Friday, 29 October 2010

Birth Plan..

I am still working on this... I know there is more, especially if I end up being transferred to hospital (hope not), but it's a start. I am going to write a letter to my mum to let her know what I expect from her at the birth. For some reason this is stuck on bold, underlined and italic.. oh well.. :)

Birth Plan...

Section one of this birth plan assumes that I am birthing at home with no complications or legitimate reasons for interventions of any kind. I am aware that things do not always go to plan and I am prepared to be flexible should the need arise. Section two will outline specific wishes should the need to transfer to hospital and also my wishes surrounding caesarian section.

Birth Place: Home
Back up hospital arrangements: The Royal Women's Hospital

Birth team: Midwife- Joy Johnston, student midwife- Melanie Tully, Husband- John, Mother- Annette

Other helpers: My daughter Molly will visit with her Aunty, Uncle and Cousins for the labour and birth

Section One:

Beginning labour
I would like my labour to begin spontaneously. If I am still pregnant at 42 weeks I am prepared to have monitoring to ensure both my baby and myself are healthy and wait for labour to start spontaneously. If there is an indication that either one of us are not well I will seek advice from my Midwife and take the steps that feel appropriate at that time. I would like to telephone Joy and Mel as soon as I feel I am in labour to give them plenty of time to get to my home.

During Labour:
I would like to take it as it comes. There will be several comfortable places around the house for me to spend time labouring. I would like to have a birth pool set up as an option but also know that it may not feel right at the time. I would like John to set up the pool and mum to take responsibility for keeping the pool at the right temperature during the labour so John can be with me.

I would like all my birth team to offer me sips of water and mouthfuls of high energy food at regular intervals through the labour. I would also like to be reminded to use the toilet regularly.

If I need massage/silence/talking/music/solitude/company/anything I will ask.

Please do not mention hospital/drugs/intervention etc. I understand that I may need to transfer at some point if any complictions arise and Joy may need to broach the subject with me. This is fine.. I just don't want any hospital banter or jokes.

If Mum or John feel fearful at any time, please try to hide this from me. Be brave, it's ok. Look to Joy and see how she is reacting. If she thinks I'm fine, I'm probably fine. If you can't hide it, please leave the room until you can come and be strong with me.

The birth:
I will birth in the position that feels best. If there is any reason for me to move to another position for the wellbeing of the baby (ie. Shoulder dystocia) Joy will be firm with me and I will do as she suggests. If I want any compress on my perineum I will ask. I will most likely just want to be left alone to birth my baby. If I am in a position where I feel I can, I would like to bring my baby out with my own hands, if I am not in a position where I can, I would like the baby passed straight onto my bare chest.
If my baby needs any help breathing, I would like this to be done with the cord still intact where possible.

I would like a physiologial third stage. Joy will assess my blood loss to see if any extra intervention is required.

The cord will be left intact until it stops pulsating. There is no rush to cut the cord. I would like to wait until I birth the placenta and our baby has all the blood from the cord. John can cut the cord if he wants to.

After the placenta is out and cord cut we will have a bite to eat and go to bed or wherever feels right at the time. If mum could do some cleaning up at this point that would be great. Joy and Mel will do what they need to do, check me, weigh baby, etc before packing up and leaving.

I am still undecided as yet.

Section 2

If I need to be transferred to hospital I would like my birth team with me.

I would like to be consulted on every intervention that may be performed. I do not automatically consent to any intervention but acknowledge that if there is a genuine emergency medical staff may need to make the call at the time.

If I require the drip I would like to start at the lowest dose possible and not to be increased if contractions are effective. When I birth my baby I want immediate skin to skin contact and I would like to wait until the cord has stopped pulsating before cutting the cord unless I have had the injection for third stage. I would like to avoid a managed third stage however I understand that interventions in labour can lead to a higher chance of bleeding.

If my baby needs help breathing I would like Joy to be with my baby and John to stay with me. I would prefer that my baby is close to me while this happens.

If I require a caesarian section I would like John and Joy with me. I would like baby brought straight to me. I do not want Endone as pain relief after the operation. Please discuss all decisions with me and ensure I am well informed about the benefits and risks of all suggestions. I would like to attempt breastfeeding as soon as possible.

If my baby needs special care I would like to be with my baby as much as possible.

Breastfeeding is very important to me and to my baby. Every effort will be made to ensure a positive start to our breastfeeding relationship and I expect all hospital staff to support and encourage this.

No formula is to be given to my baby. If my baby requires breastmilk please bring him/her to me and I will breastfeed or express some colostrum to be given to baby with a teaspoon. No bottles please. If there are any problems feeding I wish to make the decision with my family and midwife. If there are any issues I will use donor breastmilk from a family member if there is any reason the baby cannot have my milk.

Please save the placenta for us to take home.

I am still undecided as yet.

If our baby is stillborn we would like to be left alone for as long as we need to spend time with our baby.  

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