My Birth Plans

As part of our Bradley class, we’re supposed to make a birth plan. While it’s certainly not required that home birthers make a plan for home, I still figured I would so that it could remind the midwives of the little intricacies of our birth. Here is our home birth birth plan.

Labor

Dea will be in the home during labor and have the option of watching the birth (depending on her comfort level). My mother, Fay, will be present and responsible for her comfort.

We would like to labor as much as possible with just Claire and Curtis present. If we need assistance, we will let you know. Otherwise, feel free to make yourselves at home.

We would like minimal observation of the baby. When the baby does need to be periodically observed, I would like the option of getting into a position where we can use the fetoscope. If I am unwilling, then we can use the doppler.

We have prepared for our birth with the Bradley Method and would appreciate lack of light, noise, and stress to aid in relaxation during the labor process.

I would like to avoid all vaginal exams unless it is deemed truly useful or I request it.

I do not want to transfer to the hospital unless the baby or I am in immediate danger.

Birth

We would like minimal involvement from the midwife team during the pushing stage.

Of course, I would like all precautions taken to avoid tearing. If tearing does happen, I do not want local pain medication to repair.

I would like the availability to birth in the water, depending on my mood.

Curtis would like to catch the baby if he is in the position to.

Curtis would like to cut the cord.

We would like to keep the placenta and would prefer to avoid augmentation to remove the placenta unless medically necessary.

Baby

We do not want to give the baby Vitamin K, antibiotic eye ointment, or Hepatitis B vaccine.

If the baby is a boy, we do not plan to circumcise.

I would like to breastfeed the baby immediately after birth.

We would like to delay any procedures in favor of alone time for Claire, Curtis, Dea, and the new baby.

Next is our hospital transfer birth plan. The main reason that moms end up transferring to the hospital is deciding they want pain medication. After Peanut’s birth, I’m finding it difficult to believe that I will get to that point. Even my midwife is amazed that I went through that long and difficult of a labor without a midwife there for my first birth and didn’t end up going in when the hospital midwife on the phone suggested I come get a sleeping pill. So my birth plan is formatted in the mindset that if I’m there, it’s a true emergency. I’ve bolded the things that are most important to us for quick reference. Most of it is probably not necessary in a true emergency (like I’m not going to be sitting there long enough to need a vaginal exam), but I figured I’d include it just in case. Here is my hospital transfer birth plan.

We have prepared for our Bradley Method birth by exercising, eating healthy, and becoming informed on our birthing options. We are preparing for a home birth. If we are in the hospital, it is because we require some intervention that was unavailable at home. Therefore, we are prepared to be flexible on our birth plan if medically necessary. Barring any major medical crisis, we ask that you discuss with us all interventions, even those administered routinely, and allow us the opportunity to give informed written or oral consent in the presence of a witness not employed by the hospital to any procedure you suggest.

Our midwife is ___ and it is our intent to birth at home.

Our pediatrician is ___.

We would like to be thoroughly informed of our options if we need to alter our birth plan.

Labor

Unless medically necessary, I would like to avoid medical intervention. This includes, but is not limited to: continuous EFM, IV, hep lock, rupturing membranes, pitocin, etc.

I would prefer that no vaginal exams are performed during labor. If one is required, ___, our home birth midwife that will accompany us to the hospital, will perform it.

I would like the ability to push in my preferred position and at my own pace.

I do not want an episiotomy and would rather risk tearing unless the baby’s safety is in danger.

If stitching is required, do so without the use of pain medication.

We feel very strongly that we do not want vacuum extraction or the use of forceps unless the baby is in immediate danger.

I do not want pitocin or uterine massage to augment the birth of the placenta.

We would like to take our placenta home with us.

After Birth

I would prefer baby to be given to me right away; any evaluations can be done with the baby on me.

If the baby needs to be separated from me during our hospital stay, Curtis will accompany him/her.

We do not want any cord clamping, cutting, or handling until after the placenta has emerged.

We do not consent to vitamin K, antibiotic eye ointment, Hepatitis B vaccine, or circumcision.

I plan to breastfeed exclusively.

I would like to breastfeed as soon as possible after the birth.

I would like a lactation consultant to periodically check on our progress.

We feel very strongly about breastfeeding and getting off to the right start, so please do not give the baby any sort of artificial nipple or liquid other than breast milk (even water).

I would like to feed on demand and have the baby room with me at all times.

We would like to wait to bathe the baby until after leaving the hospital.

No screening tests of any kind are to be given without our explicit and specific permission.

We would like to check out of the hospital as soon as possible after the birth.

In Case of a Cesarean Section

If a Cesarean section is deemed necessary, I would like to obtain a second opinion if time allows.

I would like my husband to be present at all times during the surgery.

If the baby must leave the room for emergency reasons, Curtis will accompany him/her.

If Curtis must leave the room, please allow another support person to accompany Claire in the O.R. and recovery at all times.

We are not squeamish and would like to watch as the baby is born.

Please place the baby skin-to-skin with Claire’s chest as quickly as possible after it is born. If she is unable to hold the baby, please place the baby skin-to-skin with Curtis.

We would like the baby to nurse within an hour of birth, health permitting.

I would like the baby to stay with me in recovery.

Our midwife “approved” both of our plans at our appointment yesterday. She said that it’s unlikely that they’ll let her do vaginal exams at the hospital, but there’s no harm in keeping it there. She said that once we get to the hospital, she’s either my doula or my grandma. They don’t let her actually practice medicine or anything. Honestly, if my past experience is worth anything, they probably won’t even look at my birth plan if we get there in an emergency. Next time though I’ll bring it out afterwards at least for the baby section.

Did you make a birth plan for your home birth? Anything you think I should change or that I’ve left out?

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8 thoughts on “My Birth Plans

  1. I made up my birth plan and made it very specific and very long (I think it was a page and a half) and showed it to Melissa. she was nice about it but was like “um yeah, that’s why you picked ME as your midwife. You could have left all but a few sentences out!”

    And I assume Chris is the same way, so it might be unnecessary to add more things, but here are a few suggestions: You said your mom would be there, but when you labor you want it to be just you and your DH. Do you want the midwife to keep your mom out?
    Also, you emphasize you want methods used to avoid tearing. Again, it’s irrelevant with your midwife, but you might want to exclude an episiotomy. You have that on your hospital plan, but not your birth plan.
    Also, just in case your DH doesn’t catch the baby, do you want the midwife to announce the sex? I made it very clear that I wanted to find out for myself, and no was aloud to tell me. That was very important to me.
    I would also use stronger language on the circumcision part. instead of “we are not planning to” I would say “WE ARE ABSOLUTELY NOT” but again, that’s just me.

    I’m so curious about the placenta part. Why do you want to keep it?
    You are unclear about how long you want to wait to cut the cord: Are you doing a lotus birth? Are you waiting until the cord stops pulsing? Or are you just waiting until DH has the scissors?

    Anyway, your plan sounds lovely. How exciting! I hope it goes perfectly!

    • Thanks for the input! To answer your questions:

      I’ve thoroughly explained to my mom that her job is to take care of Peanut. If Peanut doesn’t want to be around, she just has to deal with it. She also realizes that I don’t want her there bothering me the whole time. If it comes to telling her to get out, that’s my husband’s job. He also understands that.

      I didn’t put anything about the episiotomy for my home birth plan because I specifically asked Chris when she does an episiotomy and she said only when the baby really needs to get out. I trust her to make that judgement call, so if it’s needed then it’s needed.

      I discussed with my husband whether or not he wanted to announce the sex of the baby and he doesn’t care. I also don’t particularly care. I doubt that the midwife will be shouting it, but if I don’t see it with my own eyes before others say something, it’s not heartbreaking to me.

      I’m not horribly worried about Chris trying to circumcise the baby or anything like that, so that’s why I kept the language calmer. I just wanted her to be aware of it. For the hospital plan though, I specifically said “I do not consent to…” because those are all things we feel strongly against and I basically want them to know I’ll sue the crap out of them if they do them (hence the language).

      We’re keeping the placenta because I plan on encapsulating it. I’ll be doing a post on that soon. 😀

      I should add to both plans that we want to delay cutting the cord. That’s actually something that I just forgot to put, but very important to me. Not that a hospital would actually let us wait in an emergency situation (which is when they need it most!), but I should still put that in so hopefully they’ll wait as long as possible.

      Thanks again for the input! I’m so happy that you made me remember the delayed cord cutting!

      • Cool! I planned on encapsulating my placenta; and then never got around to it. A year and a half later we moved into a house and planted a tree, finally making use of the placenta that had stayed frozen for so long.

  2. That looks very similar to our birth plan with our 2nd. (who was born at home almost 6mths ago). The only thing I don’t understand is not wanting local anasthetic for stitching a tear. Can you explain the reason for that?

    • Yes I’d be happy to!

      When Peanut was born, I tore pretty severely. I think it was 3rd degree down and 1st degree up or something like that. When we got to the hospital, the obstetrician didn’t even ask me anything, just started giving me the local anesthetic to stitch me up. It was incredibly painful. Honestly, I think that it would have been less painful for her to just do it. There were multiple shots and it felt like everything was on fire. I decided that day that if I needed to repair a tear again, I just wanted to have it done rather than get local anesthetic.

      • Thanks for replying! I have had two 3rd degree tears. With the 2nd one I had to transfer from home to hospital to have it done. Apparently they prefer to repair the big tears under epidural as they don’t want the patient to be jumping all over the place from feeling the stitches (and thus making the repair less successful). I didn’t want that – having had a lovely homebirth I wasn’t going to hospital to have an epidural! so managed to convince them that my tolerance would be fine and they could do it with just a few local injections (I’d just given birth to an 11lb baby – of course I could handle some stitches!!) so they did that instead.
        So I guess it never occurred to me that not having the anasthetic would be an option. I wouldn’t want to try actually – yep the local injections were painful, but in my thinking they only had to do about 5 or 6 of them, wheras there were 100’s of stitches to be done..in my mind that was the lesser of 2 evils! But that was just my take on the situation.
        Id be interested to know what the ob thinks if it comes to that (hope it doesn’t).

  3. Pingback: Pain Medication For Sutures « The Adventures of Lactating Girl

  4. Pingback: Preparing for Birth: Birth Plans » A Little Bit of All of It

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