Wednesday, October 9, 2013

Our Natural Birth Plan

 This is the birth plan that John and I have prepared. We want as natural of a birth as possible and will be having a hospital birth after we labor at home as long as we can. I'm happy to answer any questions about our preferences or why we made a particular selection or decision. 

(Look for my *notes* for commentary on a particular decision or wording)

I know that all over the internet you read that you shouldn't let your birth plan go more than one page. We talked to our Midwife about this - she said she didn't mind a longer birth plan. Particularly since we broke ours out into stages of labor, so if you don't have time to read it all - you can get the highlights of what is relevant at the time. We went ahead and broke out each part onto it's own page so that once we moved past that stage, it wasn't there as a distraction if someone needed to read it quickly.

We wrote our birth plan using several different resources out there - there's no point in reinventing the wheel if you don't have to. Check out some of these other great natural birth plans that we used when researching: Our Biggest Influence - Young Nesters
A great printable Birthplan check list if you'd rather go that route! Ultimate Guide to Mommy Survival
Another great birth plan & some excellent ideas on what you should include - Going Green with the Grizls 
And in regards to what newborn procedures we wanted - Modern Alternative Pregnancy

Our Birth Preferences

Pre-Admission Requests

  • To only entertain the idea of artificial induction of labor if: Labor is unusually delayed & there is medical urgency.
    • If induction of labor is necessary, breaking the sack of waters and wait a reasonable period of time to see if labor can progress without the use of artificial induction medications (such as pitocin).
  • If there are no signs of infection after the sac of water breaks, to delay induction for a reasonable period of time. 

    *We never intend for our birth preferences to be the final word, we recognize that birth is a natural process and at times "going with the flow" is necessary. By phrasing "reasonable period of time" we felt that we were flexible to what the doctors recommend, but still expressing that we'd really like to not use artificial induction if at all possible. I really like that it leaves a wide gap of flexibility to decide in the moment if necessary*
  • To remain at home as long as possible before going to the hospital.

For Hospital Admission & Throughout Labor
We request:

  • For our nurses, doctors and support staff to support our goal of a natural birth and in the absence of medical urgency, not preform any procedures that could unnecessarily prevent or prohibit our desire for the most natural birth possible. 
    • The opportunity to discuss our birth preferences with our assigned nurse.
  • To return home until labor progresses if less than 4 cm dilated and no medical reason to suggest a hospital admission is warranted.
  • To self-hydrate after admission and opt for a Hep Lock rather than the routine IV preparations. 

    *I would have preferred to not have a Hep Lock either, I'm not a fan of stuff in my veins - it's very uncomfortable for me. However, it's our hospitals policy that at least a Hep lock be in place for an emergency situation. I can be flexible & I understand their concern so we conceited on this issue*
  • To have only intermittent monitoring of FHR after admission & To be free of blood-pressure cuff between readings.
  • Maintain dimmed lights and a quiet environment in the room during labor. 
    To be allowed to wear my own gown and be afforded as much modesty as possible.

    *I wish I didn't have to put the part about modesty in here, BUT, after a visit to L&D I learned the hard way that if I don't want to be exposed to a whole host of strangers that I still have no clue why they were in my room, I should go ahead and mention that I'd like my lady bits covered when possible.* 
  • To have my husband, John and Doula, Susan present during birth.
  • To respectfully decline to participate in the taking of pain scale information and any offer of medication or labor-enhancing procedures unless requested.
    *This was a hot topic issue for me! I did not want the distraction from focusing on things other than the pain or my coping techniques to have to stop and think about how much pain am I in to answer a question that I think is inaccurate anyway. My pain level 5 may not be anyone elses, the medical staff has nothing in my background to compare what I respond with to my ability to cope with pain and therefore is null in my opinion. I also don't want someone offering drugs because I look like I'm in "pain" or that what I'm doing is "hard". I don't want to be given the options to distract from what I'm working towards. I of course know that the options are there & what options there are so if I decide I need assistance, I know how to ask for it*

During First-Stage Labor

  • To walk and move freely during labor.
  • To change positions and assume labor positions of choice.
  • Minimal number of vaginal exams-with permission-to avoid premature rupture of membranes and increased risk of infection.
  • In the event labor stalls, I prefer to try as many natural methods as possible to stimulate labor.
  • To be fully apprised, consulted and afforded the time to make an educated decision (barring medical urgency) before the introduction of any medical procedure.
  • To enjoy labor tub or shower.
  • The option for music (I will provide).
  • My husband to be allowed to photograph or take video.
                     For Pain Relief I’d like to use:
      • Acupressure
      • Breathing techniques
      • Self Hypnosis
      • Massage
      • Bath/Shower
      • Natural suggestions given by Doula/Midwife.

During Birthing

  • To assume a birthing position of choice.
  • To push instinctively and to be allowed to progress without time constraints as long as Baby & Mom are doing fine.
  • To not have an episiotomy.
  • To allow amniotic sac to rupture on its own.

Following Birthing

  • Immediate skin-to-skin contact, with baby placed on mom’s chest.
  • Delayed Cord Cutting - the cord to be clamped and cut only after pulsation has ceased.
    • Once the cord stops pulsating, Dad cuts cord.
  • Wait for natural placenta delivery without intervention
    • No cord traction, manual removal or use of Pitocin for removal of placenta unless necessary and only after consulting Mom.
For Baby
We request:

  • To have bright lights temporarily removed at moment of birth and until baby is moved to mother’s chest.
  • All Newborn procedures to be done in our presence:
    • If birth went as planned and Baby is healthy: APGARs & cleaning to happen at my chest.
    • Please only perform PKU, Vitamin K & hearing/sight test on baby after bonding time, no Prophylactic Eye Ointment administered
    • Delay Hep B immunization until after hospital stay
      Option to delay or abstain from bath, or if administered, do so in the room with Mom 
  • That father and baby stay with mother throughout the hospital stay.
  • Breastfeeding several times during the first few hours of baby’s life.
  • Breastfeeding only.  No bottles, formula, pacifier, or artificial nipples.

    *For newborn procedures we opted in for the Vitamin K shot & PKU tests because of our increased risk for Cystic Fibrosis. We would need to know ASAP if baby girl does have CF which would be made known through the PKU, or heel stick, test. As for Vit K; CF patients tend to have lower levels of naturally occurring Vit K, plus newborns tend to be Vit K deficient anyway. We figured it couldn't hurt.*

In the event of a C-Section I would like:

To make sure other options have been exhausted
An epidural for anesthesia

In the event that a C-Section is necessitated, that father will hold the baby after C-section birth and bring baby to mom for viewing and eye contact.  In absence of urgency, father continues to hold baby for bonding.

  *For the C-Section part, we put this on an entirely different page to stick behind the rest of the plan. I didn't really consider having an "incase of" plan for Cesarian, but our Doula encouraged it - she is a VBAC mom and never planned on having her own c-section. While I really don't want a C-section and lots would have to go wrong for us to make it to that point, it's still nice to know that the things that matter most to me in the event that it is necessary are noted & that I've given it thought.*

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