Birth plan again

[ailbhe]

I'm trying to draft it. I've found the oomph somewhere - a few hours of almost continuous Braxton-Hicks contractions this afternoon might have something to do with it - and so here we go.

General - vaginal or c-section

• My birthing partners will be my husband (Rob Collier), my midwife (Fiona), and possibly my mother (Niamh Leamy).
• I want to avoid vaginal exams.
• I don’t need an audience of strangers for breastfeeding or cuddling my newborn.
• I want immediate skin-to-skin contact with my baby, before the umbilical cord is cut.
• I want the umbilical stump tied, not clamped.
• Only the minimum of staff should be present at the birth and immediately afterwards.
• I do not consent to any medical students or student midwives being present.
• I want the absolute minimum number of people in the room at all stages, and I want them all to introduce themselves to me and my birthing partner(s) by name and position.
• I want my older daughter, Linnea, to visit us - me and the new baby - as soon as possible after the birth. The recovery room would be ideal.

Possible trial of labour

• What can I try without a drip and without continuous monitoring?
  • Oral medication?
  • Membrane sweep?
  • Artificial rupture of membranes?
  • Medication inserted into the vagina?
• I want to be mobile during labour.
• I do not consent to an epidural.
• I do not consent to augmentation of labour with a syntocinon drip.
• I’m quite happy to use pethidine as pain relief if I need more than gas and air. I will ask for it if I need it.

"Elective" C-Section

Before the operation

• If pre-scheduled, I want to have the baby in the morning; I want the whole family to go to hospital, where I will have a private room, and await pre-op stuff together, and then someone (probably my mother) take Linnea away while Rob and I go to theatre, and then the birth, and then Linnea will be brought back to admire the baby.
• Under no circumstances do I want to see or hear the obstetrician who did Linnea's birth. Rob can check corridors to make sure he's not around before I go from one room to another.
• I wish to be scheduled in with Miss Allott of the traumatic birth clinic. Failing that I require an outpatient appointment to see the surgeon prior to the operation who will be prepared to discuss my concerns and be familiar with my obstetric history.
• I want to meet the anaesthetist before the day of birth to discuss anaesthesia options and the importance of these to my mental state. I do not yet know whether I would prefer a spinal or an epidural. I do know that as soon as I am ready for a c-section I must be guaranteed no pain, immediately. I can not and will not endure pain during prep or the operation itself.
• I will want gas and air available for the siting IV drips, administration of epidural/ spinal block and vaginal examinations.
• I want my husband and my community midwife with me at all times if possible. Under no circumstances is anything to be done to me while my husband or midwife is not present, including adjusting my support socks or "just" inserting a canula. I will not consent to be prepped for the operation unless my husband is present.
• If I have to have a catheter, and I'm sure I have, I don't want to see it, feel it, or have to carry it around. If I am mobile, no catheter. There has to be a way to arrange this.

During the operation

• I want to have the minimum of flesh exposed during the operation.
• I want at least one hand free during the operation this time. I wish to avoid having my legs restrained.
• I do not wish to see the incision at any point during the operation.
• I want to breastfeed as soon as physically possible – not practical, but possible, after the birth - preferably while being sewn up again, even.

After the birth

• I do not consent to any treatment or examination of the baby unless s/he is in my sight.
• If it is necessary to take my new baby to SCBU or similar, s/he is to be accompanied by my husband at all times and I am to be brought to him/her as soon as I can sit in a wheelchair.
• I want Rob and myself left alone with the new baby in a private room for about an hour after the birth, so I can try to feed it and we can goo over it.
• I do not want anyone on the postnatal ward nagging me to walk. I will get up and walk when I feel ready. I have had surgery twice since my previous birth, and both times I insisted on getting up to walk earlier than the nursing staff thought appropriate. If I can walk, I will. If I can't don't nag me.
• I want to know that I have EXCELLENT pain relief available for as soon as the anaesthetic wears off and for the weeks after the birth - most women I've met who had c-sections got decent pain relief for a very few days and then had to go to paracetemol. I refuse to experience serious pain after a birth again. Not happening.
• I want a follow-up appointment with the ob who does the op a week or less after the birth to have my stitches and incision checked for soundness, in addition to the regular 6-week check.
• I want access to a lactation consultant in case I need a galactogogue due to giving birth before my body is ready, which could affect milk supply in the first few days. I explicitly do not want anyone to even SUGGEST formula-feeding unless an actual paediatrician examines the baby and finds a problem, and then they'd better suggest some other things first. There's a milk bank in Oxford, for a start.
• I want to feel confident, the day I leave hospital, that I am well enough to do so, and that I have medical support available to me after I leave if I need it.
• But mainly I want to have no pain. No pain, no pain, no pain.

ETA: I would also like help from people who don't care about the birth bits but can tell that I've repeated myself six times or accidentally written something in pig latin or similar. Edit me!