08 Nov Birth plan opportunities
The opportunity to sit down and draw up a birth plan with your partner is worth every ounce of strength it takes to do it. It makes you stop and think, opens discussion with your partner to express each ones desires and dreams for labour, birth and your baby. To communicate this with your partner is in itself a privilege. Your birth is NOT about climbing on to a conveyor belt and letting someone else drive the course of your pregnancy, labour and birth. It is about being an active participant in the event, entrusting the health outcome into a professional’s hands but being there as part of the negotiating experience.
Your birth plan is there firstly to decide exactly what you would ideally like out of the experience. The wish to experience to decide what you think are the best options for you and your baby should everything be normal and uncomplicated. That is a good basic start. It gives you the opportunity to have an in-depth discussion with your partner of how he could best support you through this process and be the advocate a labouring woman needs. He is there to be the middle man between you and the healthcare professionals looking after you. Being the buffer and the negotiator, firmly and steadfastly standing in front of you opening the way for that perfect dream to become reality. So option 1 of your birth plan – the wants, desires and needs you have. This might revolve around whether you are seeking a natural birth, perhaps without pain medication being offered to you, where you may ask for medication if you so felt the need but you don’t want it offered to you. The fact that you might wish to birth in the position of your choice, have delayed cord clamping, skin to skin immediately and continuously with mom, to be on baby time and not on hospital time – just living in the moment with your baby and newly found family. That you don’t want your baby given any bottles or formula.
In your birth plan, give them an introduction into who you and your partner are, what makes you tick, why you have chosen the options that you have. Let them identity with you as real people. Let them know about your important issues, concerns and fears. This is also the time to let the staff know about any religious or cultural needs you may have that are important to you. Let them know that you would appreciate their expertise, concern and support from them.
Tell them about past issues you might have experienced so they know about your sensitivities and can help you through these processes, such as past physical or sexual abuse, previous traumatic births, dysfunctional families and the like. Also put down clearly if there are people you don’t want allowed in to see you at the hospital. The more info they have, the more they can help you with the issues you cover.
The birth plan is not about demanding or being critical or ordering people around – it is about mutual respect and letting the healthcare professionals into your world so they know what you are looking for. The tone is respectful but one that won’t’ compromise the ultimate aim which is a healthy mother and healthy baby – the ultimate priority of a birth.
Then comes option 2 – maybe covering the what ifs a bit more in details. Admitting that labours and births are not totally in your control, the unexpected does happen. Should the unexpected happen it is acknowledging what the next lot of options and ideals would be. How we could compromise on options. How you would like all benefits and risks explained to you in the moment should complications arise – so you are still part of the process and can ask for small things that are important to you in the big picture of the scene.
As you can see, a birth plan requires plenty of thought, time and information gathering to put it together. By the time you have finished you should have a complete idea of what you can expect throughout the birthing process. This birth plan should help you develop openness and good communication with the healthcare professionals who will be responsible for you and your baby. This will increase the trust you have of each other. You don’t get a second chance at getting it right if you don’t get it right the first time – so the more effort you put into the birth plan for options 1 and 2, the more hopefully you should gain out of your birthing experience.
Some questions to help you contemplate this process – what is or isn’t important to me as a place to start.
I would like the following people with me during labour
I would like
- To play my own music during labour
- To have the lights dimmed during the birth
- To take photos and a dvd of the birth
Once in labour ward, I would like
- My partner to be able to stay with me the entire time even through vaginal examinations, epidurals etc
- To eat if I wish to
- To drink freely so I don’t need a drip
- To walk around as I choose
I would like to try the following pain management techniques
- Breathing / distraction / visualisation
- Hot / cold packs
- Entonox gas
- Epidural / spinal
- Don’t offer me pain medication, I will ask for it if I want it
When it is time to push, I would like to
- Do so instinctively and listen to my body as to when to push
- Be told how to push and for how long
- As long as the baby and I are doing well, I would like to push for as long as necessary and not have stringent time limits
I would like to try the following positions for pushing
- Semi reclined
- Side lying
- Hands and knees
- Whatever position feels right at the time
For a vaginal birth, I would like
- To view the birth in a mirror
- To touch my baby’s head as it crowns
- The room to be as quiet as possible
- To risk a tear rather than to have an episiotomy
- My partner to help “catch” the baby
- My partner to cut the cord
At birth, I would like
- To hold my baby right away, putting off any procedures that aren’t urgent
- To put my baby skin-to-skin on my chest and not to be rushed
- Let my baby go through the 9 instinctive stages
- To breastfeed my baby when he is ready to feed
- To be on baby time and not hospital time
- Time alone with my partner and baby
For my baby
- Leave my baby skin-to-skin on my chest until I am ready to have my baby moved
- Not to have my baby taken away from me to be weighed, measured, or have any injections
Caesarean birth plan
Here are some things to think about when you’re deciding what kind of caesar you want.
- I would like a spinal or epidural anaesthetic, so I can be awake and participate in the birth
- I would like to have a general anaesthetic so I will be asleep during the caesar
- I would like my partner with me whether I have a spinal or general anaesthetic
- I would like my partner to wait outside theatre if I have a general anaesthetic
- I would like a running commentary from the theatre staff about how my caesar is going
- I would like music playing in the background to relax and take my mind off the caesar
- I would like the staff and the theatre to be quiet so that the first voice my baby hears is mine or my partner’s
- I would like a gentle caesar
- I would like my baby to be put skin to skin on my chest immediately as possible
- I would like the screen to be lowered so I can see my baby being born
- I would like the screen to be kept raised until the caesar is finished in case it makes me squeamish
- I would like someone to take photos and video the birth
Once my baby is born
- I would like to discover the sex of our baby for ourselves
- I would like my baby placed skin-to-skin immediately
- I would like to wait for my baby to be cleaned before a cuddle
- I would like my partner to hold our baby if I am under general anaesthetic
- I would like to put my baby to the breast while still in theatre
- I would like my baby to stay with me all the time
Prepare well – you will see the rewards at your birth!