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2004-10-16 - 4.16pm��previous entry��next entry
The Birth Plan!
BIRTH PLAN
Neil and Alice � due date: November 5th 2004
To: Community Midwife Team
We have chosen to give birth to our baby at home because it feels like the most natural, comfortable, and familiar place to be for the occasion, and because we are confident in the ability of my body and the care of the community midwives to provide a safe and satisfying birth experience.
We realise that every birth experience is different, and that expectations cannot be set in stone.
In our desire to have the happiest and most memorable birth possible, we have listed our preferences below. These decisions have been made after much research, consultation and thought. Therefore, your help in attaining these goals is very much appreciated.
You can rest assured that in the unlikely event of complications, our full co-operation will be rendered after an informed discussion with the attending midwife has taken place, and adequate time for private consideration has been given us.
People at the birth
Neil (my husband) and Jane (my mother) will be present throughout labour and delivery.
Items for comfort during labour
I am keen to use positions during labour that will help my progress, and also to remain as mobile as possible. I will be using pillows, a birth ball and a birthing pool to facilitate these positions. If a hospital transfer is required, I would like the option to take my own birth ball with me if possible.
Nutritional needs
Snacking and drinking throughout labour as desired. I would appreciate encouragement to maintain fluids by sipping water or other gentle drinks, or by eating ice chips, especially if labour is prolonged.
Birth environment
* I would prefer dim lighting with lamps, rather than bright overhead lighting, to help me stay relaxed.
* I would like the option to play music as desired, and possibly to watch TV or a video earlier in labour as a distraction.
* I would like to be given privacy if I desire it at any stage (with the exception of a complication occurring).
* It is important to me that I am able to have solitude and quietness when I desire it, to help me relax and focus in on my body.
* I would like the freedom to move and vocalise my needs as necessary, or in whichever way helps me.
* I would prefer not to be hurried or pressurised at any point during labour and delivery, or given anxiety-producing time constraints, as long as Arthur (the baby) is tolerating labour well.
Medication
* No analgesia unless I ask for it please. I am keen to try to experience all of labour and childbirth without IV, IM or epidural pain relief.
* I would like to use a TENS machine and the birthing pool to manage the pain. I would also appreciate the freedom to request massage or to move and vocalise as necessary to ease pain during contractions.
* I would prefer not to use gas and air, but may be willing to try it if necessary. Please do not offer it to me unless I request it.
* Please encourage me to keep going without the pain relief options I have requested to avoid, as I am sure I will need the extra encouragement at the time!
INTERVENTIONS
Homebirth
* I would prefer very infrequent vaginal examinations, only as requested by me, or where absolutely necessary. I would like these to be done as gently as possible to avoid rupturing the membranes.
* I do not want my membranes ruptures artificially.
* I would prefer Arthur�s heartrate to be monitored intermittently by Doppler or with a Pinard stethoscope, and if available, I would like an underwater sonicaid to be used while I am in the birthing pool.
* It is very important to me that nothing be done or suggested that would inhibit freedom of movement or my ability to improvise movements and positions.
Hospital transfer
* If hospital transfer is required or desired, I would prefer minimal staff around me, and my husband and mother present at all times.
* Please do not artificially rupture my membranes.
* I would like the freedom to continue to mobilise as much as possible, and would therefore prefer minimal EFM which would confine me to bed.
* I do not want my baby to be monitored internally.
* Please do not use IV methods to speed up or augment my labour. I would prefer natural alternatives if possible.
* If vaginal examinations are necessary, I would prefer them to be conducted infrequently, and only after my consent is given. Please carry these out as gently as possible, to avoid rupturing the membranes.
Delivery preferences
* I would like to be able to position myself as desired, with complete freedom to improvise as the need or urge arises.
* I would prefer to avoid delivering my baby whilst lying on my back, and would like the freedom to change positions as needed during delivery.
* I am willing to comply if a certain position is required to delivery Arthur safely � eg. shoulder dystocia.
* I would prefer the freedom to deliver in or out of water, although I am aware that this is not an option with this community midwife team.
* I would like the freedom to deliver squatting, semi-squatting (supported by birth partner) or on all fours, as desired.
* I would like the freedom to touch the baby during delivery, and to view his birth with a well-positioned mirror if requested.
* I strongly desire �mother-directed� instinctive pushing, rather than coach-directed.
* I would like to take the crowning stage slowly, and as controlled as possible to avoid tearing. Please could perineal support be provided with a hot compress, and massage if requested, to help avoid tearing.
* Please do not give me an episiotomy unless it is deemed absolutely necessary, and please allow me to participate fully in the decision if it is.
* I would like the umbilical cord to be left intact until it is no longer pulsating. Neil may like to cut the cord, so we would prefer this to be an option.
* I would prefer natural delivery of the placenta. Please do not administer syntocinon, apply cord traction or uterine massage.
Hospital delivery � additional notes
If assistance in delivery is necessary, I would prefer the use of a ventouse cap to a forceps delivery if possible. Please use a local anaesthetic if stitches are necessary.
Preferences for first contact with Arthur
* I would like Arthur to be delivered onto my abdomen and into my arms for immediate skin-to-skin contact.
* I may require some help to clean him off if he is very bloody or messy, but I would prefer this to be done while he is still having skin-to-skin contact with me.
* I would like dim lighting (lamp light only) to protect his eyes please.
* I would like the freedom to initiate breastfeeding immediately � it is very important to me that breastfeeding be initiated within the first hour after birth. Please only try to help me to breastfeed if I ask for help.
* Please provide us some space as soon as possible after the birth, so that we can have some private time for family bonding. To facilitate this, we would appreciate it if any procedures such as newborn exams or jabs could be delayed until we have had some private family time.
* Please examine, clean or bath Arthur in my presence, and I would appreciate help in giving him his first bath.
Extra notes for hospital
* Please allow Arthur to stay with me at all times, unless he needs to be in the SCBU.
* Please do not feed our baby formula milk under any circumstances. It is very important to me that he is exclusively breastfed.
* Please do not supplement his feeds with water or give him a dummy (pacifier).
* We feel very strongly about our decision NOT to have our son circumcised.
* Please do not use disposable nappies on our baby. We will provide our own cloth nappies and deal with the soiled ones ourselves.
We are willing to be flexible about deviating from our birth plan if it is medically necessary, but we wish to be informed of the risks, benefits, and necessity of intervention or transfer to hospital, and to participate in those decisions.
We thank you in advance for your support and kind attention to our choices. We look forward to a wonderful birth!
Neil and Alice
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