Monday, November 5, 2012

Birth Plan, Round 2

Last week, my midwife encouraged me to bring my birth plan to the next appointment. Here's what we had for Peter's birth, which I plan on reusing unchanged. Hope this is helpful to moms trying to design their own plans! Most of my wishes were met for my first birth. I've included four footnotes to explain the few that did not go as I expected.

Aaah! This new world is so bright!

I hope to have a natural childbirth, with as few medical interventions as possible. I understand that interventions may be necessary for the health of the baby and me. I plan to have my husband, Jeremy, present throughout labor and birth. Please consult with us if medical concerns mean you will be unable to respect the following wishes. In case of a serious medical emergency, I would like a Catholic priest to be called.

Labor
I would like to be able to walk and change position at will throughout labor and delivery.(1)
I would like the room to have quiet, dim lighting, and as few people present as possible.
I would like to wait until I feel the urge to push before beginning the pushing phase.
I would like to be able to drink clear liquids throughout labor.

Medical Interventions
I do not wish to have any artificial labor induction or augmentation.
I would like to avoid using an IV or having an access device inserted unless necessary. (2)
I will ask for pain medications if I need them. Please do not offer during labor.
I prefer not to have an episiotomy unless required for the baby's safety.
I prefer not to have continuous or internal fetal monitoring, unless necessary. (3)

After Delivery
My husband does not wish to cut the cord. Please do not clamp/cut the cord immediately.
I would like to hold the baby while I deliver the placenta and any tissue repairs are made. (4)
Unless required for health reasons, I do not wish to be separated from my baby.
I plan to breastfeed the baby and would like to begin nursing very shortly after birth.

Infant Care
I would like to have the baby evaluated and bathed in my presence.
I prefer any immunizations, including Hep B, to be postponed to a later time.
If the baby is a boy, I do not want him circumcised.
I do not wish to have any bottles or pacifiers given to the baby.


(1) I spent most of my active labor time asleep, so this wasn't really an issue until the pushing phase. Somehow I ended up on my back with my legs in the air to push, which definitely wasn't what I originally had in mind. However, by that point I couldn't sustain logical thought for very long and just kind of did as I was told. This time around, my husband knows in more detail what I would like (last time, I think I confidently told him, "I can tell you what I want when it happens."). He can advocate for me more effectively.

(2) I was strep positive during Peter's pregnancy, so I was given antibiotics administered via an IV device. It was a little annoying, but not as bad as I thought it would be. Still, I hope to avoid it this time.

(3) Since there was meconium in my amniotic fluid, Peter was considered "in distress." The nurse began external continuous monitoring, which prevented me from using the shower. When my doctor arrived, he basically told her she was over-reacting, since there were NO signs of distress from the monitoring, and removed the monitor until during the pushing phase. Hooray!

(4) Again, since Peter was considered in distress, he was taken to the other side of the room immediately after birth to be checked. (His APGAR score was 9 both times, so he was fine.) Anyway, he wasn't brought back until after I had delivered the placenta and was all stitched up. Truthfully, that didn't really bother me, but since breastfeeding stimulates oxytocin release, it makes sense to have that helping along the placenta delivery.

5 comments:

  1. Thanks for sharing this, as I feel not too many people do. I think we had similar experiences and I would really like to hear how "Round 2" goes for you in terms of being able to nurse right after birth, walking during labor, and about the whole "strep" antibiotics thing.

    David was considered in distress too, so I had an episiotomy and he had to get all checked out before I got him which I didn't like at all.

    I am curious though how you may not be strep positive if you were the first time. I just assumed it was something you had for life or something. Maybe there's hope I won't be for our second? : )

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    1. Hey, look at that. I delay long enough and someone posts the answer for me!

      I'll be sure to let you know how Round 2 goes!

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  2. I should really start thinking about this too. We are planning another homebirth, but just in case something goes wrong, it would be nice to have a backup plan. (Then again, if something goes wrong, it would probably be a medical emergency at that point, so birth plans just might not matter.) I think your list looks very much like mine would. Happy birthing vibes to both of us. I'm getting slowly used to the idea that the big day is coming up soon!

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    1. Ha, I've been thinking recently that I should know what I want in case I end up delivering at home, although that's not our plan. Guess it pays to be prepared either way!

      I like your new blog layout, looks good!

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  3. Emy - no - you don't necessarily test positive two pregnancies in a row. There are some things that are basically set for life and every pregnancy (like your RH status) but strep isn't one of them. The bacterium usually lives in the intestinal tracts of people but if a woman is pregnant and the bacterium moves over to the birth canal it could cause issues with infection. It's kind of like a yeast infection or something - treatable and not permanent, but you don't want it causing issues during pregnancy/birth. Here is one good site on it if you're interested http://www.moondragon.org/mdbsguidelines/strepb.html . (Don't mind me... I'm just your local birth junkie and way overthink all things birth related!)

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