My Birth Plan - Thyme for Motherhood

On my daughter’s 2nd birthday, I was looking at old photos and came across my birth plan, a 2-page outline of my preferences during labour, birth, and post-delivery. I recall writing the birth plan because earlier in the day I messaged my sister to wish her a happy birthday. Being a nurse herself, she asked if I had my birth plan and hospital bag ready. No, I thought but I will by the end of the evening.

To be honest, I put off writing the birth plan because understandably I was quite nervous about giving birth but equally very excited for her arrival. Later in the day, I downloaded a template from the NHS website and started writing the birth plan with details such as:

where to give birth i.e. home, birth centre, maternity ward
pain relief i.e. Entonox (gas and air), pethidine, epidural, pethidine
instrumental delivery i.e. forceps or ventouse
emergency caesarean section
other items such as a membrane sweep, induced labour, and episiotomy

My generic birth plan is below with a notes page for Kenz and one for the hospital staff.

I would casually share my birth plan with mums, expectant mums, and some work colleagues. Everyone told me not to overthink the birth plan because they never go according to plan. They cautioned me to be flexible and do not expect birth to go exactly as outlined in the birth plan because you never know what will happen in the day(s) leading up to the big day. And if the birth does not go to plan, it is okay to feel disappointment but when you hold your child in your arms for the first time, know that you did an extraordinary thing: giving birth and that’s all it matters!

Birth Plan: Notes for Kenz

To Do:

Pack Hospital Bag & Snacks
Pack Buddy’s Bag
Arrange keys and alarm
Arrange dog-walking

Early Stages of Labour

I would like to remain at home during the early stages of labour as long as I can in a calm, soothing, relaxed atmosphere. Therefore, we should avoid texting/messaging family to minimise the amount of distraction. I need a lot of oxytocin hormone so lots of cuddles from you and Buddy, watch some “feel good” movies, and try to relax. Please try to keep a stress-free atmosphere! You’ll be fine, relax and don’t stress out!

To manage the pain, I’ll go take paracetamol, warm showers, warm compression, massages, and various yoga poses.
The week leading up to labour, we’ll aim for a high carb, fibre-rich meals.
When I am ready to go to the hospital, I am hoping to walk there in between contractions if I can.

Whilst at the hospital

In the event, I am in the hospital and my labour slows down, go home and get some rest, eat a hot meal and shower. Remember, I need you to be rested so you can take of me post-delivery whilst I get some rest. Ideally, I’d like to stay one night in the hospital with the baby in the nursery so I can get some rest whilst the mid-wives look after me and the baby. You should go home and get some rest. Under no circumstances should you spend the night at the hospital whether we have a private room or not. You need to be comfortable and get rest! Please go home! I should be fine if this is a straightforward delivery. I want to be sure I meet with a lactation consultant and the baby is fine to go home.

We’ll take her home in the Bugaboo Cameleon although we should have a car seat ready too.

Buddy

As soon as I am admitted to the hospital, please let our friends know that Buddy will be coming over for a short stay. We are happy for the dog walker to take him on walks. We will pick up Buddy as soon as we are released from the hospital.

I should be home with Baby V before Buddy arrives home. He’ll need to remain calm before he meets his baby sister. Have treats handy.

The Birth Plan: Notes for Hospital Staff

10 January 2018

We look forward to the arrival of our first child, a daughter (aka Baby V), in late February 2018. We have created this birth plan to outline some of our preferences for the birth of Baby V. Of course, we are flexible and will keep an open mind for the best and safest way for her arrival. Baby V and mum’s health and safety are above all most important. We trust that we will be in capable hands of the maternity ward staff at Lewisham Hospital. If things go off plan, please keep my husband and I informed of the progress, next steps, and any disadvantages.

Labor

I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
So I can stay as mobile as possible, I would prefer to have a heparin lock administered instead of an IV (as applicable)
I would like a quiet, soothing environment during labour, with dim lights and minimal interruptions.
I would like to play my own music.
I do not mind observations by students, interns or staff.
To preserve my privacy and dignity, I would prefer that everyone knock before entering.

Labour Augmentation / Induction

I would like to avoid an induction unless it is medically necessary. Please let discuss with us before any interventions.
As long as Baby V and I are healthy, I do not want to discuss induction before 42 weeks.
If my pregnancy progresses past 40 weeks, I would prefer to base the decision to induce on the results of Baby V’s biophysical profiles, not on my discomfort or impatience.
I would like to try alternative means of labour augmentation, like walking or nipple stimulation, before Pitocin or artificial rupture of membranes is attempted.
If induction is necessary, I would like to attempt it with prostaglandin gel or another means before Pitocin is administered.

Anaesthesia/Pain Medication

I prefer an epidural to narcotic pain medication.
I would like to have an epidural as soon as permissible and as earliest as possible.
I would like to have the epidural catheter placed upon my admission to the hospital.
I would like to have a light dose (walking) epidural so I can remain mobile whilst managing the pain.
I would like the epidural to wear off slightly as I approach full dilation and the pushing stage if possible. Otherwise, I will look towards the midwives for guidance on when to push.

Cesarean Section Delivery

I feel very strongly that I would like to avoid a cesarean delivery
If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like my husband Kenz to be present during the surgery.
Please explain the surgery to me as it happens.
If possible, I would like to breastfeed Baby V immediately after birth.
I would like our plans outlined here for after birth to be followed as closely as possible.

Perineal Care

I prefer not to have an episiotomy unless it is medically indicated.
To avoid an episiotomy or tearing, or my labour assistant will perform perineal massage with oil and apply hot compresses.
To help my perineum stretch, please help guide my pushing efforts by letting me know when to push and when to stop.
I would rather have an episiotomy than risk a tear.
Please administer local anaesthesia when repairing any episiotomy or tear(s).

Delivery

Even if I am fully dilated, and assuming Baby V is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.
I would like the freedom to push and deliver in any position I like.
I would appreciate help from and staff supporting my legs as I push.

Immediately after the birth

Please place Baby V on my stomach/chest immediately after delivery.
I would like to breastfeed Baby V immediately.
I would like the option to cut the cord.
Please allow the umbilical cord to stop pulsating before it is cut.

Newborn Care

I would like to hold Baby V skin-to-skin during the first hours to help regulate baby’s body temperature.
I would like to hold Baby V through the delivery of the placenta and any repair procedures.
If Baby V must go to the nursery for evaluation or medical treatment, or someone I designate, will accompany Baby V at all times.
Please delay eye medication for Baby V until we are well past the initial bonding period (a couple of hours after the birth).
If available, would prefer erythromycin eye treatment or other antibiotic eye drops instead of silver nitrate.
I would prefer to have Vitamin K administered orally.

Postpartum Care

I would prefer not to be catheterized until I’ve had some private time to attempt urination on my own.
If available, I would prefer a private room.
Once I’ve had time to recover, I would like Baby V to room-in with me.
I would like Baby V in the nursery at night but brought to me for breastfeeding on demand.
I would like Baby V in the nursery and brought to me on request and for breastfeeding.
Assuming I feel up to it and Baby V is healthy, I would like to be released from the hospital as soon as possible following the birth.

Breastfeeding

I plan to breastfeed and want to nurse immediately following the birth.
Please do not give Baby V supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
I would like to know more about breastfeeding.
I would like to meet with the staff lactation consultant.