(HEADER:) BIRTHING PLAN (MY NAME IS HERE) PAGE 1 OF 2.
D.O.B: --/--/---- BABY DUE DATE: --/--/----
NHS NUMBER: ----------- UNIT/HOSPITAL NUMBER: -------
CONSULTANT: (NAME HERE) MIDWIFE: (NAME HERE)
(HOSPITAL NAME HERE) HOSPITAL BIRTHING POOL
PLEASE NOTE: I HAVE SYMPHYSIS PUBIS DYSFUNCTION (SPD):
This means that the joints in my pelvis are unstable and painful and I need 24/7 care as I am in a wheelchair and immobile. Clexane injections daily due to stop at week 39: 25th November 2009.
There are certain things that are recommended and certain things that I cannot do during labour and birth; this is to avoid anything that may cause damage to my pelvic joints.
These are outlined in this birthing plan:
BIRTH AND LABOUR:
I am in a wheelchair and immobile due to SPD.
Clexane 20mg injections have been daily self-administered and are/should be stopped at week 39 in preperation for birth: 25.11.2009. (If it is before this date please ask if they have been stopped.)
It is highly recommended I labour in the Birthing Pool and deliver in the water: This is important so my pelvis can be supported at all times and allow me to open my legs and be able to be as mobile as possible for the birth.
A hoist is to be used to allow me to access and exit the birthing pool.
My husband, (NAME HERE) is also my registered full time carer and is to be present at all times, whatever is happening to me, this includes if a caesarean becomes necessary. (Please bear in mind that I am high risk of DVT.)
I wish for my husband and I, to be fully informed at all times about any decisions or discussions about me or my care.
I do not wish to have continuous foetal monitoring on admission or at any other stage, unless there is a strong clinical indication to do so.
I do not wish for students or any unnecessary person(s) to be present at any time.
I would like to use Gas and Air and massage (in birthing pool) as pain relief. Pethidine only if necessary and at no epidural at any time.
I wish to breastfeed my baby.
I wish my baby to be placed straight onto my tummy and close to me at ALL TIMES including when being cleaned and dressed straight after birth.
I have no objections to the injection Syntocinon or Syntometrine being given to me to help the womb contract.
(HEADER:) BIRTHING PLAN (MY NAME IS HERE) PAGE 2 OF 2.
IF A BIRTHING POOL IS UNAVAILABLE:
REMEMBER: I wish to breastfeed and cannot lie/be placed in certain positions.
I am high risk of DVT but would prefer to have a caesarean as normal birth is not possible due to the following:
I cannot open my legs very far and I need to avoid doing so (sometimes referred to as abduction of the legs.)
When lying I need to keep my legs together and I need a pillow between my knees.
I cannot stand for very long and cannot get into any asymmetrical position (e.g. standing on one leg, half kneeling, lying with one knee bent up etc.) Not even for seconds.
I find it painful to lie flat on my back and cannot open legs for examinations, so will need to be examined whilst side lying or on all fours (with no pain relief so I can explain at all times if a position is too painful.)
It is recommended I avoid forceps delivery or any intervention which involves the lithotomy position. If intervention becomes necessary I would like to have a caesarean.
I am happy to have an episiotomy only if necessary and if stitching is required it needs to be done by someone who can work whilst I am laid on my side or in a position that is not causing pain to my pelvis.
AFTERBIRTH AND AFTERCARE:
Vitamin K is to be administered by injection to my baby.
My baby is to remain close to me at all times. (High risk post natal depression)
I am very concerned about care after the delivery and whilst in hospital. I will need help with mobility, meals, self-care, caring for my baby and toileting. My husband is happy to provide this as my full time carer, however in any instance this is not possible I will need assistance with these. (If any person(s) at any time are unable to assist me with regards to my mobility, I will need alternatives such as a hoist or whatever else that can be used for immobility.)
I wish to breastfeed my baby.
I wish for my husband and I to be left alone afterwards when everything has been sorted, to bond with our baby.
I would like a cotbed that is bolted or if not possible, placed to the side of my bed, so I can lift my baby out to feed as I will not be able to get out of my bed unaided. I may also need a normal mobile cot to transport the baby and change the baby.
I will need all meals delivered to me as I cannot collect meals due to my mobility.
Thank you for your patience and understanding of my condition and birthing needs.
If you are unsure about anything please ask myself or my husband and we will be more than happy
to help you, in regards to SPD and the pain I am in.