Wednesday, January 13, 2010

Birth Plan

By MamaM

Technically, I'm not really a wabisabi mama--yet. I'm due to have my first child in less than a week. As a first-time mom, I've done a lot of research on the pregnancy, labor and delivery processes and have committed to having my daughter naturally, meaning vaginally and without medication. My studying has led me to the conclusion that these kinds of births create the most beneficial outcomes for mother and baby.

Nearly one out of every three women in this country have a C-section--the highest rate in the world. While some women actually choose elective cesareans, it is a goal of mine is to avoid this major surgery. This is one reason for an unmedicated birth.

Studies show that one intervention often leads to another. A common example would go like this: a woman (or doctor) wants to speed up labor, so she is given Pitocin. Pitocin helps the contractions come, but much faster and more intense than normal, leaving the woman in extreme pain and cutting off precious oxygen supply to the baby. To help deal with the pain, the woman is given an epidural, which forces her to have an IV, be confined to a bed and lose much, if not all, the feeling in her lower body. All of these factors may actually slow labor, resulting in a "failure to progress" diagnosis, which could result in a C-section.

As a disclaimer, I have nothing against women who use medication or surgery to have babies; any birth that results in a healthy mother and healthy baby is something to be celebrated. But I have chosen a very specific route for my labor and delivery, and I'm really hoping I am strong enough to stick with it.

To help me articulate my own goals and help my doctors and hospital staff understand my goals, I have put together a birth plan. I think a birth plan is a great idea for all women, no matter what their goals may be. There's not necessarily a template or right way to write a birth plan, but I'm sharing mine below as a sample for anyone who may be interested.

Birth Plan

We are looking forward to the birth of our first child at [X] Hospital in January. We are happy about the things we have seen and heard about hospital facilities and staff. Our goal is to have a natural, unmedicated birth using Bradley method (husband-coached natural childbirth) and are pleased by the support we’ve received in this decision from our selected OB-GYN practice. We understand that complications may arise that could affect this goal; however, to the extent possible, we request the cooperation of those medical professionals involved in our birthing process to honor the following:

1)      In attendance: We plan to have present at this birth the father, who will serve as a husband-coach, the mother of the mother, and up to two of the mother’s sisters.

2)      Environment: The birth environment is important to us. We ask that unnecessary noise be avoided, unnecessary staff be turned away and the door be closed for privacy.

3)      No medication: We are seeking to have a drug-free, non-induced birth, with the exception of an antibiotic IV used to treat GBS+. The IV should be used only to administer the proper dose of antibiotics and removed as soon as the dose is administered. We will not be using other interventions, such as narcotics, pitocin, epidurals or manually breaking the bag of waters.

4)      Energy: The mother requests that in place of an ongoing IV, she be allowed to drink fluids and eat snacks as needed.

5)      Pain management: We have prepared extensively for managing pain, including taking 24 classroom hours on Bradley method, practicing relaxation techniques, stretching, exercising, and extensive reading and research. We request that various non-medicinal methods be employed to aid in pain management, comfort and progression of labor, including: laboring in the bathtub, walking, trying different positions, not being confined to a bed and not being restricted by continuous fetal heart monitoring or an IV. Please do not offer chemical pain relief.

6)      Labor: During labor, the mother would like the ability to walk freely, use the shower and labor tub, change positions, avoid an IV and avoid an excess of vaginal exams. If inducing labor becomes necessary, pitocin is a last resort. Instead, the mother prefers to try other methods to progress labor, including walking, nipple stimulation and changing positions. Tools such as forceps and vacuum are to be avoided.

7)      Pushing: The mother plans to use the squatting or semi-squatting position for pushing. The mother would like to push at her own pace. An episiotomy is to be avoided. Natural tearing or perineal massage is preferable to an episiotomy.

8)      Bonding with baby: Immediately after our daughter is born, we request that she be put directly in the arms of the mother for skin-to-skin bonding, warming and nursing.

9)      Umbilical cord: We request that the umbilical cord remain attached to baby until it has ceased pulsing. The father does not want to cut the cord, so please do not pressure him to do so.

10)  Tests: We would like tests done to the baby while placed on the mother’s chest. If there is any testing or measurement that requires the baby off of the chest, it should be delayed at least 30 minutes after the delivery or until a first breastfeeding has been completed. We would like the baby to “room in” as much as possible. If testing requires the baby to leave the room, we request that one of the parents accompanies the baby at all times.  

11)  Vaccines: The parents choose to delay the hepatitis B shot until the two-month check-up with the pediatrician.

12)  Informed consent: In the event that the doctor or hospital staff believes intervention is necessary, they must discuss both the pros and cons with both parents and give us the opportunity to explicitly accept or refuse any procedure. In the case that intervention becomes necessary, we request that the least invasive or least restricting versions of procedures be used.

13)  C-section: The parents would like to avoid a C-section at all costs; however, in the event that a C-section is performed, the father should be present at all times during the operation, and the mother should be conscious and left with mobility in at least one arm in order to hold the baby immediately after extraction.

We thank you for taking the time to understand our birth goals and help us achieve a natural, unmedicated birth for our daughter.


Tyson and Katie said...

I admire you.

Kendra said...

This is amazing! If and when I have kiddos, I will certainly look back at this.

MamaQ said...

That's my girl, rockin' it out! I'm glad you have a clear idea of wht you want, yet are still flexible enough to go with he flow and undertand that you can't be too hard on yourself if it doesn't go as planned Can't wait to meet baby Olive!!!