My birth plan

I wrote this up six weeks before my due date, but in the end I didn't give it to the hospital staff. It was more helpful for me to have written out what I wanted, and to know it. I showed AP and Fiona, our midwife-doula, and they made most of these things happen the way I wanted.

In the end, I didn't use the shower or the gas as I didn't want to; they wouldn't let me get in the bath because of where I was at, and they had to cut the cord early because the baby needed a bit of a rub and some colour. But these were very small things.

 Cecily's Birth Plan

“I want to do this the old fashioned way”

 I believe that where mother and baby are both healthy, and where everything is working as it should, a drug-free, vaginal delivery is the best outcome for both, in terms of physical health and recovery, bonding and breastfeeding and emotional outcomes down the track.

I believe that what is commonly known as ‘the cascade of interventions’, where an intervention is given in labour to ‘help things along’ or ‘speed things up’ can actually lead to further and bigger interventions which may not have been necessary if the natural birth process had been allowed to continue by itself.

I understand that a VBAC carries with it higher risks given the 1 in 200 chance of uterine rupture or dehiscence. I also understand that this risk is less than such things as cord prolapse, which can occur in ‘low-risk’ mothers. I understand that having gestational diabetes also puts me at a higher risk of having a bigger baby, which can cause delivery difficulties as well.

I understand that medical staff like to do fetal monitoring for the purpose of keeping an eye on possible uterus ruptures.

Having experienced a caesarean section, I will do everything in my power to avoid another one, obviously, unless the medical team and I and my support person all agree that the health of the baby or myself is at extreme or immediate risk of illness or death.

I believe strongly that if I am able to minimise stress, fear and adrenaline I will be in much better condition to give birth to a healthy baby; my labour will progress faster and I will dilate and push more effectively.

I believe strongly that if I am able to be active in my labour and use natural pain relief methods such as hot water, my labour will progress faster and I will dilate and push more effectively.

I am a sensible, caring person who does not want to put her baby in harm’s way.

Pre-labour

• Gestational Diabetes. I will continue to monitor my BGL readings, follow the diabetic diet and do everything in my power to ensure that this baby does not become too big.
• Overdue dates. I will take advice as to the size of the baby towards the end of the pregnancy and wish to wait as long as possible for labour to start spontaneously. Two of my three babies were 6-7 days overdue and none have come before 40 weeks.
• Induction. I understand that induction with syntocin is not recommended for VBAC mothers due to scar rupture risks. I do not want to be induced.
• ‘Strip and stretch’ of the membranes is an acceptable way to get things moving if I am over 41 weeks.

Labour

• Support Person. Fiona, a practising midwife, will be my support person. I have full confidence in her midwifery ability, her medical knowledge and her knowledge of what I personally need as a labouring woman.
• Membranes. Allow to break spontaneously please.
• Monitoring. I prefer intermittent auscultation – listening to the fetal heartbeat before, during and after a contraction, at 15-25 minute intervals. This will allow me to stay active, move around and use the bath and shower for pain relief.
• Quiet. To reduce stress, I prefer the lights to be dimmed and people in the room to be quiet. No humming, whistling, chirpy chat or overly loud noises please.
• Pain relief. I would like to have access to bath, shower and gas please.
• Canula. I understand that the hospital prefers to put in a canula.
• “Trial of labour”. I see every labour as being a ‘trial of labour’ because the outcome is always unknown. Therefore, equally, no labour is a ‘trial’. It is what it is, and if the outcome is a c-section because it’s absolutely necessary, that’s ok.   
• "It’s for the health of your baby.” Please believe me that I want a healthy baby, even more than the hospital does.
• Internal examinations. On request only please. Results to be told to Fiona, out of my hearing.
• Timing. Please be patient with me. As long as fetal and maternal heartbeats are good, I’m not in a rush.
• Episiotomy.  Not preferred. I think I’d rather tear. If it’s a small tear and I can avoid stitches, don’t stitch.

Birth

• Time with baby. Straight up to mum for cuddle time please. Can we do APGARS and such on my tummy?
• Cord. Ideally, I would like the cord to stop pulsating before it is cut, by my husband (if he wants to).
• Immunisations. Vitamin K is ok to give.