and have been practicing perineal massage (at least attempting to practice!) from 34/40. Please avoid this where at all possible.
This is what I want to happen when the baby is born: I would like immediate skin-to-skin contact and will try to initiate breastfeeding to assist in placenta delivery. After this, I am happy for the midwife to weigh, clean and carry out checks on my baby. (If the baby does not latch on soon, I am happy for the midwife to carry out necessary checks on the baby, but I would then like to try to breastfeed.) I give permission for my baby to have Vitamin K by IM injection.
I do not want a routine Syntometrine injection. I would like a physiological third stage with the cord clamped and cut when it stops pulsating. 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. My husband may be offered the chance to cut the cord, although he may not wish to do so. **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 the benefit of all the oxygenated blood that is transfused from the placenta to the baby when the cord pulsates. However, if there are concerns with excess bleeding, I understand that this may not be possible and therefore Syntometrine a sensible choice.
Should we have to transfer to hospital:
I am happy for student midwives/student nurses to be involved in our care; however, I do not wish for medical students to be involved.
I do not want an epidural, although I am happy for my midwife to suggest this to me if it is felt that I am no longer coping well with other forms of pain management (perhaps due to a long or augmented labour). If an epidural becomes necessary, I would like a “walking epidural” and/or for it to be given in time so that I am able to feel when to push. However, please note that I have symphysis pubis dysfunction/pelvic girdle pain, and it is often recommended that women with this condition avoid having an epidural, because if anaesthetised below the waist, they may open their legs too wide, which can make the condition worse.
I intend to breastfeed - please ensure I keep my baby close.
Please do not give my baby a dummy (in the unlikely event of neonatal unit admission and nasogastric feeding being necessary, I give permission for dummy use for non-nutritive sucking).
I understand that plans may have to change according to the circumstances of the birth. I would appreciate your assistance in helping me to follow this plan as far as is practicable. Thank you.
Signed:
Amanda