Wednesday, June 15, 2011

Birth Plans - A Real Life Example

Birth plans are, by their very nature, a personal thing and while we gave a guide of a generalized birth plan previously, we thought it might be helpful to share some real birth plans prepared by others. Our thanks to the parents who gave permission to use their birth plans as an example.

In this example the mother had a health history that resulted in a high-risk pregnancy. She had some resulting constraints on her birthing options which she notes in her birth plan.

BIRTH PLAN/PREFERENCES
  • Mother's Name:
  • Partner's Name:
  • Mother's Specialists: Drs. X, Y and Z
We realize that "planning" a birth is ultimately a futile exercise. We do have some preferences when it is possible and/or advisable to consider them.
General preferences/information
  • I have a history of X (medical details including current specialist information, and medications)
  • I am not currently on an anti-seizure medication and Dr. X is my neurologist.
  • I/we would like to be told what is happening in as much detail as possible. To be included in major decisions unless an emergency situation precluded it, and being given time to discuss the options.
  • We may request that one additional person be allowed in to support us, x, x, x, x, x or x.
Pain management
  • I understand that I will be given an epidural before the second stage (for medical reasons) limiting my movement. Prior to that I would like to be able to move around as much as possible. 
  • Please let me know if other medication is called for and explain my options. 

While all the specific health information would be in the mother's file, having this information handy and ready to discuss with a nurse, doctor or midwife that you haven't seen before is useful.

Labor
  • After the epidural, I would like to be told when to push and when not to push. 
  • We have no preferences as to when the cord should be clamped/cut. 
  • We would like to donate the cord blood if possible. 
  • If possible, we would like my husband to cut the cord. 
  • I would like to avoid an episiotomy and would appreciate measures taken (warm compresses, massage and positioning etc) to do this. 
  • In case of Cesarean: I would like the process explained to me as it is carried out. My husband would like to be with me, at my head.
Have you thought about donating the cord blood? Some people like a step by step account of what is going on, others do not. Where do you fall? Most of us plan to have a vaginal birth, but there are still instances where a Cesarean Section is medically necessary. Don't skip that section in the pregnancy books because you don't plan on having a C-Section. Being informed about all possibilities is powerful.

After Delivery
  • We would like to have immediate skin-to-skin contact with and breastfeed the baby after birth, unless emergency prevents it. 
  • If possible, we would like the baby to remain in the room with us after the delivery; if this is not possible, the father will go with the baby. 
Postpartum care
  •  I would like a private room, if available, and for my husband to stay with me. 
  • Unless required for health reasons, I do not wish to be separated from my baby. 
  • I would like a visit from one of the hospital's Lactation Consultants or a trained breastfeeding specialist to help with breastfeeding. 
  • We appreciate support about breastfeeding, baby care, postpartum mama care
Private rooms, breastfeeding support, keeping baby and mama together (rooming in) immediately after and following birth are all part of our common practices at Tucson Medical Center.

NEWBORN CARE PLAN/PREFERENCES
Baby's name:
Mother's name:
Father's name
Feeding preferences: Breast milk
General preferences/information
  • I plan to breastfeed my baby and would like to begin nursing very shortly after birth. 
  • Unless medically necessary, I do not wish to have any bottles given to my baby (including glucose water or plain water).
TMC is recognized by the International Board Certified Lactation Consultants for our breastfeeding program. The preferences listed above would be considered the norm at TMC's Mother/Baby Unit.

Complications or unforeseen problems
  • If there are serious health problems with the baby, we would like to feed and care for her as much as possible, along with the specialized care from the doctors and nurses. 
  • If the baby does not survive, we have preferences we will discuss with you at that point. Please do not proceed without consulting us.
No one wants to think about these things, but what if?

Creating a birth plan helps you explore parts of childbirth you haven't thought about and articulate your preferences. Check out our earlier blog post, What is a Birth Plan? and the TMC website page about birth plans too.

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