Trying to write a VBAC Birth plan

[Leonie P]

Hi I am in the process of trying to write a VBA2C birth plan and would appreciate any advice or imput of things to add and think about.

[Midwife Melissa]

Hi there,

is it a birth plan for a home birth or hospital birth?

If it is a hospital birth, have you asked about their policies for managing your labour? That will help you work out what you write into your birth plan.

What you put in your birth plan depends what's important to you. What sort of things would you like to put in your birth plan?

Melissa.

[Leonie P]

Hi thanks for the reply Melissa,
I have written a bit of a plan that I have written based on other VBAC plans I have seen in the net and just want to make sure I have covered all bases.
I am having my baby at the Gold Coast Hospital and have had both my other babies there. My first I was 10 days late and induced then given a c-section as the labour didn't progress fast enough.
I'm not sure of their policies but don't know how much faith I have in them to look out for my best interest as they seemed to pressure me into an unwanted situation previously as I was uninformed of my options. I don't want to end up in this position again.

[vbacwantingmum]

Im having a Vbac at gold coast.


have you seen and talked to a doctor there yet??
i have an app in 5 weeks to talk to one about everything the hospital and vbac etc etc.

My first was ten days late as well i was induced and had a emergency c-section due to him getting distressed.

i have alot of faith.. mainly becuase i am very intent on having one.. and im having a doula so they will look out for my best medical needs

[Leonie P]

Hi VBAC wanting mum,

I had an appointment this past Tuesday do discuss my option to VBA2C in the hospital as in my first appointment I was told rather emphatically that I was not going to be allowed to attempt a VBA2C and that was it. I had a minor breakdown due to this information and an unsupportive husband then one day just woke up and decided that I wasn't going to take that and started to research VBA2C. The midwife I talked to this time was more supportive and took my case to the Drs and after argueing my case she came back in with the head obstetrician and after extensive questioning, he couldn't give me a valid reason to refuse my VBA2C so allowed it. I have another appointment at 36 wks so will discuss policies etc then.

I just advise you to be very clear on what you want. All the best to you

[vbacwantingmum]

Hi VBAC wanting mum,

I had an appointment this past Tuesday do discuss my option to VBA2C in the hospital as in my first appointment I was told rather emphatically that I was not going to be allowed to attempt a VBA2C and that was it. I had a minor breakdown due to this information and an unsupportive husband then one day just woke up and decided that I wasn't going to take that and started to research VBA2C. The midwife I talked to this time was more supportive and took my case to the Drs and after argueing my case she came back in with the head obstetrician and after extensive questioning couldn't give me a valid reason to refuse my VBA2C so allowed it. I have another appointment at 36 wks so will discuss policies etc then.

I just advise you to be very clear on what you want. All the best to you

Wow.. the midwife i got was all for my trying for one (its only my second child)

I have already done all my research and there is no way im going to let doctors push me around.. my partner is being sportive as well though.

best of luck at the app

[Midwife Melissa]

I am having my baby at the Gold Coast Hospital and have had both my other babies there. My first I was 10 days late and induced then given a c-section as the labour didn't progress fast enough.
I'm not sure of their policies but don't know how much faith I have in them to look out for my best interest as they seemed to pressure me into an unwanted situation previously as I was uninformed of my options. I don't want to end up in this position again.

Honestly, I'd steer clear of the hospital. It sounds like their policies don't even support a non-VBAC labour. Do find out what their VBAC policies are, and then you will have some basis for what to put in your birth plan. Have you considered having a private / independent midwife with you for advocacy and support?

[Leonie P]

Hi again Melissa,
I just don't know how comfortable I feel about home births, I am a good 45 minutes from the hospital in the case of an emergency and couldn't afford the $4-5grand they seem to cost.
I have another appt in 6 wks so I will ask about the hospitals policy for managing a VBAC labour.
Yes, I have been looking into finding a midwife trained doula to advocate for me, not sure how much they cost. I have 10 wks to go so hopefully I will sort it out in the mean time.
Also how would I go about finding out about a hospitals stats re: suggessful VBAC etc?

[Midwife Melissa]

Hi again Melissa,
I just don't know how comfortable I feel about home births, I am a good 45 minutes from the hospital in the case of an emergency and couldn't afford the $4-5grand they seem to cost.
I have another appt in 6 wks so I will ask about the hospitals policy for managing a VBAC labour.
Yes, I have been looking into finding a midwife trained doula to advocate for me, not sure how much they cost. I have 10 wks to go so hopefully I will sort it out in the mean time.
Also how would I go about finding out about a hospitals stats re: suggessful VBAC etc?

Hi there,

I wasn't referring to home birth in my second post. For once!

Do ask for a copy of the hospital's policy for managing VBAC. Then you know what you need to consider in your birth plan.

Midwives and doulas are different - midwives are qualified and registered and can give advice and clinical care, second opinions, support etc, whereas doulas can only provide support and general info. They're not qualified or registered. Doulas cost anyehere from $500 - $2000; midwives fees vary depending where you are. I'm in Sydney - it's around $4000 - $5000; some charge less for hospital births.

You can ask the hospital about their stats. Be suspicious if they don't tell you. Are you in NSW? I have the NSW stats with me. Australia-wide, VBAC rates are only about 15%. Some hospitals are as low as 2%

[Michelle71]

Wow - that is an amazing stat Melissa It makes me feel so proud to be one of the successful VBAC's. Good luck ladies. It is worth working for.

[joey123]

Hi,

Here is a cut and paste of our birth plan for my VBA1C. Hope it helps ...



We are hoping for a natural childbirth without unnecessary interventions or the use of drugs. This birth plan is intended to express the preference and desires we have for the birth of our baby. We fully realise that situations may arise such that our plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options. Thank you.

Miscellaneous:
• To complete all possible paperwork prior to admission
• To have pictures and video taken
• No calls to the room

First Stage (Labour):
• I would prefer to keep vaginal exams to a minimum & not to be told of my cm dilation unless requested
• Maintain mobility (walking, rocking, shower etc.)
• Please do not offer me pain medications, I am aware of the options and will ask for them if I want them, I will be using Hypnobirthing Relaxation techniques
• Please refrain from any references to “pain”
• I would prefer intermittent EFM unless continuous monitoring is medically necessary
• I wish to be free of time limits and not have my labour augmented unless in a medical emergency

Second Stage (Birth):
• Choice of position
• Prolonged length, if progress is being made
• To have a mirror available to enable me to see crowning and birth
• I would prefer to tear than have an episiotomy, but please use compresses, massage and positioning. I only consent to have an episiotomy if there is a genuine medical emergency, or it becomes apparent that I will sustain a severe tear in which an episiotomy would prevent/be less severe.
• Husband to receive (‘catch’) the baby if possible
• To wait until the umbilical cord stops pulsating before clamping and allow my husband to cut the cord
• Baby not to receive Hepatitis B injection on day of birth

Third Stage (Delivery of Placenta):
• Allow at least 40 minutes for natural placenta delivery (No manual removal or injection)

Baby Care:
• I would like our baby to be immediately placed onto my bare chest
• Allow vernix to be absorbed into our baby’s skin
• All newborn procedures (weighing and measuring) to wait until I have had time to bond with and breastfeed our baby
• I would like the opportunity to view the placenta
• Breast feeding only (no pacifiers, formula or glucose water)

If an Emergency Caesarean Birth is required:
• Partner present
• Video/Pictures taken
• Screen lowered to view the birth or mirror
• I would like to have the theatre nurse unbutton my gown so baby can be placed straight onto my bare chest.
• Delay the clamping and cutting of the cord until it has stopped pulsating
• Partner to cut/trim the cord
• Our baby to be with me in recovery and to be able to breast feed in recovery also. Should medical circumstances prevent this, I request that our baby be with her father at all times.
• In the unlikely event that I need to have a general anaesthetic for my caesarean I wish for the birth of the baby to be photographed and videoed so I can view this at a later time. I also wish for my husband and baby to be in recovery upon my waking and I would like our baby to be placed onto my chest in recovery as soon as I awake so we can commence the bonding and feeding process.

[Trillian]

Niliac had her birth plan on here and it was great - very concise. I will see if I can find it...

[Ilithyia]

Hi Leonie!

Good on you for not taking no as answer! You're doing a great job!

Birthrites is a website about healing after cesarean's but has a VBAC birth plan template. The link I've added should take you right to the template.

I've also got a few bits and pieces on my computer if your interested. Let me know and I can PM or email them to you!

I honestly wish you all the best hun!

Take Care!
x

[Fleur]

Hi everyone... I
Leonie P, vbacwanting mum,
I am also having a VBAC at GCH (in July) and started on my birth preferences today, so this is good timing
The midwife I saw at my first appt was ok didn't seem too bothered by it... but I am a bit suspicious of being 'over-managed'... it's not something I thought about until the last couple of weeks, all of a sudden it has hit me that I should do a bit of prep work
The more I read the more I learn there is to think about! I am thinking about requesting an earlier appt there to discuss a few things.. I don't know if this is any helpt o you Leonie, and I think you have done a great job already convincing them to let you VBAC there! but here are the things I am thinking about for mine:

- induction of labour - the midwife I saw said they wouldn't induce me but friends have told me differently, so I want to confirm their policy on this - also I particularly want to know how far post-dates they would let me go, as my prev 3 bubs were all post-dates - I will be 10 days over on a Friday & I don't plan on being induced/given CS to get it in before the weekend! in fact my very strong preference is not to be induced at all and I believe this is better anyway for a VBAC.

- when to arrive at hospital - the midwife says immediately, for monitoring - my second labour was 6hrs before it really kicked in & I have no intention of spending that time at hosp - I don't mind going once labour is established but I don't want to be put 'on their clock'

- and as regards that, I would prefer not to have my stages of labour timed! I can't see any reason why, if it is progressing & bubs is doing well, & I am coping, it can't let run to it's own time-frame?

- monitoring - I am happy to be monitored but I would like to move around & be able to use the shower etc - so this might mean taking the monitor off for a while, using the doppler instead, etc

- should a CS become necessary I do not want a spinal block - I had a reaction last time (not sure why, have to get my records from Caboolture hosp :S) - very nervous about having another spinal

I like joey123's plan very thorough!

Melissa I will definitely ask for a copy of the hospital's policy & stats.

what amazes me is the things I didn't know before I started looking into it.. this is my 4th child & I didn't even know i had the right to refuse any intervention!
thank goodness for Bellybelly.

One other thing - I notice that both Leonie & vbacwanting mum were induced at 10 days which resulted in CS - so was I - in my case I believe there is a fair chance I would have had a CS anyway due to the amount of cord entanglement - BUT why are they inducing mothers at 10 days, when full term is considered 37-42 weeks?
(with my 2nd I simply didn't go to hosp for my last few appts, saw my GP instead & went into labour at 14 days post-dates while waiting to be induced - can't recommend it as I'm not a medical professional BUT that decision definitely worked for me!)