Birth Plans

[sweetangel2811]

Well - there seemed to be a fair consensus that we should start up a thread to post our birth plans.

Mine is attached below, hopefully people don't think it is too long a post!!

Keen for comments of course as well!

K

Birth Companion
• My birth companion will be my husband, Nam.
• He is to be with me at all times and through all procedures.
• He is also to be included in all communications with the midwives and doctor.

Positions for labour and birth
• I would like to be as mobile as possible throughout the labour and birth.
• I would like to maintain an ability to move around and find the positions that are most comfortable to deal through the pain.

Communication
• I need completely honest and open communication from my doctors and midwives.
• I need to be aware of all things to do with the birth. I don’t respond well in circumstances where I don’t know what is happening or what should be happening.
• If time is running out for pain relief, I would like to be told well in advance.
• If there are any complications, I want to be told in a straightforward way.

Pain Relief
• I would initially like to see how I go without any pain relief. It is a personal goal to try and work through the labour and birth with no pain relief. However, I am keeping my options open.
• If the baby should be in any danger as a result of prolonged labour and using pain relief will assist in the safe birth of my baby, then I will take pain relief.

Epidural
Of all the pain relief available, epidural is the one I would prefer to use, should the need arise.

Gas
I will consider using gas, but am concerned about the potential side effect of wooziness and nausea.

Pethidine
I would prefer not to use pethidine at all. I do not like the sound of putting an opiate such as this in my body. I also am not happy with the potential side effects of nausea, wooziness, loss of control.

Birthing Pool
If there is a birthing pool available for use, I would like to use this during my labour.

Lighting/Music/other
• If it is possible, I would like the lights to be dim, not glaring; and,
• if I remember, I would also like some of my personal music to be playing.


Monitoring baby’s heartbeat
• Making sure the baby is okay is paramount to me. I would like the baby to be monitored, but given my preference to move around, would prefer not to be strapped down to a monitor.
• If I have had an epidural, than being strapped to a monitor is fine.
• If the baby is in distress, then I will forgo everything else and have the constant monitoring if required.

Assisted delivery
• I would prefer vacuum extraction rather than forceps if the need for this arises.

Episiotomy
• I prefer not to have an episiotomy, but if it is required, I would like it explained why and I will make the decision.

Delivery Position
• If I am still able to move around, I would like to give birth in an upright position, allowing the baby to move down naturally with gravity.
• If I have had an epidural, then whatever position I am supposed to be in is fine.

Cutting the Cord
• My husband would like to cut the cord
• We would like to have some time following the birth before clamping/cutting the cord, at least until the pulsating slows down or stops.

Cleaning, weighing, warming
• I would like the baby cleaned a little bit, but not totally washed as I would prefer those first few moments spent with my husband and I.
• As soon as possible I would like the baby handed to me to cuddle and for the baby to suckle if it wants.
• The weighing and assessing of the baby comes third, and when this is done, I would like my husband to be with the baby at all times.

Third Stage
• I don’t want this stage to be rushed through as I have concerns about excess bleeding etc if the placenta comes away prematurely.
• I would prefer to have a natural third stage

Feeding the baby
• I will breastfeed the baby and as mentioned would like to hold the baby as soon as possible just in case the baby wants to feed.
• I do not want any bottles or formula given to the baby

Unexpected situations
• I am aware that situations may arise that are beyond control.
• The healthy birth of the baby is more important than anything else and I am willing to forgo any and all of this plan in order to ensure that nothing jeopardises this.
• If a caesarean delivery is needed, then I will consider it.

[Sarie]

Good work! I didn't do a birth plan for #2, cause my first labour didn't go to plan at all!!
But stick to what you are comfortable with.
The only thing that I would say is that I would probably go the gas over the epi, though only because I'm in a fairly low % of people that an epi doesn't work for. I had a bad reaction to pethadine (as did my first son) and I did my second labour only on gas.
I love gas!!!
Best of luck
Sarie

[the_queen]

Yeah that all sounds very good!

Just wanted to add, something I found out from my MW is that they can actually do the APGAR test while bubs is in your arms, if that's what you'd prefer. I'm asking for that.

:thumbsup:

[cosmic]

That all sounds great, K.. and Queenie, that's a good one to put in too!

Sarie, I'm with you... I don't know how much I'll use it in labour, but I loooove gas at the dentist. :D :yelclap:

[Scout]

Ok, I didn't want to do one but K, you have done an outstanding job. My friend (who will be at the birth with me) is coming over tonight so I think that we might start discussing things.

[wktz]

Sweetangel this is an outstanding job...you've inspired me to try and write one of my own :p

[stellaj]

Fine i"m going to do one too!

I think yours is good sweetangel and it includes all the things that the middy would try to do anyway. Hope you hubby is good with blood and guts though, my DH would not go down 'the business end' at all and the dr. tried to cut the cord and it was so thick be was hacking at it for ages and when he got through it blood sprayed out like a fountain. After i had Conor it sounds awful but they put him in my arms and i kind of had a look and then tried to hand him back as i was too tired and dsorientated to appreciate the moment, it definately wasn't a huggies moment.

When are we meant to pack our bags? I am scared i won't be able to find anyone to mind Connor, this baby needs to come at night when everyone is home!

[Bubble*Crazy]

Hi everyone,

I've just joined and have come across these posts ... If I'm still in the right area you're all due May 2006? I'm due 4th May with my 2nd (so really I'm "working mum to 1 but almost 2". My daughter is 5+ and has just started pre-primary. :D

I work full time and can't wait for my mat leave to start in 5 weeks so I can organise myself and get everything ready for the arrival of our little one - I'm unfortunately feeling the tiredness & complete lack of motivation this time round after a full days work !!! :eek: Probably because I'm trying to savour the last few weeks of "us being 3" before it's "the 4 of us"...

I'm very impressed with the birth plan, sweetangel - I've got the same plan (so far!) as what I had with #1 - just go with the flow and do what is needed at the time.... not sure if that's lazy or being "open" to something that shouldn't happen, but at this stage I'm happy with that and it worked out first time round: completely natural birth with absolutely no drugs whatsoever. Must admit, I'm still proud of myself and don't mind telling others that will listen!!!!! Just hope I don't disappoint myself if I can't do the same again ... maybe it is time to at least look at putting pen to paper?

Hope I'm not babbling too much, but it'll be nice to "speak" with others at the same stage in preg :ecomcity: :ecomcity:

[HoopDeeDoo]

Great birth plan you've given me a lot to think about. :yelclap:

Just want to mention if your baby happens to come earlier than expected as in prem then bub will have to be given formula until your milk comes in. Just something you should think about, I had no idea Noah would be 5 weeks early, it was a shock to everyone. He was in NICU for ten days, and was tube fed and given formula for the first few days, so he didn't lose any wieght, and then he was breastfed and tube fed my breast milk.
Of course the chances of this happening to your bub are fairly small, just something to think about, cause the whole experience was really unknown and scary to me, it would have been nice to know what could happen

[sweetangel2811]

Hey everyone - thanks for the feedback and nice comments!! I am trying to stay flexible with the dr's and midwives, without coming across too idealistic!! There are some things that I have definite views on though, so I figured doing a bplan would be better than leaving it to when I am less coherent and rational!!

Sarie - I was a bit worried about the gas - does it make you feel light headed or nauseous at all? That would be my only concern. I figure with the amount of pain I will be in, the last thing I want to be doing is throwing up as well! :eek:

The reason I chose epidural though is I have had surgery and had 3 ribs removed (VERY painful and long story!!) and had the epi running directly to the ribs for about 5 days - worked a treat! Didn't get rid of the pain completely, so was also supplemented with morphine for the first 3 days, but definitely took the edge off!! Also didn't make me feel sick (the morphine took care of that!)

Queenie - I might ask my OB on wednesday about the apgar test - that sounds perfect - just what I want!! I read that it is best for baby to stay with you and husband after brith as it is your voices that reassures them that all is okay, which is why I outlined that the testing of bubs comes third! But if they can do it while I am holding him/her that would be perfect - thanks!!

Stella - That all sounds horiffic!! Forget DH being able to stomach all of that - what about me???? I have a terrible gagging/vomiting reflex when I see heaps of blood!! Maybe I should put in the plan that I don't want to see the blood etc. Or do you think I will be too exhausted to care? ;) I think DH should be right though. He is alot better than me when it comes to all of that. He has already told me though that he won't be investigating the business end during the labour as he would get too freaked out by all of that 'stretching' etc :p You should see his reactions when I show him photos of the head crowning etc!! Cracks me up!!

Workingmum - welcome!! The more the merrier in our lil group here!!

Mumtonoah - I hear what you are saying, and I think I will have to deal with situations like that when the time comes. I hope I don't have to. I guess it is with those sorts of things that my desire for as much communication as possible will come into it. It is positive to hear from you that being formula ffed for those first few weeks, didn't affect your ability to breastfeed later down the track though!

Well I get to see my OB on Wednesday to go through this with him. Hopefully he doesn't laugh me out of the room!

K

[shereejoy]

Keirsten,

What a fab job you have done.

I am worried about my partner, he is not good with blood and stuff, so I guess he will just be holding my hand and not going down the business end. I wish he would, but hey I can't make him, and I certainly don't want him feinting, I want him there the whole time. My mum will be there if the need arises thank god, as I am a bit concerned about Wade. Have antenatel starting next week, so should get a better idea of how he is going to react then I guess.

[stellaj]

don't worry Sheree, my DH is the biggest wimp when it comes to blood and he survived without fainting. His face did look like this :eek: though, i kept saying 'STOP DOING THAT FACE' and he would go 'what face?' and look even more terrified.

sweetangel you will cope, i don't even remember all the gross stuff very clearly, sort of like a foggy dream the whole time. I think you wont be able to avoid seeing the blood and guts and at the time you probably won't care either. I still have not asked DH if poo came out of me :eek: yuck, don't want to know. As for vomiting, most women vomit during labour i think, i was puking when i arrived at hospital and again when i was in transition and to be honest, i did not care. You feel like there is stuff coming out of every place possible on your body and there is nothing you can do about it, very primal in a way i guess.

[lottiesmum]

sorry to poke my nose in teh ''wrong" month (#2 is due 2 September) but I just wanted to chip in about using gas. My experience with #1 with gas for what it's worth is that I started using it 13 hours into an 18hr labour. I too was reluctant to use it because of nausea. I had terrible morning sickness and hate feeling nauseous or out of control...but the beauty with gas is that when you stop breathing it in it wears off within a v. short period of time (less than a minute I think...). It is worth trying because if it makes you feel sick (and most women I've spoken with have vomited in labour...) you can stop and try it again later. The strength can also be adjusted up/down. Also most hospitals have 2 kinds of mouth pieces for gas - one you put in your mouth and clamp with your teeth and another which is a mask. I hated the mask (too claustrophopic!) but loved the mouthpiece...especially in transition when the contractions came one after another in waves. gas got me through :thumbsup: but it is such a personal choice of course, so maybe others have had negative long lasting symptoms from using it but I''ve not heard this.

I got alot out of reading it in terms of starting to think about birth for #2. thank you for sharing! and all the best for your birth.

[Marie-Jo]

Hey Girls,

Finally, here is my birth plan...

Mother-to-be: Marie-Josée

Birth Partner: My husband Rodney who is to be with me at all times and through all procedures. He is also to be included in all communications with the midwives and/or doctors.

Due Date: 01/05/06

Place of Birth: Monash Birth Centre

This birth plan is intended to express the preference and desires we have for the birth of our baby. It is not intended to be a script. We fully realise that situations may arise such that our plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options. Thank you.


First Stage (Labour):

* Dim Lights.
* Peace and Quiet.
* Music of our choice.
* Would prefer my own clothes to gown.
* Would prefer to keep vaginal exams to a minimum.
* Maintain mobility (Walking, rocking, up to bathroom, etc.)
* Eat and drink to comfort.
* Intermittent Monitoring (ACOG Standards) with a Doppler.
* Relaxation techniques (breathing, focusing, etc.).
* Positioning as desired.
* Water (Shower or Tub).
* Heat or Cold packs.
* Massage (back, foot, counter pressure, etc.).
* Please do not offer me pain medications, I will ask for them if I want them.


Induction:

* I would prefer to use natural methods to start labour.

Augmentation:

* I would prefer to walk to speed labour.

Second Stage (Birth):

* Choice of position
* Spontaneous Bearing Down
* I would prefer to tear than have an episiotomy, but please use compresses and positioning.
* Please avoid forceps or vacuum delivery. If need be, I would prefer vacuum delivery.


Third Stage:

* I am happy to use oxytocin to assist the delivery of my placenta.


Baby Care:

* Delay the cord cutting (until the cord stops pulsating).
* Prefer partner to cut the cord.
* Breast feeding only
* No pacifiers or glucose water
* No separation of Mother & Baby

Caesarean Birth:

* Spinal/epidural anaesthesia
* Partner present
* Video/Pictures taken
* Free one hand to touch the baby
* Partner to cut the cord
* Breast feeding in recovery room, if possible.

Sick Baby:

* Breast feeding as soon as possible
* Unlimited visitation for parents
* Handling the baby (Kangaroo care, holding, care of, etc.)
* If the baby is transported to another facility, move us as soon as possible.

[the_queen]

Marie-Jo, that sounds like a great birth plan!! Hope you get the birth you want :)




Here's mine, I've got a copy in my file with the midwife, and I'll be taking about 4 copies into the hospital with me. Also, this will all be moot if I manage to birth at home !! MW says we will stay at home as late as possible, and if everything seems to be going well then she will "string things along a bit" with DH :D so hopefully we'll have an "accidentally-on-purpose" homebirth!!

But this birth plan can do for either home or hospy birth.

FIRST STAGE - At home
I'd like to stay at home until as late as possible. Vallerie will be in Bordertown with my parents, and when I go into labour I will call them to come up to Adelaide (approx 3 hours). I would very much like to see Vallerie before I go to the hospital.
I need to be relaxed to stay focused. I need MUSIC I need SOLITUDE I need to be able to focus on breathing and positions, eg all fours; pelvic rocking. I will want to use water as pain relief - shower/bath/hot water bottles.

TRANSITION - At the hospital
NO ARTIFICIAL RUPTURING OF MEMBRANES
NO OXYTOCIN
NO PETHADINE
NO CONSTANT FOETAL MONITORING - I accept that they will probably want to put the monitor on me when I first arrive, to get a trace of the baby's heartbeat - but after that I do not want it on me at all.
DEFINATELY NO INTERNAL MONITORING.
NO UNNECESSARY VAGINAL EXAM'S - I accept that these will be necessary from time to time but I do not want my dilation to be measured against the clock.
I would like to have the bath/pool available as pain relief.
I want to follow what my body tells me to do; eg f I feel like I should walk around, if I feel like I should have a shower, etc.
When I'm not in the bath, I'd like warm flannels for my perineum.

SECOND STAGE
I don't want to be told to push. I will push when my body tells me to. I accept that some coaching will be inevitable, but I don't want to feel as though I am not in control of this.
I'd like someone supporting my perineum (ideally DH) while I'm pushing.
I want to be able to push in whatever position feels right for me at the time; eg all-fours or slight squat.
Ideally, if I feel like I want to at the time, I would love to birth bubs in the water.
If DH wants to at the time, I would love for him to catch the baby. If he doesn't want to, then I would like to catch bubs myself.
NO EPISIOTOMY - I would rather tear than be cut.

THIRD STAGE
I would like a physiological third stage (if possible)
I would like to attempt breastfeeding ASAP.
I do not want any drugs to deliver the placenta.
If the cord is around his neck, I would like it to be pulled off, rather than cut off, if possible.

FIRST HOUR WITH BUBS
I would not like the vermix rubbed off bubs' skin.
I would like the APGAR checks done with bubs in my or Malcolm's arms.
I would like to breastfeed ASAP and continue holding bubs so we can keep offering the breast.
I would like Vallerie to be brought in straight after the birth (as soon as I have some clothes on!) and no-one is to hold the baby before her (other than DH).
I will check bubs' palate immediately following birth. If there appears to be some clefting, I would like MW to check him before bringing in a doctor.
NO VITAMIN K INJECTION
NO HEPATITIS B INJECTION

Ideally, all being well, we would like to go home a couple of hours after birth.




IF ALL DOES NOT GO ACCORDING TO PLAN

If c-section is absolutely necessary, I would like the spinal, not GA.
DH to be with me in the operating theatre.
Everything I've written re: "First Hour", is to still be observed after a c-section (as much as possible). I accept that if bubs requires medical attention immediately after birth, then I will not be able to hold him or feed him straight away. DH is to be with bubs AT ALL TIMES when he (bubs) is away from me. Definately no vitamin K or hep B.

[cosmic]

Finally, here's mine! I will probably still put some finishing touches on it, but this is the gist..

My name: xxx
My husband: xxx
Our EDD: 2 May 2006

Who will be present at birth: My husband, xxx
My birth support person, xxx

Important Information:

• We have chosen the RPAH Birth Centre as our place of birth because we would like the birth to be natural and active; free from unnecessary medical intervention.
• We request that our presence at the hospital NOT be confirmed to anyone over the phone or details of our condition to be given except to relevant medical personnel.

Before Labour:

• I would prefer that induction for an overdue baby not be discussed until 14 days after my EDD, providing there are no complications.
• I wish to try natural methods of induction if it becomes necessary before medical methods of induction are used.
• Unless my baby’s health is clearly at risk, I prefer not to be induced at all.

First stage of labour:

• I would prefer no internal vaginal exams during my labour, and certainly none after my waters have broken.
• Please do not offer pain medications unless I ask for them and even then, please remind me of my preference for a natural, unmedicated birth.
• After medical guidance for pain relief, I require some private time with my partner to discuss which pain management technique or medication I would like to use.
• I prefer for the baby to be monitored intermittently and externally (by doppler), if necessary.
• I would like the room to be as quiet as possible and to have lighting dimmed or only use natural light if possible.
• It would be appreciated if medical staff entering the room could keep talking and distraction to a minimum.
• I will provide music, oil for the burner, massage oil etc to assist me with pain relief.


Second Stage Labour:

• My husband would like to catch the baby.
• I would like the room to be as quiet as possible during delivery and to have lighting dimmed or only use natural light if possible.
• I would prefer to push instinctively rather than being told how and when to push.
• While I am not planning a water birth if I am in the bath when the time comes for the baby to be born, I prefer not to be moved from the bath.
• I prefer to tear naturally unless there is a clear medical reason for performing an episiotomy. An episiotomy is not to be performed without my express consent.

After the birth:

• As long as my baby is healthy, I would like her placed immediately on my abdomen in skin-to-skin contact.
• It is my preference to have a physiological 3rd stage of labour.
• I prefer to delay the clamping and cutting of the cord until after the placenta has been delivered.
• Wherever possible, I would like routine tests to be administered while the baby remains in skin-to-skin contact with me.
• I do not wish for the baby to be cleaned and weighed until after she has breastfed, even if this is several hours after the birth.
• I prefer to rub the vernix into my baby’s skin, not for it to be cleaned off
• Vitamin K to be administered orally.
• No Hep B injection.
• There are to be no visitors immediately after birth without my permission.

In the postnatal ward:

• To facilitate bonding, we do not wish for anyone to hold our baby in the first 24 hours after birth except myself and my partner and medical personnel if required.
• My baby will be exclusively breastfed on demand.
• My baby is not to be offered anything other than breastmilk (no glucose water, dummies or artificial nipples at all)

[stellaj]

they are all good, the only thing i would be careful of is having your partner catch the baby, they are really slippery things and apparently it takes years of practice not to jump away when the huge gush of fluids arrives to soak the 'catcher' . I guess you could have a back-up catcher if required.

[cosmic]

Good point, Mel. I think I would like a middie there with her hands right next to my hubbies. Don't want him dropping the slippery little sucker. :D