Birth Preferences... advice, comments, have I missed something?

[Indadhanu]

These are our birth preferences (lol yes I just want to be prepared!).

I don't want any personal opinions about what we have chosen, as we are happy with our birth decisions and don't want a debate about it, but would love some feedback on the plan itself. Have I missed anything? Not clear enough on certain things? Something else for me to think about?

Haven't included anything on our support people, as we're not sure what we're doing yet (still got time, no rush!). I am going to write something else up for our support people, more specific on the techniques we'll use etc. Wasn't sure if that was necessary in the plan for the hospital...?

We talk to the midwife about it at our next appointment (15th) and see how it fits into hospital policy though I think we'll be pretty safe as they gave us an example plan and its all pretty relaxed and natural.

So what do you think?

ETA: it's really not as long as it seems, prints out to be 3 pages of Ariel size 12, with the Caesarean on the 3rd page by itself... same size as the example they gave us.

Birth Preferences for Alisia and Michelle
Our names are Alisia and Michelle
We like to be called Alisia and Michelle
This is our first baby

We are hoping to have a natural birth experience, and we would like our experience to be unhurried, empowering and respectful. We would also like to avoid intervention, limitations and medical procedures.

However we understand that birth cannot be planned and circumstances change. We would like you to discuss all options openly and honestly with both of us if a difficult situation arises.

Early Labour
 We will to stay at home until labour is established.
If we come to the hospital and labour is not established we would like the option to return home if it is medically appropriate.
 If it is necessary for me to be in hospital during early labour, please help me to relax and remind me to rest, eat and drink (and sleep if possible)

Established Labour
 Michelle is not to be asked by hospital staff to leave me alone at any time. If she needs a break or would like to leave she will make that decision.
 Please encourage me to drink regularly during labour
Allow me to eat during labour if I choose to
 I will decide during labour if I would like music playing or the lights dimmed
 We will be trying active birth techniques to manage pain... this includes movement, massage, relaxation, breathing, hot water (bath or shower), heat packs, and positioning. You can help by giving us gentle suggestions.
 Please do not offer or encourage any pain relief medication, I am aware of what is available and will ask for the gas if I feel I need to
 If I am vocalising and making noise please do not ask me to be quiet, but if I seem to be getting panicked or out of control please encourage me to be calm and direct my energy to relaxing
 Please let me to wear what I want at the time; own clothes, gown or naked
 If labour slows or stops please let us try the natural labour stimulation techniques we are aware of before any medical augmentation
 I would like to avoid vaginal examinations unless absolutely necessary, or if I request one out of curiosity
 I am happy to have intermittent external foetal monitoring
 Please let me know when I am in transition.
If I ask for pain relief medication while in transition please remind me that I am nearing the end so I can re-evaluate my request


Birth
 Please allow me to choose the birth position, depending on what feels right at the time. I do not wish to be encouraged into another position once I have found what is comfortable for me
 I will follow my body?s natural pushing instincts/urges and also ‘Exhale Pushing’. Please support me by not trying to coach or direct my pushing efforts unless you genuinely believe I need help
 I do not want an episiotomy, and would prefer a small tear. I have done perineal massage during my pregnancy and will be using heat compresses and almond oil during labour to soften the tissue.
If it looks as if the perineum might tear, please give me some guidance on how to slow down the crowning and support the head or perineum
 I would like the freedom to touch and view our baby during the birth
 Please give Michelle the option to assist in the birth and ?catch? our baby
 If an instrumental birth is required, I would prefer vacuum extraction rather than forceps

After the Birth, assuming baby and I are well
 We would like this time to be peaceful and calm, so please speak and move quietly and slowly, with no unnecessary talk or procedures
 Please allow Michelle to announce the sex of our baby
 Michelle will cut the cord once it has stopped pulsating
 We would like lots of natural/candid photos of this time which we will arrange
 Please allow our baby to take the first breaths unassisted, with no suction unless necessary
 We are happy for our baby to have the Vitamin K and Hepatitis B injections
 I would like uninterrupted skin on skin contact with our baby, with a warm towel/blanket covering us, immediately after birth, for at least an hour. Please delay all newborn procedures (weighing/measuring etc), and don’t clean or wrap our baby, until after this time
 I will let the baby become interested in the nipple and suck when ready. Please support me to look for signs that our baby is ready, and assist me in breastfeeding when the baby is ready, but do not rush this process.
I plan to exclusively breastfeed on demand, so please do not offer our baby formula, water or dummies without our expressed permission

If our baby needs to be taken out of the room for any reason Michelle is to accompany and stay with it at all times, and I am to join them as soon as possible.

Birthing the placenta
 Assuming there is no excessive blood loss, I?d like to have an un-rushed physiological third stage. I?d like to concentrate on breastfeeding when the baby is ready, which will maximize the release of my oxytocin to help the placenta clamp down. Please let me have at least half an hour with our baby before offering the Syntocinon/Syntometrine injection, and no controlled cord traction or pulling on the cord without my consent
 We do not wish to take the placenta home, but I?m not sure if we would like to view it or not. Please give us the option after the birth.

We would like wait until after the birth to discuss and decide if early discharge from hospital with visits at home by Community Nurses is what we would like as we are not sure yet.


If a Caesarean becomes necessary:
 I prefer an epidural over general anaesthetic where medically possible
 Please insert the catheter after the epidural
 I would like the cannula to be placed in my arm and not on my hand/wrist
 Michelle is to be with me at all times (aside from scrubbing up)
 We would like the option to have the screen lowered so we can witness the birth of our baby
 As with a vaginal birth, we would like this time to be peaceful and calm, so please speak quietly.
Please engage in conversation that includes us and is related to the birth only. Please be respectful and remember that this is not just an operation, but the birth of our baby. We would like to know what?s going on at all times when appropriate
 Please allow Michelle to announce the sex of our baby
 Michelle will cut the cord once it has stopped pulsating if possible
 I would like our baby to either be placed on my chest while you complete the procedure, or be held by Michelle while you complete the procedure, depending on what is appropriate.
 Please be sure that a double layer suture is used and not a single layer, in order to improve my chances for a future VBAC
 In the event of general anaesthetic being used I would like Michelle to be with our baby as soon as possible after the birth, before any unessential newborn procedures (weighing/measuring) and for them to stay together at all times.
I would like both Michelle and our baby to be waiting in recovery for me.
 I would like the opportunity to breastfeed our baby in recovery. If you do not have the staff to enable this, I wish to have Michelle with me so I can breastfeed in recovery.
I plan to exclusively breastfeed on demand, so please do not offer our baby formula, water or dummies without our expressed permission
 I would like you to encourage and help me to be mobile as soon as possible after the birth

If our baby needs to be taken away for any reason Michelle is to accompany and stay with it at all times, and I would like to be with them as soon as possible.