Ok - well i know there is a thread for birth plans, BUT i would very much like your opinions / thoughts. Am i being reasonable? Have i made enough room for movement, so to speak?
The plan is a combination of Kelly's example, but in response also to the questions outlined on the form i was given by Lisa, my midwife.

Birth Preferences

Our names are Ashlea-Jayne ###### and Anthony #######.
We prefer to be called Ashlea and Anthony.
We are expecting our first child, and his EDD is 26/02/2008.
I have requested that Anthony be my support person for the duration of my labour.
My mum, Tania, and/or close friend, Sarah, may also be there with me.

This plan represents our preferences; however we recognise that in the event of unforeseen difficulties it may need to be re-negotiated. Please discuss all options with us, should the need arise. We would then like the opportunity to contemplate our options without the presence of any medical staff. We would like the birth experience to be respectful and private as we know this is conducive to a successful birth, with minimal interruptions, quiet voices and dimmed lighting.


I hope to use the following things to aid relaxation during labour.
Music
Massage

We?re hoping for a natural childbirth without unnecessary interventions or the use of drugs. I am aware of the pain relief that is available, but please do not offer it. If I ask for pain relief in the transitional stage please remind me how close we are to the end and let me reconsider. If, and when I request any pain relief, please encourage me to further discuss it with Anthony, as he knows me better than any medical practitioner and is best aware of my wishes.

I would highly appreciate access to a bath if it is feasible and can be provided. I use it as a tool for general pain management, and feel that it will be highly beneficial to my progress in labour. I also think that it will assist with my state of relaxation, and ability to cope with pain / without drugs for a longer period of time. If a bath is not available I would like full access to the shower.

I am uncomfortable with the idea of medicine or midwifery students in attendance during my labour. I understand that they need to learn, and how else can they; but as I am anxious enough about giving birth as it is, I do not wish to have any students present. Maybe next time.
I would prefer if we can be left alone as much as possible, as I feel the continued presence of medical personnel will raise anxiety and cause undue psychological stress, and hence the probability of also hindering my progress.

I will be happy to have intermittent fetal monitoring, with a portable device. I do not wish to have continued fetal monitoring, especially as I would like as much access to bath/shower as possible, and as active a birth as possible. However in the event that it becomes medically necessary, please discuss this with us further.

I am completely uncomfortable with vaginal examination. If and when an examination is required to be performed, I would like them to be kept to a bare minimum. I would firstly like to be informed of what he/she hopes to ascertain from the exam, if it will at all benefit me, and whether it is medically necessary for it to occur. I feel the tension caused from this sort of procedure may be detrimental to my progress.

I wish to be free of time limits and not have my labour augmented unless in a medical emergency, in which case this is to be further discussed at the time. Please read below for further preferences regarding Induction and Augmentation.

I?d like the freedom to choose positions, use the shower or bath and walk around in labour as desired. I do not at any time wish to be confined to the bed.

Please allow adequate time for the perineum to stretch naturally. I?d only like and episiotomy if there is a genuine medical emergency, and this can be further discussed at the time.

As stated previously, we?re hoping for a natural childbirth without unnecessary interventions or the use of drugs. However if complications arise, and an assisted birth becomes medically necessary, please inform us of all our options and give us time to discuss privately.

No, I do not require a mirror to view the baby?s head, but I would like to be informed of when is an appropriate time for me to touch his head, so at the time I can decide. The gender of our baby was determined at our ultrasound, so there is no necessity to keep the information quiet.

Presuming baby and I are well, we would like for Anthony to be given the opportunity to ?catch? the baby, and for him to cut the cord if he wishes. I would like to wait until the umbilical cord stops pulsating before clamping, to allow my baby to receive the valuable blood and iron stores. Because we will be delaying the clamping of the cord, no, we will not be donating the cord blood.

I am happy to have the syntometrine injection for third stage management. I would like this to be given after the cord has been clamped and/or cut.

I would like Anthony to place our baby on my chest immediately after birth. I would like the opportunity to facilitate breastfeeding as soon as possible. I would like for all newborn procedures (weighing and measuring) to wait until I have had time to bond with and breastfeed our baby. Yes, I plan to breastfeed and request that only breastmilk be given to our baby.

I am yet to decide completely on my preferences for visitors. I would like for Anthony and I to be left alone as long as possible to optimise bonding with our child. My other support persons, Tania and Sarah, will be permitted to visit, and mother in law, Fiona. I will be advising them to call first, to get an OK, and any other visitors may be discussed further at the time.


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.

________________________________ Signed (Patient)

________________________________ Name ______________ Date


________________________________ Signed (Practitioner)

________________________________ Name ______________ Date



INDUCTION / AUGMENTATION

If baby and I are well, I would like my baby to decide his/her own due date. I am happy to discuss a plan should my pregnancy reach the end of term at 42 weeks. Should labour induction become medically necessary at any time, I'd like to start with the least artificial means first - i.e. nipple stimulation, acupuncture, massage or a stretch and sweep before a medical induction. I would like time to allow the natural inductions work.

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

To only have my waters to be broken at first instance if my cervix is open. I would like to be given a generous amount of time for labour to establish upon rupture of membranes (i.e. more than just a few hours) before other forms of medical induction / augmentation.

If I require Syntocinon, I would like a very low dose, to be increased gradually and slowly. Once my labour is established I would like to choose to stop the dose being increased, lower the dose or stop the drip to allow my body to continue to labour without artificial oxytocin. Please put the cannula in my arm and not my hand so I have more freedom of movement.


CAESAREAN

I am absolutely terrified of having a caesarean, but if it becomes medically necessary?

I would like for Anthony to be present at all times. I would like the ability to use my hand held music player during the surgery, to block out any noise. And I would prefer if I could have the option of being blindfolded for the procedure.

I would like to be able to choose whether the screen is up or down at the time, and if I am to be blindfolded, Anthony can make that decision so he can choose to watch. I request for all discussion to be respectful and minimal - only what is required medically and to inform Anthony and myself of what is happening. This is to reduce my fear if I do happen to listen.

Unless prevented by medical emergency, I would like my baby to be placed on my chest while you complete the procedure. I would like the operating surgeon to ensure that a double layer suture is used and not a single layer in order to improve my chances for a future VBAC.

Again, we wish for the cord to stop pulsating before clamping for reasons aforementioned.
I also wish to have the opportunity to breastfeed our baby in recovery.