Our Birth Plans

A friend asked me if she could take a look at our birth plan/s and it made me think that it might be a good idea to share our birth plans with others. So here are the birth plans for our two children. You'll notice that I was much less of a super hero the second time around. The changes we made to the birth plan for Jelly Bean's birth are small but they show what I learnt about myself and what I could handle and was prepared to handle during labour. Please feel free to copy our birth plan layout and ideas if you'd like.

Our Birth Plan - Curious George

Mother’s Name: Emma Frith Nomvula Povey

Father’s Name: Stephen Michael Povey

Due Date: 7 June 2010

Delivery to take place at: Genesis Clinic

Midwives: Growth Spurt Midwives

Back up Doctor:

Desired type of delivery: Vaginal Water Birth

Our picture of labour and the birth of our baby:

We view the birth of our little one as a precious and miraculous gift from God. We would like to have as natural a birth as possible as we believe that this is best for the baby. I would also like to have the full experience of giving birth and all the sensations that go with it.

Please Note:

This birth plan is intended to express the preferences and desires we have for labour and the birth of our baby. What follows is not intended to be a script but rather a set of guidelines. We understand that situations or circumstances beyond our control may arise which mean that our plan would no longer to preferable in terms of the safety and well being of baby and mother. If this becomes the case we understand that the plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options so that we can experience the birth we hope for. Thank you.

First Stage of Labour

Early Labour:

We would like to spend as long as possible labouring in our own home. I feel I will be better able to cope with early labour using distractions like taking a walk, watching a movie or having a bath in my own space. We will proceed to the clinic on instruction from the midwives based on communication with the midwives regarding the timing and duration of the contractions.

Active Labour

Environment:

We would like to create a relaxed environment with as little distraction and interruption as possible. As I have a tendency to get stressed out and worry I would like to make this phase of labour as normal as possible by reading, chatting to Stephen, playing cards and listening to music between surges. I believe this will aid in my not becoming too tense about the event and halting my own progress.

Things which will assist in creating this environment:

• Dim Lights
• Our own music
• Candles
• Wearing my own clothes
• As few interruptions and exams as possible
• Limiting the number of people coming in and out of the room to only those necessary.
• Stephen to be present at all times.
• Warm room but not too hot as excessive heat makes me nauseous.
• Constant communication with the midwives regarding the progress and relevant details and expectations of labour.

Mobility:

I would like to be able to move and change position when and if I feel it is necessary or more comfortable. We have been to Tina Otte’s antenatal classes and I have been attending her mommy exercise classes.  Suggestions on positions, postures and movements would be appreciated between surges.

Things to aid in positioning:

• Our own birth ball which we will bring
• A straight backed chair
• My own pillow

Monitoring:

I would prefer to have as few internal exams as possible and would like to have intermittent monitoring of the baby. However having a healthy baby and mother is much more important to us than discomfort or inconvenience. As such we will trust the Growth Spurt midwife’s judgment on how to handle monitoring during our labour and birth experience.

Pain relief:

I would prefer to try and get through the labour without any form of medicated pain relief. However, as this is my first baby and I’m not completely sure what to expect.  I would like to attempt to not use any medicated pain relief during the active birthing stage so as to gain the full benefit of the medicated pain relief during transition and stage 2 labour.  In the event that medicated pain relief is necessary I would like to limit the medicated pain relief to the following types (in ascending order of preference).

• Entanox – Gas
• Pethadine Butterfly – with antidote before second stage
• Epidural – only if I cannot cope at all with the pain. I would really prefer not to have to do this.

Natural Pain relief:

• Relaxation techniques
• Massage
• Wheat bag
• Breathing
• Tens machine – in early part of Active Labour if necessary
• Water

Transition

I would definitely like to be in the water for this period. This is when I may need one of the medicated forms of pain relief.

Stage 2 – Pushing

Position:

We would like to try and give birth in the water. I would appreciate advice on what positions to try in the bath during this stage. I would like to then be able to choose the position that is most comfortable for me.

Episiotomy/Tearing:

I would prefer not to have an episiotomy if I cannot give birth in the water. I understand that they cannot be done if I am in the water and that I may tear. I would prefer to tear rather than have an episiotomy.

Birth of the Baby:

We have had concerns about the length of time the baby is under the water so would appreciate assurance that the baby is OK at this stage until he is brought out of the water. We would like to baby to be able to come straight onto my chest (skin to skin contact) and try to latch on his own. We recognize the importance of the vernix and do not feel the baby needs to be cleaned immediately.

Cutting the cord:

Stephen would like to cut the cord. The length of time before the cord is cut is something we would like to discuss ahead of time.

Photos:

Please take a family photo of us at this stage.

Stage 3 – Delivery of Placenta

We have agreed to an injection of syntocine to assist in the delivery of the placenta. Please give the baby to Stephen at this stage.

Complications

Although we are aiming for as natural a birth as possible we place far more importance on the health and safety of mom and baby. If things start to go wrong or baby is in distress we would like to be informed as soon as possible. Please explain all the options we have at that stage (wait, try something different etc). We will take these and the midwives counsel into account before making any decisions. In the event that I am not able to comprehend or decide on my own please consult Stephen before taking over completely.  We give full medical decision making power to the caregivers in the event of a serious/life threatening complication trusting in their expertise and care for the mother and baby’s physical and emotional well being.

Emergency Caesar:

If we have to have a Caesar we have spoken with Dr Mia about the option of doing a “skin on skin” Caesar. As long as there is no risk to the baby we would like the following:

• Dimmed lights
• Our choice of music

• To have a spinal so that I am conscious for the birth
• To be seated in an inclined position so I can watch the birth
• Stephen to cut the cord.
• The baby to come straight to my chest and any non-emergency procedures to be done with the baby there (APGAR etc).
• To allow the baby to try and latch on his own before he is moved away.
• As much as possible we would request that the attending OBGYN be as gentle and respectful during the procedure (i.e. in the extraction of the baby).

Our Birth Plan 2 - Jelly Bean

Mother’s Name: Emma Frith Nomvula Povey

Father’s Name: Stephen Michael Povey

Due Date: 7 June 2012

Delivery to take place at: Genesis Clinic

Midwives: Growth SpurtMidwives

Back up Doctor: 

Desired type of delivery: Vaginal Water Birth

Our picture of labour and the birth of our baby:

We view the birth of our little one as a precious and miraculous gift from God. We would like to have as natural a birth as possible as we believe that this is best for the baby.

Please Note:

This birth plan is intended to express the preferences and desires we have for labour and the birth of our baby. What follows is not intended to be a script but rather a set of guidelines. We understand that situations or circumstances beyond our control may arise which mean that our plan would no longer to preferable in terms of the safety and well being of baby and mother. If this becomes the case we understand that the plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options so that we can experience the birth we hope for. Thank you.

First Stage of Labour

Early Labour:

We would like to spend a short time labouring in our own home, as the last birth proceeded very quickly. As we now have a toddler and are renovating our home I feel I will be calmer and less distracted at Genesis. I am happy to labour at home until the contractions become regular or intense enough to warrant a trip to the clinic. I would prefer to be told that it is too early and to go home rather than rush.  We will proceed to the clinic on instruction from the midwives based on communication with the midwives regarding the timing and duration of the contractions.

Active Labour

Environment:

We would like to create a relaxed environment with as little distraction and interruption as possible. This phase was short to non-existent with the birth of our son so please be prepared. As I have a tendency to get stressed out and worry I would like to make this phase of labour as normal as possible by reading, chatting to Stephen, playing cards and listening to music between surges. I believe this will aid in my not becoming too tense about the event and halting my own progress.

Things which will assist in creating this environment:

• Dim Lights
• Our own music
• Candles
• Wearing my own clothes
• As few interruptions and exams as possible
• Limiting the number of people coming in and out of the room to only those necessary.
• Stephen to be present at all times.
• Warm room but not too hot as excessive heat makes me nauseous.
• Constant communication with the midwives regarding the progress and relevant details and expectations of labour.

Mobility:

I would like to be able to move and change position when and if I feel it is necessary or more comfortable. I would greatly appreciate suggestions on positions, postures and movements would be appreciated between surges. Please be aware that my lower back and left leg have been giving me problems throughout my pregnancy and that some positions (like squatting) may not bring relief.

Things to aid in positioning:

• A birth ball (happy to use one from Genesis) if requested
• A straight backed chair
• My own pillow
• Walking and standing with something/one to lean on.

Monitoring:

I would prefer to have as few internal exams as possible and would like to have intermittent monitoring of the baby. However having a healthy baby and mother is much more important to us than discomfort or inconvenience. As such we will trust the Growth Spurt midwife’s judgment on how to handle monitoring during our labour and birth experience.

Pain relief:

I would prefer to try and get through the labour with minimal forms of medicated pain relief. My first labour was medication free however I feel I would manage better mentally with less pain this time around. If there was less pain I feel I could be more focused. When I ask for medicated pain relief I would like to limit the medicated pain relief to the following types (in ascending order of preference).

• Entanox – Gas (please have this on standby as I will probably ask for it)
• Pethadine Butterfly – with antidote before second stage
• Epidural – only if I cannot cope at all with the pain. As a last resort.  

Natural Pain relief:

• Relaxation techniques (I am not very good at this please assist if and where possible)
• Massage
• Stroking hands and back
• Wheat bag
• Breathing
• Tens machine – in early part of Active Labour if necessary
• Water

Transition

I would definitely like to be in the water for this period. During my previous labour I felt that the bath was not ready in time. There was undisolved salt which dug into my knees distracting me. I did not have time to get used to the bath and position myself properly between surges because I got in so late. I would like the bath to be ready and perhaps even be in the bath before this time. Please have towels on standby to put under my knees.

Last time my water did not break on its own. Please advise me on the procedure now so I am aware of what is happening if it occurs again.

Stage 2 – Pushing

Position:

We would like to try and give birth in the water. I would appreciate advice on what positions to try in the bath during this stage. Last time I felt alone and isolated in the bath because it was hard for people to reach me as the baths are quite deep.  I would like to have Stephen in the bath with me at this time. His physical support was very important to the delivery last time.  I would like to then be able to choose the position that is most comfortable for me.

If the bath is not working for me I would then like to move to the birthing stool with Stephen sitting behind me.

Episiotomy/Tearing:

I would prefer not to have an episiotomy if I cannot give birth in the water. I understand that they cannot be done if I am in the water and that I may tear. I would prefer to tear rather than have an episiotomy. Last time I had a second degree tear which was horribly painful but healed well.

Birth of the Baby:

We have had concerns about the length of time the baby is under the water so would appreciate assurance that the baby is OK at this stage until she is brought out of the water. We would like to baby to be able to come straight onto my chest (skin to skin contact) and try to latch on her own. We recognize the importance of the vernix and do not feel the baby needs to be cleaned immediately.

Cutting the cord:

The length of time before the cord is cut is something we would like to discuss ahead of time. We would prefer that the midwives cut the cord at the correct time.

Photos:

Please take a family photo of us at this stage. We really liked the fact that the doula took photos last time throughout the birth.

Stage 3 – Delivery of Placenta

We have agreed to an injection of syntocine to assist in the delivery of the placenta. Please give the baby to Stephen at this stage.

Complications

Although we are aiming for as natural a birth as possible we place far more importance on the health and safety of mom and baby. If things start to go wrong or baby is in distress we would like to be informed as soon as possible. Please explain all the options we have at that stage (wait, try something different etc). We will take these and the midwives counsel into account before making any decisions. In the event that I am not able to comprehend or decide on my own please consult Stephen before taking over completely.  We give full medical decision making power to the caregivers in the event of a serious/life threatening complication trusting in their expertise and care for the mother and baby’s physical and emotional well being.

Emergency Caesar:

If we have to have a Caesar we have spoken with Dr Mia about the option of doing a “skin on skin” Caesar. As long as there is no risk to the baby we would like the following:

• Dimmed lights
• Our choice of music

• To have a spinal so that I am conscious for the birth
• To be seated in an inclined position so I can watch the birth
• Stephen to cut the cord.
• The baby to come straight to my chest and any non-emergency procedures to be done with the baby there (APGAR etc).
• To allow the baby to try and latch on her own before she is moved away.
• As much as possible we would request that the attending OBGYN be as gentle and respectful during the procedure (i.e. in the extraction of the baby).