Department of

Obs tetrics

BIRTH PLANS

UNIT 1 BOGULKUNTA 4-1-1230, Off Abids Road, Bogulkunta, Hyderabad 500001. UNIT 2 HYDERGUDA 3-6-282, Opp. Old MLA Qrtrs., Hyderguda, Hyderabad 500029. UNIT 3 JUBILEE HILLS Plot # 769, Near MAA TV, Road # 44 Jubilee Hills, Hyderabad 500033. ALL THREE UNITS Centralized Tel. : +91 40 40222300 Appointments only Tel. : +91 40 40632301 Website : www.fernandezhospital.com

What is a birth plan? A birth plan is a way of communicating with the doctors, and nurses who care for you in labour. It tells them about the kind of labour you would like to have, and what you definitely want to avoid. What one needs to understand is that it is not written in stone, because the best birth plans acknowledge that things may not go according to plan. You need to write the plan in such a way that your midwife or doctor doesnt feel she has her hands tied. She may need to recommend a course of action, which is not what, you had originally hoped for, but which is in the best interests of your baby and you. How do I go about writing a birth plan? Before you start writing, get as much as information that you can. This can involve: Prenatal classes at your hospital. Talking to other women who have given birth at the hospital you are going to. Find out if the hospital can provide you the type of care you are looking for. Talk to your partner or, the person who will be with you at the time of birth and their role. The type of labour and birth would you like to have.

Make a note of all your thoughts as they come to your mind. A plan can then be created based on what you have jotted down. What should I include in my plan? Here is a list of headings that you might want to use in your birth plan. You certainly dont have to use them all, only those you feel are important. Perhaps there are others which you can think of which arent included here. Birth companion who will be with you in labour? Do you want this person to stay with you all the time, or are there certain procedures or stages in labour when youd prefer them to leave the room? Positions for labour and birth which positions you, would like to use during labour and for your babys delivery? Do you want to remain mobile as long as possible, or do you want to be in bed? Mention if you want to give birth, standing, kneeling, squatting or lying on the bed. Pain relief are you looking for pain relief, if so what kind? Fetal heart rate monitoring how do you want your baby to be monitored at labour, manually by a hand-held device, or electronically via a belt strapped around the waist? Assisted delivery what kind of assistance would be preferred, in case needed at the end of labour? E.g. forceps or vacuum.

Feeding of the baby if you are only going to breast-feed the baby or, if there would be any bottle-feeding as well. Handling of unexpected situations what if the baby needs to be shifted to the NICU? Would it be at the same hospital or do you want to transfer the baby to another hospital. You also need to look at the option of who will be around to care for the baby, if you are in no position to care for the baby yourself. Any special needs any religious needs or rituals that need to be conducted at the birth of the baby. In case you have any disabilities, would you need any special assistance at the time of birth and in care of your baby? Do you have any reactions to medications? Is there any specific format for a birth plan? There is no special form. You can use the attached checklist or create one of your own.

BIRTH PLANS CHECKLIST

Name : _____________________________________ Spouse/Partner : _____________________________ M.R. No : ______________ Date : _______________ Desired Hospital : Unit I Bogulkunta Unit II Hyderguda

Name of Consultant: __________________________ EARLY/FIRST STAGE LABOUR Environment : Wear own clothing Coach/partner only desired attendees other than medical staff (maximum 2 people) I would prefer to wear my contact lenses/ glasses Mobility (choose one) : Unlimited freedom to move (walking, bathroom, rocking chair, fitness ball, etc.) Mobility is not important to me I.V. : I.V. insertion is acceptable at any point I.V. placement should be attempted only if dehydration occurs Please attempt to insert I.V. on left/right (circle) Monitoring (choose one) : Intermittent monitoring (Fetoscope, Doppler, etc.) No monitoring except in emergency situations Catheterization : I would like to avoid catheterization unless it is absolutely necessary Pain Relief Offer (choose one) : Do not offer; I will ask if I desire it Offer if I appear uncomfortable Offer as soon as possible Pain Relief Options : Natural Relaxation techniques Hot or cold compresses

Positioning Massage I.V. Medication _______________________________ Epidural Walking epidural Traditional epidural Labour Induction/Augmentation : Induction only if medically indicated Augmentation only if medically indicated Cervical gel (PGE2) Foleys catheter Prostaglandin E 1 (Misoprostol) Pitocin Rupturing of the amniotic sac I prefer my amniotic sac be allowed to rupture on its own SECOND STAGE LABOR Pushing Push in position of my choosing I am not concerned with positioning Spontaneous pushing (when I feel the need) Pushing with medical direction Delivery I would like a mirror available to view pushing/ crowning / birth IMMEDIATELY FOLLOWING DELIVERY I want baby placed on my chest immediately after birth I would like my partner/coach to cut the cord Partner/coach does not want to cut cord Please delay cord clamping and cutting until pulsating ceases I would like to hold the baby while delivering the placenta I wish baby to be examined in my presence. If baby cannot be examined in my presence, I wish my partner/coach to remain with baby at all times unless medically not appropriate. I will hold baby and provide body warmth instead I want to bank cord blood

EPISIOTOMY I do not want an episiotomy unless there is an emergency situation I would like to attempt perineal massage to stretch the perineum I would like an episiotomy to reduce risk of tearin BABY CARE I wish to breastfeed exclusively I wish to breastfeed, but formula supplementation is acceptable I wish to formula feed I would like to meet with a lactation consultant as soon as possible I want baby circumcised I do not want baby circumcised PRIVACY I would like baby to room in I am comfortable with male obstetrician I welcome all well wishers I wish to limit visitors I do not wish to have medical students involved in my care Other ______________________________________ CESAREAN In the event that a cesarean section is deemed necessary, I would like the following: Partner / spouse present In the Event that Baby Requires Special Care Due to Trauma or Illness: I would like to breastfeed/pump breast milk

Mothers Signature ____________ Date : _________ Fathers Signature ____________ Date : _________ With a well-considered, well-organized plan in place youll relieve stress by knowing what to expect and by ensuring that your wishes and preferences are known to all including your doctor.