Posts Tagged ‘hospital birth’

Fall Childbirth Class Schedule

Wednesday, August 5th, 2015

Fall Childbirth Class in Colorado Springs
Thanks so much for your patience as I took a break from blogging while I was away at the CAPPA conference in Tucson, then hit the ground running with several births nearly as soon as I landed back in the Springs! That said, we are gearing up for a busy season.

Our fall childbirth classes are on the calendar, which you can check out HERE.

What I want to highlight are the names of our Saturday workshops. Since we began offering them in the spring, I have gotten a lot of helpful, specific feedback from Saturday students, and am excited to offer our new “Tool Kit” Saturday schedule!

It’s shorter. It’s sweeter. It’s more relevant than ever.

Plus, we have way more fun than is probably good for any of us!

Here’s the nutshell version of each new Tool Kit class:

  • Early Pregnancy Tool Kit: Nutrition, fitness, specialty diets, what to expect in the 1st and 2nd trimesters, care providers, and birth locations.
  • The Natural Birth Tool Kit: Planning a natural or home birth? This is the class that will equip you to handle labor, birth, and that first “golden” hour.
  • The Epidural Tool Kit: Planning to have an epidural? This is the class just for you! What you can expect, how it all works together, and that first “golden” hour.
  • The Newborn Care Tool Kit: More than just diapering, this class covers what you really need to know about your “4th Trimester.” Getting out of the house, parenting styles, babywearing, bonding, and more.
  • The Postpartum Tool Kit: This class covers topics rarely discussed. Relationships, family planning, emotional/mental health, and even basic logistics.
  • The Breastfeeding Tool Kit: Everything you need to know from nipples to normal feeding to nursing in public. Bonus: This class is for your partner too!

We also have some fabulous specialty “Tool Kit” classes:

  • The VBAC Tool Kit: This class is especially geared for those going for a vaginal birth after cesarean(s). The nuts and bolts of stacking the deck in your favor, no matter where you are choosing to give birth.
  • The Teen Tool Kit: This class is in the works, so stay tuned for the first scheduled appearance! It will be a two- or four-week Tool Kit just for teen moms and their support partner(s). We’ll cover the basics of coping with labor, breastfeeding, and sex ed.

Also – we are so excited to be planning the first ever Preparing for Birth Trunk-or-Treat on Halloween this year! Watch for details as we let our nerd selves loose in a Comic-con style costume party! Sherlock, Doctor Who, Lord of the Rings, Harry Potter, Stark Trek, Star Wars, and more! Bring the kids, get your blooming belly painted, and get your geek on with us!

Thanks for hanging around!

Warmly,
Desirre & Tiffany

5 Things Midwives, Doulas, and Postpartum Moms Love

Monday, July 6th, 2015

5 Things Midwives, Doulas, & Postpartum

As I was in the shower today, after two births in 24 hours–one in the hospital as a doula, the other at home as a student midwife–I was appreciating the perfect temperature of the water, the smell of my shampoo, and the utterly clean feeling I had when I stepped out onto the mat. I was positively luxuriating in my shower! I couldn’t help but compare it to the first shower I took after my babies were born. That first shower post-birth is simply divine.

This got me on a train of thought I hadn’t really contemplated before.

Midwives, doulas, and postpartum mothers share a sisterhood in more than just birth. There are five things we all love after a birth, whether it was our own or one we attended.

    1: Taking off the sweaty/goopy bra.
    Taking off the bra at the end of the day is magnificent enough. Imagine peeling off a sweaty, potentially goopy and wet bra! Birthing a baby is hard work, and so is attending a birth. (Not on the same level, obviously, but we often get very physical, sweaty, and wet too) Oh, the glorious freedom of a bra slipped off and tossed aside!

    2: That first shower.
    Letting all the mess of birth wash down the drain. The sweat of hard work. The fluids, vernix, and blood of the birth. Even some of the heightened emotions are shared. They are on different scales but are sourced in the same hormones. And yes, birth professionals tend to get a little baptized with the birth fluids too. I cannot tell you how amazing it is to get into that warm shower and just feel clean again!

    3: The first meal.
    Whether it’s steak and eggs, sushi, fried chicken, gyros, cheese and crackers, bananas and peanut butter, smoothies, or a fistful of Cheetos, it doesn’t matter. No food tastes as good as post-birth food.

    4: The first nap.
    Most births happen in the wee hours before dawn, so everyone involved loses some sleep. Combine that with a hit of high-inducing oxytocin, endorphins, and adrenaline, and you have a perfectly natural sleeping potion circulating in your blood. The first nap post-birth is the best! Even if it’s interrupted by a hungry baby, or a text from a client (we’re usually still on call), it’s still lovely to sleep. Mostly because we are in bed. It’s all about the bed. And the cool side of the pillow.

    5: Seeing your kids again.
    There’s something about a family coming together again after the birth of a new baby. After you’ve come home from the hospital, or your kids were brought back home from Grandma’s, being together as a family with a new member to induct is just plain special. Some of my favorite post-birth memories, when my kids were born, were introducing them to their new tiny sibling. Now, walking in the door from the latest birth, and being greeted by four sets of arms hugging me, and four voices saying “Yay! Mommy!!!” is such a blessing.

What is your favorite thing after having a baby and/or attending a birth?

Grace & Peace,
Tiffany

Grace Under Pregnancy: Responding to Negativity

Monday, April 27th, 2015
Created using Canva.com

Created using Canva.com

We’ve all seen those blog posts listing all the hilarious, snarky retorts we can have at our disposal when well-intentioned people make comments about our pregnancy, parenting, or birth choices. There is definitely a place for a well-placed one-liner, but not everyone will see the joke. Those remarks are most often only appreciated in theory, not in practice. Of course, it often helps us to alleviate the stress of constant, unhelpful remarks. Who doesn’t need a good laugh after several “Haven’t had that baby yet” moments?

Granted, most of us just politely smile, nod, and walk the other way, keeping our irritated sarcasm to ourselves. We think sarcastic thoughts, or post them on Twitter, but we choose manners when we are in the moment. We none of us really want to be rude, even if we feel like it. We know that answering rudeness with rudeness often just escalates the situation.

Some people, of course, are just rude. It’s best to just walk away in that case. But, what can we do when we feel a strong need to respond in some way? Are sarcasm and snark the best approach? Sometimes, probably. Some people need the wake-up call. However, most people don’t realize that they’re being rude — however well-intentioned they may be — and grace goes a long way. You never know. You might be the one who helps someone treat the next pregnant lady a little better. Isn’t that worth biting back a stinging remark, then going one step beyond and extending grace?

So, what does responding in grace look like?

“You’re having a home birth? Aren’t you afraid of –insert random, rare emergency here–?”
Snark says: “You had hospital births? Weren’t you afraid of –insert random, common intervention here–?”
This kind of response is designed to shut down conversation, and while the person may deserve snark, isn’t a little kindness more powerful?

Grace says: “I appreciate your concern, but no, I am not afraid.”
There is no need to explain your decisions to anyone since you are the one who walks it out, but this kind of response may invite questions and conversation that could benefit the hearer in long run.

“Wow! You are getting sooooo HUGE!”
Snark says: “Thanks! So are you!”
While hilarious in theory, (I’ll admit, I chuckled) two wrongs don’t make a right. People really don’t know what to say, and aren’t necessarily comfortable with just a friendly silence.

Grace says: “Thanks! I’m so excited to be able to grow such a healthy baby!”
This can encourage people to view the full-term pregnant body as something beautiful, normal, and healthy, instead of just weight gain. They won’t expect the kindness.

“Let me tell you ALL THE HORROR STORIES surrounding my births!”
Snark says: “Well, at least you have a healthy baby, right?!”
This can add another layer of sorrow or regret to the woman who opened up to you, and can be just as hurtful to hear as her horror story was to you. Again, two wrongs don’t make a right.

Grace says: “Wow – what a rough ride. If you could go back and change anything about your births, what would it be?”
Women learn in community. It’s why we write and read blogs, attend La Leche League and MOPS groups. Such things have replaced the old quilting bees. It’s also why we are compelled to share our birth stories, positive and negative. Perhaps, this woman has only ever been told she should be grateful, because her baby is healthy. Maybe no one has acknowledged her experience, or made space for her to process it. Maybe you have just been given the chance to help a fellow human being take one more step toward healing by your validation of her experience. Plus, you might learn something.

Kindness goes so very far when we see others as humans who make mistakes. Really, haven’t we all said insensitive things without meaning to, only to learn our mistake later? Can’t we all recall that one time we really blew it by putting our collective feet in our collective mouths? We all cringe at such memories, right? How beautiful was it, in those moments, when someone extended grace to us?

Well, why not make those moments a little less cringe-worthy in your turn by extending grace to our sometimes clueless fellow human beings? Maybe they don’t deserve it, but we all have undeserving moments. That’s the whole point of grace– it’s unmerited favor.

Remember: In the end, it is love that wins the day, not wit or cleverness.

What would you add? When have you responded with grace instead of sarcasm? What other comments can be hurtful, and what might you say or do instead?

Grace & Peace,
Tiffany

Doulas Benefit Care Providers, Too.

Monday, October 28th, 2013

Image credit: apperson.com/support

I’ve written a lot about the measurable benefits of trained labor support for women and their families, which is important. However, I believe firmly that doulas have great potential to benefit care providers and staff as well. As one more important piece of the birthing puzzle, doulas can either add to or detract from the big picture of any birth they attend.

When a doula is at her best, when she understands her role and her scope of practice, she brings freedom, communication, and peace to the place of birth.

Part of my Scope of Practice as a CAPPA-certified Labor Doula reads as follows:

During labor and birth, the labor doula provides the mother and her partner with physical, emotional, and informational support. She facilitates and promotes self-advocacy, informed choice, and effective communication between the family and care providers. She seeks to foster a cooperative, respectful, and positive atmosphere with all members of the birth team so that the mother can birth with confidence. (emphasis mine)

What does “effective communication” look like at a birth?

It looks like a bridge. A sturdy, well-built bridge that begins with openness, humility, and an extended hand from the doula to the staff member or care provider that does not interrupt their conversation with the client.

It’s remembering that the client chose her care providers just as much as she chose her doula.* That fact alone should elicit basic human respect from the doula toward those caring for her client. Period. Regardless if that respect is returned or not. Doulas do no one any good unless we do our best to leave those chips on our shoulders at home. We do best when we take the high road, and treat everyone on the birth team with dignity and respect.

Side note: respect doesn’t mean agreement or likeability. It simply means getting along, and choosing to work together toward a common goal: The safety and health (physical, mental, and emotional) of both mother and baby.

When a doula sees herself as an integral part of the birth team, and understands that everyone else there has their place (as long as her client chose them), there are a lot of benefits she has to offer to the care provider and staff she is working with.

Among those benefits:

  • Added perspective–Doulas can often get very creative when coming up with ways to help a labor progress effectively before medical interventions are truly needed. Care providers often appreciate suggestions that don’t interfere with safety, and that seem to help the mother.
  • Someone labor-sitting–Care providers are rarely available to labor sit as long as a doula can. Even home birth midwives may not have as much opportunity to do so, and usually arrive later in labor than a doula would. This means that a doula can fill in the provider and staff on what has been going on, what tricks have been tried, and things that may be relevant to improving her client’s care. The doula can often provide clarification where the mother’s or partner’s recollection is fuzzy. This helps the care provider have a more accurate picture of how labor is going.
  • Continuity of care for patient–This is one of the hardest things to provide as a care provider. Nurses, doctors, and hospital-based CNM’s change shifts–no matter what. Even home birth midwives may have to send a backup if two births are happening simultaneously. The doula provides one continuous thread of care, and we all know that this works out to better quality care in general. Also, can bond more quickly with the new people on shift, making her care easier for the staff and/or care provider, as they have to spend less time establishing trust.
  • Bridge of communication with patient–Doulas teach their clients to ask good questions, relevant to their own care, and how to understand the answers they’re given. This helps the client to build trust in her chosen provider, which makes caring for her easier for the care provider. A doula’s presence should facilitate togetherness at a birth, not a sense of “us vs. them.”
  • Extra set of hands–As much as care providers love to do hands-on care, many times they are simply not able to do so. Doctors, nurses, and even home birth midwives and their assistants, can easily get bogged down by charting, checking and setting up needed equipment, and (in hospitals) caring for other patients. This is as it should be, since the safety and health of the mother-baby dyad rests on their shoulders. Any non-clinical care they get to do is icing on the cake. Doulas have no such worries impeding their care. Non-clinical care is their only focus.Therefore, care providers are able to focus solely on their number one priority: the health and safety of mom and her baby.

I know that the above benefits are really more indirectly beneficial to the care provider. However, when there is benefit to the birthing woman, there is benefit to her care provider as well. The patient load of most OB’s is such that it can be extremely difficult for them to individualize care. After all, the care provider has as little time, per appointment, to get to know their patient as the patient has to get to know them.

Therefore, if there is any way for a doula to help build bridges, encourage their client to ask good questions, and utilize whatever time they have with their care provider, it enables and empowers the care provider to do what they want to do most: Provide evidence-based, individualized, humane care to their patients. This results in good feedback for them, and encourages them to be more open to the next client asking questions or wanting something different than the basic standard of care.

In short, the presence of a doula can mean heightened communication, empowerment, and a positive experience for everyone on the birth team, not just the mother.

*I understand that many women only have very limited, or no choice, when it comes to their care provider, due to geography, local/state laws, financial constraints, or other factors. Still – they ultimately still have chosen their care provider, rather than birthing unassisted at home. Therefore, they are placing some modicum of trust in that care provider. I appreciate feedback on this.*

Care providers: How often do you work with doulas? What do you appreciate most about good doulas? What tips might you offer to doulas who are still learning, or who need to understand your perspective better? What ideas do you have to foster better relationships between clinical and non-clinical professionals?

Thanks for reading!

Grace & Peace,
Tiffany

EMAB and Doulaparty Team Up

Friday, June 22nd, 2012

 

 

Join the #doulaparty on Twitter or follow along at DesirreAndrews.com, June 22nd 6pm PT/9pm ET to kick off summer birth work with something extra special!

 

I am very excited that Earth Mama Angel Baby is sponsoring this weeks live chat. EMAB has amazing products for all types of birth professionals and families.

 

A note from the EMAB Team:

 

Are you a midwife, doula, nurse or obstetrician looking for pure, safe products to comfort postpartum mamas and brand new babies? You’ve come to the right place! Earth Mama Angel Baby offers safe alternatives for your clients who are concerned with detergents, parabens, 1,4-Dioxane, artificial fragrance, dyes, preservatives, emulsifiers and other toxins. Earth Mama products are used in hospitals, even on the most fragile NICU babies, and they all rate a zero on the Skin Deep toxin database, the best rating a product can receive. Earth Mama only uses the highest-quality, certified-organic or organically grown herbs and oils for our teas, bath herbs, gentle handmade soaps, salves, lotions and massage oils.

Earth Mama now offers a Birth Pro Cart for wholesale pricing available for birth support professionals! Join Earth Mama Angel Baby on the #doulaparty chat Friday June 22 to talk about their new shopping cart plus answer any questions you may have. Earth Mama will be giving away Postpartum Bath Herbs and Monthly Comfort Tea, Mama Bottom Balm, Mama Bottom Spray, and a grand prize of their new Travel Birth & Baby Kit!

Some Say I Am Brave

Tuesday, May 8th, 2012

Image from http://www.vickidonlan.com

Some say I am brave for choosing homebirth. To me, that’s like saying I’m brave for having a big wedding. No matter how involved the planning, we all know the real work of marriage starts when the wedding is over.

So it is with birth. Our childhood, our growing up, and our pregnancy is the training ground. Birth is the opening ceremony. Motherhood is the marathon.

Some say I am brave for choosing homebirth. Others would counter that choosing a hospital birth is brave.

I say choosing to become a mother is brave, no matter where you choose to bring your child into the world. I say learning to make fully informed decisions — guided by a beautiful hybrid of evidence-based information and your intuition — is brave.

Doing this often means going against the flow of society in general, and the tide of modern obstetrics in specific.

It means navigating endless resources, asking questions, and taking time to figure out answers. It means identifying, confronting, and processing fears, anxieties, and stressors that hinder you from being able to fully trust your body and your chosen care provider. It means letting go of a process we have very little control over, when all is said and done, and forming realistic expectations about your birth based on your unique emotional health, health history, and risk factors.

It means being able to tell your well-meaning loved ones that you appreciate their input, but that you are choosing a different way than they did. It sometimes means being willing to give up your ideal for reality — whether that entails a homebirth transfer, an unplanned cesarean, or an accidental homebirth.

The location of your birth doesn’t matter nearly as much as how you got there.

Navigating the road on this journey isn’t as simple as using GPS systems to decide where to turn. It’s less like a road trip, and more like a sea voyage. You may have all the tools in the world in your boat, but unless you use them, the horizon looks exactly the same no matter which direction you look. Sure, you can guess which direction is the right way to go, but you can’t really know unless you have a destination in mind, and you’re able to use the tools around you.

It’s up to you to pick up those tools and make use of them. No one else is really in that boat with you.

It’s up to you to be brave.

Where do you want to go?

Do your homework. Take nothing for granted. Never say never. Then, when you know where you want to be, pick up the tools you have and get yourself there. No one else can (or will) do this for you.

Some say I am brave for choosing homebirth.

What really made me brave was my willingness to open my mind and look beyond the status quo at all the options available to me. That was the hard part. What continues to make me brave is looking four little ones in the face each morning, and loving them in spite of the challenges that mothering them presents.

Some say I am brave. I say that all mothers are brave; some just have not figured it out yet.

When did you realize your bravery as a mother? In what moments have you been brave as a mother?

Pick up good books. Take an evidence-based childbirth class. Know where evidence-based information resides on the internet. (It’s not typically at BabyCenter, just FYI.) Ask questions of your care provider every appointment. Hire a doula. Look outside your box. Interview providers you might not have considered. Confront your anxieties and fears about birth – with professional help if you think you need it.

Grace & Peace,
Tiffany

 

Top 10 Things I’d Do If I Were Pregnant Again

Tuesday, April 10th, 2012

Image from decalsground.com

We all have things we’d like to hit the rewind button for. Today, I thought I’d share the top ten things I’d do differently if I were to miraculously find myself pregnant again. Why not? It’s not something I’ve shared before on this blog. I don’t often get very personal, but I’d like my readers to see me as a real person, who has made real decisions about birth.

So, without further ado, and in no particular order:

The Top 10 Things I’d Do If I Were Pregnant Again:

Image from richmondmidwife.com

1) Have a water birth.

The first time I’d heard of water birth was at our group tour of the birth center where DS #1 was born. In answer to another mom’s question, the midwife leading the tour said something like “No, we don’t do water births here, because we don’t think babies were meant to be born that way.” They did allow moms to labor in tubs, and I tried it. My labor practically stopped. I didn’t know then that if you get in the tub too early, the water can slow/stop your labor. I never thought twice about it all the time I was birthing my four children. Now that I have seen several water births, I would definitely choose to have a pool set up in my house for that purpose.

2) Have my placenta encapsulated.
This is an option I had no earthly idea about when I was having children. I think it could really have helped me with a whole slew of issues. I never struggled with baby blues or a PPMD, but I did have pretty roller-coaster-y emotions in the immediate postpartum days. Also, I have never been able to say that my milk supply was abundant, and I think the reassurance of the placenta pills’ ability to boost supply would have been a welcome comfort to me.

3) I would take a comprehensive, independent childbirth class.
Since I am a certified childbirth educator, I don’t think I’d actually take a full course, but I would probably take a refresher workshop of some kind, just to see if there is any new information out that would be important for me to know, and to give my husband a chance to internalize information he has heard at random since I became a doula. There is always room to grow, and I think we would both benefit from additional education.

One more thing. If I found out that I had to birth at the hospital, for some medical reason, I would definitely take a full, comprehensive course. Since I have never birthed at a hospital, I would really need to fully equip myself for the big differences I would face.

4) I would take a breastfeeding class.
Breastfeeding, for me, though a beautiful experience, was a struggle. I never had cracked, bleeding nipples. I never had to overcome hospital “booby traps,” because I never birthed in a hospital. I had the full support of my husband, my friends, and my mother.

Still, I was never able to meet my breastfeeding goals. When I look back, I know it was simply a lack of basic knowledge of how breastfeeding works. I hadn’t even read a book about it. I think that, if I were pregnant now, that is the first class I would sign up for, and would make sure I had the phone number to some good lactation support.

Image from portlandplacentaservices.com

5) I would make placenta prints.
Before I had it encapsulated, of course. I would frame them and hang them in my living room. They’re gorgeous when done correctly.

6) I would exercise.
Now that I have started trying to take care of my body, and can see the immediate benefits to my emotions, my confidence, and my overall well-being, this is something I would do during pregnancy. Though I did eat well, I never officially exercised with any of my kids, except for the occasional walk with a friend. I know that if I kept up a good exercise routine, I would probably enjoy my pregnancy more.

7) I would try a few different baby-wearing carriers.
For all four of my babies, I had a trusty ring-sling. One was a hand-me-down, and one was custom-made for me by a dear friend. I loved my ring sling, but there were some definite downsides to it. I had no idea there were any other carriers out there that would be properly supportive of my babies (Snugli’s and others like them are not ergonomically correct for a developing baby). So, if I were pregnant again, I’d hook up with the local “baby-wearing lady” in town, and try something new.

Image from hottopic.com

8) I would YouTube/Facebook/Tweet my birth.
I wasn’t on any kind of social media during my other pregnancies, but this time, all my friends would be hearing from me regularly! I’d probably try to facebook/tweet pictures and thoughts as I labor, and be able to announce my little one’s arrival as soon as he got here!

9) I would have professional prenatal photos taken.
This is something I really wish I had done before. I look at all the adorable baby bump photos around me, and sigh a little, wishing I had done the same.

10) I would have a professional photographer at my birth.
There is nothing as powerful as positive birth images. Images that reflect the intimacy, the intensity, the power, the strength, and the sacredness of birth.

There, that about covers it. I can come up with a few more, but I’ll leave that up to you! What would you do if you were pregnant again? If you’re already pregnant, what kinds of things are important to you? What are you doing to enjoy your pregnancy this time around?

Grace & Peace,
Tiffany

All We’re Really Trying to Say

Tuesday, December 20th, 2011

There is a misconception I have noticed among the general population in regards to birth professionals who advocate for the kind of birth outlined in the above photo. How surprised they are when they learn that doulas, childbirth educators, and midwives are actually all for advances in technology and care. We just desire that practice be driven by evidence, not by the shiny new toy.

Let me explain.

I think part of the misunderstanding lies in the belief that because birth professionals outside the medical profession unapologetically share what is scientifically verifiable to be the healthiest norms for mothers and babies, that we are therefore against hospitals/technology, etc. Nothing could be further from the truth!

Speaking for many like myself, what we really desire are two things: 1) True cooperation between hospitals, doctors, and midwives, so that women and their babies get the best, individualized care, and 2) Practices based on the most scientifically sound evidence, rather than the shiniest new toy or convenience for the care provider, or any other reason than the medically verifiable health and well-being of the mother-baby dyad.

Cooperation between the medical establishment and midwifery care isn’t an either-or proposition. Advocating for normal childbirth does not equal opposition to hospitals and all they offer.

Normal birth and all that it implies is a truth with a solid foundation of evidence – nothing more, nothing less. It is not a commentary on any individual woman’s story. It is not a value judgment on the choices made by any woman. Every birth experience is valid, and has inherent value. Every birth is still a miracle. Birth is always sacred and special , no matter how the precious little ones make their appearance.

Every birth is ours, as women, to own and learn from. The planned cesarean is no less valid than the natural home birth so many birth professionals support and love.

Information shared about normal birth is what it is: statements of fact, backed up by evidence, and fueled by an undeniable passion for helping women empower themselves to make truly informed decisions regarding the care of themselves and their babies.

A passion to change the world.

To change the world through loving women and their families, and building bridges of communication between women and their chosen care provider. If we can do those two things, the rest will follow so much more easily than if we tried to force it.

To accomplish the change we are advocating for, we need to speak. Out loud. About unpleasant, but truthful subjects.

And we need to do it all through the filter of love and compassion.

I encourage you to take our words to heart if you can. If it’s too painful – speak out. Find out why it hurts so much to hear about another beautiful home birth. You matter. Your voice matters.

Thanks for hearing me out.

Tiffany

Writing Your Own Birth “Plan”

Sunday, October 16th, 2011

A birth plan has more than one purpose. It begins as a value clarification exercise, then becomes a communication tool with your care provider and ultimately a guide of needs and desires during labor, delivery and postpartum. Even if your birth location does not ask for birth plans, it is a good idea to write one for your own benefit.

Step 1

Clarifying your needs, wants and desires. Here are the  Birth Menu of Options and Assessing Your Feelings we use in class  to begin the value clarification process.  The birth menu is most helpful when you begin by crossing out what you are not interested in, highlighting the items you know you want and circling what you need to research. The AYF worksheet is for you and your husband/partner/non-doula labor support person to go over together to ensure you are on the same page and open up conversation. Doing this prior to 35 weeks of pregnancy gives you more time to coordinate with your care provider or birth location. If you have a doula or are taking a childbirth class, she/he can help you in this part of the process as well.

Step 2

Write down in order of labor, delivery, immediate postpartum and in case of cesarean needs and desires. Your plan really needs to be within one typed page for easy reading and digesting by care provider and staff. The only items that must be listed are care options that are outside of usual practices, protocols or standing orders. Here is the Sample Low Intervention Birth Plan we use to help you see a finished format and types of pertinent information that may be necessary to list.

Step 3

Take your written plan into your care provider. This is a conversation starter, a beginning, a partnering tool. As I encouraged above, early to mid 3rd trimester gives you more flexibility in communicating with your provider and setting your plan in motion. It also gives you opportunity to change providers or birth location if you cannot reach a comfortable agreement.

Step 4

Make any changes.Finalize.  Print out final copy.  Give one to care provider, have one in your bag for labor and birth, give one to doula (if you hired one). Though this is not a binding or legal agreement it can go a long way toward the type of care and birth you want.

Step 5

Gestate peacefully until labor begins!

Low Intervention Birth Plan

Sunday, October 9th, 2011

A birth plan has a few real purposes. It can act as a values clarification exercise for you and your partner. Then it is a vehicle to open communication with your care provider about your needs, desires, wants for labor, birth and postpartum.  What you want and need matters.

 A brief one page plan with an opening paragraph with bullet point information specific to individualized care and desires not usually within your care provider’s standing orders or usual protocols of the birth location.

I advise you take the written birth plan to a prenatal visit at least a month prior to your given estimated due date. This gives time for conversation, to have a clear understanding of expectation and agreement.

If it becomes apparent that you and your provider are not on the same page, you then have time to seek out another provider that fits you and you fit with.

Remember it is not a legal document that your location of delivery or care provider must adhere to.

=======================================================

Birth Needs and Desires for: _______________________. 

Care Provider:_________________.

Estimated Due Date: _________________.

I am planning on a no to low-intervention labor and delivery.  I plan on being mobile, lightly snacking, drinking orally, and having ___________ present.   I understand that intermittent monitoring of me and my baby will be necessary.  I want to be fully consented for any procedure that may come up and fully participate in the medical care for myself and my baby.  I understand that there is pain management available to me, I will ask for it if I so desire.

  • I plan on wearing my own clothing. I will ask for a gown if I change my mind.
  • I would like a saline lock in lieu of a running IV.
  • Limited vaginal exams after initial assessment.
  • In the event an induction and/or augmentation is medically necessitated-
    • Ripening – Foley Catheter instead of Cytotec (misoprostol), Cervadil or Prepadil
    • Pitocin – A very gentle and slowly administered dosage increase.
    • AROM – will only consent to if an internal fetal monitor is a must.
  • Spontaneous pushing and delivery in any position I am most comfortable with.
  • External pressure and/or compresses instead of any perineal or vaginal stretching.
  • No cord traction or aggressive placental detachment, including deep uterine massage.
  • Delayed cord clamping for at least 10 minutes or until my placenta spontaneously detaches (baby can receive oxygen or other assistance while still attached to me).

Postpartum and Baby Care

  • Request that my baby is on my belly or chest for assessments and warmth (even oxygen can be given on me)
  • Delayed bathing
  • Delaying vaccinations including eye ointment and vitamin k.
  • Exclusive breastfeeding, no pacifiers, sugar water, or formula. I will hand express if necessary. I will hand express if needed to syringe feed my baby.
  • No separation from me unless absolutely medically necessary not just protocol.

Cesarean: In the event a cesarean becomes necessary and is not a true emergency requiring general anesthesia.  I would like to keep the spirit of my plan A to plan C so the delivery can be as family centered and intimate as possible.

  • Only essential conversation related to the surgery and delivery
  • Lower sterile drape or have a mirror present so I may see my baby emerge
  • Only one arm strapped down so I may touch my baby
  • Pictures
  • Aromatherapy as I desire for comfort, abate nausea and to mask surgical odors
  • Baby to stay with me continuously in OR and recovery
  • If baby must leave OR for treatment, my partner/spouse goes with baby and I would like my ____________ to stay with me so I am never alone.
  • Breastfeed in OR and/or recovery
  • Delayed immunizations
  • Delayed washing and dressing of baby
  • No separation from me except what is absolutely medically necessary
  • I am willing to hand express if baby cannot get to breast right away.

This “plan” may be copied, pasted and edited  for use by others.