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VBAC Cubby - vaginal birth after cesarean

Planned Hospital VBAC Birth Plan #2
Mother: (list the names of each)
Father:
Siblings:
Doula:
Sibling supervision:
EDD:
Obstetrician:
Birthplace:

Dear Care Providers:

We appreciate your kind care and respectfully request the following for our labor and birth:

  • Intervention only as medically necessary (nothing routine) and with our consent (not general)
  • Freedom to move about, our choice of positions for all stages of labor
  • Encouragement of natural relaxation techniques
  • Relaxing, unhurried environment
  • Whole family together during entire birth process
We request that our Professional Labor Assistant remain with us throughout our labor, birth and afterward regardless of our type of birth (including cesarean section), and that she be given freedom to support us as we have chosen barring medical necessity.

We recognize that true emergencies do sometimes arise, and will be relying upon your skill in the event of such a circumstance. We hope to have full communication in that case, with you informing us of all our options. (In case of emergency, see reverse.)

General: Doctor, husband, siblings (with supervision), and doula to attend the labor and birth in the hospital; family to be educated and prepared for childbirth through classes, books, videos, research, etc.

Pregnancy: No arbitrary time limits, routine induction of labor, or stripping of membranes

Labor (Stage I):

  • LDRP room for labor, birth and hospital stay
  • No routine vaginal exams
  • Monitoring of fetal heart tones by fetoscope or DopTone
  • No routine IV
  • Unrestricted movement and positions throughout labor
  • No arbitrary time limits or routine augmentation
  • Membranes left intact to rupture spontaneously, esp. prior to engagement of head
  • Pain relief by relaxation, shower, walking and other movement and position changes, adequate nutrition by mouth
  • Opportunity of signing "Against Medical Advice" waivers if certain options are declined

Birth (Labor Stage II):

  • Choice of comfortable and effective positions
  • Allow mother to birth at her own pace with no arbitrary time limits
  • Encouragement to birth slowly and gently following own pushing urges, allowing tissues time to stretch and pelvic outlet to open properly
  • Possible compresses and perineal support to allow tissues to stretch

(Stage III):

  • Allow baby to clear own mucus naturally rather than routine suctioning
  • Baby to be placed on mother's abdomen immediately upon birth; warming by skin-to-skin contact and blankets placed over baby
  • Allow cord to stop pulsating completely before any clamping, cutting or administration of medications to mother
  • Local anesthesia should there be tearing in need of repair
  • Time for breastfeeding and natural separation of placenta
  • No manual exploration of uterus after birth
  • Breastfeeding as desired by mother and baby, on demand

Postpartum:

  • Rooming-in of baby with mother
  • Unrestricted visiting by immediate family members
  • All observation/examinations/procedures for infant to be done in mother's presence
  • Bathing done at parents' request, by parents, or not at all if parents desire
  • Vitamin K given only with informed consent of parents
  • Delayed eye treatment, given only with informed consent of parents
  • PKU test given only with informed consent of parents (after at least 24 hours of breastfeeding)
  • Vaccines given only with informed consent of parents
  • No circumcision
  • 100% breastfeeding; no bottles, water, pacifiers, etc.

ADVERTISEMENT
Thank you very much.
SIGNATURES
Mother
Father
Obstetrician
Pediatrician
Hospital representative
Professional labor support

On the reverse I had a very similar plan in case of emergency.

I never actually got a pediatrician or hospital representative to sign it, though they did file it with my pre-registration chart and follow it during my labor and postpartum. My doctor signed it as is, but asked me orally to change a few things. I did have my membranes stripped, have intermittent electronic fetal monitoring, and a saline lock. My older children stayed out in the hall during most of labor and had gone to the cafeteria for breakfast during the actual birth. My baby was bulb-suctioned and eventually warmed on the radiant-heat warming table, my uterus was explored manually, and the baby was taken away the next day for a hearing test. I gave specific consent for each of the changes.

Planned Hospital VBAC Birth Plan #1
Planned Hospital VBAC Birth Plan #2
Return to VBAC Birth Plan article

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