Birth plan for a homebirth with midwives (UK)
This birth plan was shared by Olga who lives in the UK.
Olga and her partner planned for their second baby to be born at home assisted by midwives, after a traumatic induction with their first baby. You can read the story about Olga’s positive and empowering second birth here.
OLGA’S BIRTH PLAN
My husband, Christian.
I agree to student midwives being present during my labour.
Positions for labour and birth
I would like to remain active and use whatever position I find comfortable. Please encourage me to stay off my back! I may wish to move throughout the house and to use the bath or shower from time to time. I would like to minimise internal examinations. Please do not offer to break my waters, and please be very careful to avoid doing so during any internal examinations. If the baby appears to be poorly positioned or labour is not progressing well for some reason, I would appreciate it if you could suggest changes of position or movements which might help. I will use aromatherapy and homeopathy during the labour.
Please do not offer pain relieving drugs unless I ask for them. I do not wish to use Pethidine under any circumstances so please do not offer it. I would like to use a birth pool and natal hypnotherapy techniques. Please leave Entonox in the car but I would like it to be available in case I ask for it.
I have bought a birth pool in a box and intend to give birth in it. It is important that the pool temperature is comfortable for me so, unless it is outside normal safety limits, I will choose the temperature myself. I understand that I would probably want a cooler temperature during the first stage of labour, and warmer – nearer blood temperature perhaps – for the second stage. I would like to have a water birth if possible and would appreciate your support in encouraging me to give birth underwater.
I am happy for you to examine me to let me know when I am ready to begin pushing my baby out. Please keep the room as quiet as possible during the second stage and adopt hands-off approach. I would like to minimise distractions at this time. I would like to give birth in an upright, kneeling, supported squatting or all-fours position to give the baby maximum space to descend through my pelvis. I do not want to be on my back or semi-reclining unless that position seems right for me on the day, having tried alternatives. If I am too tired to maintain an upright position then please encourage me to lie on my side instead of my back, to allow maximum mobility in my pelvis. When my baby is born, I would like my husband to catch him and he will pass baby straight to me. I would like to avoid perineal damage if possible and would appreciate your guidance in giving birth gently to accomplish this. However, I would rather tear naturally than have an episiotomy. I would like the lights dimmed when my baby is born, and for the minimum amount of noise to be made. I hope that it will be a gentle entry into the world. Please do not suction mucus from the baby’s nose and mouth ‘just in case’ – only suction if necessary.
Monitoring your baby’s heart rate
I do not agree for continuous monitoring, but I am happy with hand held Doppler or waterproof Doppler for when I am in the pool if you feel that’s necessary. I would like Doppler monitoring to be kept to absolute minimum. Please do not ask me to come out from the pool for monitoring.
Do not perform routine episiotomy. I do not agree for forceps/ ventouse delivery unless absolutely no other options, especially not because ‘lack of progress’.
I would like a physiological third stage with the cord clamped and cut when it stops pulsating. I wish no drugs to be used unless specifically indicated. It is important to me that you do not clamp the cord until it has stopped pulsating, if baby needs to be resuscitated, please do it with cord still attached. Please do not pull on the cord or use fundal pressure unless there is a specific indication to do so, as I have read that this is contra-indicated in drug-free third stages. If I give birth in the pool, I may like to get out of the water for the third stage.
Care of the baby
I would like to breastfeed my baby as soon as possible after the birth. I would like to keep the baby unclothed and close to my skin immediately after birth, to maximise skin-to-skin contact. Please do not administer prophylactic Vitamin K after the birth.
In case of transfer to hospital
If transfer by ambulance becomes necessary, please do not strap me in on my back – I would prefer to be on my side, to make contractions easier to deal with.
Please do not offer Pethidine/Demerolas I am concerned about its possible effect on my state of mind in labour, and on my baby’s health. I would prefer to have an epidural. I do not agree to student doctors being present during my treatment.
I am very keen to avoid a caesarean section if it is at all possible, as I do not want to enter future labours with a scarred uterus. I particularly would like to avoid a caesarean just for slow progress. If labour is simply taking a long time but my baby is not in immediate danger, please would you encourage me to keep going and perhaps to try changes of position or movements which might help. Please do not offer a caesarean unless my baby is in danger.
If a caesarean section becomes necessary, I would prefer to remain awake with epidural or spinal block anaesthesia. I would like my husband to stay with me at all times, and would like to breastfeed the baby as soon after birth as possible.
If I suffer a severe post-partum haemorrhage, please do not perform a hysterectomy unless it is the only available course of action.
Please do not give my baby supplements of glucose water or formula milkwithout my permission. I would expressly like to avoid having any formula supplements unless it is unavoidable, and certainly not in the first two days in any event.
Under no circumstances is my baby to be bottle-fedas this could lead to nipple confusion and hinder breastfeeding. If supplements are necessary, please give them by spoon or other method, not by bottle.
If I have trouble breastfeeding, I would greatly appreciate the help of a midwife who is fully supportive of breastfeeding, and would also like to be given contact details for local breastfeeding counsellors.