Birth plan, draft one

Tips for your birth plan
Keep it simple and short!
Keep it positive in tone. Let those around you know how to help you.
Be flexible. Remember that you're not always going to get everything on your birth plan.

Birth plan for J., C., and Baby G.

Background & philosophy: Our first baby, Emily, died 4 days after her birth due to a 2X nuchal cord combined with monitoring failure in March 2004.

The pushing stage of labour was almost 3 hours, although early labour was fast (first contraction was at 6:30 am, at 9:30 am J. was 7 cm dilated; pushing started at 3:30 after the membranes were ruptured by the obstetrician). An epidural was used and an episiotomy performed.

We did not see an obstetrician at any point between membrane rupture and delivery. We both feel that our trust in the delivery team and the medical system was strained if not violated and anticipate that we'll need extra information, reassurance, and definitely as much monitoring as possible.

We strongly want whatever is medically best and most cautious for the baby's health at all points during labour, delivery, and post-partum care.

Labour & delivery:

• support: C. to be present at all times; J2 is also authorized to be present at our request
• monitoring: we would like belly monitoring throughout (with the possible exception of periods of walking, in the earliest stages of labour) and, during the pushing stage, a scalp or other internal monitor. And any other new monitoring methods, or old ones, are okay with us. Vaginal exams are fine.
• information: we would like as many updates and explanations as possible. Both J. and C. tend to be outwardly calm under stress; it would be really helpful to us if staff took extra care to check in on how we are doing
• comfort measures: the elective medication we prefer is an epidural, but we prefer to make that decision as labour progresses. Otherwise visualization, massage, music (we didn't have time to use water therapies or a birthing ball or anything like that last time, so not sure)
• pushing: because of the lengthy pushing and results last time, we would like to request a c-section after 40 minutes of pushing, if delivery is not imminent at that time
• shaving: no, unless there is a safety reason
• episiotomy: if necessary; local (or other) anesthetic would be nice if stitching is happening
• c-section: would prefer spinal or epidural anesthesia to general; C. to be present and to hold the baby as soon as possible; J. to touch the baby as much as possible
• would like baby delivered onto belly; nursing as soon as possible, and as much holding as possible; if tests, eye medication, etc. can safely be delayed for a little while that would be great

Postpartum:

• we plan to breastfeed exclusively and would like to avoid bottles, pacifiers, glucose water, etc., unless there is a medical need
• we prefer rooming in unless the baby needs to be in a nursery
• no circumcision
• we would like as much screening as is available to newborns at Mt. Sinai

Thank you staff, in advance, for helping us through this next, fearful delivery.