Birth Plan

Since there are so many philosophies and choices during labour and birth these days, most doctors and midwives encourage their patients to write a "birth plan". Your birth plan basically communicates your wishes to your doctor, nurses and labour support people so that you don't have to do any explaining during labour. I went over mine with my doula and my doctor today and they both said that it was doable and reasonable, so here it is:


Our Wishes for Labour, Delivery, and Postpartum
Amanda and Aaron McKellar
Patient of Dr. Irma Schuurman
Estimated Due Date: November 23, 2006

Our goal is to have a natural childbirth with as few interventions as possible. We would like to stick to our birth plan, but we realize that emergencies do occur and we may need to deviate from our initial wishes. If this occurs, we would like to be consulted and have the risks and benefits of any proposed procedure explained to us beforehand. The following is a list of our wishes:

Labour

• I prefer to remain at home during early labour, as long as the baby and I are safe and comfortable.
• Once active labour is well established, we will proceed to Surrey Memorial Hospital where we have pre-registered.
• A hospital room with a bathtub to use for pain relief is preferred. A room with a shower will do if no bathtub is available.
• People to be present during labour and birth are Aaron and our doula Vicki Kunzli. Please keep all other visitors outside until after the birth. No excess hospital staff please.
• I would like to be free to eat and drink as needed throughout labour.
• I would prefer not to be hooked up to an IV as long as I do not become dehydrated. If IV prep is required, I would prefer a heparin lock.
• As long as the baby is not in danger, I would like to avoid having labour induced or augmented in any way. I would prefer not to have my membranes stripped, my water broken, prostaglandin gel applied, or pitocin administered.
• I would prefer for my water to break on its own unless labour is particularly long and the baby’s head is fully engaged. If this is the case, I would like to be consulted before an amniotomy is preformed.
• I wish to be free to move around as desired throughout labour.
• I would like for the baby to be monitored periodically, not continually. If the need arises for continual fetal monitoring, I would still like to be able to stand and sit instead of being confined to bed. Please use internal fetal monitoring as an absolute last resort.
• I wish for a drug free labour – please do not offer me drugs. If I change my mind and would like medicated pain relief, I will ask for it.
• I would like internal exams to be kept to a minimum to reduce the chance of accidentally rupturing the amniotic sac, and to reduce the chance of infection after my water has broken.
• As long as the baby is doing well, I’d like my labour to progress on its own timeline, without any rigid restrictions.
  

Delivery

• I would like to push instinctively – please do not direct me to push. However, if I am pushing ineffectively, please DO let me know.
• I would like to push in the position I find the most helpful at the time – most likely a vertical position of some kind. If I must be horizontal, I would prefer to push in a side lying position.
• As long as the baby is doing well, I’d like the pushing stage of my labour to be free of any rigid time restrictions.
• As long as the baby is doing well, I would like to stop pushing as the baby crowns to allow time for gradual stretching of the perineum to help avoid tearing.
• Please do not perform an episiotomy without my consent. I will only agree to an episiotomy if the baby is in distress and needs to be delivered quickly – I would like to be involved in this decision. I would prefer to tear naturally.
• If assistance during delivery is absolutely necessary, please try to use vacuum extraction first, rather than forceps.
• Please delay clamping the umbilical cord until the cord stops pulsating on its own.
• Aaron would like to cut the cord.
• I prefer to deliver the placenta in my own time, without the use of any drugs or cord traction to speed up the process. If pitocin were to be deemed necessary to deliver the placenta or to stop hemorrhaging, please consult me first – I would prefer to use natural remedies such as immediate breastfeeding and uterine massage.
  

Postpartum

• I would like my baby to be placed on my abdomen immediately after birth.
• We would like for any evaluation of our baby to be done with our baby on my abdomen.
• If our baby needs any warming, we would prefer to use skin-to-skin contact and blankets. If it is necessary for our baby to go to the warmer, Aaron will accompany our baby.
• We would like for any non-essential medical treatments and tests for our baby to be postponed for at least 1 hour after birth.
• We would prefer for our baby to not be given eye drops after birth. We understand that we will have to sign a waiver to refuse this procedure.
• We would like to be responsible for giving our baby its first bath.
• I would like to attempt breastfeeding immediately after birth.
• I would like a local anesthetic for the repair of any perineum tears.
• We would like for our baby to room in with us at all times during our hospital stay.
• We wish for our baby to be exclusively breastfed on demand. Please do not offer anything to our baby, including formula, water, a bottle, or a pacifier.
• If our baby needs to be taken from our room for emergency treatment, Aaron will accompany our baby at all times.