Yep, I had one. I googled for examples and then made mine up from there. I gave it to my OB at 36 week appointment and we went through it and negotiated anything he wasn't happy with (most of it he agreed to without an issue, but did question some stuff) I also took it up to the mid floor and had them put a copy in my file so that when I rang to say I was coming in they had a chance to look at it before I got there.
Some tips are,
- keep it to one page (I had my CS plan on the back)
- have a CS plan too just incase (if things do go pear shaped you have planned for it too)
- try and keep your requests short and to the point
- put it in the order things happen
Here is a copy of mine. (I still have it saved to my computer 2 years later)
VAGINAL BIRTH PLAN for__________due date _______
Support People: ____________________________________
During Labour and Birth
o If my membranes rupture before labour starts I would like to have at least 24 hours to get things moving, and then if nothing has happened I am open to discussion about what to do.
o I do not wish to have continuous monitoring. I am however happy to have monitoring done intermittently so that I can maintain mobility.
o I do not wish to have frequent vaginal exams.
o I would like to eat and drink as desired.
o I prefer to have no cannula or IV inserted. I understand this may slow the availability of drugs if needed and will only consent to one if it is deemed medically necessary.
o I would like access to bath and shower for pain relief.
o Please do not offer me any analgesia. I will ask for it if necessary.
o I prefer my waters to break naturally, although I am open to a discussion if ARM is thought to be beneficial at the time.
o I do not want an episiotomy; I understand that a tear may be unavoidable.
o Please encourage control, position and breathing through pushing to reduce the chance of tearing.
o As long as the baby and I are doing well I do not wish to have time restraints put on me.
o I would like to choose my position for birthing unless there is good reason for an alternative one.
o If foetal distress is suspected or any other sort of medical issues arise with the baby during labour, before interventions are deemed necessary we would like time (within reason) to discuss and try all alternatives before resorting to a CS.
o _______ is to help catch the baby if he wishes to do so.
After the birth
o I wish for skin to skin contact with my baby as soon as it is born.
o Please let us discover the sex of our baby.
o The cord is to have stopped pulsing before it is cut.
o _______to cut the cord.
o The use of Syntocinon to birth the placenta to be assessed after the birth depending on blood loss.
o I wish to see and KEEP the placenta.
o Please don't weigh, measure etc the baby until I am able to participate if I am not mobile as I missed this with my other two children.
CAESAREAN BIRTH PLAN
o Spinal anesthesia
o If I require a general anesthesia, please give the baby to ______ straight after the birth and allow s/he to remain with him until I am able to hold baby. _____ will tell me the sex of the baby
o ______ present
o Pictures to be taken
o Screen lowered to view the birth with a mirror if possible
o I would like to see and KEEP the placenta
o ______ to trim the cord
o All checks of the baby to be done within view while being stitched up
o Skin to skin contact within recovery room
o Breast feeding in recovery room
o Partner to remain with baby at all times
o Weighing and measuring to be done in our room where I can see or to be delayed until I am able to participate.
Yep I had one. Just kept it really simple. Showed it at one of my appts after 30 weeks, which was a waste of time really since I saw a really unsupportive dr that day. Gave it to the midwives as soon as I got into hospital in labour and they were happy with it. I'd be happy to pm you when I'm at home in the computer
Birth plan for VBAC
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