I was originally going to write one based on what I’d read in “What to Expect When You’re Expecting”, but I received a lovely offer from Shiau Chen after writing my previous post on selecting an obstetrician to send me a copy of her birth plan. With her permission, I’m posting it here for anyone else that might like a template to follow when writing up a birth plan.
Thanks Shiau Chen – this is very detailed (probably far more so than I would have written in my own plan!)
We would like to have the labor to progress naturally and for my baby to be born in an atmosphere of calm, quiet and love. Should there be a medical emergency, we will give our full cooperation after we have been given clear and adequate explanations of all procedures, of the progress of labor as it is accessed, and of any possible complications if they occur. We look forward to working with you, and appreciate your cooperation in helping our family to achieve our personal birthing goals.
BEFORE LABOR BEGINS:
- If the baby and I are fine, and it is past my estimated due date, I prefer to wait until I go into labor naturally.
- If my water breaks at the onset of labor and there are no signs of infection, I prefer to wait at least 12 hours before induction is considered.
FIRST STAGE OF CHILDBIRTH: LABOR
First Stage, Phase I – Latent Labor:
- It is crucial for me that I will not be separated from my partner(s) at any point during labor or birth.
- Ideally, I prefer my environment to have dimmed lights, soft music and voices respectfully lowered
- I would be grateful for the personal space to give birth comfortably without feeling hushed or rushed.
- No shaving of pubic area unless it is medically necessary. Please explain the procedure beforehand.
First Stage, Phase II – Active Labor – Getting to 10 cm:
- Ideally, I’d like a drug-free birth. No suggestion of anesthetic/analgesics unless requested.
- I prefer that labor to progress at a natural rate with no artificial time constraints on any stage of labor.
- I would like to keep internal vaginal exams to a minimum to avoid premature release of membranes. No Pitocin/amniotomy/stripping of membranes without discussion.
- I would like no restrictions on food or drink if labour prolonged.
- I would prefer not to have any drips inserted, unless medically necessary. If an IV prep becomes necessary, I would like a heparin/saline lock to be considered.
- I would like intermittent monitoring (ACOG Standards), using external electronic monitor or Doppler. No continuous EFM unless medically necessary.
- If complication arises, my birth partner and I would like to take a few moments to privately discuss my pain-relief options before a decision is made.
- I would like to be allowed to move about freely as my body dictates, and to assume any position that I find comfortable.
SECOND STAGE OF CHILDBIRTH: PUSHING AND DELIVERY
- As long my baby’s heart tones are good and that she/he is receiving sufficient oxygen, I would like to be free of time limits on pushing; to allow my body to operate in its natural rhythm and time-table.
- If my doctor or midwife feels that pushing may not be progressing efficiently, I would like to be reminded that sometimes changing positions helps.
- I would like to avoid an episiotomy. Try for intact perineum with massage, support & hot compresses.
- Pressure episiotomy if necessary. Use local anesthesia for repair of tears/episiotomy.
- Use of suction device rather than forceps if medically necessary.
If Complications Lead to a Cesarean Delivery:
- Please keep communication open. If, at all possible, please wait for my express consent, or that of my partner, before initiating any procedure.
- Ideally, I would like to remain awake and aware, avoiding general anesthesia if possible.
- Please leave at least one of my hands free so I may touch my baby when he or she is born.
- Assuming the baby is well, I prefer to hold my baby on my chest and/or nurse my baby as soon as possible.
- Please discuss options for postpartum medication, if needed, with me.
- Please provide me with nutritious food and drink as soon as possible.
THIRD STAGE OF CHILDBIRTH: DELIVERY OF PLACENTA OR AFTERBIRTH
Ideally, I would like to deliver the placenta unassisted — without Pitocin, uterine massage, syntometrine injection or cord traction. If a procedure is necessary, please do it after the umbilical cord has stopped pulsating, clamped and cut. I understand these drugs and procedures can be lifesaving if there is heavy bleeding, but if everything is going well I’d rather have a natural third stage possibly in an upright position.
IMMEDIATE NEWBORN CARE:
Skin-To-Skin and Cord Care:
- I would like to have my baby be immediately placed on my chest to have immediate skin-to-skin contact following the birth and initiate breastfeeding immediately.
- If warming is necessary, please allow baby to be warmed on my abdomen, covered by blankets.
- I would like to wait until the cord stops pulsating before it is clamped and cut.
Eyedrops, Vitamin K and other Procedures:
- Please delay all routine administrative matters eg weighing, measuring etc, wait until at least 1/2 hour after the birth to allow bonding between me, my partner and my baby.
- I would like to postpone any immunizations until a later time. I will allow our baby to be given Vitamin K, BCG and Hepatitis B vaccinations.
- I would like to have any additional newborn procedures thoroughly explained to us.
Bathing and Circumcision:
- Allow vernix to be absorbed into baby’s skin; delay cleaning/rubbing
- Please do not bath my baby immediately.
Rooming-In and Feeding:
- My feeding preference is to breastfeed exclusively.
- I would like the assistance of a lactation consultant to help me with nursing.
Sick Baby and Postpartum Care:
1. If my baby is not well, I would like to:
- accompany my baby, or have my partner accompany the baby if transported to another facility.
- breastfeed, or provide my expressed milk for my baby.
- have unlimited visitation for my partner and myself.
- hold, rock and care for my baby, if possible.
2. I would like my hospital/birth center stay to be as short as possible.
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