Wednesday, June 22, 2011

Birth Plans - A Real Life Example II

Nothing can fully prepare you for the experience of childbirth. Taking childbirth classes, talking with your midwife or OB/GYN, and with your partner about what you hope for during childbirth can help it be the wonderful, positive experience we want for all women. Articulating your hopes into a birth plan is part of preparing for childbirth. Below is our second example of a birth plan. Our sincere gratitude to EL for sharing her birth plan. You can find an earlier example here, and a description of a birth plan here.

EL's Birth Plan/Preferences
Here's our birth "preferences". The jist of it is that we're flexible and would appreciate advice on nearly everything.

Mother's name: EL
Father's name: Mr. EL

The Big issue:
-Please, no IVs in my hands unless absolutely necessary. I can take multiple sticks to try to get one in my arm or wherever. If an IV in my hand is the last resort, then please do not tell me about it beforehand – just say “we’re putting it in your hand right now” and immediately put it in. Please don’t give me time to worry about it.
 Be upfront about any medical issues or worries you have. Let them know if you have strong preferences on how you want to receive information.

Basically, my wish is to have a balanced labor and delivery – a good balance between the health of our child and my health. We want to be as flexible as possible, and are open to any and all suggestions, but here are our preferences:

-I will be bringing my own music to play, if possible.
-I would like to be free to walk around as much as possible.
-I would like to be free to move around and change position at will throughout labor.
-I would like to try the birthing tub as a comfort measure. (If comfortable, and the midwives think it’s okay, then birthing there will be fine.)
-I would like to have fluids by mouth throughout the first stage of labor.
-I would like to wear my glasses at all times.
-I would like my husband to be present at all times. No other visitors, please,  though medical students might be okay on a case by case basis. I would like to reserve the right to ask any non-essential people to leave if needed.
-Suggestions on other comfort measures to try would be greatly appreciated.

We encourage our TMC moms to walk, to play music, to utilize the bath tubs or shower to provide comfort. Nurses will even jump in the shower to help if you want. 

Labor augmentation:
-I would prefer to try changing positions and other natural methods of augmentation (walking, nipple stimulation, etc) before pitocin is administered or the amniotic sac is ruptured.
-Suggestions on other methods of augmentation would be greatly appreciated.

Anesthesia/pain management:
-I’d like to try other natural comfort measures before any pain medication is given (birthing tub, shower, walking, birth ball, positions.)
-Please give me pointers and suggestions on other things to try.
-When I’m ready for an epidural, I’ll ask for one.

-I’d like to avoid a Caesarean unless absolutely necessary.
-If the midwives determine a C-section is necessary, I’d like to be a part of the decision making process as well as my husband. If I am unable, I would like my husband to participate as my representative.
-I would like my husband to be present at all possible times at my head until delivery.
-I wish to have an epidural for anesthesia.
-If the baby is not in distress, the baby should be given to my husband immediately after birth.
-I would like my husband to stay with the baby while I am stitched up.

EL did not plan on having a cesarean section, but recognized that it may happen and thought about what she would like in case the birth proceeds in that manner. Knowing your options and possibilities is empowering. In the end EL did not need a C-section. Know TMC has a lower C-section rate than the national average even including those births that result from mothers risking out of El Rio Birth Center. Our goal is to reduce the C-section rate even further.

-Suggestions on how to best avoid, or mitigate an episitomy or tear would be greatly appreciated.
-I would appreciate guidance in when to push and when to stop so the perineum can stretch.
-If possible, I would like to use perineal massage to avoid the need for an episotomy or a tear.
-I would like a local anethestic to repair an episotomy or a tear.

-I would like to choose the position in which I deliver, though I welcome advice and suggestions.

Immediately after delivery:
-If possible, I would like my husband to cut the cord.
-I would like either my husband or myself to hold the baby while the placenta is delivered and any tissue repairs are made.
-We would like vitamin K, the eye ointment and all weighing, etc to take place as soon possible after delivery so we can start bonding as soon as possible. 
-I would like my husband to be with the baby at all times during essential procedures.

Post Partum:
-I would like a private room, if available.
-Unless required for health reasons, I do not wish to be separated from my baby.

All our brand new beautiful rooms are private with plenty of space for family to visit. We encourage rooming in and unless medically necessary mother and child are not separated.

-I plan to breastfeed the baby, and would like to begin nursing as soon as possible after birth.

We have lactation consultants and trained staff to support breastfeeding mothers. We were recognized by the International Board of Certified Lactation Consultants for our support of breastfeeding.

-we do not want our baby circumcised.
We encourage parents to become informed about the risks and benefits of circumcision.

Birth plans are individual in nature and we encourage you to create your own. You can find help for writing your birth plan during our childbirth education classes also.

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