As I mentioned in Friday's post on birth plans, I have written a birth plan for the birth of my third child (due sometime in the next 3-4 weeks, give or take!). Although this will be my third baby, it's my first official birth plan. For my first two, I thought endlessly about my birth and had birth plans/preferences in my head, but never followed through with writing and submitting an actual birth plan. And in hindsight, I really wish I would have -- not necessarily for my care provider (she and I discussed at length my preferences for birth), but rather for the labor and delivery nurses, with whom I did not meet in advance and discuss my birth and preferences for newborn care.In sharing my birth plan below, my intent is not to show you the "perfect birth plan," but rather to show one that demonstrates the tips and formatting that I mentioned in my last post as well as to point out my thought process and reasoning behind why I included (or didn't include) certain items. The text in black represents my birth plan and the red text is my commentary.__________________________________________________________________________________________Birth Preferences Cara Terreri DOB: XXXXXX [Included as an identifier in addition to my name.]Thank you for taking the time in advance to read our birth preferences. We realize that unexpected circumstances do arise and do not intend this as a script for our birth. We hope you will be able to keep us informed and aware of our options. Thank you!LABORPlease do not offer an epidural or narcotics for pain relief.If mom does not require antibiotics for GBS, she does not want a routine IV.[I've been told by my doula that this is frowned upon at the hospital where I plan to birth. At a minimum, nurses want to insert a Hep lock to provide access to an IV if needed. However, I also know that it is within my right to refuse an IV. Because I have had an uncomplicated pregnancy, do not want an epidural, want the freedom to move around and plan to eat and drink as needed, the likelihood for me needing an IV is very low.]Please use fetal monitoring intermittently so that mom can be mobile as much as possible.[Most hospitals, per guidelines developed by the American Congress of Obstetrics and Gynecology, require that fetal monitoring be performed every 30 minutes while in labor. I agree and will gladly comply with this request, but do not want to be monitored continuously. Fetal heart rate monitors work most effectively when mom is on her back -- the worst and most uncomfortable position for a laboring mom! Continuous monitoring would severely restrict my ability to move around in labor.]Please allow mom to push as she feels urges; do not count or coach for pushing.[I've never pushed without nurses counting and coaching me to hold my breath, bear down and push for 10 seconds. It seems to be the hospital standard. Because I plan to birth for the first time without an epidural blocking my sensations to push, I would like to follow that urge and push on my own.]Please allow mom to push in a position that is most comfortable for her.[This shouldn't be an issue, as I'm told that the providers in my practice have helped moms birth babies in other positions than the standard "dead cockroach" position. Who knows -- I may be comfortable pushing while on my back. But if I'm not, I want the option to do otherwise.][**What I did NOT include in this section: I plan to wear my own clothes for labor and birth. I am well within my right to do so and therefore, this should be a non-issue. I plan to eat and drink as I wish. This is technically against hospital policy, but I also know that my provider tends to turn her head and allow it. Routinely restricting food and drink during labor is outdated advice and is not an evidence-based practice.]BIRTH (vaginal)Please allow dad to announce baby's gender.Please allow baby's cord to stop pulsing before cutting. Dad would like to cut cord.Please provide immediate, uninterrupted skin-to-skin contact after baby is born.[This was the most frustrating issue I experienced with the birth of my last child. He was born healthy and crying and yet, the nurses took him from me very shortly after birth to perform routine procedures. I barely had the chance to see his face and touch his body before he was whisked away. None of these procedures was urgent or life-saving. This time, the staff will need to be patient and wait for us to meet, bond and breastfeed. Only then will I allow anyone to take my baby!] Please perform all necessary tests while baby is with mom please delay other routine procedures after the baby has breastfed for the first time.[Contrary to what is typically done, apgar scores can be taken while baby is with mom. Weighing and measuring the baby is not something that needs to be done immediately after baby is born.]IF CESAREAN IS REQUIRED[While moms expecting and planning a vaginal birth don't want to consider an unplanned cesarean, it can and does happen. It's important to prepare mentally for this possibility. Including preferences in your birth plan for an unexpected cesarean is part of that process.]Please allow dad to be present at all times.Please allow doula, Tracy Cuneo, also to be present.[I've been told that this is against my hospital's policy, but it doesn't hurt to ask.]Please allow dad to announce baby's gender.Please allow baby's cord to stop pulsing before cutting. Dad would like to cut cord.Please allow mom to have skin-to-skin contact with the baby in the OR.[Skin-to-skin in the operating room after a cesarean surgery is not standard, though it is starting to happen in a few locations across the United States. When mom is not under general anesthesia for a cesarean, this should be a reasonable request and will help with the initial mother-baby bonding that might have otherwise been missed.]NEWBORNRoutine newborn procedures:
- NO eye ointment
- NO Hep B shot (we will do this later)
- YES vitamin K shot
[These are the three basic, routine administrations given to baby after birth. If you have strong feelings about any of these procedures, make your wishes known in advance. If not, when you give birth in a hospital, they will be performed routinely.]Baby will be exclusively breastfed; please NO pacifiers, bottles, water, formula or otherwise. Dad will be going with the baby to attend or give the first bath.[Many hospitals will invite dads to attend or give baby's first bath, but this is not always the case. I want to be sure that my husband goes with our child to his or her first bath for a few reasons: because he wants to be there; because I don't want our little one to be without a parent when he or she leaves the room; and because we plan to bring our own natural soap to wash the baby.]__________________________________________________________________________________________
Feedback? Questions? Comments? Let's hear it! How did your birth plan differ from mine?
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BirthBirth plansHealthy Birth Practice