Birth Plan vs Reality

A comparison between my birth plan and what really happened.

Our Son’s Birth Plan

K77 and N73 (unit record #)

My Relevant Medical History:

Right unicornuate uterus

One ovary

One tube

Single right kidney

Single right ureter

Severe Endometriosis

One extra vertebrae

Needle phobia (I use Emla cream one hour prior)

**The following plan contains our cultural and spiritual requirements** (a bullshitty way to phrase it which means they have to take notice, can’t be seen to be disrespecting cultural/spiritual stuff)

Prior To Birth

• My partner N77 is to be present at all times (the only time she was away from me was when either of us got changed into gown/scrubs)
  
• Any and all support people to be present as requested by me (they were)
  
• I expect to be treated with respect and understanding at all times (I was)
  
• Nothing is to be done to me without a thorough explanation and my informed consent (No problems, though I do ask a lot of questions anyway)
  
• If I am unconscious or unable to respond at any time informed consent must be obtained from my partner N77 (thankfully I was fully conscious)
  
• I do not want invasive physical examinations unless proven necessary by me. This include blood tests, weighing etc (nothing was done unless I okayed it)
  
• No students or any other non-essential staff to enter my birth space unless I have given prior consent (it was only the people who really had to be there, and I’d met most of them before)
  
• I refuse to be treated by Dr G (the asshole who assaulted me early on, he was nowhere to be seen but I felt I needed to have that in there anyway)
  

Birth

• Emla cream is to be applied one hour prior to any needles (I did this myself)
  
• Spinal anaesthetic to be administered by a fully qualified anaesthetist only (he was lovely)
  
• Catheter is only to be inserted AFTER I am numb (done, no worries)
  

• Do not cut through my tattoo during surgery (they missed it by an inch, if that)
  

• One arm must be left free so that I am able to hold my baby (both arms were free)
  

• When our baby is born he is to be placed directly onto my chest or into my arms (if for some reason I am unable to hold our child he should be placed in N77’s arms only). Our baby is to be handed immediately to me before any other person eg paediatrician (it didn’t happen that way but I didn’t and don’t mind at all)
  

• I need to have skin to skin contact with my baby immediately after his birth – there will be no wiping, cleaning or washing of our baby at any time following his birth unless I have given my consent (he was covered in vernix when I kissed him, we didn’t bathe him until he was 4 days old)
  
• All newborn procedures can be carried out while I hold our baby including APGAR, administration of oxygen or suctioning (didn’t happen that way my choice and necessity)
• The ONLY exception to the above 3 rules is if our baby is in serious distress and needs URGENT medical attention such as resuscitation. Oxygen and suction can be applied if needed while the baby is in my arms (I wasn’t up to holding him and he was only a couple of metres away with DP)
  
• Our baby’s umbilical cord and placenta is to stay attached AT ALL TIMES –this is to be a ‘lotus birth’ where the placenta is left attached until our baby decides to shed it (this was completely respected)
  
• A double layer closure is required (will have to get my records to check this)
  
• There will be no unnecessary speaking; this is our son’s birth, not an everyday work event (I think I talked more than anyone!)
• I want absolute minimum interference during our initial bonding period (the staff were helpful and hands-off)
  
• If I am unable to hold my baby he will be carried in kangaroo care style by N77/ support people only. There will be no use of plastic boxes with wheels (we had no plastic box until I asked for one a couple of days later, was handy to store stuff in)
• Photos & video to be taken at my request (video was not allowed in theatre but DP was sneaky and switched our digital camera over to video for a little while. we got plenty of photos)
  

In the unlikely event of a General Anaesthetic:

· A general anaesthetic is an absolute last resort and I must consent in full prior to administration

· N77 is to remain present at all times

· Our baby is to be handed to N77 and remain with her at all times

· Our baby is to remain near or on me wherever humanly possible

· All my wishes regarding the manner in which the surgery proceeds are still be to followed

(I didn’t need a general luckily)

Following Birth

• Our baby is to remain with me at all times, including in recovery (OUR BABY IS NOT TO BE TAKEN AWAY FROM ME UNLESS A TRUE MEDICAL EMERGENCY ARISES) (he was always with me from the time he was born to when we left the hospital except for 30 mins with DP when I went for the xray)
  
• Our baby is to receive skin to skin contact at all times (he certainly did and I think it enhanced bonding)
  
• I want gentle and respectful assistance with breastfeeding ASAP(got it in recovery)
• Our baby is to be exclusively breastfed – NO formula offered at any time (formula was never even mentioned)
  
• A dummy is NOT to be offered at any time (never even mentioned)
  
• I DO NOT consent to a vitamin K injection (changed my mind and got it later)
  
• I DO NOT consent to the Hep B injection (only had one midwife pester me about this and she backed off right away, same with cosleeping)
  

• I DO NOT consent to baby’s blood sugar being tested without my express consent (wasn’t an issue)
  

· Nothing is to be done to my baby without a full explanation and my permission (had a couple of midwives try to take him for tests without me but I called them on it)

· Weighing and measuring of my baby is ONLY to be done when I say my baby is ready (it was done only upon my request)

• Any and all support people to be present as requested by me (I had who I wanted when I wanted)
  

· Any appropriate post natal special care will be discussed if the need arises but with the principles of lotus birth and parental skin to skin contact maintained as a priority at all times (N/A)

· Rooming in will be immediate and continuous unless there is a genuine problem with our baby’s health and informed, written consent is obtained from myself for any treatment of our baby. At all other times he is to be left with me, my partner, or a designated support person (no problems)

In the unlikely event that our baby needs special care:

• Any procedures must be explained in full and informed, written consent must be obtained before any intervention is performed
• Parent(s) (or support person of my choice) will remain with our baby at all times – absolutely no exceptions
• Our baby will be fed breastmilk only. Strictly NO formula feeding
• Only if absolutely necessary our baby will receive expressed breastmilk given via syringe. Breastfeeding is to be our first choice wherever possible
• Even if our baby is premature, there will be no mandatory period in the nursery. Any length of time spent in a special care nursery will be based solely on need, not as a precaution
• Kangaroo care and as much skin to skin contact with parents (or support person of my choice) as humanly possible if our baby is unwell
• No procedure should be proposed unless it is necessary to save our baby from a demonstrable risk of death or severe injury/disability.

(we were very lucky not to need any special care)

We trust that you will understand and support our wishes as we have made these choices about my / our care based on much research and deliberation.

We ask that our birth plan be followed at all times. Under no circumstances are our wishes to be disrespected or unsupported. Thank you for your cooperation.

We ask that this plan to be added to my medical file and my baby’s medical file so that all staff can refer to it at any time.