38 Weeks And Counting

Tomorrow is Christmas, and I will be 38 weeks on the dot!

 I have been meaning to post on here for months, but it just never happened.

Here I be at 37 weeks! 

And here's a quick catch up from the last time I posted.

A week or so after I last posted, Kevin and I decided we were all in for a home birth, whether my insurance was or not. I think he saw the emotional toll it was taking on me, phone call after phone call with the insurance, and he didn't think it was worth it. It was a struggle for me, being ok with the  the financial part of it, but there is still a good chance that they will pay for part of the birth (after I go through the appeal process). All in all it's money, and it's not going to break us. If my insurance does smart up and pay for their portion, it may actually be the same cost as it was for Dallin. Either way, we will be ok, and thank goodness for tax returns!

In November, I hired Kimberly Flake again to be our doula. I'm excited for her and her birth pool to be at our house come labor day:) She came over and gave me a prenatal massage which was wonderful. We went over my birth plan (one I used for Dallin) in case of a transfer, just so we could get that over with and set out minds on the fact that I'm having this baby at home:) We talked about where to put the birth pool and a few other things. She offered to take pictures using our camera, and will also encapsulate my placenta like last time.

At 32 weeks I started my hypnobabies home study course. This is the same childbirth prep I used with Dallin's birth, and I'm hoping to get the same results. It's been difficult finding time to listen to the scripts every day, but I do them pretty much every night as I'm going to bed. I fall asleep a few minutes in, but they say that even if you are asleep that they will still benefit you. We shall see:)

Two weeks ago, I had my 36 week in home appointment with my midwife Anne Marie and student midwife Nikki. We had a nice visit, and I was glad that Kevin was able to be there. It was the first midwife appointment he has been to this pregnancy, other then the ultrasound at 20 weeks. For about a month prior, I had slowly started gathering all the home birth supplies on the list she gave me. At this appointment I had them all ready in Josie's co-sleeper. Looks like a mess kind of, but it is actually quite organized...atleast for me:)

 

 We gave them a quick tour of our house, and talked about the set up that we will have in our bedroom for the birth. Anne Marie asked Kevin if he wanted to catch this time, and we decided that either him or I would catch, assuming that we are in a good position to do so. I'm excited!

For those who are curious, here's part of the homebirth supply list. The only things we needed to buy were the birth kit, coconut water (for hydration), some drop cloths, and an aquarium net. The rest of the stuff was already in our house, and just needed to be collected. This of course, doesn't include all the supplies that my midwife will be bringing to the birth.

 

At my last appointment I got some red raspberry leaf tea (Mormon-friendly peeps), and have been drinking one cup every day. The herbs are suppose to help tone your uterus so that contractions will be more effective. It does not induce labor, but strengthens the uterus, and so I decided to give it a try. I've also been making sure to continue all my supplements. I'm not a big fan of taking any sort of pill, but since I know the good they are doing it makes it easy.

Every night before bed I take a prenatal (rainbow lite one a day), two calcium magnesium (generic,saves me from charlie horses in the middle of the night!), and two flax oil (barleans-great source of omega fatty acids). Overall I have felt really good this pregnancy. Healthy, although I do have the usual pregnancy discomforts, but there isn't a supplement for that:) I believe the supplements are helping a lot.

It's kind of crazy thinking that I am actually going to have a home birth, and in about 2 weeks! It's been a dream of mine ever since I started researching birth options after I had the twins. I thought that once I had the OK to have a home birth that I would be so ecstatic and bouncing off the walls wanting to tell everyone. That hasn't been the case. I feel good about our decision, but it's more of a good normal peaceful feeling. It reminds me of when I gave birth to Dallin, and how I wondered if I would cry or yell something in excitement like many VBAC moms do, but instead I just felt like that same peaceful good feeling. Like it was the way things should be. Kind of the same thing I think.

Now I just wonder when she is going to come, and how her birth will be. I envision labor starting in the morning or afternoon, and then giving birth in the evening or early morning. I can see it happening within a 24 hour period, and I can see it being quicker then last time. I can see myself laboring in the pool again, and giving birth there, although I will go wherever I feel like at the moment. Our bed and a birth stool will also be options. Her due date is January 8th. My guess is the 5th or the 12th because everyone in our family but me is born on the 5th or the 12th. Then again, maybe she'll join me on the 16th:) I'm horrible at guessing though, but I'm glad she will come when she is good and ready. That is what is most important!

I made it to a temple session this last week, and I was so glad I did. I really wanted to go before I had her, because I knew things would only get busier. Being in the temple gave me such a peaceful and comforting feeling, and it's exactly what I need going into this birth. I prayed and meditated about her birth, and asked for angels to be here in our home as she is ushered into this world. I know they will be there for me and for Josie, and I feel blessed for yet another opportunity to bring a child into our family.

Wish us luck:)

Interviews, Insight And Inspiration

The first week of July, and at 13 weeks along, I interviewed two midwives that can legally do HBACs (home birth after cesarean) in Arizona. They are my only legal options at the moment. It was wonderful being able to sit down with them and talk about birth and their experience, etc. It was also great to know that they would take me as a client. Days before, I made a long list of questions to ask them, and tried to be as thorough as possible. Each consultation ended up taking about an hour, and gave me a good idea as to their personality, practices,education, knowledge and hands on experience. They were both wonderful women, and I was grateful for their willingness to sit down with me and give of their time.

Something that I really appreciated from these interviews was the insight that each midwife offered when it came to choosing where to give birth. Neither of them tried to convince me that home birth was the right thing to do. They had both given birth in a hospital setting as well as in their own homes. They both knew and understood what a big decision and commitment it was either way. Both midwives encouraged me in my searching and pondering to really follow my intuition and go with my "gut," when deciding what was best for me and my baby. I of course translated that into listening to The Spirit, and that is what I was hoping to do.

After the first interview, I left feeling that a home birth would be safe for me and my body. At that point, my mind and prayers were focused solely on the baby I am carrying, and what is right for him or her. The second interview came, and at the end I mentioned my concern of giving birth to a baby with special needs at home. When Kevin and I were first married, I read an article in the Ensign and had a feeling that there was a possibility of having a special needs child in our family. So far our three children have been born healthy and have developed normally, so there's always that thought in the back of my mind, that maybe this time will be different. There is such a wide variety of special needs out there, and some are seen at birth, while others don't manifest themselves until later in life. I think I was curious how this could effect the baby's health if they were not born in the hospital. The midwife told me about some special needs babies (down syndrome) that had been born at home with her and the midwife she apprenticed with. They were both fine, and nothing negative came of them being born at home. She remarked that this isn't always the case, and that it depends on the severity of the "special needs" per se. I was grateful for her insight and honesty in her experiences.

As my kids and I left her office and began loading up in the car, The Spirit hit me.  I felt that a home birth and a hospital birth were both safe, and good options for this baby. The concern and worry about the health my baby was met with a comforting feeling, and I felt that my Heavenly Father was pleased with me and my desire to find and do the right thing. A few more thoughts came to my mind that I will keep private, but ultimately I knew that the choice of birth place was up to me, and I was not expecting that.

After reviewing the information I gathered at the interviews, I found that I felt good about the second midwife, and had confidence that she could provide a safe environment to birth in at home. The first midwife was great, but lacked in experience which is a necessity for me to feel comfortable. My husband and I agreed that it would be best to transfer to the 2nd midwives care, and continue with plans for a home birth. Before I called her to share the news, I wanted to double check with my insurance. I figured she would be covered as out of network, but found that they would not cover her at all because she is a naturopathic doctor as well as a midwife. I argued with them two different times on the phone, but there was no working around it. If I use her as my provider, I would have to pay 100% out of pocket and would not have any insurance benefit.

So to break it down Arizona law says I can't use a midwife at home unless she is a CNM or a Naturopathic Doctor, yet my insurance says I don't have any coverage for a midwife if she IS a Naturopathic Doctor. Kind of ironic, isn't it?! They almost completely cancel each other out, other then the CNM option. Dallin's birth with a midwife in the hospital cost us between $600-$700 for everything (including prenatal care). I understoood that doing a home birth, and using an out-of-network provider would cost us more, but wa not planning on having to pay for everything on our own.  If I were to use the midwife I felt good about, it would cost us around $2900. As of now it's too much of a financial burden, and I am searching frantically trying to find another legal option that will have some insurance coverage. This is where I am at the moment.

I could just stick with the Bethany midwives and have a hospital "drive through delivery," like I did with Dallin, but I still have the desire to be at home. I have a hard time visualizing myself at the hospital giving birth, but if I have to do it I will. I just keep hoping and praying that another option will open up to me. I've sent out emails, called birth centers, and searched out other midwives that may be able to take me, but so far I've had no luck.  It's annoying, because I consider myself low risk and pretty similar to all the other moms out here in AZ who have their pick of any midwife in the valley. Even so, my previous c/s almost 5 years ago, prevents me from having real options when it comes to birthing at home. It doesn't seem fair, but I know respecting the laws even when I don't agree with them is the right thing to do. I have faith that Heavenly Father is aware of my situation, and that he will bless me with whatever He sees fit, and as my husband keeps assuring me "the right thing will happen":)

First Trimester Round Up

For anyone who may be following this blog and not my family blog, SURPRISE! Baby #4 is on their way and expected in early/mid January:)

(baby bump at 9 weeks)

Yesterday I hit the 12 week mark, and boy I am glad to be done with the first trimester! I keep starting blog posts and then not completing them, or not being happy with the way they turn out. My thoughts and experiences are kind of all over the place, and I usually prefer things to be a little more organized when I share. I do want to blog about my experiences and feelings, even if they aren't entertaining for everyone to read and I figure I must start somewhere!  Here is a round up of sorts from my first trimester for those who are interested, and for myself obviously:)

Charting:

I found out super early again that I was pregnant thanks to charting. I think I was like 3.5 weeks! Usually you can't get a positive at that point, but the pale line was there. We got pregnant the first time I ovulated after Dallin weaned, which was quite a surprise. I don't get a period when I'm nursing. I had one period a few months after he stopped breastfeeding, and here we are again. I'm not complaining though! Just shocked is all. This baby was meant to come sooner then we had expected for whatever reason:) Another blessing of charting was having a better "guess" date for when this baby would arrive. I'm not a 14 day ovulater, like they assume all women are. I ovulate on day 20 regularly, and so my due date is 6 days later then if I just went off of my LMP. So when I give my LMP I just add  6 days to it. What a blessing to know this information! A week makes a huge difference, especially when you are at the end of your pregnancy. When I went in to my midwives office at 8 weeks 2 days (according to charting) I had an ultrasound which put baby at exactly 8 weeks 2 days. So if all else fails, thank goodness for early first trimester ultrasounds for more accurate due dates:)

Mental Health:

I had some major anxiety issues when I was 4-5 weeks along. Heart pounding, feeling like something horrible was going to happen at any second anxiety. I couldn't sleep well, and I ended up having a nervous break down of sorts 4 days in. I think I had a lot of unresolved issues and concerns with this pregnancy and birth that I didn't realize, and that combined with early pregnancy hormones can be scary! I ended up going in to see my midwives and felt a lot of relief after speaking with them and my husband. I was really worried that I was going to have severe anxiety my whole pregnancy (due to a blog story I read) and it was such a blessing when it went away. I wanted to share because maybe one day a friend or family member will experience something similiar, and it would be good to know that not everyone suffers through it the whole 9 months!

Physical Health:

I was eating the healthiest I had ever eaten, the months leading up to my pregnancy. Lots of whole foods, and very little processed stuff. I read the book "In Defense of Food," and tried to follow the advice as realistically as possible. I was working out at the gym a few times a week, and I felt pretty healthy. Unfortunately, once I hit 6 weeks my senses went crazy and I could no longer palate the meals that I had loved months before. All day morning sickness/nausea kicked in, and I had to start eating every 2 hours to keep it at bay, which took time to get use to.  Weeks 6-8 were the worst of the first trimester. Nothing sounded good, and yet I HAD to eat every 2 hours if I wanted to feel anything close to "good." I found out by accident that my prenatals and supplements were making me really sick, and immediately stopped taking them. I tried a whole food based prenatal instead, but it made me dry heave for 2 hours. I tried chewable childrens vitamins, but they gave me a stomach ache too. My body wanted nothing to do with vitamins of any sort, and so I listened to it. I had lost 4 pounds within a 2 week span due to not being able to eat enough food and feeling awful, and taking prenatals was not worth that in my opinion. My midwife said I could take a short break from prenatals, and that it was more important for me to be able to eat enough food. In the last week the nausea has subsided, and now I just get stomach aches a couple times a day. I feel SO much better, and I am so grateful! I haven't been able to work out very much, but I plan to start again now that I am feeling well. I still can't fathom eating a green vegetable (other then lettuce), but I hope that will go away soon too. I haven't gained any weight, but I think part of it is because I lost some weight earlier, and lost some muscle from not being able to work out. I look very pregnant already, and I'm sure the scale will reflect that soon.

Birth Plans/Thoughts:

Oh mercy. I set myself up for failure early in this pregnancy. By that I mean that once I found out I was pregnant, I just assumed that I would feel awesome about having a homebirth. It's been a dream of mine to have a homebirth, and well I just wanted it to be an automatic this time. So I waited for that warm, fuzzy feeling, you get when something is so right, and I did so without any preparation or real searching or studying. I had not interviewed a homebirth provider or anything, I just wanted Heavenly Father to just "give me" this one. Ha! Just "lay it on me," and skip all that busy work. Right? Well I waited for that warm feeling.....and lo and behold, it never came. I felt so confused and sad, lost you could say. Yet, I can look back and say "you silly girl! what were you thinking?" Eventually my brain began to work again, and I stopped obsessing with needing to know RIGHT NOW whether a homebirth was right or not. It was still on my mind, but I had to stop freaking out that I didn't know whether it was right or not. I have my part to fulfill when it comes to searching, pondering and praying, and Heavenly Father always upholds His part. I also realize that I need to humble myself, and be ok with going to the hospital, if that is what feels right. Dallin's birth helped me get over my fear of being in a hospital, and while I would prefer to be home, I know I could do it in a hospital again if necessary. I am not anti-hospital at all, I just think how nice would it be to have this baby in our home, in the sacred space that feels so safe and peaceful.  How nice to not be removed abruptly during intense labor, fly in a car half way across town, give everyone in the hospital a show, and worry about the possibility of a baby being born in the car, or on the way to the delivery room, or at home without a medical provider present?  I came across homebirth kits online, when checking out some homebirth providers, and I swooned. I loved how simple they were and how little is needed for birth in most cases. The simplicity of it all attracts me. If I can find a competent provider that will assist me in a homebirth, and Heavenly Father confirms to me that it is right, I will do it. If I cannot, I will stay with the Bethany Midwives, as I feel a genuine support from them, am confident in their abilities and love the ones I've gotten to know so far. Right now I have two midwives to interview. They are pretty much my only options at this point when it comes to a homebirth (because of AZ laws) and so I have some homework to do:)

And there you have it, 12 weeks in a nutshell!

Why I'm Glad I Hired A Doula

When I first heard the word "doula," I had no idea what it meant. It wasn't until I had joined the local birthing community that I learned what a doula was.

The following italicized information comes directly from the DONA website:

The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

Some of the benefits of having a doula for your birth:

Numerous clinical studies have found that a doula's presence at birth

tends to result in shorter labors with fewer complications
reduces negative feelings about one’s childbirth experience
reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
reduces the mother’s request for pain medication and/or epidurals

Once I learned about what doulas were, and heard birth stories involving them, I knew that I wanted one for Dallin's birth. Fortunately, there are TONS of wonderful doulas in the valley to choose from. I interviewed three, and then chose the one I felt was the best fit for me.

Here are some of the benefits I had because I had a doula (Kimberly).

(Kimberly doing counter pressure during a contraction)

Support From Someone With Experience

Kimberly had attended over 200 births in the valley when I interviewed her. Most of these births were unmedicated, but she had the ability to support whatever kind of birth we wanted. She had supported moms through C-sections, VBACs, hospital and home births. With being a RN and attending so many births, she knew a LOT about what to expect with birth. I felt confident that she knew what was normal, and what wasn't. So while I made sure to educate myself in childbirth, it was nice to have another educated person on our team. Kimberly also knew different ways to support moms through their labor. She was familiar with all the tools available to use during birth. Kimberly had lots of experience using birth balls, heat packs, counter pressure, birth pools, massage, and changing positions. Knowing that I would have someone so experienced on my birth team gave me confidence that I would be successful.

Help with my birth plan

Our doula was a RN/ Labor & Delivery nurse so she was very knowledgeable when it came to hospital procedures. She had clients who used different hospitals in the valley, so she was familiar with the different doctors and midwives as well as the hospital staff. Kimberly could predict what could be potential roadblocks to my plan because she was familiar with the environment that I would give birth in. At my request, she sent me several birth plans from previous clients, to help me form my own birth plan. She answered any questions via phone, email, and during in home visits. Once I had a rough draft of my birth plan she went over it with me in our home and helped to solidify it. Kimberly kept a copy so that she could bring one to the hospital just in case we forgot to bring ours.

Prenatal Massage

Kimberly is also a licensed massage therapist, which I thought was a major perk:) She included a one hour prenatal massage with her doula package and it could be given whenever it was wanted. She told me that giving her clients a massage gave them the opportunity to become more comfortable with her before the birth. Once I felt in need of a good massage (towards the end of my pregnancy) I set up an appointment. She came to my house with a massage table that had a drop out specifically for the belly. The massage was wonderful and relaxing. It was also nice to know that she would be there to massage my back or feet etc. when I was in labor, if needed.

Birth Resources

Doulas usually have their own library stocked with birth resources. At our first visit, Kimberly offered several birth books and DVDs for me to borrow and I took advantage of it. She also had a birth ball and a birth pool that I could use. Going out and buying these items would have cost me a LOT, so being able to borrow them was a blessing.

Hypnobirthing/Hypnobabies Knowledge

One of the reasons I hired Kimberly, is because she had a knowledge of Hypnobirthing, which is similar to the Hypnobabies class I was taking. It was so helpful to have someone who had already used hypnosis techniques with her clients, and had done so with success. She would follow up with me, and ask me about the different classes I was taking. Kimberly offered to do the scripts with me if I wanted, and gave suggestions when I was having issues in certain areas. Towards the end of my pregnancy, I hit a rough spot and began to let the fears of my last birth effect me. Kimberly came to my house (per my request) and took me through a hypnobirthing fear release that helped me immensely.

Mental, Physical and Emotional Support

When Kevin and I had our first meeting with Kimberly, we talked about our last birth, our fears, hopes, and what we were planning for this birth. She asked us lots of questions about what we wanted and why, so that she could know how to best support us throughout the process. Another reason why I hired Kimberly is because she was a VBAC mom herself. She had experienced a C-Section, a medicated VBAC, and two unmedicated VBACs. I felt it was beneficial to have someone who had been there done that, and could understand where I was coming from. She continuously gave us support and encouraged us. She was available by phone or email to answer any questions, and would check up on me ever so often to see how I was doing. When it came to the actual birthing time, Kimberly was there to offer any support that I wanted/needed. She was my saving grace as I had back labor the ENTIRE 40 hours I was in labor and kept me comfortable by applying counter pressure on my lower back. While Kevin did this as well, it was nice to have someone to take turns with, because doing counter pressure that often can get tiring. Our doula also did a great job of keeping me focused when my contractions were very intense. When she noticed that I was tensing up, she would talk to me with a calming voice, and remind me to relax which helped so much. In the raw footage of my birth video I saw first hand how she was able to get me from being tense to relaxed, just by using her voice. It was neat to go back and see that. When I was going through transition (which I didn't realize at the time) and I was getting tired and discouraged, she was there to tell me to keep going. She was there every step of the way offering the support that I needed. (I should add that Kevin was too, but since this is about my doula I'll keep it about my doula)

Monitrice Services

Doulas don't do medical procedures, but monitrices can offer to monitor the baby's heart rate and do cervical checks as wanted. This was really important to me as I wanted to be able to stay at home for as long as possible when I was in labor. It was reassuring for me to have someone there to make sure Dallin was doing well, and to tell me how far I was dilated if I wanted (although that never ended up happening).

An Extra Pair of Hands

Whether it was helping fill up the birth pool, applying counter pressure on my back, keeping me hydrated with sips of water, walking me through the front of the hospital, or taking photos/video of the birth, Kimberly was always busy doing something for us. This allowed Kevin to not be as stressed about doing EVERYTHING the entire time, and it made it possible for him to focus on me and not taking pictures when Dallin was being born.

Extra Perks

Kimberly offered to help with breastfeeding when Dallin was born which I appreciated. Even though I had nursed twins, it was like I was a new mom all over again, and each baby is different. She also offered to encapsulate my placenta for me which was something I wanted, and was grateful for. On our final visit (postpartum) she came to our home and gave us a copy of Dallin's birth story (written from her perspective). We discussed the birth, and how Dallin was doing.

Having a doula for Dallin's birth was such a blessing. She invested so much time and energy into our birth, and gave us non-stop support throughout the whole process. I know that things wouldn't have been the same without her.

Birth Plans

One of the things I regretted about my last birth experience, is that I didn't have a birth plan. I knew I was going to have a c/s, and so I figured I didn't need one. I never put any thought into what options I still had with a cesarean birth.

Since then, I have learned that whether a mom has a cesarean or vaginal birth, a birth plan can definitely be a great help. As many people will point out, a birth plan doesn't *guarantee* anything. It doesn't mean that everything will go as you had hoped and planned, because nothing in life ever goes that way. Even so, a birth plan is a way of setting goals, and preparing for them which can definitely pay off.

Some Benefits of a Birth Plan:

*They lead you to ask the question "what do I want/not want for my birth?" I doubt your run of the mill provider will ever ask you that question, plus it's nice to have it all on paper.

*Because they cause you to ask questions as to what you want/don't want, the natural next step would be for you to become more educated about your choices and the risks/benefits involved with each decision you make. This is a very good thing.

* They can be given to your husband/doula/midwife/OB/ nurse so that they can better understand what it is that you want.

Recently, I read this blog post about birth plans, written by a home birth midwife here in AZ. She makes some really great points about birth plans, and what they should really be about. I think the main point is that if we want our birth plans and preferences to be respected and supported, then we need to FIRST find a provider and birth environment that already offers and supports exactly what we what we want. Getting the kind of birth you want shouldn't be a tug of war between you and your provider. This is why it's so important to go into your provider interview with your birth plan in mind, instead of waiting until you are 36 + weeks to discuss what it is that you want. Trying to convince a provider to do something that they don't normally support is risky and could really backfire on you. Your provider should be 100% supportive of what you want, and you should know this before you hire them.

After many interviews and lots of pondering and prayer, we decided to go with the Bethany Midwives for this birth. During my interview with them, I found that they genuinely wanted what I wanted for myself, even before mentioning what it was that I wanted. There was no convincing needing to be done because they already offer the kind of support I was looking for. Although I'm not excited to be in a hospital environment, I know that I am going to have 100% support from my provider, doula and husband. My written birth plan is really for the nurses and hospital staff, as they will not know what it is that I want, and are used to following hospital protocols, unless asked otherwise.

Kevin & Melissa’s Birth Plan

We have chosen the Hypnobabies method for a relaxed natural birth. We have given careful consideration to each specific request in our plan. We realize that as labor ensues, special circumstances may arise that cause us to deviate from our plan. We trust that you will provide us with a clear explanation of special circumstances, the medical need for any procedures you may anticipate, and what options may be available. Thank you for your cooperation and support.

For hospital admission, we request:
• To be assigned a nurse who is partial to natural birthing.
• To self-hydrate and decline routine IV and or heplock upon admission.
• To be able to eat light foods and drink clear fluids to maintain hydration and energy.
• To have a quiet labor and birthing room with a Jacuzzi tub, subdued lighting, and hushed tones. • To have intermittent monitoring after 20 minute required strip at admission.
• To respectfully decline to participate in the taking of pain scale information.

During first stage of labor, we request:
• Freedom to walk, move, change positions and assume labor positions of choice as well as having full use of the Jacuzzi tub. Privacy when requested.
• Minimal number of vaginal exams, with permission.
• Natural means of inducement, moving to minimal doses of artificial induction, only if medically urgent.

• To be fully apprised and consulted before the introduction of any medical procedure – augmentation, amniotomy, membrane stripping, internal fetal monitoring ect.
• Husband (Kevin) and doula (Kimberly) to be present at all times.
• Please refrain from offering pain medications and or an epidural to Mother.

During birthing, we request:
• To be allowed choice of positions for pushing – avoid stirrups and breaking down the bed.
• Mother directed pushing with quiet guidance when needed. Guidance on when to stop pushing in order to avoid tearing.
• Perineal massage with oil as well as perineal support to avoid tearing. Episiotomy only if necessary and after discussion and expressed permission of Mother.
• Baby to be placed immediately on mother’s chest, skin to skin, and breastfed.
• Allow 20 minutes for delivery of placenta, and please refrain from using pitocin post partum unless there is an emergency situation.
• Placenta to be placed in cooler that we will provide.
• Umbilical cord to be cut by husband after pulsing has stopped.

For baby, we request:
• That baby stay with parents at all times. Father to accompany baby if special care is required.
• To allow vernix to be absorbed into the skin, gentle rubbing with towels instead of bathing.
• Delay newborn procedures until baby has breastfed and has had a few hours to bond with Mother and Father.
• To allow baby to remain with Mother while performing newborn procedures
• To respectfully decline the hep b shot and eye gel.
Breastfeeding only – no bottles, formula or artificial nipples

Cesarean Birth Plan

Should the situation arise where a cesarean is medically necessary, I would appreciate your support and assistance in making it the best experience possible for my baby and I. Thank you for respecting my following wishes.

• Unless it is an emergency situation, I would like to be given a spinal/epidural so that I can be awake and alert.
• I would like my arms to be kept free during surgery
• I would like my husband (Kevin) to accompany me in the OR.

• I would prefer to choose the type of music that is being played during my surgery, if there is going to be music playing.
• I would like the atmosphere in the OR to be kept light and peaceful, and I would like it if the doctor could lower the drape temporarily so that I can see my baby right when he is born (before he is wrapped up).
• I would appreciate it if my husband could hold our baby next to my face after he is born, and while I am being sutured.
• Unless it is an emergency situation, I would like to have a low transverse incision that is closed with double sutures.
• Placenta to be placed in cooler that we will provide.
• I would like to respectfully decline the use of eye gel for my baby and the hep b shot.
• I would like the vernix to be left to absorb into my baby’s skin, and to do light rubbing with towels instead of a bath.
• Delay newborn procedures until baby has breastfed and has had a few hours to bond with Mother and Father.
• To allow baby to remain with Mother while performing newborn procedures
• I would like to breastfeed and have skin to skin contact with my baby as soon as possible.
Breastfeeding only for my baby-no bottles, formula, or artificial nipples please.

Some tips on creating a birth plan are:

*Keep it to one page if possible

* Bullet point each item so it is easy to read

*Try to use wording that isn't really negative or defensive,
for example: "DON'T YOU DARE GIVE MY BABY A BOTTLE!!" probably isn't the best way to get your point across.

* Some things that you plan on doing may not need to be included in your birth plan depending on the situation. For example- I'm planning on wearing my own clothing when I get to the hospital, but instead of putting it in my birth plan I will just say "no thanks" when they offer the hospital gown. Also- I plan on laboring mostly at home before going to the hospital, but there is no need to put this on my birth plan, I just go to the hospital once I feel ready and that is that.