Birth Plan
Page Contents:
Birth Plan, Written by Jane Palmer, Midwife – Australia
Birth Plan Example, Written by Rachael Austin, Midwife - Australia
BIRTH PLANS
Written by, Jane Palmer, Midwife – Australia
(26th April 2001)
Birth Plans have been around for many years. Birth Plans originated to assist women to inform their midwife or doctor of their wishes during labour, particularly if they wanted to avoid routine interventions. Birth Plans have evolved since their humble beginnings. Birth Plans now may be comprised of many things, including thoughts and expectations of what you would like for the birth of your baby. I must say from the out set, that I personally dislike the term ‘Birth Plan’. The term ‘Birth Plan’ implies that there is some control over birth and that you are able to plan for it. The reality is that you have little control over labour and birth, making it very difficult to formulate any sort of plan. Perhaps it would be better to think in terms of listing ‘Birth Preferences’ or compiling a ‘Wish List’.
The concept of a Birth Plan however, can be very valuable in acting as a tool of communication between your self and your midwife or doctor. Birth Plans can be used to help people around you know about your preferences before labour starts. As a tool to help you to explore different issues surrounding labour, birth and afterwards, Birth plans can help you formulate ideas on what you would like or not like to happen. You may find it very helpful to work on your birth plan with your partner, so they can be part of the decision making process and be able to assist you in implementing your plan.
Birth Plans can be quite varied, they can be short and to the point or extensive and cover every possible contingency you can think of, right through to caesarean birth to caring for the baby after the birth. There is no right or wrong way to write a birth plan. You can gather ideas for writing your Birth Plan from friends, books, childbirth educators, midwives, doctors, hospitals or the Internet (see the reference list for some online help).
I am thinking of writing a birth plan. What sorts of issues should I include on my birth plan?
This is a really difficult question. Every birth plan is very different and the sorts of issues that are important vary from woman to woman. A good way to start working on your birth plan is by undertaking the following five-step process:
Explore your options
Examine your feelings
Evaluate your priorities
Examine your person situation
Discuss issues with your midwife or doctor
This will give you a good basis on which to start formulating your birth plan.
The following is a large list of issues that you may or may not want to include on your birth plan:
1st Stage of Labour
Choice of birth place
Clothing during labour (own or hospital gown)
Monitoring of the baby
Activity during labour
Eating and drinking in labour
Students during labour
Vaginal exams
Pain medication
Positions during the first stage of labour
Use of water
Use of heat
Self help techniques
Caesarean birth options
2nd and 3rd Stage of labour
Positions during the second stage of labour
Pushing during the 2nd stage
People present during the birth
Natural or managed 3rd stage of labour
Episiotomy and tears
Immediate contact after birth
Cutting of the baby’s cord after birth
Baby’s first breastfeed
Postnatal Care
Vitamin K
Hepatitis B Immunisation
Rooming in with mother during the postnatal stay
Newborn Screening Test
Breastfeeding/bottlefeeding
Preferences if baby has complications
This list is by no means exhaustive. There are many other issues that can be considered. Use this list just as a guide.
Who should have copies of my birth plan?
When writing a birth plan it is ideal to make copies for each person who is going to be present during labour. This may include your partner, support people, midwife or doctor. A copy can also be made for your hospital records. Some women choose to have a meeting with their support people and discuss the issues raised on the birth plan. You will also need to discuss the contents of your birth plan with your midwife or doctor. You may like to have your midwife or doctor sign your birth plan when it has been finalised – this can be helpful when presenting your birth plan to the hospital, particularly if some of your wishes are different to hospital policy.
I am currently working on my Birth Plan. How do I present my Birth Plan to my doctor, without offending her?
The ideal time to present your birth plan to your midwife or doctor is around 32-36 weeks of pregnancy. This way you have had time to research your options, but there is still time left discuss any issues with your midwife or doctor and make changes to your Birth Plan if necessary. One of the positive aspects of Birth Plans is that they help ensure that there are no surprises for you or your caregiver. Birth Plans are also a great tool for fully informing your midwife or doctor of your preferences, though you may need to negotiate on some points. Overall Birth Plans are generally well accepted. Though some health care practitioners do not like Birth Plans as they feel they are being told what to do. So when presenting your Birth Plan to your midwife or doctor, try being open and acknowledge their concerns, maintain eye contact and be assertive (but not aggressive).
Very occasionally a midwife or doctor may be unhappy with a woman’s choices for labour and birth. In an ideal world it would be great to be able to negotiate a mutually acceptable outcome. However this may not always be possible. A woman several options here:
There are so many things that can happen in labour, how can I account for all of them on my birth plan?
Birth plans should be written in a way that is flexible. As you have already identified, labour and birth does not always follow a predictable path. You will not be able to account for every possible variation of labour on your birth plan.
To help make your birth plan more flexible it is better to use words like ‘I would prefer’ or ‘if possible’. This helps prevent the birth plan as been seen as a list of do’s and don’ts that must be followed. Birth Plans indicate the preferences of the woman in labour and provides an outline of how she would like the birth to be.
Some women do include contingency plans within their Birth Plan. For example some plans include preferences if a caesarean birth becomes necessary or preferences if the baby needs to be transferred to Intensive Care or Special Care Nursery.
Reference List
Websites:
http://www.childbirth.org/interactive/ibirthplan.html ttp://www.babycenter.com/calculators/birthplan/QueryForm.jhtml http://www.fensende.com/Users/swnymph/birthplan.all.html
http://www.fensende.com/Users/swnymph/birthplan.all.html
http://pregnancy.tqn.com/health/pregnancy/library/weekly/aa031097.htm http://members.aol.com/mrobyn/birthpla.htm (sorry website no longer available) http://www.suite101.com/article.cfm/pregnancy_and_childbirth/3336 (sorry website no longer available)
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
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BIRTH PLAN EXAMPLE
Author Rachael Austin, Midwife - Australia
While this is the birth plan I used for my homebirth, it can easily be adapted to suit your individual needs for a hospital, birth centre, homebirth or freebirth.
Homebirth Birth Plan
Thank you reviewing our birth plan. My partner and I have chosen to birth our baby in the comfort of our own home here at (insert address), providing this is a ‘low risk’, singleton pregnancy, with a cephalic presentation and labour commences after 36 completed weeks gestation. We will be attended to by our midwife, (insert midwives names). (Midwife’s name) will be the principal caregivers during this time. (Partners’ name) and I believe strongly in the normality of birth and are happy for the labour to progress without any interference.
However, as life goes, it throws unexpected things in our direction. We would like to be prepared for this in labour and have contingency plans in the event that this happens. This birth plan is a brief overview of what I expect during all phases of pregnancy, labour and postpartum and also demonstrates what should happen if transfer becomes clinically necessary. This birth plan is by no means a complete list, but a guide line to how we would like our pregnancy, labour, birth and postpartum to be managed by our care providers.
EDB: Insert due date as per your last menstrual cycle
Part One: Pregnancy Preparation for Homebirth
Prelabour
First Stage (Labour):
Planned Hospital Birth:
Website: www.gentlebirth.com.au
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Birth Plan, Written by Jane Palmer, Midwife – Australia
Birth Plan Example, Written by Rachael Austin, Midwife - Australia
BIRTH PLANS
Written by, Jane Palmer, Midwife – Australia
(26th April 2001)
Birth Plans have been around for many years. Birth Plans originated to assist women to inform their midwife or doctor of their wishes during labour, particularly if they wanted to avoid routine interventions. Birth Plans have evolved since their humble beginnings. Birth Plans now may be comprised of many things, including thoughts and expectations of what you would like for the birth of your baby. I must say from the out set, that I personally dislike the term ‘Birth Plan’. The term ‘Birth Plan’ implies that there is some control over birth and that you are able to plan for it. The reality is that you have little control over labour and birth, making it very difficult to formulate any sort of plan. Perhaps it would be better to think in terms of listing ‘Birth Preferences’ or compiling a ‘Wish List’.
The concept of a Birth Plan however, can be very valuable in acting as a tool of communication between your self and your midwife or doctor. Birth Plans can be used to help people around you know about your preferences before labour starts. As a tool to help you to explore different issues surrounding labour, birth and afterwards, Birth plans can help you formulate ideas on what you would like or not like to happen. You may find it very helpful to work on your birth plan with your partner, so they can be part of the decision making process and be able to assist you in implementing your plan.
Birth Plans can be quite varied, they can be short and to the point or extensive and cover every possible contingency you can think of, right through to caesarean birth to caring for the baby after the birth. There is no right or wrong way to write a birth plan. You can gather ideas for writing your Birth Plan from friends, books, childbirth educators, midwives, doctors, hospitals or the Internet (see the reference list for some online help).
I am thinking of writing a birth plan. What sorts of issues should I include on my birth plan?
This is a really difficult question. Every birth plan is very different and the sorts of issues that are important vary from woman to woman. A good way to start working on your birth plan is by undertaking the following five-step process:
Explore your options
Examine your feelings
Evaluate your priorities
Examine your person situation
Discuss issues with your midwife or doctor
This will give you a good basis on which to start formulating your birth plan.
The following is a large list of issues that you may or may not want to include on your birth plan:
1st Stage of Labour
Choice of birth place
Clothing during labour (own or hospital gown)
Monitoring of the baby
Activity during labour
Eating and drinking in labour
Students during labour
Vaginal exams
Pain medication
Positions during the first stage of labour
Use of water
Use of heat
Self help techniques
Caesarean birth options
2nd and 3rd Stage of labour
Positions during the second stage of labour
Pushing during the 2nd stage
People present during the birth
Natural or managed 3rd stage of labour
Episiotomy and tears
Immediate contact after birth
Cutting of the baby’s cord after birth
Baby’s first breastfeed
Postnatal Care
Vitamin K
Hepatitis B Immunisation
Rooming in with mother during the postnatal stay
Newborn Screening Test
Breastfeeding/bottlefeeding
Preferences if baby has complications
This list is by no means exhaustive. There are many other issues that can be considered. Use this list just as a guide.
Who should have copies of my birth plan?
When writing a birth plan it is ideal to make copies for each person who is going to be present during labour. This may include your partner, support people, midwife or doctor. A copy can also be made for your hospital records. Some women choose to have a meeting with their support people and discuss the issues raised on the birth plan. You will also need to discuss the contents of your birth plan with your midwife or doctor. You may like to have your midwife or doctor sign your birth plan when it has been finalised – this can be helpful when presenting your birth plan to the hospital, particularly if some of your wishes are different to hospital policy.
I am currently working on my Birth Plan. How do I present my Birth Plan to my doctor, without offending her?
The ideal time to present your birth plan to your midwife or doctor is around 32-36 weeks of pregnancy. This way you have had time to research your options, but there is still time left discuss any issues with your midwife or doctor and make changes to your Birth Plan if necessary. One of the positive aspects of Birth Plans is that they help ensure that there are no surprises for you or your caregiver. Birth Plans are also a great tool for fully informing your midwife or doctor of your preferences, though you may need to negotiate on some points. Overall Birth Plans are generally well accepted. Though some health care practitioners do not like Birth Plans as they feel they are being told what to do. So when presenting your Birth Plan to your midwife or doctor, try being open and acknowledge their concerns, maintain eye contact and be assertive (but not aggressive).
Very occasionally a midwife or doctor may be unhappy with a woman’s choices for labour and birth. In an ideal world it would be great to be able to negotiate a mutually acceptable outcome. However this may not always be possible. A woman several options here:
- Take a stand against the procedure or intervention – in some cases this may result in the woman needing to choose a different midwife or doctor for their care.
- Negotiate a compromise
- Accept the midwife or doctors preference
There are so many things that can happen in labour, how can I account for all of them on my birth plan?
Birth plans should be written in a way that is flexible. As you have already identified, labour and birth does not always follow a predictable path. You will not be able to account for every possible variation of labour on your birth plan.
To help make your birth plan more flexible it is better to use words like ‘I would prefer’ or ‘if possible’. This helps prevent the birth plan as been seen as a list of do’s and don’ts that must be followed. Birth Plans indicate the preferences of the woman in labour and provides an outline of how she would like the birth to be.
Some women do include contingency plans within their Birth Plan. For example some plans include preferences if a caesarean birth becomes necessary or preferences if the baby needs to be transferred to Intensive Care or Special Care Nursery.
Reference List
Websites:
http://www.childbirth.org/interactive/ibirthplan.html ttp://www.babycenter.com/calculators/birthplan/QueryForm.jhtml http://www.fensende.com/Users/swnymph/birthplan.all.html
http://www.fensende.com/Users/swnymph/birthplan.all.html
http://pregnancy.tqn.com/health/pregnancy/library/weekly/aa031097.htm http://members.aol.com/mrobyn/birthpla.htm (sorry website no longer available) http://www.suite101.com/article.cfm/pregnancy_and_childbirth/3336 (sorry website no longer available)
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
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BIRTH PLAN EXAMPLE
Author Rachael Austin, Midwife - Australia
While this is the birth plan I used for my homebirth, it can easily be adapted to suit your individual needs for a hospital, birth centre, homebirth or freebirth.
Homebirth Birth Plan
Thank you reviewing our birth plan. My partner and I have chosen to birth our baby in the comfort of our own home here at (insert address), providing this is a ‘low risk’, singleton pregnancy, with a cephalic presentation and labour commences after 36 completed weeks gestation. We will be attended to by our midwife, (insert midwives names). (Midwife’s name) will be the principal caregivers during this time. (Partners’ name) and I believe strongly in the normality of birth and are happy for the labour to progress without any interference.
However, as life goes, it throws unexpected things in our direction. We would like to be prepared for this in labour and have contingency plans in the event that this happens. This birth plan is a brief overview of what I expect during all phases of pregnancy, labour and postpartum and also demonstrates what should happen if transfer becomes clinically necessary. This birth plan is by no means a complete list, but a guide line to how we would like our pregnancy, labour, birth and postpartum to be managed by our care providers.
EDB: Insert due date as per your last menstrual cycle
Part One: Pregnancy Preparation for Homebirth
Prelabour
- I want to prepare myself naturally with empowerment and knowledge and the support of (partners name) and other women.
- We have specifically chosen midwifery care for our pregnancy and birth as we believe birth is a normal physiological event, unless otherwise indicated, and we do not wish to create an unnecessary medical situation.
- I will have antenatal care with my midwife as per normal antenatal care and attend at 8 weeks, 20 weeks, 28 weeks, 36 weeks and then weekly till birth.
- I will see (insert GP, or obstetricians name) at key intervals including routine blood tests and ultrasonography referral.
- Antenatal care to be documented by all providers and a copy provided to me so that I can bring to antenatal visits by any of the care providers.
- I am happy to sign a waiver for denying Syntocinon in the instance where it isn’t clinically indicated..
- I will only have 1 ultrasound (u/s) unless there is concern about the baby. I will NOT have a dating scan. I have been accurately recording my cycles. However, if there is a suspected problem, or something that deviates from “normal”, for example an ectopic pregnancy, or suspected miscarriage, I will attend a clinic where I will have an early scan. Where possible I would like “My Baby’s Ultrasound Exposure Record” to be completed (See Appendix E, p.22) at any time I have a u/s. This won’t apply to pregnancies where the baby isn’t viable.
- If you detect a problem with the baby, we will NOT be choosing an elective abortion, i.e. down syndrome etcetc
- I will only have 3 set of blood tests, (8, 28, 36 weeks) unless more are clinically indicated. I will have a GCT at 28 weeks but do not routinely want a GTT.
- My baby isn’t late or overdue, it will come when it is good and ready and not before. The baby is choosing its birthday. If the baby is past it’s EDB by over 14 days I will accept routine CTG’s to monitor the baby’s well-being until birth.
- I would prefer to use castor oil, herbal or other natural methods such love making, meditation, aromatherapy and acupressure to start labour.
- Unless there is a concern about the baby, I will not be artificially inducing my labour.
- I would prefer to try nipple stimulation or breastfeeding (if you are breastfeeding an older child) or other ‘normal’ ways of augmenting labour such as position changing walking etc.
First Stage (Labour):
- I want (partners name) to know my birth plan well enough to speak for me should I be unable to speak for myself. I also want my (support persons name/s) to know and understand my birth plan.
- (Partners name) to prepare my birth essentials, i.e. Birth ball, birth pool, aromatherapy diffuser, massage oils, padded floor mats, chairs, and any other essentials I may accumulate.
- I want to create a sacred space for birthing in my own home
- I want to feel safe and secure with my choices and that I am supported
- Phone to be taken off the hook. No phones at all!!
- I want clocks removed from the walls, my womb and baby have their own clock
- Dim lights.
- Peace and Quiet.
- Music
- NO VE's (vaginal exams) unless clinically indicated, i.e. If my care providers suspect a problem. I do not want to know my progress, and do not want to check for cervical lip. If there is a suspected problem, then I will happily accept a VE.
- Maintain mobility (Walking, rocking, up to bathroom, etc.)
- Eat and drink to comfort. Please provide me with ice.
- Intermittent Monitoring with a Doppler.
- Relaxation techniques (breathing, focusing, etc.). If I find making noise on exhalation helps allow me to do this without asking if I am OK every time, it helps relieve tension.
- Hypnobirthing
- Acupressure
- Positioning as desired.
- Water (Shower or Tub).
- Heat or Cold packs.
- Cold Washer to wipe my forehead.
- Ice to suck
- Massage (light stroking, back, foot, counter pressure, etc.).
- Aromatherapy, please keep diffuser topped up with the blends that I provide.
- I want to be touched reassuringly
- I want to be held and encouraged to rest I want the feeling of “I can’t go on” etc to be validated but I do not want to be taken to hospital unless there is a medical indication, in which case I will happily transfer. I expect that my support persons and professional helpers trust in my ability to birth, and support me through any difficult moments of labour and birth.
- I want the love in the air to provide support if I can’t stand verbal encouragement or touch
- I want the space around me to feel safe and sacred
- I do not want to be crowded or bothered or chatted to
- My partner will be with me at all times.
- If I choose at the time, my other children will be with me also.
- I want a quiet, peaceful sacred space created by all those I choose to be present
- I want EXTREMELY minimal fuss, I will tell you what I need and when.
- I want gentle encouragement throughout difficult stages
- I want people to speak in whispers if at all
- Water birth if desired
- Choice of position
- When birth is close, please bring (children’s names) into the room if they aren’t already there.
- I would like to see and touch my baby’s head as it is being birthed if I choose a land birth. My goal is to “catch” the baby myself, help direct me to do this. If at the time I do not want to do this, direct (partners name) on what do to.
- If I choose to have a water birth, allow either (partners name) or myself (direct me if necessary) to pick the baby up from the water once the baby is birthed.
- I would prefer to tear than have an episiotomy, but please use hot compresses, massage and positioning.
- Do not tell me how or when to push, I will listen to my body and breathe my baby out.
- Do not bother checking for cord when the baby's head is birthed, unless the baby isn’t able to move down, in this instance only, cut the cord early if necessary, if possible take the cord over the baby’s head.
- Baby to given to me immediately after birth if I choose not to “catch” the baby myself.
- Cry, laugh, and celebrate!!!
- Please take photos of me in labour and giving birth and immediately after and in the following stages afterward. Photo with (older children’s names) with the newborn also.
- Do not tell us the sex of the baby we will discover this out ourselves in our own time.
- If the baby’s apgar’s are low, carry out necessary procedures with the baby on my belly and still attached to the placenta (so the baby is receiving oxygenated blood). Start simply by rubbing the baby dry as a stimulus first, if this is unsuccessful then go to secondary measures such as oxygen and suctioning while the baby is still on my stomach and attached to the placenta.
- If Apgar’s continue to be low < 6 and the baby needs to have bag and mask ventilation, I would prefer to have this done while the baby is attached to the placenta receiving oxygenated blood. However if this isn’t possible at the time and there is a need to transfer to a more suitable place for optimal resuscitation, please do not take the baby away from me because this is ‘usual practice’.
- Physiological 3rd stage, NO Syntometrine NO Syntocinon unless clinically indicated
- Do not pull on the cord
- Do not apply fundal pressure
- Baby to breastfeed as soon as possible to assist the birth of the placenta.
- If we choose to cut the cord (partners name) will do this once the placenta has birthed (Modified Lotus Birth). I may choose yet, to have a Lotus Birth. I will let you know closer to the time.
- If we choose to cut the cord, we will bury the placenta somewhere in the garden, or dispose of it however (partners name) chooses at the time. Preferably somewhere where the dogs won’t dig it up or eat it!
- Allow me time to bond with my baby. Do not rush me.
- I will have a shower in my own time
- Do not wash the baby; he/she is already clean.
- When we are ready, weigh and measure the baby.
- Dress baby
- Please offer me something to eat and drink, I have worked very hard and am probably hungry.
- Bask in the beautiful glow of postpartum hormones and the absolute joy of giving birth while we adore our wonderful baby and introduce him/her to their elder siblings.
- Skin to skin contact immediately after the birth
- Breast feeding only
- No pacifiers or glucose water
- No separation of Mother & Baby
- We don’t plan to circumcise if the baby is a boy
- NO Vitamin K
- NO vaccinations
- I will get conscientious objector forms for denying vaccinations.
Planned Hospital Birth:
- Refer to homebirth plan above and please maintain to this plan.
- A planned hospital birth will be because of multiple birth or breech birth. A birth centre or hospital respecting my wishes for a spontaneous vaginal birth will be chosen in this instance, most likely (Hosptial or birth centre name) at (insert Town).
- No continuous CTG monitoring. I would prefer close monitoring with a Doppler.
- My husband (partners name), my (support person/s) and my midwife xxxx will advocate for me if I am unable.
- If transfer is clinically indicated transfer me to XXXX Hospital. Clinical indication could include Meconium liquor with foetal distress.
- As per Homebirth Australian and ACMI guidelines for a homebirth, 1 hour is an appropriate cut of time to a maternity hospital in the case of transfer.
- Do not offer me medical analgesia; I do not need it unless I ask for it.
- Do not ridicule me, or make me feel by choosing a homebirth I have chosen an unsafe way to birth my baby.
- I do not want to be catheterized, remind me to go to the toilet regularly, unless in the situation where it is physically impossible.
- If premature rupture of the membranes (PROM) occurs do not offer me routine IVAB’s, less than 96 hours, I will use aromatherapy/essential oils. Please take my temperature regularly so that I know I am afebrile. If I become febrile, i.e. over 38 degrees Celsius, I will have IVAB’s.
- I would prefer Ventouse to Forceps. I do not wish to utilise either option unless a genuine medical emergency arises and there is no other option available whatsoever.
- Do not manually try and stretch my perineum, it stretches fine!!
- Blood Transfusion – I will accept this if it is genuinely medically required in an emergency.
- In the instance of a hospital birth, please dispose of the placenta, I not wish to keep it (That will save (partner) another job to do!) unless of course I have chosen to have a Lotus Birth.
- I will refuse all artificial methods of induction unless clinically indicated. i.e. Baby in distress, PIH with proteinuria, medical problems, placental abruption, etc…being over due does not constitute as clinically indicated unless the placenta isn’t functioning properly.
- If such a clinical situation occurs I would prefer to begin with the simplest procedures first. I would prefer to use castor oil, herbal or other natural methods such as love making, meditation, aromatherapy and acupressure to start labour.
- The next approach to a clinically indicated induction will be a strip and stretch.
- If this fails I will be requesting a vaginal examination to know my Bishop’s Score. A total score of 6 or more will be suitable for induction with the prostaglandin vaginal gel ONLY if clinically indicated as stated previously. I intend to go home within a half hour to an hour, after a ½ hour satisfactory CTG, to allow labour to commence naturally thereafter, unless there is a clinical indication preventing me from doing this safely.
- I would prefer not to have an amniotomy (ARM) but will accept if absolutely necessary.
- I do not want to have oxytocin to induce labour, but should the baby or I be in a clinical situation where there is absolutely no other choice, I will accept an IV line.
- If clinically indicated, you can preform an ARM but not to hasten the labour unnecessarily. Do not ask me unless there is a clinical problem.
- I do not want to have Oxytocin or Prostaglandins to induce my labour, unless there is a major problem, a lengthy labour isn’t a problem unless there is foetal distress.
- As stated above in section two Labour and Birth.
- If a caesarean section is necessary, (a breech presentation is not a clinical reason for a caesarean birth) a hospital transfer will be arranged by the homebirth midwives attending me in conjunction with the doctor.
- I would prefer a Spinal/epidural anaesthesia, but will allow a general anaesthesia if the baby’s life or my life is in immediate danger.
- There will be no pre-operative medications, especially sedative drugs
- (partners name) is to remain with me in the OT at ALL times, this includes putting in the spinal/general. While I accept this isn’t usual hospital protocol, I would like my birth to remain a family event and not a medical procedure.
- If a caesarean is indicated we prefer that OR staff not carry on unnecessary conversations or idle chit chat, however please tell me about the birth and let us know what is happening.
- (partners name) and I expect that we will be given the chance to participate in our baby’s birth in the OR. We expect that the environment will be every bit as respectful, as if we were having a vaginal birth. While we respect that the situation is serious and emergent, we want the birth to be a gentle experience for the baby’s birth into the world.
- I DO NOT want the standard screen up to prevent me from seeing the birth. I want to be able to witness what is happening. I want to assist the baby’s birth from my abdomen onto my chest. (Partners name) will probably need to assist me to do this safely. Please direct me as to when it is time. Please provide me with sterile gloves, so as not to cause infection in my uterus. Unless I have a general anaesthetic or do not have the strength to hold the baby with assistance, in this case (partners name) is to hold the baby, preferably on my chest.
- Free my hands for me to do these things.
- Baby to be placed onto my chest and covered with a blanket and to stay there while I am being sutured. Any resuscitation to be done on my chest, with baby attached to the placenta until 3rd stage is complete (modified Lotus birth). I understand that the placenta does not naturally expel during a Caesarean Section and it will be gently removed, however, I would like the cord not to be cut until such time that the placenta is safely out.
- Please keep the baby’s body close to, or slightly below, the level of my uterus after birth so allow gravity fed drainage of the blood to the baby. Support skin to skin contact.
- If the baby’s apgar’s are low, carry out necessary procedures with the baby on my chest or thigh and still attached to the placenta. Start simply by rubbing the baby dry as a stimulus first, if this is unsuccessful then go to secondary measures such as oxygen and suctioning while the baby is still on my stomach and attached to the placenta.
- If Apgar’s are below 6 and the baby needs to have bag and mask ventilation, I would prefer to have this done while the baby is attached to the placenta receiving oxygenated blood. However I will understand if this isn’t possible at the time and there is a need to transfer to the resus trolley for optimal resuscitation. But please do your best to keep the baby on me.
- Do not tell us the sex of our baby; we will discover this out ourselves.
- Laugh, Cry and Celebrate!!!
- Please use the double layer suturing technique (NOT single layer suturing) so that for future births I can achieve a HBAC (home birth after caesarean) or VBAC (vaginal birth after Caesarean)
- Do not cut the cord until 3rd stage is complete (Modified Lotus Birth) unless we have chosen to lotus birth, in which case it isn’t to be cut.
- (partners name) to cut the cord if applicable (ie. We have chosen not to have a lotus birth).
- Breast feeding in recovery room or sooner if possible.
- Breast feeding as soon as possible
- Breast feeding only
- If the baby is unable to breastfeed I will express and feed by cupping or by syringing, not by bottle. If I am still under a general anaesthesia please allow a midwife/lactation consultant to express my breast milk to feed the baby.
- Do not microwave my breast milk.
- Do not formula feed the baby, breast milk is sufficient. If I cannot express, I will find a milk donor.
- Unlimited visitation for parents
- Unlimited handling of the baby (Kangaroo care, holding, care of, etc.)
- If the baby is transported to another facility, move us as soon as possible
- No pacifiers/dummies
- No glucose water
- No separation of Mother & Baby
- NO Vitamin K
- NO vaccinations
- We don’t plan to circumcise if the baby is a boy
Website: www.gentlebirth.com.au
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