Birth plans

BIRTH PLAN #1
SUZY'S BIRTH PLAN
(To read Suzy and Steve's full birth story and how they put this birth plan into action, click here).

Our ethos is to encourage a natural childbirth experience and empower Suzy to be in control at all times. We are both aware of the need to be flexible, however, and should unforseen complications arise during labour that require emergency medical attention in hospital then we will approach any changes positively together. We have employed Natalie as our doula, please speak with her in the first instance.

The environment
Peace and quiet
Relaxed and positive
Subdued lighting and soft music
No lengthy 'observing' or chatter

Natural birth
Suzy will be using the following techniques (with Steve): self-hypnosis, breathing, deep relaxation and visualisation
Please do not offer any drugs
Please do not ask to perform internal examinations
Please do not give 'updates' on how labour is progressing or dilation or time scales
We would like our baby's heart to be monitored by a stethoscope
We would like our baby to be born in water
Suzy would like Steve to tell her if it is a boy or a girl
Suzy would like an active labour - leaning forward, standing, using the birthing pool
Suzy will be quietly 'breathing down' her baby, please do not ask her to push
Immediately after our baby is delivered we would like skin-to-skin contact (Steve if Suzy can't)
Please do not cut the cord until the pulsations have stopped
Please allow the vernix to be absorbed into our baby's skin - there is no need for any cleaning or rubbing
Suzy would like to deliver the placenta naturally
Please help Suzy to immediately begin breastfeeding our baby
We would like all checks of the baby to be done as late as possible after the birth
We would like the vitamin K injection to be given

Emergency situation/intervention/changes
Please discuss any changes/medical requirements with Natalie and Steve in the first instance. They will then discuss the options with Suzy and we will take a few minutes to make a decision together as to how to proceed.

Thank you for your support.

BIRTH PLAN #2
I have replaced the Mother's name with the letter X and the Father's name with the letter Y to protect their anonymity.

About us
My name is X and my husband's name is Y.
Our doula is Z. Please speak with her in the first instance as she knows our wishes. She will also take some photos during the birth.
Y and our doula will stay with X all the time.
This is our first baby. X has had an uncomplicated pregnancy.
X has a prolapsed disk and sciatica in her left leg. This is treated monthly by an osteopath and no problems occurred during the pregnancy.
X experienced some mild symphysis-pubis pain early on in the pregnancy.
We have attended HypnoBirthing classes and hope for a natural water birth without intervention.
We are willing to consider other options so long as we are fully informed of the advantages and disadvantages.

Environment
Our ethos is to encourage and empower X to be in control at all times.
We would prefer an atmosphere that is peaceful, quiet, relaxed and positive.
In order to achieve this, X would like subdued lighting, soft background music, to be mobile, to use the birth ball and the birthing pool.
It would help us if there were no lengthy 'observing', chatter or lots of people in the room as it would make X feel that her privacy and dignity are respected at all times.
We are happy for a female midwife to be present, but no other men apart from Y, and no students observing.
If there is any research you would like us to participate in, please provide us with the details in advance of the birth.
We are both aware of the need to be flexible and should unforeseen complications arise during labour that require emergency medical attention in hospital, then we will approach any changes positively together.

First stage of our labour - thinning and opening
If our pregnancy goes beyond the estimated due date we would like to avoid induction and a membrane sweep. Any proposed intervention (eg breaking waters, oxytocin drip or acceleration) needs to be explained and discussed first with us and ideally to be kept to a minimum or avoided. If X's waters have broken, but she has not gone into labour, we will adopt a 'wait and see approach' to see if labour will start naturally. X will monitor her temperature, loss of fluid and general wellbeing as suggested within the NICE guidelines.
X would like to remain at home for as long as it is comfortable before going into hospital.
Before we go to hospital, X would like to be able to arrange with the hospital an appropriate time to arrive and use the birthing pool upon our arrival. X would like Y to be able to join her in the pool if she chooses this at the time.
Our preference is for a water birth. Do not offer pain relief, as X would request any (eg gas and air) when needed. We will also make use of a TENS machine, breathing techniques, massage, HypnoBirthing and relaxation techniques.
We would like information about any proposed medication or intervention before receiving it, including the purpose, potential side effects on X/the baby and options on timing (eg before or after the baby is born).
X would like to remain as active as possible, finding the best positions and changing these as she wishes. She would use the birthing ball and various birthing positions in the birthing pool.
X would like to try and rest between contractions where possible.
We would like the monitoring of the baby to be kept to a minimum and by using a hand-held device, unless there is cause for concern, and try to avoid continuous or internal monitoring.
X would prefer not to have a vaginal examination.
Please do not give X 'updates' on how the labour is progressing (eg dilation and time scales), but speak instead to our Doula and to Y.
We will bring snacks and water and our doula will remind X to drink and use the bathroom. X does not want to have an intravenous drip, but to eat and drink as usual. X prefers not to eat meat and has no food allergies.

Second stage of our labour - birthing
X would like to remain upright and mobile for as long as possible during labour.
X would be 'breathing down' our baby until crowning takes place and not forced pushing. It would be appreciated if staff could keep their voices calm and encourage X without shouting.
X has been practising perineum massage in order to avoid an episiotomy unless it is an emergency. X will appreciate support to adopt positions to minimise tears and will appreciate advice and guidance to guard against too quick a delivery giving the perineum time to fan out thus (hopefully) preventing a tear. If there are any tears, for them not to be stitched unless it is essential to healing by the female midwife or doctor and not a student. If stitching is necessary X would want pain relief/local anaesthetic to be administered prior to stitching.
We would like our baby to be born in the water and for Y to pick up our baby.
We would like skin-to-skin contact immediately after our baby's birth (Y if X can't) and time to bond with the baby / start breastfeeding. Our baby is only to be removed in the case of a medical emergency. Please let our baby take his time to feed.
Please allow the vernix to be absorbed into our baby's skin - there is no need for any cleaning or rubbing. Please do not suction mucus from the baby's nose and mouth - only suction if necessary.
Please discuss any changes / medical requirements with our Doula and Y in the first instance. They will then discuss the options with X and we will take a few minutes to make a decision together as to how to proceed.

Third stage of our labour - placenta delivery
We want a physiological third stage and would like to try breastfeeding to assist natural delivery. X would like to hold the baby while the placenta is delivered.
We would like for Y to cut the umbilical cord when pulsation has stopped when directed to by the midwife.
Please no cord traction, Syntometrine / Syntocinon or manual removal unless there is an emergency or signs of haemorrhage.
We would like to see the placenta and have it explained to us, then it may be disposed of.

In case of Caesarean section / special care / emergencies
X is keen to avoid a Caesarean and will only agree to one for a genuine medical emergency. Please do not offer a caesarean unless our baby is in danger.
If a Caesarean is required, that it would be done with an epidural or spinal block so that X can remain awake during the procedure.
Please do not perform a hysterectomy if there is a severe postpartum haemorrhage, unless it is the only option available to save X's life, as we would like to have more children in the future.
Y and our Doula to stay with X at all times in the theatre.
X would like to hold our baby straight away and would like to breastfeed the baby as soon after birth as possible. Appropriate pain relief and support with breastfeeding will be required if X finds it difficult to move after the operation.
We do not want our baby taken out of the theatre unless it is an emergency. If our baby needs to go into special care then Y will go with him. X wishes to be kept informed of baby's well being and start expressing if baby goes into special care. Please do not admit our baby to special care simply for observation, but only if there is a specific reason for concern.
If for any reason our baby has to go to the special care baby unit we would like to be allowed to care for him as much as possible ourselves, and to be transferred with him to another hospital if a transfer is necessary. If this is the case, Y is to be allowed to stay with X and the baby at the hospital.
If we require an assisted delivery, please use a ventouse instead of forceps if possible.
In case of emergency / assisted breathing please bring the trolley to the baby and leave the cord on.
Y will stay with our baby if there is any emergency and the baby needs to be taken to a different room. Our Doula will stay with X.

After birth/post natal
We would like our baby to stay with one of us at all times and perform all care for our baby ourselves (eg nappy changes and baths).
We would like all checks of the baby to be done as late as possible after birth and the baby to be examined in our presence, preferably while in X's arms. We expect our baby to be treated with kindness after the birth and not to be subjected to any bright lights.
No vitamin K to be given unless our baby was born by forceps, ventouse or Caesarean. If the birth is traumatic for the baby or there is some other risk factor for HDN (haemorrhagic disease of the newborn), we will be happy to discuss this with the midwife and allow vitamin K if we decide it is appropriate. In that case the injection is only to be given once our baby has been fed and settled.
X would prefer to be early discharged to go home within six hours, after she has received help and advice with breastfeeding.
We prefer our baby not to receive any bottle-feeding or to be given any supplements of glucose water or artificial milk. We would prefer to breastfeed on demand.
In summary of above, we recognise that the birth may not go according to plan and that the wellbeing of our baby and of X is paramount at all times. We appreciate that we must be flexible in our choices if things do not evolve in the way we wish. We will be guided by balanced, informative advice.

Thank you for your support.
X and Y

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