Wednesday, January 27, 2010

The Birth Plan (13 Days Until Delivery)


When we began this process, I had no idea what a birth plan was or how to write it or why it was important. It wasn't until Gabe and I took a childbirth class at the hospital where we will deliver, that I realized the value of a written document. I had no idea there were so many options in the delivery process. I had just planned to go along with whatever I was told - I didn't even realize that I had choices!

After conducting some research, reading several delivery books and doing some extensive internet browsing , I found some great sample plans. Reviewing these samples was was so helpful and generated a lot of great discussion. Gabe and I talked about each step of the process and talked a lot about our ideal birth experience. Once I talked Gabe out of the idea of giving birth on the living room couch, things got a lot easier. Below is what we plan to share with our doctor at our next visit. After she looks it over, we will make any changes she suggests, print out several copies, and tuck it in our hospital bag.

You don't have to wait until week 38 to do this - I've just been procrastinating. I guess I just feel silly having so many preferences for something that has so much uncertainty. But I have learned to take advice, and I've been advised to get something in writing. So for those of you working on a birth plan, here is ours. It's pretty graphic, so I don't recommend the unpregnant continue. But for my pregnant pals, hope this helps as you put your own birth plan together. And just remember, there is no right or wrong way to do this and you can always change your mind.

Mother-to-be: Pop Culture Casualty
Partner: My Calm and Loving Husband
Support Person: My Kick Ass Mother-in-Law

Due Date: 02/09/2009
Practitioner: Whomever is available from our OB practice
Place of Birth: The Hospital

This birth plan is intended to express the preference and desires we have for the birth of our daughter. We fully realize that situations may arise such that our plan cannot 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 so much for your care through the labor process.

First Stage Labor
  • It is important to us that we remain together at all times during the labor and delivery (vaginal or cesarean). We would like to have our support person, Anne Fairchild, stay with us throughout, as well.
  • We would like to have a private labor room and prefer to have dim lights, peace and quiet and the music of our choice.
  • It is our preference to not see students or residents in our room.
  • We would like to have the option of sucking on ice chips, and may also want to try walking, different labor positions, and perhaps a hot shower for pain relief in labor.
  • Please perform vaginal exams only upon consent; as few and as gently as possible.
  • We intend to use relaxation techniques (breathing, focusing, etc.) until at least 4 cm dilated, at which time we would like to be offered an epidural.

  • As long as things are progressing well, we prefer intermittent monitoring with an external fetal monitor. We very much want to avoid internal fetal monitoring unless it is specifically medically indicated.

Labor Augmentation/Induction
  • No augmentation of labor such as pitocin, amniotomy, or stripping of membranes unless non-medical techniques for augmentation of labor are not effective.

  • Please do not offer any pain medication or procedures other than the epidural.
  • If available, we would prefer an ultra low dose epidural or walking epidural if available.

Second Stage Labor/Delivery
  • We would like to have a choice of positions for pushing - no stirrups for birth please.
  • We are comfortable with a prolonged length of second stage if progress is being made.
  • We would prefer to tear rather than have an episiotomy and request the use of compresses, massage, coaching for slow birth of baby’s head and positioning other than lying down with stirrups to avoid the need for an episiotomy.
  • Please allow husband and/or nurses to support the mothers legs as necessary during the pushing stage.
  • If assistance in delivery is needed, please use suction and NOT forceps.
  • Even if fully dilated, and assuming our daughter is not in distress, we would like to try to wait until the mother feels the urge to push before beginning the pushing phase.
  • We would like to have our daughter placed on our new mother's stomach/chest immediately after delivery.

Cesarean Birth
  • If our primary care provider determines that a Cesarean delivery is indicated, we would like to obtain a second opinion from another physician if time allows.
  • We would like the father to be present at all times if our daughter should require a Cesarean delivery.
  • Spinal/epidural anesthesia is our preference for anesthesia.
  • If possible, we would like the screen lowered to view the birth.
  • Please explain the surgery as it's happening.
  • If our daughter is not in distress, our daughter should be given to the mother immediately after birth.

After Delivery
  • It is very important to us to hold and nurse our baby immediately after birth, and to have the weighing and bathing done in our room so that we can watch. If this is not possible, we would like to have the father stay with the baby at all times. Also, we ask that you discuss any routine neonatal procedures with us before they are performed.
  • We plan to exclusively breastfeed our baby, and therefore request that she not be given bottles, water, or a pacifier without our prior approval.
  • If available, we would like to have a private maternity room with 24 hour rooming in, and a cot or comfortable chair for the father.
  • We would like the father to cut the cord.
  • After the birth, the mother would prefer to be given a few moments of privacy to urinate on her own before being catheterized.
  • We would like to have a natural delivery of the placenta.
  • No post-delivery pitocin or pulling on the cord please.

Sick Baby
  • If for any reason, the baby is transported to another facility, please move us as soon as possible.
  • We request unlimited visitation for parents.

  • We would like to have the option to take photos or make a video recording during labor and/or the birth. We pledge not to live blog or twitter after 4 cm dilated.

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