My Birth Plan (inspiration for yours:)

As promised in my previous post, here is the Labour Plan (or Birth Plan a.k.a. Birth Wish List, as we decided to call it), so you can draw some inspiration as you’re writing your own:

Before Labor Begins

  • As long as the baby and I are healthy, I would like to go at least 10 to 14 days over my due date before inducing labor. I prefer to go into labor naturally rather than be induced.
  • If NST (=fetal non-stress test) observation becomes necessary after my due date, I am flexible and support this procedure.

 Hospital Admittance

  • If I am less than four centimeters dilated, I would like to discuss with my healthcare provider the option of going home.

 Vaginal Exams

  • I would like no internal vaginal exams, within reason, during my labor until I have an urge to push. I prefer at no time to have my membranes broken.

 Induction

  • If induction becomes necessary, I would like to try natural induction techniques first (with the guidance of my practitioner)

Natural induction techniques I would like to try  

  • Breast stimulation/ Sexual intercourse
  • Walking
  • Herbs/ Acupuncture/ Reflexology

If my water breaks before I go into labor, I would like to

  • Wait as long as possible before being induced
  • Talk to my practitioner about alternatives to treatments such as antibiotics after 12 hours or more.

Environment

  • Upon arrival at the hospital, I prefer to have my husband with me at all times.

 I prefer to give birth in a

  • Birthing room with a shower and/or bath
  • Birthing bed
  • Use birthing ball/ stool

Miscellaneous environment items  

  • I would like to have dimmed lights and for people entering the room to speak softly.
  • I would like to play my own music.
  • As few vaginal exams as possible
  • I would like to have my birth photographed/ filmed/videotaped (by my husband).
  • Hospital staff limited to my own doctor and nurses (no students, residents or interns present).

Pain Relief

  • Please do NOT offer or discuss any pain medications with me.

I am prepared to try to handle pain with these natural and alternative methods:

  • Hypnotherapy & Meditation (Childbirth Hypnosis) and relaxation
  • Breathing techniques
  • Massage/ Acupressure/ Acupuncture
  • Water/bath/shower
  • Distraction techniques

Other Considerations

  • Ideally, I want to be able to walk around and move as I wish while in labor.
  • I would like to feel unrestricted in accessing any sounds of chanting, grunting, or moaning during labor.
  • Please always keep my door closed while I am in labor.
  • I would like to eat and drink as approved by my doctor

Monitoring

If necessary, I prefer the baby to be monitored

  • Intermittently monitored to allow for as much mobility as possible
  • External
  • Performed only by Doppler
  • Performed only if the baby is in distress

 

Second Stage Labor

  • As long as the baby and I are healthy, I prefer to have no time limits on pushing.

I would like to be encouraged to try the following different positions for labor (whatever feels right at the time):

  • Squatting/ Birthing Ball/ Classic semi-recline/ Hands and knees/ On the toilet/ Standing upright/ Lean on my husband/ Side Lying

 Episiotomy

  • I prefer to have no episiotomy and risk tearing
  • If I need an episiotomy, I prefer a pressure episiotomy.

 To help prevent tearing, please

  • Use perineal massage/ Apply oil/ Apply hot compresses
  • Support me in breathing in accordance with hypnobirthing for slower crowning.

 Other labor considerations

  • Please allow the shoulders and body of my baby to be born spontaneously, on their own.
  • No stirrups
  • Only use a local anesthetic for repairs.

The Delivery

Pushing

  • It’s important to me to push instinctively. I do not want to be told how or when to push.
  • Push without time limits, as long as the baby and I are not at risk

Miscellaneous  

  • I would like my husband to catch my baby and pull it onto my abdomen (I would like the doctor to catch my baby only if necessary).
  • I would like for our baby to hear our voices first.
  • I WOULD LIKE MY HUSBAND TO ANNOUNCE THE GENDER.
  • I prefer to have the lights dimmed for delivery or, if it is daylight, to access only natural light.

After Baby is Born

  • As long as my baby is healthy, I would like my baby placed immediately skin-to-skin on my abdomen with a warm blanket over it for BREAST CRAWL.
  • Please do not separate me and my baby until after my baby has successfully breastfed on both breasts.
  • Please delay all essential routine procedures on my baby until after the bonding and breastfeeding period (i.e. bathing, suction etc.).
  • If the baby has any problems, I would like my husband to be present with the baby at all times, if I am unable to.

 

Third Stage Labor

  • Please wait for the umbilical cord to stop pulsating before it is clamped.
  • Please allow my husband to cut the umbilical cord.

Placenta  

  • I would prefer for the placenta to be born spontaneously without the use of pitocin, and/or controlled traction on the umbilical cord
  • I would like the option of taking home the placenta.

Newborn Procedures

Administration of Eye drops / Vitamin K / Immunizations

  • Please do not administer eye drops to my baby, I am willing to sign a formal waiver if need be.
  • I would like only the orally administered vitamin K to be given to my baby.
  • I am ready to sign a vaccine exemption waiver and have any immunizations postponed to a later time.

Bathing Baby

  • After we had time to bond, we would like to give our baby his/her first bath using our own non-toxic baby products (advice on bathing appreciated) or not bathe baby at all until next day.

 Circumcision

  • If a boy, please do NOT circumcise my baby.

 PKU (phenylketonuria)

  • Please do routine PKU Testing after 24 hours
  • We decline routine PKU testing at the hospital and have made other arrangements for this procedure at a later date this week.
  • We would like to wait, and delay the PKU testing until we are ready to leave the hospital

 Feedings

  • My baby is to be exclusively breastfed, feeding on schedule.
  • I would like to see a lactation consultant as soon as possible for further recommendations and guidance.

 Do not offer my baby the following without my consent  

  • Formula
  • Pacifiers
  • Any artificial nipples
  • Sugar water

 If my baby’s health is in jeopardy, I would like:  

  • To be transported with my baby if possible/ My husband to go with the baby if I can’t.
  • To breastfeed or express my milk for my baby.
  • To have as much bodily contact with my baby as possible.
  • To be offered a room at the hospital for the duration of my baby’s stay (within reason).

 I would like my in-hospital routine to be

  • Full rooming in, no separation, no exceptions, unless my baby is sick.

My Hospital Stay

I prefer that my hospital stay be

  • As short as it can be.

 Other hospital preferences

  • I prefer a private room and discuss other options.
  • I prefer to have my husband stay with me for the duration of my hospital stay. If my husband cannot stay with me, I’d like for him to have unlimited visits.
  • I would like my guests to be permitted to stay as long as they wish.

As needed post-delivery, please give me:

  • Stool softener.
  • Laxative – I will have my own (coconut water, bananas…) + abdominal massage.

If baby is not well, I’d like:

  • My husband and me to accompany it to the NICU (= neonatal intensive care unit) or another facility.
  • To breastfeed or provide pumped breast milk.
  • To hold him or her whenever possible.

Cesarean

  • If a C-Section is not an emergency, please give my husband and me time alone to think about it before asking for our written consent.
  • My husband is to be present at all times during the c-section.
  • Ideally, I would like to remain conscious during the procedure and have the surgery explained as it happens
  • I would like the baby to be shown to me immediately after it’s born.
  • I would like to have contact with the baby as soon as it is possible in the delivery room.
  • I prefer to have a hand free to touch the baby.
  • We would like to photograph or film the operation as the baby comes out.
  • We would like to film or photograph only the baby after delivery.
  • If possible, please discuss anesthesia options with me (including morphine options).
  • I prefer a low transverse incision on my abdomen and uterus.

 

Recovery

  • If my baby is healthy, I would like to hold my baby and nurse it immediately in recovery.
  • I would like to sign any waivers necessary to permit me to be with my baby in recovery.
  • As long as my baby is healthy, I would like my husband to be the baby’s constant source of attention until I am free to bond with it (i.e., holding, skin-to-skin contact, etc.).
  • Please pay special attention to our nursing needs in recovery. I may need some extra help nursing after the operation.
  • I would like to have my catheter and IV removed ASAP after my recovery period.
  • Please discuss with me what I can expect to feel immediately following the procedure.
  • Please discuss my post-operative pain medication options with me before or immediately following the procedure.

 

I hope you find some of the points inspiring and worth discussion!

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Birth Plan and Day D

When I found out I was pregnant, I was looking for a way to avoid C-section at any cost. Living temporarily in the USA, I knew about the alarming rates of UNNECESSARY  C-sections and the overuse of medications during birth and figured out we needed a good doctor and a PLAN. A birth plan! But I have to warn you – you cannot plan EVERYTHING in advance and you shouldn’t think that everything will go accordingly to the plan. So let’s start calling this “plan” a “Birth Wish List” instead.

I am from a family with twins left and right (last set born 3 years ago) and none of the mothers had a C-section. Here most doctors automatically plan for a Cesarean the moment you find out you are carrying twins. I wasn’t pregnant with multiples, so I knew unless we found ourselves in an unusual situation, I would not let any doctor talk me into a Cesarean. I’m not a control freak, but I wanted to be able to decide/ co-design how my baby enters this world.

Even if you’re planning for a C-section (and I will not judge you), it’s nice to know what’s coming and how to make yourself, your loved one (whoever you’d like to have with you on the magical day) and your baby/ babies as comfortable as possible by planning a bit in advance. Have your list nearly ready by 36. week of your pregnancy, just in case…

Once you have the list, print it several times, even if it’s not finalized yet. If you had to leave for hospital right that moment, you have already something in your hand. And why multiple times? Give one copy to your nurse, one to your doctor, have one with you and you will always have a copy when the nurses change shifts, because what if the first one misplaces it? Also when you hand the wish list over, give them a box of cookies or order a pizza on your way to hospital – you have no idea how much your nurse’s attitude towards you and your “list” changes! It’s not corruption, you’re making sure your nurse will be a happy camper even if it’s an overnight shift!
Also if you’re planning to deliver in a hospital, I highly recommend to fill out your paperwork a few weeks in advance. Once you’re in labour, you will save yourself a TON of time – and nerves (who remembers their employer’s telephone number at such time and why are they asking anyway?). You’ll just sign admittance sheet and you’re in!

WHAT GOES INTO A BIRTH PLAN (wish list, I mean;)? I will include my own Birth Plan in a separate post for inspiration.

First, write down any worries you have, and how would you like to proceed if things don’t go ideally. These will be your most important questions to discuss with your doctor, midwife or doula. Then, if you’re taking any birthing classes, jot down the information you would need to know once you’re in the hospital (or at home or wherever else you’ve chose to give birth) and make sure you won’t forget details, so you can incorporate your classes’ skills.

Start writing your plan! I found several downloadable versions on the internet, one of my favourite is here. I copied the 3 I liked the most and combined them, because each had some details the others didn’t. It was about 8 pages long (!!! I know…) Then I gave one copy to my husband so we can each work on it on our own and compare ideas. It’s not necessary, but I wanted to see what he’d see differently before knowing what I thought and vice versa.
At first I was working with the list like this:

I prefer to give birth in a:
Birthing room
Room with a shower and/or bath
Delivery room
At home

I didn’t delete any options, not even those none of us selected. We took the list to our doctor and over a course of 3 visits we discussed the points and I was slowly deleting the selections we no longer needed. The list ended up being 2 pages long (BIG progress from the starting 8:))) and included also our choices in the event of an emergency C-section (see, I DID think of almost everything).

And how it helped? A lot, I say! For example I didn’t want to have an IV if not for an emergency, so although it was offered, nobody reinforced it (my husband had to sign some paperwork, of course). I also didn’t want any painkillers discussed and the nurses were amazing – didn’t mention medications even once! If I had to explain this when I was already in labour, I’d be discussing it right there an then – that wouldn’t help avoiding discussing it, right?

I believe that if you even as much as attempt to write a Birth Wish List, it will help you do some research. And only when you’re really informed, you can make an informed decision. Do not rely on your doctor for everything. Sometimes even doctors assume that what they think is best for you is what YOU THINK is best for you.