Birthrites: Healing After Caesarean.

Please feel free to use the birth plan below.
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Birth plans can help to reduce conflicts and misunderstandings during labor and delivery. They include the parents' ideas and expectations about the birth of their child but they should be considered as a guide only with the understanding that if a medical emergency arises then it may be necessary to deviate from the plan.


Birth Plan

 

_______________ and _____________'s Birth Plan.

(Baby due: ________________).

As this is a planned VBAC birth, we are looking forward to an active, positive and natural birth.

Our desire is to give birth vaginally, with as little medical intervention as possible. We want to participate in this birth to the fullest, with the wonderful support and encouragement of our birthing team.

This is assuming my birth goes normally - if it does not, we are flexible about deviating from the plan if it is medically necessary, but we wish to be informed of the risks, benefits and necessity of intervention and to participate in these decisions.

We have listed our preferences below, these decisions have been made after much research, consultation and thought. Therefore, your help in attaining these goals is very much appreciated.

__________ would appreciate, at all times, being encouraged in a patient and supportive manner.

As I have a longer than normal menstrual cycle (5 weeks) could this please be taken into account, and an extension granted to my due date.

On Admission:

No enema or shave please. ___________ will bring her own clothing to wear.

____________ and our Midwife will be providing support and physical help during the labour, as well as the midwife supplied by the hospital.

We do not wish to have medical students present during our labour, or student midwives, unless they are in their final year of midwifery.

Care During the First Stage:

I would like to have an active labour/positions. So could you please encourage:

- as mobile as possible.

- use of different positions.

- use of beanbags, cushions, etc.

- frequent drinks and snacks.

- regular use of the toilet.

- human fetal monitoring using a fetoscope or a Doptone. If this is not suitable then using a Telemetry unit or if really needed, intermittent EFM along with fetoscope evaluations. ________ must still be able to assume mobile positions even if being monitored, and the EFM volume should be turned down, or even off if possible.

- Please do not set time limits. We do not want to be hurried with time constraints, as long as the baby and mother are tolerating labour please assess their progress rather than looking at the clock.

Pain Relief:

- Because we worry about their effects on the baby, could drugs not be administered unless they are requested by ________. This will only be if, at the time, ________ feels strongly that she cannot manage without, and all other options have been tried.

- We would like to use the water bath, showers, breathing, relaxation, massage, mobility, heat and cold, plus any other suggestions.

- If we decide to use drugs, we would prefer gas initially, and other drugs only after discussion.

We want to avoid:

- Induction, or acceleration, of labour with Oxytocin. Though I would prefer even this than contemplating another caesarean.

- Artificial rupture of membranes, unless _________ and partner can both be convinced that it will be helpful in their particular labour. Such as if there was a reason to be concerned about the condition of the baby, but definitely not to put an electrode scalp monitor on the baby.

- Frequent vaginal examinations - as few and as gently as possible.

- Internal electronic monitoring, as infection could be passed to the baby via the puncture site of an electrode clip on the scalp.

Care During Second Stage:

- Unhurried second stage, so long as baby and __________ okay, that is waiting to push until _________ feels ready.

- Choice of positions for birthing.

- No episiotomy, please give the perineum every chance to stretch. To an extent _________ would rather tear naturally than be cut.

- If assistance in delivery is necessary, please use suction rather than forceps.

At the Birth:

- A mirror available.

- A quiet and intimate environment. Dimmed lights with no unnecessary noises.

- Allow baby to take first breaths unassisted, if possible.

- Allow _________ to discover the sex of the baby.

- Allow _________ the freedom to touch the baby during delivery and to feel the head as it is crowning.

- Baby to be put immediately on to _________'s abdomen and put to the breast, as long as medically stable.

- Cord left intact until pulsing has ceased, and then to be cut by _________, (if he wants to).

- I would like to deliver the placenta naturally. No pulling on the cord, no Ergometrine or Oxytocin. I realise these drugs and procedures can be lifesaving if there is heavy bleeding, but if everything is going well I'd rather have a natural third stage possibly in an upright position (eg, kneeling or semi-squatting).

- Baby to remain with us in first few hours after birth- waiting until later for weighing, tests or washing, etc.

- If there is a problem with the baby, _________ is to stay with him/her at all times, and _________ wishes to join them as soon as possible.

- Please perform all physical examinations and procedures in the room with the parents present.


As we mentioned before, we realise there may be problems (some we may not have taken into consideration here) and we are willing to co-operate, all that we ask is that our informed consent be sought before any procedure or medication is used.

We also realise there is a chance that ________ may require a caesarean, and all the points mentioned above then become mostly invalid. If _________ does need a caesarean the important points are mentioned below.

In case of caesarean:

- If we do need a caesarean, then we would appreciate it if _________ could receive a spinal epidural and remain conscious during the operation.

- _________ to remain with _________ at all times.

- If emergency caesarean necessary, under general anaesthetic, then we wish for the baby to be given to _________ straight after birth and held by him until _________ is awake and can be told of the baby's sex and well-being (by _________).

- If an elective caesarean is necessary, then _________ would like to begin labour naturally before the caesarean is done. That is, we do not want a date and time preset, we wish our baby to decide the day on which it is ready to be born to avoid any problems with prematurity and for both of us to reap the benefits of our hormones.

- If we are convinced that a scheduled caesarean must be performed, then we would appreciate preoperative blood work and tests to be done on an out-patient basis, and hospital admission on the day of the birth (not the night before).

- _________ and _________ would both like the option of viewing the birth, either by lowering the screen or by positioning a mirror. _________ has had a previous caesarean and it is still a bit unreal, as she has never actually seen a baby leave her body - they tend to just appear from behind the green screen and be held up for a quick look before they disappear to be wrapped up and tested.

- _________ and _________ would appreciate a verbal description of the birth as it occurs. _________ especially has felt left out of her previous caesarean as her body and labour have been discussed as though she wasn't there.

- _________ would love to meet her new baby in his/her unclothed, naked newborn state. Could the baby please be placed on her chest with a warm blanket over them both. It would do a lot to make this surgical delivery a bit more natural for mother, father and baby. And it may even resolve a few inner conflicts that are faced after the birth.

- _________ would like to feed her baby while she is being sutured, if she feels up to it, and we would like the baby to stay with her throughout the surgery and even during the recovery. _________ would be delighted to hold his child within _________'s view throughout these procedures if she feels unable to participate in the bonding (at least she would be able to witness it this time).

- It is very important for _________ and _________ to view the placenta. Please do not just discard a part of _________ that she has carried for nine months as insignificant. We will be taking the placenta home, so please be sure to make suitable arrangements with us to see that this happens.

Thank you very much for taking the time to read our Birth Plan, and I hope we can discuss any problems you see with it.

We thank you in advance for your support and kind attention to our choices, as we look forward to a wonderful birth. Your support and co-operation is really appreciated.

Sincerely,

________________________ ______________________

 


For many women the thought of having a caesarean is terrifying, the knowledge that after viewing your newborn child, you may be unable to hold or even see your baby for at least an hour (sometimes longer), can be devastating. Paula Beckton experienced a ground breaking caesarean, where she helped assist in the birth of her second child Oliver (during an elective caesarean) and not only was he not whisked away immediately, but was placed on her chest for cuddles and mother/baby bonding.

*Click here to read her story.

* Oliver's Birth Plan - Click here to download a copy of it.

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