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

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 :rolleyes: 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.

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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.

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sounds good to me, i wish i was so well informed when i had my first, good luck with the birth of your baby and i hope you and michelle get to have the birth you have planned for.

Good job Alisia, that is really well written. Two things though that I saw were with the eating, chances are you wont feel like eating at all and may get frustrated with attempts to get you to eat LOL and also if you do eat, it may make you feel nauseous and/or vomit (just something to bare in mind :) ) so thats something to think about, and also IF you need a c/s (but you wont, you will birth this girl all by yourself), ask for the canula (you will have to have one put in as routine to allow IV access for fluids/abs etc) to be placed higher in your arm and not your hand/wrist as it gets really sore after a while because you get too much movement in the area from bending your wrist/hand etc and it is generally a PITA anyway - trust me, that is something you want to avoid.

ETA - another thing too is for a possble c/s outcome is that you can still have a phsyiological 3rd stage too - but it is something you may have to fight for, but naturally if you need to hurry it up you wont push the point kwim? Also you could ask for one of the midwives or even Michelle to put her straight to the breast and have skin to skin even if you have a GA too.

It s good, I'd put in "please let me know when I am in transition"

It's the one time for me when I feel like it's all too much, but If I know its transition, I know the baby is close and I get a HUGE second wind.

Sorry but i dont have anything to offer. I just wanted to say how amazing you are for being so relaxed and open to the birth of your child, im having my first in about 4 weeks and i am freaking out i have no birth plan as i have no idea what to expect and whether my body can even take the pain (ive been told im a woss when it comes to pain) so i just wanted to say good luck with everything and i hope you wishes a respected by everyone.

Hi Leasha
What a great birth plan.
The only thing I can think of is should you need a CS you will also have to have a catheter inserted. You can have this inserted either prior to going to theatre or after you get there. The difference is if you choose to have it inserted prior to theatre you will only have your midwife or Ob seeing your girly bits but havint the catheter put in can be a little uncomfortable. If you have it put in after you get to theatre they will insert it after you have had the epi. You will not feel anything but there will be a lot more people seeing your girly bits.

good plan! It's great to see you have a written plan for different circumstances. Even though you might be disappointed if you

I'll go through a few things you might want to comment on that I can think of.

Lights - do you want them on, dimmed etc.

If you had to have one would you prefer vaccum or forceps delivery? Do you have any other preferences in terms of this?

How about cleaning and wrapping your baby?

Maybe list what drugs you would prefer or any that you will not consider and in which order you will opt for them? - I know youare after a drug free birth but might be good to include incase you get to the point where you decide you want something, you know what you want and in which order. When you are in labour your ability to think and make decision just isn't there so maybe think about that.

Also in terms of your other post I would include something in your birth plan about support people and people waiting outside. Depending on the hospital layout they would almost certainly have to wait in the waiting room and not be allowd just outside the door. Add your wishes on this and also for after the birth. That way you won't have to deal with it on the spot.

I would maybe include that shell is your partner, if you are worried she will be treated as a friend, family member etc. That way it is clear this is a very important experience for her too.

On the off chance that you do end up needing a c/s, many hospitals will require a midwife to be with you in recovery in order to allow your baby to be, so they may not allow it just with yout partner. CHeck with the hospital. Is hiring a private midwife an option for you?

I just think this is amazing. When i had DD i had no idea that you could even write a "plan" and ws very P***** off with the hospital when they gave her a dummy.

I'll definately be taking yours as a draft, if that is ok??!!

WOW WOW WOW, Good on you leasha :dance: that is an amazing birth plan, which clearly reflects your desire to control or direct (as far as possible) your own birth. I cannot explain to you how many women do not put as much thought into their birth as they should. Honestly, some people put more thought into buying a car than they do into the birth of their child. Good on you, you and shel should be so very pround of yourselves for researching and putting so much thought into the most important event of your life. I come from a long line of midwives who are passionate about empowering women in their OWN births and they would be so impressed with your attitude towards NORMAL birth.

Just as a suggestion for birthing positions and pain relief - I found the exercise ball amazing pain relief (boucing up and down on it), the bath was great, labouring on all fours and rocking back and forth really took the pressure off my back and belly dancing is great practice for labour movement. And using a mirror when baby is crowning is empowering and motivating. But....you probably already know this, just though Id share my experience with natural drug free labour. Goodluck hun, you'll be great!

Issy

Sounds great hun!

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i wish i was so well informed when i had my first

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Not that I did'nt get the birth I wanted first time around......but I agree.

Its amazing how much you learn and grow from your previous pregnancies and births. I changed the way I wanted things in Colbys birth as I learnt some much in from the time of Brileys birth up until I wrote my birth preferences and birthed Colby.

I already have different plans for next time! ;)

well done leasha! you have been very thorough which is excellent! I agree that you will need to think about which assitance you want should it be necessary, i personally prefer the vaccuum, which is how my neice was born. you also may need to specify if you dont want artificial rupture of membranes and if you have a negative blood type you will need to look into the type of the SD as to whether or not you will need Anti D.

:) Thanks everyone, some really interesting points (had no idea about the canula or catheter! Completely forgot about forceps vs. vacuum).

Kitten :) Go right ahead LOL!

ETA: Jas, we've got a lot of support and acknowledgement from our midwives regards to Shel's place in the birth so I'm definately not worried about the staff not recognising that :) Thanks though!

HaydenSamAdam - please hang about in here. Arm yourself with knowlege, read some books and spend some time checking out the threads in this section. This is the place to be when it comes to finding your way to a great birth experience.
You have 4 weeks left and there is plenty of time for you to get to know your way around your preg/birth. You can ask any old question you like.

It is important to know what will happen and how to prepare. Your body will do what it needs to do, but fear is best left at home! I wish you were excited about this, not apprehensive - we are all happy to help xoxoxoxo

Wow what a great birth plan. Like a few others have mentioned, I only wish I'd been this informed for my first birth. Good luck with it all & I hope you get the birth experience that you want. :)

leasha i think you should put in induction info to.
so if your happy to have gels then arm but wait for synto and any times between each procedure.

Alan - girly bits!? :rofl:

Leasha, it's great, and you're obviously really well informed, BUT (could you hear that but coming!? LOL).... It is very long. There's nothing wrong with that at all, and you have all your bases covered, but mine was a similar length (fit onto one side of A4 actually printed), and even with a homebirth, my midwives didn't have time to read it. Unless you are SURE you'll have the same middie for your birth as for your antenatal care it might be worth making another page with just the 3-5 MOST important things on it without details, like in bold:

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Do not offer me drugs.

No VE's unless requested.

No directed pushing.

Immediate and prolonged skin-to-skin and breastfeeding.

Cord left to pulsate and physiological 3rd stage.

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And have it on your door or wall in the labour room to anyone who comes in can see at a glance what you want. Also, the transition thing - i went into transition 10 minutes after being 2-3cm and 25% effaced - my midwives didn't realise that was my transition! So just in case it happens to you that way too, if you get to a stage where you feel you just cannot do it anymore, you need an epidural and a lower-body amputation and you want to throw up and run away at the same time and your heart is racing with fear - you'll be holding your baby before you know it! :)

Loves

Bx

Have you had a think about vitamin K and the hepB vacination for your baby at all?
They usually give the vitaminK injection very soon after birth. The other options are to administer it orally and occasionally people choose to forgoe it alltogether.
The hepB vaccination is usually administered within a few days of birth too. Some people are happy to go along with the government vaccination schedule and others delay it and others choose not to vaccinate at all.
It's a contentious area and lots of people feel passionate about both sides but you're going to need to figure out where you stand as parents so you may as well start before the first round of needles.
I guess it's not part of the birth per se but you'll be faced with the issue very soon afterwards and you may as well be prepared.

I think youve done a fab job! :clap:
I think this will also encourage alot of other mummies-to-be out there too so good on you darl :)

It's almost like mine! I love it. You'll probably find that when you show it to the midwives, they'll say it fits in with what they would do anyway - not sure if you were going through a FBC or not, but my FBC pretty much operates closely to what my birth plan directed.
I'll find my plan and PM it to you, for any additional ideas.
My plan was read in advance by the midwives and they knew the day I was in labour how to prepare for our arrival. I reckon every single one of them had read the plan! The attending midwife on the day even apologised for the managed third stage - not quite sure why, I had PPH and she dealt with it beautifully!
Anyway, this plan will let them know what your philosophy is and how you need to be treated in all eventualities :)

Maya, our birth plans are so similar! I'm not in a FBC but the midwives are fantastic, I got into the midwife 'team' called 'Holding Hands', and have heard from others and them that they arr very pro-natural and I do have a feeling they'll just say "Yep, nothing new there lol" but just in case!
So Bec I'll definately have one of three midwives on the day, and I'll have a chance to go through the birth plan with them beforehand :) But I like the idea of a shorter one. I keep thinking "its waaaaaaaaaaaay to long, but I'll get my midwives to cut it down with me I think, so they know too.
Chloe, got stuff about the vacs on there... well I think I do I'll have to check but we have made that decision :)

Oh WOW.. That is fantastic and reading it and thinking about my own experences and the births of my babies, just made me cry.. so many good memories I would go through it all again in a heart beat. I truly wish you all the best and believe in your self and your body's ability to be able to give birth naturally. You are so well informed, use that knowledge. Good luck. and best wishes.

BTW your birth plan is great. ;)

I love your birth preferences. I had a similar one but ended up with an emergency c section which I had not prepared for and because it was late at night and I had theater staff who had been on their feet all day many of my wishes went out the window.

Just one thing you might need to check out is Apgar testing. Usually done 1 min and 5 min after birth (I think). I didn't get my baby until these had been done. Maybe check with you hospital what their policy is. I have been told that it's important as it can determine if your bub need 'special' help or not ie oxygen.

I wish you the best with it all. :)