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5 Reasons you need a birth plan no matter what kind of birth you want.
- You definitely need a birth plan if you are planning to have an:
-epidural – waiting until you’re at least 5-6cm dilated to get your epidural decreases your chances of an unplanned Cesarean.
-a natural birth – having a natural birth in a hospital is not typical, so you need to make it clear that is your goal and you need help from the staff to achieve your natural birth.
-a planned Cesarean – you can ask to see the birth, not see the birth, have skin to skin with baby, and lots of other non-typical things done during a Cesarean
- If there are particular things you want that may not be typical at your birthplace, you need a birth plan. Staff have to follow typical protocol unless otherwise specified.
- You need to make it clear to the staff when you arrive at your birthplace so they can help you have the kind of birth you want. They won’t know unless you tell them with your birth plan.
- You need to talk about it in advance with your doctor or midwife. They will better be able to support your goals if they know in advance.
- Your nurse is really busy. Your nurse is also someone else’s nurse. She will check on you and help you as much as possible, but she’s got to keep track of at least one to four other moms in labor. But in most cases you will be assigned a nurse who will support what you want for your birth. She won’t know what that is though without a birth plan.
3 Important Points to Remember:
- Your birth plan is just that…A PLAN. The definition of a plan, in this case, is a well thought out, and written program or procedure in order to achieve a particular outcome.
- BUT…a birth plan isn’t written in stone, nor is it a binding legal document.
- And you can count on one thing, and one thing only, when it comes to labor and birth-THE UNEXPECTED!
So create your intention and goals for your ideal birth, write them down, hope for the best, but plan to be flexible. If things don’t go as planned, don’t abandon the entire birth plan, just make whatever adjustments you need to get back on the road to your goals.
Make sure you have at least three copies of your birth plan:
1. One copy signed by your doctor and placed in your file at the office
2. Another signed copy to take with you when you pre-register at your hospital or birth center
3. Another signed copy to hand to your care providers when you arrive at your birth place in case they misplaced the one you gave when you pre-registered. Feel free to bring more copies of your birth plan to hand out in case there is a staff change while you are still in labor.
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There are many resources on line for birth plans. Just make sure to start writing your birth plan by the beginning of your 7th month. You should have already started a childbirth class by then. If you haven’t it is NEVER too late to start. Good luck and have a wonderful, joyful birth day! Here is my guide to help you create your own birth plan:
GUIDE FOR – THE BIRTH PLAN/GOALS/WISHES OF ___________
Example: We understand this plan consists of our goals for our baby’s birth. We intend to be flexible. We consider mother’s and baby’s health and safety our top priority. We hope you will work with us as a team to achieve the birth we envision. We would appreciate all your help in achieving a natural birth.
I.V. __no I.V.
__placement (forearm, hand, etc.)
__manual auscultation (fetoscope,stethoscope-you can only get this from a home birth midwife)
__One 20 minute external electronic strip
__Intermittent external fetal monitoring once every 1 or 2 hours
__continuous external fetal monitoring(necessary if induced or pain meds used)
__continuous internal monitoring
Positions for labor
__freedom to change positions/walk around
__confined to bed in various positions
__confined to bed in one position
Dealing with pain
__natural methods & positions
__medication at mother’s request
__DO NOT offer medication
Enhance or speed labor
__natural methods (visualization, walk, change positions, nipple stimulation…)
__enema, castor oil
__artificial rupture of membranes
__walk to toilet
__bedpan in bed
__juice, water, Popsicles
__ice chips only
__I.V. fluids only
__very few – at mother’s request only
__if membranes have ruptured, minimal, no more than 2
Positions for pushing:
The mother has been encouraged to take whatever position is most comfortable to her and to vary positions during second stage until delivery(semi-sitting, sitting, side-lying, hands and knees, standing, squatting, etc. she has been discouraged from using the lithotomy or any supine position during descent of the baby, and for a delivery unless forceps, vacuum extractor, or episiotomy become necessary.
__mother’s choice(vertical, hands/knees, squat,side-lying
Bed for Birth
__birth chair, bean bag, floor, bed, toilet
__hospital bed/labor bed
Physiological/Instinctive pushing. Rather than prolonged breath holding and bearing down throughout contractions, her bearing down and breath holding efforts will be spontaneous and in response to the strength and duration of her urge to push. Bearing down will be for a shorter period (5-6 seconds) than is usually encouraged. There will be several moments between these bearing down efforts during which she will breathe without pushing.
__spontaneous bearing down
__directed pushing (counting by birth attendants)
Speed actual birth:
Pelvic floor relaxation
1 suggest that she change position if progress is slow
2 remind her to bear down with the urge, and not to push unless she has the urge
3 remind her to let go-thereby relaxing the pelvic floor
4 if spontaneous bearing down and changing position do not result in progress, ask her to bear down longer and more forcefully.
5 Please no counting
__prolonged pushing on command
__patience for natural methods ( position changes, visualization, intense coaching)
Slow actual birth
Care of Perineum
__Try for intact perineum ( massage, positions, support, hot/cold compresses)
__pressure episiotomy without pain medication
__parent’s choice (father, coach, family member)
__clamp & cut after pulsating stops
__clamp & cut immediately
__parent’s choice who cuts cord (ie father/coach)
__doctor or nurse
__Spontaneous/natural (breast stimulation, baby suckling, )
__No Pitocin unless clear medical indication
In case of Cesarean Section: See also Ideas For The Best Cesarean Possible
Timing (if planned)
_After labor begins
_Scheduled before labor begins
Precaution (if not planned)
_Fetal scalp sample
_no fetal scalp sample
_no separation of mother and coach
_medical staff only
_regional with little or no premedication
_regional with premedication
_screen lowered at birth
_events explained as proceeding
_no participation by parents
Contact with baby
_held by mother or father skin to skin soon after birth
_breastfeeding soon after birth
_sent immediately to nursery with father in attendance
Don’t forget to discuss pain management options for post surgery. Remember to ask about meds. effects on breast milk and baby. Ask your pediatrician and lactation consultant the same questions. You may get a different perspective or answer.
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