My Birth Plan

Only 31 days to go... I can't postpone writing my birth plan any longer.

I had the first meeting with my doula, Patti Ramos, today. We've discussed my birth plan. Not in great detail since I am not sure how different this labor will be, but enough to cover the most important points. Having already delivered 2 babies, I know exactly what I DON'T want. I had to prepare the home & hospital birth (in case of an emergency transfer) versions. I wanted to get right to the point since there is a running joke among conventional OB providers that "the longer the birth plan, the faster it's to a C-section." I've been postponing this part of the birth preparation long enough...

My Birth Plan for Home

I would like to:

- Walk around freely, stand or squat during contractions
- Eat & drink as desired
- Be disturbed as little as possible & labor in a quiet, dimly-lit environment. I tend to be silent & close my eyes while resting between contractions - it doesn't mean something is wrong.
- Bear down & push spontaneously in an upright position (most likely while kneeling & preferrably in a birthing tub)
- Use counter pressure & controlled pushing to help maintain intact perineum (Please use local anesthesia for any stitches after birth)
- Help "catch" the baby
- Have the baby on my chest immediately after birth & keep it there for observation/Apgar scoring
- Breastfeed the baby as soon as possible
- Leave the umbilical cord unclamped/uncut until placenta is delivered (If the cord is too short, wait until it stops pulsating before cutting it)
- Refrigerate the placenta right away to preserve it for encapsulation
- Decline the newborn antibiotic eye ointment/vitamin K shot
- Skip the newborn bath all together
- Take lots of photos/video during & after birth

My Birth Plan for Hospital

- My delivery is a planned VBAC
- Please treat me with respect & obtain my informed consent before touching me or performing any procedures
- Don't ask me to rate my pain & don't offer any pain medications unless I ask for it first
- When monitoring fetal heart tones, please use intermittent Doppler or a telemetry electronic fetal monitoring to allow for my greater mobility

I would like to:

- Have my husband, doula & midwife present with me during labor & delivery
- Have the hospital staff to be limited to my own doctor & nurses (no residents)
- Walk around freely, stand or squat during contractions
- Eat & drink as desired
- Be disturbed as little as possible & labor in a quiet, dimly-lit environment. I tend to be silent & close my eyes while resting between contractions - it doesn't mean something is wrong. If you need to ask something, please ask my husband, doula or midwife 1st.
- Bear down & push spontaneously in an upright position (most likely while kneeling). Please don't count & stay calm while I am pushing.
- Use counter pressure & controlled pushing to help maintain intact perineum. I prefer having a tear to episiotomy (Please use local anesthesia for any stitches).
- Have the baby on my chest immediately after birth & keep it there for observation/Apgar scoring
- Leave the umbilical cord unclamped/uncut until placenta is delivered (If the cord is too short, wait until it stops pulsating before cutting it)
- Deliver the placenta spontaneously (no pulling on the cord) & refrigerate it right away. I will be taking it home with me for placenta encapsulation (Please see my signed Release of Placenta & Waiver of Liability form).
- Breastfeed the baby as soon as possible

For baby:

- No circumcision
- No newborn antibiotic eye ointment or hepatitis B vaccine
- No vitamin K injection (I will be administering oral vitamin K instead)
- No pacifiers or artificial supplementation of any kind (formula, sugar water) as I plan to breastfeed
- All medical tests/exams to be done in my presence
- Delay baby's first bath until at least 1 hour after birth

My hospital birth plan turned out to be a bit longer than I preferred. I chose my midwife & doula carefully so many of the points outlined in the hospital birth plan didn't have to be spelled out for them. Many parts of the hospital birth plan will not apply in an emergency home birth transfer (I doubt anyone will have the time to read my plan in a true emergency), but it was important for me to cover "all the bases" just in case. One less thing to do on my birth preparation check-off list!