Birth Plan. Due Date: 2/26/08
Home Birth Plan
I expect and plan for this to be an easy delivery. My pregnancy so far has been uneventful, and my previous three pregnancies and births were routine. The only differences this time are that it’s at home instead of in the hospital, and my partner will be supportive.
Visitors are more than welcome through the entire labor and delivery. The downstairs should be clean and tidy, and it’s available to everyone. Visitors can come up to see me, but be aware that I’m not going to pay a lot of attention to modesty after a certain point. My midwife, Ellen Estes, might have to ask people to step out of the room from time to time. Izzie and Liz are welcome to be in the room the entire time, if they wish. I seriously doubt anything can possibly get Spike away from me. I do not plan to have a doula; my sisters, partner, and midwife should be more than enough support.
I’ll probably move through the house as I need to. I’ll be using the master bathroom for showering or bathing and everything else. The curtains should be closed in any room I'm in, especially during the day. I don't want bright lights.
My other four children are mostly self-sufficient. They can come in and out of the room as they want. If they want to be present for the birth, Liz will call them into the room. Otherwise, Ron will take care of them.
I may choose to eat or drink during labor. I’ve done this before, so I have an idea of what my limits are. If I become too stressed, I may have a single glass of wine. However, herbal tea should be enough. If I can’t keep down liquids at any point, I’ll have ice chips.
I prefer to avoid vaginal exams, unless labor fails to progress. Ellen and I will discuss those as needed. Ellen knows my preferences on all medication. I don’t want any pain medication offered or any hormones given. Sterile water papules may be administered if I have back labor, and I’ll use alternate means of pain control, like massage, hot and cold packs, and breathing techniques. Eyedrops and vitamin K may be given to the baby. I will produce the placenta either naturally or after nursing. I don’t want that forced.
The bed will be ready, if I happen to give birth there. The rest of the room will be kept clean and have plastic sheeting down. If I find a place that’s comfortable and a position that works for me, I’ll use it.
If any circumstance arises that makes Ellen, myself, or Izzie uncomfortable, we will talk about the situation. If there is any reason whatsoever to go to the hospital instead of remaining at home, Princeton-Plainsboro is the only option. In a true emergency, an ambulance is preferable to driving ourselves. Spike absolutely must come with me.
If there is, at any point, a conflict between my original wishes and the baby’s health, the baby’s health comes first. If anything is seriously wrong with the baby or I have preterm labor, my first choice for care is Dr. Robert Chase, an intensivist at Princeton-Plainsboro. I have a birth plan in place if hospitalization is needed.
Hospital Birth Plan
My first choice for labor and delivery is to do everything at home, and my midwife, Ellen Estes, is aware of all my preferences. Should a hospital become necessary, these are my wishes. Circumstances calling for a hospital include prolonged labor without progress (thirty hours without water breaking, or three hours with no increase in cervical dilation or thinning), signs of fetal distress, placenta previa or placental abruption, prolapsed umbilical cord, or maternal distress, such as falling blood pressure or pulse or hemorrhaging.
Cesarean:
I expect and plan for this to be an easy delivery. My pregnancy so far has been uneventful, and my previous three pregnancies and births were routine. The only differences this time are that it’s at home instead of in the hospital, and my partner will be supportive.
Visitors are more than welcome through the entire labor and delivery. The downstairs should be clean and tidy, and it’s available to everyone. Visitors can come up to see me, but be aware that I’m not going to pay a lot of attention to modesty after a certain point. My midwife, Ellen Estes, might have to ask people to step out of the room from time to time. Izzie and Liz are welcome to be in the room the entire time, if they wish. I seriously doubt anything can possibly get Spike away from me. I do not plan to have a doula; my sisters, partner, and midwife should be more than enough support.
I’ll probably move through the house as I need to. I’ll be using the master bathroom for showering or bathing and everything else. The curtains should be closed in any room I'm in, especially during the day. I don't want bright lights.
My other four children are mostly self-sufficient. They can come in and out of the room as they want. If they want to be present for the birth, Liz will call them into the room. Otherwise, Ron will take care of them.
I may choose to eat or drink during labor. I’ve done this before, so I have an idea of what my limits are. If I become too stressed, I may have a single glass of wine. However, herbal tea should be enough. If I can’t keep down liquids at any point, I’ll have ice chips.
I prefer to avoid vaginal exams, unless labor fails to progress. Ellen and I will discuss those as needed. Ellen knows my preferences on all medication. I don’t want any pain medication offered or any hormones given. Sterile water papules may be administered if I have back labor, and I’ll use alternate means of pain control, like massage, hot and cold packs, and breathing techniques. Eyedrops and vitamin K may be given to the baby. I will produce the placenta either naturally or after nursing. I don’t want that forced.
The bed will be ready, if I happen to give birth there. The rest of the room will be kept clean and have plastic sheeting down. If I find a place that’s comfortable and a position that works for me, I’ll use it.
If any circumstance arises that makes Ellen, myself, or Izzie uncomfortable, we will talk about the situation. If there is any reason whatsoever to go to the hospital instead of remaining at home, Princeton-Plainsboro is the only option. In a true emergency, an ambulance is preferable to driving ourselves. Spike absolutely must come with me.
If there is, at any point, a conflict between my original wishes and the baby’s health, the baby’s health comes first. If anything is seriously wrong with the baby or I have preterm labor, my first choice for care is Dr. Robert Chase, an intensivist at Princeton-Plainsboro. I have a birth plan in place if hospitalization is needed.
Hospital Birth Plan
My first choice for labor and delivery is to do everything at home, and my midwife, Ellen Estes, is aware of all my preferences. Should a hospital become necessary, these are my wishes. Circumstances calling for a hospital include prolonged labor without progress (thirty hours without water breaking, or three hours with no increase in cervical dilation or thinning), signs of fetal distress, placenta previa or placental abruption, prolapsed umbilical cord, or maternal distress, such as falling blood pressure or pulse or hemorrhaging.
Cesarean:
- Spike will be present. Please don’t ask him to leave.
- I prefer to also have Ellen in the room, as a familiar presence. One of my sisters may also be present, if either chooses.
- I want to be conscious. A spinal is my preferred anesthesia, if there’s time.
- I want to see the baby being born. Please lower the drape, or use a mirror.
- Spike should be allowed to hold the baby right away.
- I plan to breastfeed. Please don’t offer the baby a bottle at any point.
- As soon as possible, I want to be reunited with the baby.
- My certified nurse midwife, Ellen Estes, will be present and monitoring constantly.
- Start monitoring right away. Discuss with me, but internal monitors should be fine if they’re needed.
- Please call Dr. Robert Chase.
- I don’t want any sort of pain medication or induction that could increase the baby’s distress. A spinal is fine if we need to move to a Cesarean.
- If time is critical and the baby is sufficiently descended, forceps may be used. If the baby is not sufficiently descended, please ask me before using a vacuum.
- An episiotomy may be performed if forceps or a vacuum need to be used.
- If the baby’s Apgar scores are sufficient, I want to hold it right away. Skin-to-skin contact is preferable.
- If the baby needs to be taken up to NICU, please get me cleaned up as fast as possible. I want to be with the baby.
- Even if the baby needs to go to NICU, please don’t ask Spike to leave. If I think he needs to go, I’ll say something.
- Despite what Spike will say, treat the baby as your priority. I’m a healthy, fit adult. The baby is none of those.
- If I am not capable of consenting to treatment, consult Spike, Dr. Isobel Stevens, and Elizabeth Navarro. They will have my best interests in mind, as well as the baby’s.
- I have an advance directive in place authorizing heroic measures. It’s filed with the hospital.
- As soon as I’m stable, please bring the baby back in the room. Once I’m capable, I want to be able to hold and bond with the baby.
- My ICU doctor of choice is Dr. Robert Chase. If it is not an ICU situation, consult Dr. James Wilson. If he’s unavailable, consult Dr. Chase or Dr. Greg House. If they’re unavailable, Izzie can find someone.
- Ellen will be present and monitoring.
- I prefer a heparin/saline lock to an IV line.
- Please do not offer pain medication. I’ll ask for it if I need it.
- I would prefer no hormones of any kind be given.
- If possible, I want to be able to move around the room and use different positions.
- I prefer a family-style room, where my children and friends can be present if they choose to be. There will be several adults in attendance who can take the children out, if necessary.
- Please discuss any changes in monitoring or status with me.
- If the baby’s Apgar scores permit, I prefer immediate maternal-infant skin-to-skin contact. Bathing can wait.
- Please don’t give the baby any sort of bottle or pacifier. I plan to breastfeed.
- Vitamin K and eyedrops are permissible.
- Please don’t take the baby from the room without conferring with me.
- We do not plan to circumcise if we have a son. Please don’t ask us.
- Under absolutely no circumstances should Spike be asked to leave the room. Everyone else may be, but not him.