Share your birth intentions (birth plan)

[tattoo_mama]

jeepers some are very long!!
i got told by my mw to make it short and sweet so the docs and mw can follow it easily
so mine is basically

i want to try with no drugs but if i ask, give them to me!
dp to cut the cord
me to hold bubs right away (injections etc can wait)
and no bloody visitors til i say so (dps family are psycho baby hoarders lol)

[Tanya]

What about internals TM? Cord clamping? What about a physiological third stage? Skin to skin contact with your DP also?

[tattoo_mama]

Originally Posted by Tanya

What about internals TM? Cord clamping? What about a physiological third stage? Skin to skin contact with your DP also?

hey tanya
my hossy is very pro natural and allows cord to finish pulstaing before clamping, skin to skin with both parents immediately (as long as no medical complications of course), i have signed form to allow the injection to deliver placenta cause im worried about PPH, also just booked in for an induction next week (40+9, if she doesnt arrive normally by then). it might sound naive and everyone has different opinions but i was v. happy with what i was told at the hossy-run antenatal classes and am positive they will try and provide the best birth possible for me

[Tanya]

Awesome

[JellyBean]

Please tell me if I am missing anything major in the following intentions!!

? I wish to stay at home for the early stage of labour. I intend to inform you and update you on my progress whilst this occurs.
? I do not wish to be artificially induced. I would like for labour to start spontaneously, whether that be at 38 weeks or 42 weeks (I am not expecting to reach 42 weeks due to my first labour starting spontaneously at 38 weeks).
? I plan to endure labour pain naturally, with warm water (bath/shower) and massage as my only form of pain relief.
? I would prefer internal examinations be kept to a minimum.
? I do not wish to have continuous fetal monitoring ? only intermittently when necessary.
? I plan to bring my own relaxation music, and would prefer to have the room dimly lit.
? My husband will be my sole support person throughout the labour.
? I intend to have an active labour ? utilising gravity and various positions to assist me.
? I do not wish to birth laying on my back, but in a standing or squatting position, where gravity will be of assistance.
? I wish to avoid an episiotomy if possible (I suffered a post-labour perenial haematoma due to an episiotomy at my first birth ? very painful experience!), and I would like to receive assistance in supporting the perenium to prevent tearing.
? I wish to have my baby placed on my chest immediately after birth.
? I wish for my husband to cut the umbilical cord, only after it has stopped pulsating.
? I wish for my baby to remain closeby whilst he/she is checked.
? I do NOT wish for my baby to receive Hep B or Vit K injections, and I wish not to be challenged on this decision, as it is a well informed one.
? I wish to deliver the placenta in my own time, without the assistance of drugs.
? If an episiotomy/tear is inevitable, I would prefer a midwife (female) to attend to the sutchering under local anesthetic (the sutchering after my first birth was performed by a young male doctor who was incredibly rough and heavy handed with me ? definitely my most traumatic and painful birth encounter, and I believe partially to blame for the haematoma developing.)
? I do not wish for my baby or myself to be administered antibiotics post labour (or during labour for that matter!) due the the effect this has on the beneficial bacteria in the breastmilk.
? I wish to initiate breastfeeding as soon as possible after the birth.
? I wish for my baby to be on the breast when his or her ?heel *****? blood sample is taken.
? I wish to be informed as to which blood group my baby belongs to (my firstborn?s blood group was not recorded on his hospital documents).
? I do not wish to receive visitors, until both mother & baby have had the oppurtunity to sleep and recuperate.

[JellyBean]

Why is it everytime you cut and paste something from microsoft word the punctuation comes up as question marks???? (See above!!)

[lauren22]

Birth Preferences

Our names are Lauren Oakley and Beau Morgan
We like to be called Lauren and Beau

We?re hoping for a natural childbirth without unnecessary interventions or the use of drugs.
This plan represents our preferences; however we recognise that in the event of unforeseen difficulties it may need to be re-negotiated.

ACTIVE BIRTH

I?d like the freedom to choose positions, use the shower or bath and walk around in labour as desired.

I?m happy to have intermittent external fetal monitoring unless continuous monitoring is medically necessary.

Please don?t offer drugs; I am aware of the options for pain relief and will ask for it if needed.

I wish to be free of time limits and not have my labour augmented unless in a medical emergency.

I?d only like an episiotomy if there is a genuine medical emergency. Please allow time for the perineum to stretch naturally.

If this is unsuccessful and a medical induction or augmentation becomes medically necessary I?d like:

CAESAREAN

If a caesarean becomes necessary I?d like:

For my partner and mother to be with me at all times aside from scrubbing
For discussion to be respectful and minimal - only what is required medically and to inform me of what is happening
For the screen lowered so we can witness the birth of our baby
Unless prevented by medical emergency, I would like my baby to be placed on my chest while you complete the procedure
To be sure that a double layer suture is used and not a single layer in order to improve my chances for a future VBAC
For the cord to be clamped and cut straight away.
The opportunity to breastfeed our baby in recovery. If you do not have the staff to enable this.
BIRTH AND SOON AFTER

Presuming baby and I are well, we?d like:
For the ob to ?catch? our baby
For my partner to cut the cord
To hold our baby immediately after the birth
For all newborn procedures (weighing and measuring) to wait until I have had time to bond with and breastfeed our baby
I would like to have the routine Syntocinon injection to help deliver the placenta
The Umbilical cors to be clamped and cut straight away
For our baby to have vitamin K as an oral dose.
For baby to be given only breastmilk ? strictly no water or formula.
To Have all vacines immediatly

Please sign our birth preferences in good faith that it has been read, will be treated respectfully and that we have your support in all of the above.



Ahhhh glad to have a draft going.......

[julie_ann_jules]

I Here is the birthplan I used. :O)

Birth Preferences
Name:
Baby due:

As this is a planned VBAC birth, we are looking forward to an active, positive and natural birth.
Our desire is to give birth vaginally, with as little medical intervention as possible. We want to participate in this birth to the fullest, with the wonderful support and encouragement of our birthing team.

This is assuming my birth goes normally - if it does not, we are flexible about deviating from the plan if it is medically necessary, but we wish to be informed of the risks, benefits and necessity of intervention and to participate in these decisions.

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.

Care During the First Stage:

I would like to have an active labour/positions. So could you please encourage:
- as mobile as possible.
- use of different positions.
- use of beanbags, cushions, etc.
- frequent drinks and snacks.

- CTG- We understand the benefits of having continuious CTG monitoing. Ideally we would have access to a Telemetry unit. If it becomes difficult to get a good trace (due to my position or movements) then, intermittent EFM along with fetoscope evaluations would be preferred. I must still be able to assume mobile positions even if being monitored, and the EFM volume should be turned down, or even off if possible.

- Please do not set time limits. We do not want to be hurried with time constraints, as long as the baby and mother are tolerating labour please assess their progress rather than looking at the clock.

Pain Relief:
- Drugs not be offered or administered unless they are requested by Julie-Ann. This will only be if, at the time, Julie-Ann feels strongly that she cannot manage without, and all other options have been tried.

- We would like to use the water bath, showers, breathing, relaxation, massage, mobility, heat and cold, plus any other suggestions.

- If we decide to use drugs, we would prefer gas initially, and other drugs only after discussion.

We want to avoid:
- Induction, or acceleration, of labour with Oxytocin. Though I would prefer even this than contemplating another caesarean.

- Artificial rupture of membranes, unless Julie-Ann and partner can both be convinced that it will be helpful in their particular labour. Such as if there was a reason to be concerned about the condition of the baby, but definitely not to put an electrode scalp monitor on the baby.

- Frequent vaginal examinations - as few and as gently as possible.

- Internal electronic monitoring, as infection could be passed to the baby via the puncture site of an electrode clip on the scalp.

Care During Second Stage:
- Unhurried second stage, so long as baby and Julie-Ann okay, that is waiting to push until Julie-Ann feels ready.

- Choice of positions for birthing.

- No episiotomy, please give the perineum every chance to stretch. To an extent Julie-Ann would rather tear naturally than be cut.

- If assistance in delivery is necessary, please use forceps rather than suction.

At the Birth:
- A quiet and intimate environment. Dimmed lights with no unnecessary noises.

- Baby to be put immediately on to Julie-Ann 's abdomen and put to the breast, as long as medically stable.

- Cord left intact until pulsing has ceased.

- Baby to be caught by Lee and Cord to be cut by Lee.

- I would like to deliver the placenta naturally. No pulling on the cord, or drugs to quicken the process. I realise these drugs and procedures can be lifesaving if there is heavy bleeding, but if everything is going well I'd rather have a natural third stage.

- Baby to remain with us in first few hours after birth- waiting until later for weighing, tests or washing, etc.


________________________________________


In case of Caesarean

As we mentioned before, we realise there may be problems (some we may not have taken into consideration here) and we are willing to co-operate, all that we ask is that our informed consent be sought before any procedure or medication is used.

We also realise there is a chance that Julie-Ann may require a caesarean, and all the points mentioned above then become mostly invalid. If Julie-Ann does need a caesarean the important points are mentioned below.

In case of caesarean:

-Lee and our independant midwife to be present.

-Julie-Ann to remain conscious during the operation if possible.

- If caesarean under general anaesthetic, then baby to be given to Lee straight after birth and held by him until Julie-Ann is awake and can be told of the baby's sex and well-being by Lee.

- Lower the screen so Lee and Julie-Ann can view the birth. Julie-Ann has had two previous caesareans and it is still a bit unreal, as she has never actually seen a baby leave her body - they tend to just appear from behind the green screen and be held up for a quick look before they disappear to be wrapped up and tested.

- A verbal description of the birth as it occurs. Julie-Ann especially has felt left out of her previous caesarean as her body and labour have been discussed as though she wasn't there.

-The cord to be left longer so Lee can still experience cutting the baby?s cord.

- Baby to be placed immediately on Julie-Ann?s chest in its naked newborn state with a warm blanket over them both. It would do a lot to make this surgical delivery a bit more natural for mother, father and baby. And it may even resolve a few inner conflicts that are faced after the birth.

- We would like to view the placenta.

Thank you very much for taking the time to read our Birth Preferences, and I hope we can discuss any problems you see with it.
We thank you in advance for your support and kind attention to our choices, as we look forward to a wonderful birth. Your support and co-operation is really appreciated.
Sincerely,

[Inertia]

Mine is fairly detailed in sections, so any suggestions on how to make it more pointed and brief welcome. Also anything missing?

-----
Needles

SMALL CANULA ONLY. As a needlephobe I suffer syncope with needles. For canula placement I need to be laying down to avoid postural hypotension.
The small canula was suitable for my >2000ml PPH, so should still be suitable now. My preferred placement is in the back of the left hand. I will be using an EMLA patch on this position. I would like it to be placed by an experienced nurse or pathologist as I am going to be unable to sit through a session of "find the vein".

The syntocinon is not to be "hooked up" until after birth. I wish to attempt natural delivery of he placenta and a physiological (unmanaged) third stage. I understand this will require monitoring of my loss and am willing to forgo this preference if loss exceeds 800ml.

----
Labour Stage

No AROM.

I would like to be active with minimal monitoring.

I do not want VEs. External signs of progress to be used unless baby becomes distressed and checking my actual progress becomes needed.

I would prefer a gravity based birth position. This is to minimise pushing strain and maximise potential of a natural placental delivery.

No Episiotomy. I will never agree to purposeful damage to my perineum.

No Epidural. It would be unsafe to attempt to place a needle into my spine - this is because of the phobia.

If assisted delivery becomes necessary, I would prefer ventouse (no episiotomy) be attempted first. If this fails and baby can not be delivered safely without further assistance, then we consent to an emergency c-section under general. Baby is to remain in care and proximity of my support person if this happens.

----
After Birth

As part of my unmanaged third stage, I would like for the cord to remain uncut for at least 2 minutes. If Phil is able to be present then he is to cut the cord.

I would like to collect my baby from birth and maintain skin to skin contact and initiate feeding without any interruptions (saving for needed third stage management or baby in distress). Basically, only mum and dad to touch her until after third stage has finished.

[LoriRae]

OK, here are my intentions for the birth and post-birth period of my dd.

Above all, a safe delivery for both mother and baby.

No foetal monitoring throughout the birth unless medically neccassary.

Mininal VE's, unless medically neccessary.

Happy to use gas. Attempting to birth without pethidine, but if I start swearing at people, give it to me (Epidurals aren't offered my mw program).

I want the freedom to move around as much as possible during labour and to birth in whatever position I feel comfortable in. I ask that I not be made to lay down on my back unless it is absolutley medically neccesary and there are no other options.

Natural and unmanaged third stage of labour. I would like immediate skin to skin contact and a baby led breast attachment. All the weighing, injections, etc, can wait.

In the unlikely event of a c-section or myself needing surgery post-birth, I would ask that access to our dd is limited to my husband and son, and no other family members or friends.

If at any stage after the birth I choose to introduce a complimentary formula feed, for my mental or physical health, I ask that my informed desicion to do so be respected.

[TeniBear]

Here's mine, it's not quite finished yet though....

- Active birth
o I would like to be free to move around the room during contractions, and avoid the bed as much as possible.
- Drug-free
o I understand birth is a very difficult and painful process, and many women find it easier to make the pain go away with drugs, but I am not one of those women. I am quite tolerant of pain. However, if the pain does get too severe for me to cope with, I am happy for gas & air to be offered.
o Unless absolutely necessary, I do not want a cannula to be put in me at any point. I am afraid of needles and other foreign bodies being in me. It would only serve to distract and distress me if I were to have one.
o If a cannula is necessary, I would prefer it in the inside of my elbow, as this is where the veins appear strongest. It is to be covered immediately so I cannot see it, and after it is inserted I will not be moving that arm at all until it is gone.
- Birth partners
o My husband, Scott, will more than likely be attending the entire birth. If he is at work at the beginning, he will be joining me as soon as possible. I would like him to be the one to announce the baby's sex to me and for him to be allowed a cuddle before the baby is handed to me. I would prefer him to cut the umbilical cord, but he's not sure if he'll be able to do it. Give him the option first.
o My mother, Leanne, may be with me as well, especially if Scott is unable to be there. If she is there and Scott is not, I would like her to announce the sex. If both of them are there, she will be last to hold the baby of the three of us.
- No unnecessary intervention
o Under no circumstances am I to have an episiotomy unless I specifically ask for one.
o Unless there is real need for it, I would not like any other intervention (forceps, etc) until it has been offered and accepted by either me or my partner.
- Vaginal, not surgical
o I would only agree to a Caesarean if my or the baby's lives were at risk. I am not putting myself through unneeded surgery because the hospital/obstetrician/midwife has a time limit on vaginal birth. Even if it takes me days to give birth, I'd rather do it naturally.
o If a Caesarean does become necessary, I would like one of my birth partners to be there with me.
o Unless there is a medical emergency preventing it, I would like the baby to be placed with me while the procedure is being completed.
- Cutting the umbilical cord
o As mentioned above, I would like my husband to cut the cord. If he can't stomach it, I am happy for a doctor or midwife to do so. Please wait until the cord has stopped pulsing before clamping.

[Kirley64]

Mine is a work in progress - got a few more months to work out minor details
Mother: Kirsty-Lea (take note of spelling - I am not KRISTY!!)
Father : John
Support Person : Heather

- i would like to have an active birth and be able to move around how I please. I would like to find my own way to cope with the pain so any suggestions in regards to positions and options would be more than welcome.
- I would like the option of a bath or shower and if possible water birth - I find water a great pain relief and know this will probably help me relax greatly.
- I do not wished to be confined to a bed for continuous monitoring unless absolutely necessary.
- I do not want alot of people coming and going the whole labour; I would rather be left with my husband and Heather until the time comes where I am closer to birthing my baby - other than the occassional checking on progress.
- I do not want to be pushed for time constraints. Labour happens in a natural progression, not to your staff shifts.
- Dim lighting if possible. And I would like the choice to eat and drink if i feel the need. Do you have a radio I can turn on?

- I am not against intermittent checking of my bloodpressure etc or the baby's heart rate; i just do not wish to be confined to a bed for long periods of time while this is happening.
- Please keep an eye out for blood pressure problems through my body language as my mother has had pre-eclampsia with both pregnancies including needing resusitation and life-support, and so this could be a real issue with my labour. Don't overly obsess over it as that will stress me and my husband out more, just be aware of the signs please.
- I would prefer no VE if possible.
- I am aware of the pain relief options/drugs available; please don't offer them to me unless I ask.
- I do not wish for an episiotomy. I wish for a midwife to offer the correct physical support when the time comes. I would rather have stitches after for natural tearing.

- If my husband feels he is up to catching the baby - i would like him to be the person to do that.
- I would like my husband to cut the umbilical cord after it has finished pulsating.
-If in both instances my husband does not feel up to either task - i would like Heather to be offered both those tasks .
- I would like the baby to be bought up to my chest for skin-to-skin contact and the option for breast feeding straight away.
- I would like to have bonding time with my husband and baby for at least half an hour to an hour before he/she is taken away for measurements/bathing etc. If Heather chooses to stay or leave then that is up to her.
- I do not want my baby to have the Vitamin K injection or oral dose, nor do i want he/she to have the Hep B injection. I am well informed and educated in my decision and do not wish to be pestered about this. I will however agree to the Vitamin K injection if my baby has had a traumatic birth or is somewhat injured/bruised. In this case the injection can be administered when the measurements are being taken.
- I wish for my baby to be breast fed.

- I would like to try deliver the placenta naturally. I'm not a fan of seeing what it looks like. Please don't offer.

C-Section
- I understand that sometimes things do not go according to plan and that there may be complications.
- If a c-section is needed, I wish for my husband, myself and heather to all be explained the reasons for needing it.
- If possible i would like my husband still present for the birth & to be able to cut the cord after it finishes pulsating. I'd also like for the baby to still be placed straight onto me after being born. If not possible to me, then for the baby to be given to my husband.

- No visitors until I say.