Ideal Birth Plan
What is an Ideal Birth Plan? A birth plan is a guide to agreements between yourself, your partner (if you have one) and your doctor or midwife. Your ideal birth plan is discussed and agreed to during prenatal care visits. We can plan and prepare, knowing everything can change in a moment, that’s just the nature of birth. An ideal birth plan is a written “what if” statement. An ideal birth plan is proactive: Informed consent is agreed to before the stress of labor when making decisions is more difficult. An ideal birth plan is a way to get to know your doctor or midwife’s: Policies Practices Standards of care. Specific concerns may be asked as questions, your doctor or midwife’s answers should clear any doubts. Be flexible. Be willing to compromise. Be aware that an emergency or complication may occur. You may need to change or even give up your ideal birth plan. The care you receive in the hospital during labor and through the complete delivery of your baby is part of your prenatal care. Make a consultation appointment to talk to your doctor or midwife about specific practices and policies he or she has regarding labor and delivery. Pregnancy Journal A pregnancy and birthing journal is a wonderful chronicle of your experiences. Begin with the first day of your last menstrual period, the date your pregnancy was first confirmed, and your due date (EDC: estimated date of confinement). Ask your Doula to keep birth notes for you, and after the baby is born, your birth notes make a great addition to your birth plan/pregnancy journal/baby book! Home Birth Ideal Birth Plan An ideal birth plan for a home birth involves more specifics about the roles of those present. Who will catch the baby? Will you have a midwife? What kind of midwife? What is her training? What is her approach? Is she “hands off” in her management" of labor and delivery? Does she follow a "medical model" approach? What is her transport rate? Why? What are her experiences with complications? Emergencies? How many people attend a birth with her? Who are they? What do they do? Why? What is her overall "track record"? Who is her medical back up doctor? Where does s/he practice? Where does s/he have hospital privileges? There are many more aspects specific to home birth preparedness, not detailed here. However, the outline for creating your ideal birth plan is similar. Home birth ideal birth plans do not include analgesics, lithotomy position, internal fetal monitors--etc. --simply because these are not part of a home birth! Home birth plans are another book! A responsible ideal home birth plan always includes an emergency plan in case transport to a hospital is necessary. First version of your ideal birth plan Homework If you don’t know what a physiologic normal labor and delivery are, how can you plan your experience of childbirth? Are there blank spots in your ideal birth plan? Get the details you need. Obstetrician? Midwife? ABC Room? Method of prepared childbirth? Prepare a list of question, leave enough space for notes. Your choices make a difference in your experiences. If your baby is conceived with assisted reproductive technologies, you will deliver in a hospital with an obstetrician. Choosing a care provider: obstetrician or midwife? The first step is obtaining quality prenatal care from a doctor, midwife, or clinic. Your first choice is your selection of the type of practitioner you want to see for prenatal care and labor and delivery. Find good quality prenatal care as soon as you think you are pregnant. During your prenatal visits, your doctor will be looking for progress and growth of your preborn baby as well as your own continued health. Your doctor will screen for nutritional, medical, genetic, and social issues that may be problems. Risk factors during pregnancy affect your choices of care provider, place of birth, birth attendant, and method of childbirth. Sample questions How many others may be in the labor/delivery room? What is the policy on use of external and internal fetal monitors? *Internal monitors are not used in home births. What is the policy on IV use? What, if any, are prep procedures used routinely? Is amniotomy a common practice? Are laboring mothers encouraged in walking or bed rest? Pain medications: What and when? Positions in labor and delivery: lithotomy and modified lithotomy positions. Episiotomy: is it routine or a spot decision? Light eating and/or drinking during labor? Is immediate breastfeeding at delivery encouraged? Policy on delayed cutting of the umbilical cord? Newborn exams: Done at mom’s bedside? Rooming in and partial rooming in: encouraged? How early after giving birth is early discharge? Circumcision: policy. If you have any special questions write them on your list to ask your hospital and care provider. Your ideal birth plan will go with you to the hospital, and is then a permanent part of your medical records, attached to your chart at the foot of your bed. Nurses on duty can then look at your ideal birth plan and know what you want and don’t want. Be sure to have your doctor or midwife "sign off" on your ideal birth plan. Uncompromising Birthing Fantasy Visualization Visualization is a technique of imaging specific details of an event before it happens. The purpose of your uncompromising ideal birth fantasy is to imagine every phase of giving birth and lay down a memory track in your brain as if this happened! While you are imagining you are visualizing, and your brain doesn’t know it is fantasy! This is how athletes, public speakers, politicians, actors, and YOU may create a memory so that when its time to actually give birth, your mind and body believe you’ve done this already! When you visualize details with all of your senses, your brain believes it is happening. When its time to actually give birth, your body will recognize it as a version of your "memory" created during visualization. The second version of your ideal birth plan can be written after you’ve gone through several versions of your uncompromising fantasy version. Different from the first version, the second version should fill in any gaps in your first plan. This is still your fantasy. Exercise in classic, textbook normal Relax in a comfortable place where you are free of disturbances. See yourself in your mind’s eye, at full term of your pregnancy. You are healthy. Your cervix is ripe. Your uterus is strong. You and your preborn baby are well nourished and ready for birthing. You’re ready to have this baby on the outside, in your arms! Your preborn baby is full term, healthy, engaged deeply within your pelvis, in the appropriate position and presentation for birthing. You are the star! Everyone is here because you are pregnant! Without YOU there’s no baby and no birthing! You are the most important person at this birth. What do you want? Everyone is here to serve you. Everyone is here to make you comfortable; to emotionally, physically, mentally, and spiritually support and take care of you. Taking care of you is their job. Your job is to be yourself and to give birth. Your job is harder than everyone else’s job. You are the only one who can give birth to your baby. You are strong and safe and listen to your body. Everyone around you listens to your body, too. Your body tells you what you need, when you need it. Your body tells you when to sit, stand, walk, rest, and sleep. Your body directs your breathing, and you breathe normally, according to the amount of work you are doing. Your breathing changes normally according to the amount of work you are doing. You trust your body because your body knows, often before your mind does. See, hear, feel, taste, and smell every phase and stage of labor and delivery. How does labor start? What are you wearing? What time of day, or night, does labor start? What are you doing? Where are you? What to you see? Hear? Taste? Smell? Feel? Who is there? What are they doing? When do you go to the hospital? If you are having a home birth, when do you call your midwife? If you are having a n unattended or unassisted home birth, what do you do? When do you need to concentrate on contractions? What’s happening when your breath catches? Who is your labor support? When do you call them? When do you call the doctor or midwife? What are they doing? What are you doing? What’s it like? Imagine pushing your baby down and out of your body. How do you push? What positions work efficiently? Who is with you? What are they doing? Imagine your baby’s birth. How are you breathing? Are you pushing between contractions? Imagine your baby is now completely born and lying on your belly, and lifted to your breast. Your baby’s eyes are open, looking at you. How do you feel? Imagine your baby is offered your breast, latches on, and suckles for the first time. You deliver the placenta, are examined for “skid marks” (little tears that don’t require sutures), and have time to bond with your baby before the newborn exam. Change your ideal fantasy as many times as you desire. Imagine as many versions as you like. Go for your ideal perfect experience. There are no ‘should this’ or ‘should not that’ involved. Play with this fantasy. Now write it all down. Communication Share your first written fantasy. Be prepared for anything! You may get either an “oh, no!” or a “that’s perfect!” reaction. Talk about it. This is where communication comes in and the great part is now there’s something definite to talk about. You’ve imagined your perfect birth, and now you can share feelings, thoughts, and desires. You have defined what you want during labor, delivery, and the first hour after birthing. One and only rule: No criticism allowed. This is your sacred fantasy. No put downs! Talking about your ideal birth plan gives you both, as parents, to imagine, plan, and prepare, beginning in early pregnancy, how you choose to bring your child into the world. If your baby's father is not with you, share your ideal birth plan with your Doula, friend, or family member. Emotional support during labor is important! Who is that person? Share your ideal birth plan with him or her. Rehearsal time! Fantasize together! Call it a "dry run!" Compromise with win-win agreements. When you have a mutual ideal birth plan, write it down. Hospital Tour Hospitals have certain routine policies, procedures, and practices. Perhaps your doctor or midwife has standing orders at the hospital. Hospital birthing room tours are the perfect time and place to look around and ask questions. Take paper and a pen! Later, at home, you can both read how your written ideal birth plan fits into hospital routines. Now that you’ve gathered more information you have a more concrete view of what happens at a normal labor and delivery at your hospital, attended by your midwife or doctor. How does this fit into your ideal birth plan fantasy? Based upon the information you have, you may see areas that are compatible or not. Try it on for size. Relax and imagine yourself in labor and giving birth. Are you comfortable? Are you safe and secure emotionally, physically, and spiritually? Are there things that clash? Is there something that doesn't feel right? Is something scary? Pay attention to what doesn't fit. These are areas you will need to deal with if you deliver your baby at this place with this doctor or midwife. Write down your feelings Identify any anxieties or fears. An anxiety is an unnamed fear. We are most afraid of the unknown. If something pushes your buttons, look into it. Do your homework! Accurate up-to-date information is often what is needed to eliminate fears and anxieties. Fear and anxiety contribute to tension. Tension lowers the pain tolerance and increases perception of pain. The fear-tension-pain cycle may be avoided, in part, by becoming an information sponge while you are pregnant. Vague, nagging undefined anxieties may be your body’s way of telling you there is something you need to face or research. By looking into anxieties, they are named and their power to upset you may be lessened. Second Version Ideal Birth Plan Write your second version of your ideal birth plan. Take it with you for your next prenatal. Talk it over with your doctor or midwife. Most likely, there will be areas that you may need to change. Go home, talk it over, and make your changes. Third Version You’re now working on your third version of your ideal birth plan. Take your final version to your prenatal with you. When everything is agreed upon, sign your ideal birth plan, and have your doctor or midwife sign also. Keep your ideal birth plan with your hospital bag, ready and waiting, with your admission papers (you should fill out in advance). |
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