Thursday, 22 December 2016

Being Prepared Part 2: The Birth Plan

The Birth Plan... My other half has told me that very little of my birth plan seemed to actually be referred to during Baobao's birth. You would think this would mean that I wouldn't have one for Xiaobao, but I do think that the birth plan has a purpose, even if the medical professionals don't actually refer to it. It serves as a way for you, as the person going through labour, to think about the options you have and how you would prefer your labour to go.

It also allows your birth partner to be your advocate. By the time I had an epidural with Baobao, I had been in labour for 35 hours. I was hysterical and had to be held down by four members of staff and my other half. My partner was able to quickly make the decision to have the epidural go ahead, because we had clearly thought about and discussed our birth plan.

Just as with my hospital list and baby list, which I will post next week, my birth plan follows a template outline provided by my NCT ante-natal class leader. I also used the NHS's own birth plan generator, to clarify some of the wording in my birth plan. In spite of the intervention I had to have with Baobao, I would still like Xiaobao's birth to be as natural as possible and my birth plan reflects that.

During Xiaobao's birth

1st Stage
  • I would like to give birth in a maternity team unit in hospital. 
  • I would like low lighting. 
  • I would like to be alone with my birth partner when possible. 
  • During contractions I intend to close my eyes and focus on my breathing. It would be helpful to be in complete silence and for my birth partner to hold/massage me. 
  • I would like to find the best positions for myself and change this as I wish. 
  • I will be using a birth ball and yoga mat. 
  • I would like to try and rest between contractions where possible.
  • I would like monitoring of the baby to be kept to a minimum unless there is cause for concern.
  • I would like interventions such as stretch & sweep, vaginal examinations, breaking waters, to be kept to a minimum. 
  • I would like my birth partner to be informed of the reasons for any interventions. I would like information about any proposed medication to be given to my birth partner before I receive it, including the purpose, potential side effects on me/the baby and options on timing e.g. before or after the baby is born.
Pain Relief
  • I would like to try to manage with minimal pain relief. I would like to primarily use Entonox (gas and air). I will consider the use of diamorphine. I will only consider an epidural as a last resort.
  • I would like to use breathing and relaxation, massage, moving around, shower to manage pain and to be given lots of support to help with this. 
  • I welcome words of encouragement and support with breathing and visualisation. 
  •  I will find it useful to be told how labour is progressing 
Transition
  • I wish to be very centred on myself at this stage and to have no intrusion. 
  • Gentle support and firm guidance will be appreciated. 
  • Information on progress and caring support will be helpful. 
  • I would like to be reminded that it is nearly time to push and to meet my baby. 
  • I will try to adopt a useful position and focus on my breathing

2nd Stage 
  • I would like to find my own comfortable position for pushing 
  • I wish to know when the head is crowning 
  • I will appreciate firm advice and guidance at this time to guard against too quick a delivery to prevent a tear. 
  • If my birth partner wishes he can look when the baby’s head is visible. 
  • I do not wish to have an episiotomy unless vital. I would like my birth partner to be informed of the reasons for and against. 
  • If possible I would like my birth partner to catch the baby. If not, I wish the baby to be passed on to my birth partner and for him to place our baby on to me straight away without being cleaned. I would like to offer skin to skin immediately after birth 
  • I wish the cord to remain attached until it stops pulsating. 
  • I would like our baby to have the vitamin K injection 
3rd Stage 
  • I wish the baby to suckle to encourage the third stage. I would like to attempt biological nurturing. 
  • I wish to deliver the placenta physiologically 
  • If there are signs of haemorrhage then I will have syntometrine/ergometrine as necessary 
Tears 
  • I hope to avoid this, but if one occurs I would prefer to be stitched If stitching is necessary I do want a local anaesthetic to be administered prior to stitching. 
Emergencies 
  • I and/or my birth partner will discuss all eventualities as they arise. Please share any concerns with us as soon as they arise. 
  • It will help us to know the answers to these questions: 
    1. What is wrong? 
    2. What do you suggest and why? 
    3. What would be the possible outcomes with and without this intervention? 
    4. How much time do we have to make a decision? 
    5. Are there any other courses of action open to us? 
  • We will be guided by your balanced, informative advice. We want a healthy baby and mother and will take all necessary steps to achieve this.

Caesarean Birth 
  • In the event that a caesarean birth is necessary I would like to have a spinal anaesthetic. 
  • We would like to have a commentary of what is happening for the whole time spent in theatre 
  • We would like the theatre to be as quiet as possible at the moment of birth 
  • I would like our baby lifted out onto me, if possible my birth partner to place his/her hands on the baby as she is lifted out. We would like to hold our baby immediately 
  • I would like to put our baby to my breast whilst the operation is in progress. 
  • If a general anaesthetic is used, my birth partner would like to put the baby to my breast as soon as possible. 
  • I prefer to have dissolvable stitches to be used to close the wound 

Post-birth

  • We would like our baby to stay with one of us at all times 
  • We would like to be consulted if our baby needs to go to special care and I would like my birth partner to accompany the baby. If the baby needs to go to special care we would like to be taken to her as soon as possible after the operation
  • In the post-natal ward I would like to be offered regular pain relief which does not conflict with my desire to breastfeed. This includes not being given a drug that will make me too drowsy 
  • We do not want our baby to be given any artificial milk. I intend to breastfeed on demand and I would like our baby with me at all times 
  • We would like to do all the baby care ourselves. If this is not possible I would like one of us to be present when our baby has a nappy change or bath 
  • I would like to receive breastfeeding support before leaving hospital
  • I would like no visitors
Did you have a birth plan? Were there things you did differently on your birth plan?

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