Birth Plan

Дата: 06/06/03 06:58

Автор: Кузькина Мать

Birth companion:

Husband (if he'd be available) to stay throughout whole labour.

When to go to hospital

Due to strep B. would come for antibiotic treatment as soon as first signs of labour would appear.

Activity during labour

I do not want residents or students to be present during the birth.

Options for coping with labour

Would like to have epidural as an option to use in case of severe pain.

Monitoring baby's Heart beat

Continuous electronic monitoring .

Types of Birth

I would like to avoid induction unless it is medically necessary.

I do not wish to have the amniotic membrane ruptured artificially unless emergency.

If my water breaks at the onset of labour, I would prefer to wait at least 24 hours before inducing, if my and my baby's condition permits.

Unless I'm having a medical emergency, I would prefer not to have an episiotomy offered to me.

If using epidural during labour I'd like to use it for repairing a tear or an episiotomy. Otherwise please administer local anaesthesia for reparing.

I feel very strongly that I would like to avoid a caesarean delivery. If a caesarean is necessary I would prefer epidural anaesthesia, if possible, in order to remain conscious through the delivery. If possible, I would like to breastfeed the baby immediately after the birth.

Delivering the placenta

I would like to deliver the placenta unassisted. I would therefore like to wait until the cord stops pulsating before it is clamped and cut.

Care of baby immediately following

I would like my baby to be placed on my abdomen immediately following the birth.

I would like to breastfeed my baby immediately following the birth. I would like all new-born procedures to take place in my presence.

No bottles, no water, sugar water or pacifier offered to the baby. Breasfeed on demand. If there will be necessity to transfer baby to another facility, I'd like to accompany him/her. If not possible, I'd like to breastfeed or provide my expressed milk for my baby.

I'd like Vitamin K to be given to the baby orally.

Going home

(http://forums.khv.ru//Index.cfm?CFApp=1&Message_ID=1610325)

Изменено: 06/06/03 08:34

Автор: Кузькина Мать

> 2. "I'd like Vitamin K to be given to the baby orally."

Тут его всем дают - от проблем со сворачиваемостью крови. Либо один укол, либо 2-3 (2 искусственникам) раза orally (вот подробнее: http://www.babycentre.co.uk/refcap/551938.html

Но он, как я понимаю, повышает риск желтушки (или затягивает имеющуюся). Так что получается вроде бы, если не вкатывать сразу всю дозу, а растянуть, то меньше риск желтушки.

(http://forums.khv.ru//Index.cfm?CFApp=1&Message_ID=1610398)

Изменено: 06/06/03 08:41

Автор: Анютина Мама Send Email to Author

Subject: Birth Plan (очень подробный)

Этот план отсканирован из книжки - пособия по методике родов HypnoBirth. Он очень подробный, можно сделать свой набор требований.

Pre-Admission requests
[ ] To complete all required paperwork during a preadmission visit to eliminate interruption during relaxation for labor.
[ ] To delay artificial induction of labor for 24 hours after the rupture of membrane if mother and baby show no signs of infection.
[ ] To consider artificial induction only when there is a medical urgency.
[ ] To remain at home as long as possible before going to hospital.
[ ] To take light nourishment if early first stage is prolonged.
[ ] OTHER REQUESTS:

For Hospital Admission
[ ] To elect wheelchair assistance or to walk to my room
[ ] To decline routine IV prep upon admission.
[ ] To use natural means of inducement, moving to artificial inducement only for a medical urgency.
[ ] If necessary to initiate labor, only a minimum Pitocin drip to be used
[ ] Pitocin drip removed once uterus is naturally contracting.
[ ] To return home until labor progresses further if less than 4 cm dilated or if there are no other situations that warrant admission.
[ ] To have a private birthing room with subdued lighting and drawn drapes-
[ ] No move from a labor room to delivery room.
[ ] To bring a tape and player and have soft, lulling music in background. To take enema for bowel elimination.
[ ] Yes
[ ] No To have pubic shave "prep" around birth canal.
[ ] Yes
[ ] No To have pubic clipping around birth canal.
[ ]Yes
[ ]No To have the following persons present during my birthing:
[ ] husband
[ ] relative
[ ] other birthing companion
[ ] labor support person
[ ] To have pictures or video taken-
[ ] To have telephone calls relayed to my room.
[ ] To have no telephone calls relayed--only messages.
[ ] OTHER REQUESTS:

During First-stage labor
[ ] To have quiet room, dim lights, our own music tapes-
[ ] To have only necessary hospital staff, please. (We ask also that staff honor the need for quiet and refrain from any references to "pain," "hurt," "hard labor", etc.)
[ ] To have husband/birthing companion and other labor support person present at all times-
[ ] To be free of blood pressure cuff between readings.
[ ] To have continuous EFM.
[ ] To have EFM turned off after pattern is established, except for required readings.
[ ] No EFM monitoring; intermittent fetoscope use only, please-
[ ] No internal monitoring in the absence of fetal distress.
[ ] No offer or suggestion of anesthetics or analgesics or labor enhancing procedures unless requested.
[ ] Nutritional snacking if labor is prolonged-
[ ] Fluids to sip on including juices, herbal tea, broth.
[ ] Ice chips and Popsicles.
[ ] Freedom of choice to walk and move or not walk or move during labor.
[ ] To change positions and assume labor positions of choice.
[ ] Minimal number of vaginal exams--with permission--to avoid premature rupture of membranes.
[ ] To allow labor to take its natural course without references to "moving things along," or "augmenting labor."
[ ] To use natural oxytocin stimulation--nipple or clitoral stimulation--in the event of a stalled or slow labor, and to be accorded the uninterrupted privacy to do so.
[ ] To be fully apprised and consulted before the introduction of any medical procedure.
[ ] No augmentation of labor via Pitocin, amniotomy, or stripping of membranes without discussion.
[ ] To enjoy labor tub or shower prior to ROM.
[ ] To maintain membranes intact unless there is medical necessity to rupture-
[ ] OTHER REQUESTS:

During Birthing
[ ] To remain in tub for water birthing if available.
[ ] To allow natural birthing instincts to facilitate the descent of the baby, as much as possible, with mother-directed bearing down until crowning takes place
[ ] Use of HypnoBirthing breathing techniques--not Lamaze method.
[ ] To birth in an atmosphere of gentle encouragement during the final pushing stage without loud "coaching." Please--calm, low, tones, free of "Lamaze-type" prompts.
[ ] To assume a birthing position of choice that will least likely require an episiotomy.
[ ] Use of birthing stool or bed; semi-squatting, kneeling, or leaping frog position.
[ ] Perineal massage with oil; hot compresses to avoid episiotomy.
[ ] Episiotomy only if necessary and only after discussion.
[ ] Use of topical anesthetic for episiotomy.
[ ] To decline use of suctioning device (vacuum) or forceps, unless assistance is medically necessary .
[ ] To allow for complete birthing before suctioning baby's nose and throat.
[ ] Videotaping of birth.
[ ] Use of mirror to enable me to see crowning and birth.
[ ] To have our other children present
[ ]during
[ ]shortly after birth.
[ ] OTHER REQUESTS:

Following Birthing
[ ] To have father/birth companion announce sex of baby to me.
[ ] Immediate skin-to-skin contact, with baby placed on my stomach. No wrapping of baby. (Father/companion joins in this bonding by placing hand on baby's skin).
[ ] Father/companion/labor support allowed to remain with me in the operating and recovery room in the event of a C-Section.
[ ] Father will hold the baby after C-Section delivery and accompany him/her to the nursery or mother's room.
[ ] Cord to be clamped and cut only after pulsation has ceased.
[ ] Father/birth companion will cut cord.
[ ] Cord to be cut by attending health care provider after pulsation has ceased.
[ ] Allow at least 30-40 minutes for natural placenta delivery-
[ ] Baby brought to breast to assist placenta birth.
[ ] Immediate massage every fifteen minutes to assist placenta birth.
[ ] Uterine massage every fifteen minutes to assist placenta birth
[ ] Natural nipple stimulation to assist in placenta expulsion. .
[ ] No cord traction, manual removal, or use of Pitocin for removal' of placenta unless necessary .
[ ] OTHER REQUESTS:

For Baby
[ ] To have bright lights temporarily removed at moment of birth and until baby is moved to mother's chest.
[ ] Allow vernix to be absorbed into baby's skin; delay "cleaning or rubbing." Use of a cloth, not terry, when rubbing is appropriate.
[ ] Baby to remain with me and birth companion
[ ] 1/2 hr.
[ ] I hr.
[ ] 2 hrs.
[ ] Delay use of Erythromycin or other medication for baby's eyes to allow optimal sight for bonding.
[ ] Oral Vitamin K to be used rather than an injection.
[ ] Please, a soft cloth or Chux pad between baby and scale.
[ ] APGAR exam performed with one or both parents present-
[ ] For male baby we request
[ ] Circumcision
[ ] No circumcision.
[ ] Father will stay with mother and baby throughout the hospital stay.
[ ] To have footprints made in the baby's birth book.
[ ] Breastfeeding several times during the first few hours of baby's life.
[ ] Breastfeeding only. No bottles, formula, pacifier, or artificial nipples.

Miscellaneous

I would like to learn about or have demonstrated for me the following:
[ ] Proper bathing of the baby
[ ] Umbilical cord care
[ ] Taking baby's temperature
[ ] Circumcision care
[ ] Breastfeeding techniques
[ ] Using a breast pump
[ ] Formula feeding techniques
[ ] Calming the "fretful" baby
[ ] Care of nails
[ ] Diapering
[ ] Identifying signs of illness
[ ] Normal sleep patterns
[ ] Developmental ability signs
[ ] Postpartum "baby blues"

Удачи и здоровья, Лена, Анюта (03.12.99) и Июльчик 2003 (34 неделька)

(http://forums.khv.ru//Index.cfm?CFApp=1&Message_ID=1611999)

My family

Name: Sasha,Sergey

Midwife or OB: Dr.Pupkin

Pediatrician: -

Professional Labor Assistant:

Birth Center or Hospital: Shady Grove Adventist hospital

Approximate Due Date: 06/24/2000

Personal Statement:

We understand that birth can be unpredictable. We are presenting this birth plan to encourage dialogue and to help us achieve a safe and satisfying birth. Our baby's health and well being is of utmost importance to us. We look forward to working with you, and appreciate your cooperation in helping our family to achieve our personal birthing goals.

BEFORE LABOR BEGINS:
1. I expect, and trust, that my practitioner will seek my opinion, and that of my partner, on all issues that may affect my birth experience or that deviate from this plan.
2. If the baby and I are fine, and if I go past my estimated due date, I would like to wait until I go into labor naturally.
3. If my water breaks at the onset of labor and there are no signs of infection, I would ideally like to wait at least 24 hours before induction is considered .
4. If my baby is overdue, prior to induction, I would like to try the following techniques first (with the guidance and supervision of my doctor or midwife):
  - Breast stimulation
  - Enema
FIRST STAGE OF CHILDBIRTH: LABOR
1. First Stage, Phase I - Latent Labor- Getting to 3 cm (contr.1 in 20-30min,con t~ 30-45c, t~20 *)
  1. Upon entering my hospital or birth center, it is crucial for me that I will not be separated from my partner(s) at any point during labor or birth.
  2. While I understand and can appreciate the need for training and teaching, I may prefer not to have residents or students walking in and out during my labor and delivery. Please respect my wishes as I state them while laboring and delivering.
  3. Ideally, I would like my environment to:
    - have dimmed lights
    - to have voices respectfully lowered
    - include music I provide
  4. I would like the hospital or birthing staff to know that I may have my own personal style to birthing -- from walking, moaning, or grunting. I would be grateful for the personal space to do this comfortably without feeling hushed or rushed.
  5. Upon being admitted, I would like to avoid a routine enema.
  6. I am uncomfortable having my pubic area shaven unless it becomes medically necessary to do so. Please explain such a procedure beforehand.
2. First Stage,Phase II - Active Labor - Getting to 7 cm (contr.1 in 3-4 min, con t~40-60 c, t~2-3,5*)
  1. I would like to keep internal vaginal exams to a minimum.
  2. I understand that I will be working REALLY hard. Therefore:
    - If hospital rules do not allow food, I would like to insist on access to clear fluids, like water, Recharge? and/or ice-chips.
    - If an IV prep becomes necessary I would like a heparin/saline lock to be considered.
  3. Since mobility is important to me, I would like Intermittent Monitoring (ACOG Standards), using (if it's possible):
    - Fetoscope
    - Or External Monitoring
  4. My birth partner and I would like to take a few moments to privately discuss my pain-relief options before a decision is made.
    - Ideally, I'd like a drug-free birth. Only offer medications if I ask.
  5. I would like the opportunity to try non-medical, non-invasive pain-relief methods. Some therapies I feel would be useful for me include:
    - Massage
    - Guided relaxation
    - Water (shower/bath)
    - If bath or shower, I would like my partner to join me.
    - Change in position
  6. Ideally, I would like to be allowed freedom of movement -- to walk, rock, use the bathroom and move as my body dictates.
  7. I am interested in having access to certain birthing equipment. If available, I would like to use:
    - Birthing bed
    - Birthing stool
    - Birthing chair
    - Beanbag chair
    - Squatting bar
    - Birthing pool/tub
3. First Stage, Phase III - Transition - Getting to 10 cm(contr.1 in 2-3 min, con t~60-90 c, t~15-60 min) :
  1. I understand that transition is unpredictable. I may throw-up, my water may break if has not already, and/or I may expel other bodily fluids. I am appreciative of help that reduces my anxieties and my sense of vulnerability.
  2. At this point, my body may be most sensitive. If I am feeling that my support person's or staff member's voice and/or touch feels too much, I will indicate so.
SECOND STAGE OF CHILDBIRTH: PUSHING AND DELIVERY
1. Pushing(contr.1 in 2-5 min, con t~60-90 c, t~2*):
  1. I have the following coaching preferences:
    - I would like Bradley-like coaching.
  2. As long as it is clear that my baby's heart tones are good and that she/he is receiving sufficient oxygen, I would like to be free of time limits on pushing. It is important to me to allow my body to operate in its natural rhythm and timetable.
  3. If my doctor or midwife feels that pushing may not be progressing efficiently, I would like to be reminded that sometimes changing positions helps. Because I may be very internally-focused, I would like to be encouraged to try one or more of the following delivery positions:
    - Squatting
    - Side-lying position
    - Standing upright
    - Hands and knees on floor
    - Kneeling, resting arms on bed/chair
    - Semi-reclining on bed, knees pressed to chest with support person behind me, providing counter-pressure
    - Whatever feels right in the moment
2. Vaginal Delivery:
  1. Ideally, I would like to avoid an episiotomy. To that end, I would like my practitioner or birth partner to support me with:
    - warm compresses applied to my perineum , which I will supply
    - vit E to massage and stretch my perineum
    - encouragement to breath with my urge push, allowing me to move with the flow and force of my uterus.
  2. If I need an episiotomy, my preference is for a pressure episiotomy -- no anesthesia.
  3. I would like local anesthesia for repairs (stitches).
  4. If an assisted vaginal birth becomes medically necessary, I prefer:
    - the use of forceps
  5. I would like to be given the option to view my baby's entry into the world by using a mirror.
  6. I would like to catch my baby, or have my partner catch the baby, as he or she descends.
  7. I would like for my baby to hear our voices first.
  8. I would like my baby to be placed on my abdomen immediately following the birth.
  9. If warming is necessary, please allow baby to be warmed on my abdomen, covered by blankets.
3. If Complications Lead to a Cesarean Delivery:
  1. Please keep communication open. If, at all possible, please wait for my express consent, or that of my partner, before initiating any procedure.
  2. It is important to me that my partner(s) be present with me at all times during the birth.
  3. Ideally, I would like to remain awake and aware, avoiding general anesthesia if possible.
  4. Please discuss anesthesia options with me.
  5. Please use a low-transverse incision on my uterus and abdomen.
  6. Please leave at least one of my hands free so I may touch my baby when he or she is born.
  7. Assuming the baby is well, I would like to hold my baby on my chest and/or nurse my baby as soon as possible.
  8. I would like the opportunity to see and/or photograph my placenta.
  9. Please remove my IV and catheter as soon as possible following my baby's birth.
  10. Please discuss options for postpartum medication, if needed, with me.
  11. Please provide me with nutritious food and drink as soon as possible.
THIRD STAGE OF CHILDBIRTH: DELIVERY OF PLACENTA OR AFTERBIRTH (5-60 ***)
1. Ideally, I would like to deliver the placenta unassisted -- without Pitocin, uterine massage or cord traction. If a procedure is necessary, please explain it to me.
2. I would like the opportunity to see the placenta. I understand that the placenta has been my baby's life support system, providing him or her with daily nutrients, warmth and eliminating his or her wastes. Assuming both baby and I are well after the delivery, I would like the opportunity to see the placenta. If possible, I would like my doctor or midwife to show me the maternal and the fetus' sides.
IMMEDIATE NEWBORN CARE:
1. Suction and Cord Care:
  1. I would like my baby not to be suctioned unless medically necessary.
  2. Ideally, I would like my partner to have the opportunity to suction the baby.
  3. In my ideal world, my healthy baby will be immediately placed on my chest. If this is the case, he or she will be above the placenta and I would therefore like to wait until the cord stops pulsating before it is clamped and cut .
2. Eyedrops, Vitamin K and other Procedures:
  1. I understand that it is routine to administer antibiotic drops or ointment, such as erythromycin, to newborn baby's eyes to protect against gonorrhea and chlamydia, as well as other more common bacterial infections.
    - I would like this treatment, but ideally, I would like it to be delayed until I have spent some time bonding with my baby.
  2. I understand that in the United States, it is routine procedure to give newborns a one-time injection of vitamin K.
    - I prefer not to have my baby undergo this treatment at all (if it's possible).
  3. Ideally, with either a vaginal or cesarean birth, I would like to postpone routine newborn procedures until I have had a chance to bond with my baby.
  4. I would like to have any additional newborn procedures thoroughly explained to us.
  5. I would like for my birth partner(s) or me to be present during all newborn procedures.
  6. I would like to postpone any immunizations until a later time.
3. Bathing and Circumcision:
  1. I prefer that the baby be gently wiped down to remove fluids, and wrapped in a receiving blanket. Please do not bathe, to allow my baby's natural vernix to continue to soften and protect skin.
  2. If the baby is a boy, please do not circumcise.
4. Rooming-In and Feeding:
  1. My preference for in-hospital infant care is:
    - Full rooming in -- no separation. (may be except during mothers sleep and showing)
  2. Please do not offer my baby the following:
    - Formula
    - Sugar water
    - Pacifiers
    - Artificial nipples
  3. My feeding preference is:
    - to breastfeed exclusively.
5. Sick Baby and Postpartum Care:
  1. If my baby is not well, I would like to:
    - Accompany my baby, or have my partner accompany the baby if transported to another facility.
    - breastfeed, or provide my expressed milk for my baby.
    - have unlimited visitation for my partner and myself.
    - hold, rock and care for my baby, if possible.

I would like my hospital/birth center stay to be as short as possible.

Approved by: __________________________