Birth Plan

Below is the birth plan we have put together, to be given to those attending the birth. It is all aimed at allowing for a natural child birth, allowing the child to come when the time is right without induction or cesarean section.^1,2

The Euphrony’s Birth Plan

Mrs. and Mr. Euphrony, with their daughter Lil'E, would like to thank you for the rolls you are playing in the birth of our new son and brother, Lil'er E. Our doula, Debbie, will be assisting Mrs. E and our midwife³, Karen, during the birth process. We have a few requests that we hope you will recognize to make this the best possible birth experience for our family.

• We recognize the need for care for the infant during the birthing process, and ask that such monitoring be minimal.
• We request that no IV be administered to Mrs. E. (We recognize the importance that the mother be well hydrated and plan on using clear fluids for this.)⁴
• Please do not offer medication for pain relief. We would like to use the tub and shower for pain relief, and will request medications if needed.
• We also request that no aggressive coaching for pushing ("purple pushing") be offered.⁵
• We would rather allow for natural tearing, rather than have an episiotomy⁶, and that forceps not be used.
• Please wait for the placenta.
• We ask that no routine post-partum pitocin be used. If necessary, please use an injection of pitocin in the thigh.

Thank you for becoming familiar with our wishes for a smooth and natural birth process.

Fact Sheet:

1. Induced labor tends to be more intense and painful for the woman, often leading to the increased use of analgesics and other pain-relieving pharmaceuticals. This cascade of intervention has been shown to lead to an increased likelihood of caesarean section. Currently, in the United States, 41% of mothers get induced.
2. The World Health Organisation estimates that the rate of caesarean sections at between 10% and 15% of all births in developed countries. In 2004, the caesarean rate was about 20% in the United Kingdom. In 2005 the cesarean rate was 30.2% in the United States. During 2001–2002, the Canadian caesarean section rate was 22.5%. In the United States the cesarean rate has risen 46% since 1996.
3. In the United Kingdom, midwives are the lead healthcare professional attending the majority of births, mostly in a hospital setting although home birth is a perfectly safe option for many births. In the United States, Nurse Midwives are advanced practice nurses who have specialized in the practice of obstetrical and gynecological care of relatively healthy women. In addition to a registered nursing license, many nurse-midwives have a master's degree in nursing. Nurse-midwives practice in hospitals and medical clinics, and may also deliver in birth centers and at home. They are able to prescribe medications in 48 out of the 50 states.
4. In the United States, 85% of mothers are connected to an IV line during labor and only 15% of mothers were permitted to eat during labor.
5. Purple pushing, during which the patient holds her breath for 10 seconds while pushing, is safe in the approximately 80% of women with low-risk pregnancies. But that doesn't mean it works best. Furthermore, in physiologically high-risk cases, the baby can't tolerate that kind of pushing. In the United States, 57% of mothers who give birth vaginally are on their backs while giving birth. A squatting position will provide the most intrauterine pressure and is safe in low-risk patients. Higher-risk patients, such as those with fetal heart rate changes should avoid this position; in those cases, a side-lying position will improve heart rate patterns and Apgar scores. Other positions to consider include semirecumbency, standing or leaning, and hands-and-knees positioning. Some patients may prefer use of a birthing chair or stool.
6. Routine episiotomy is a major cause of infections, some of them fatal. Recent studies indicate that routine episiotomies should not be performed, as they may increase morbidity. Having an episiotomy may increase perineal pain in the postpartum period, resulting in trouble defecating. In addition it may complicate sexual intercourse by making it painful and replacing erectile tissues in the vulva with fibrotic tissue.

Tags: Birth, Natural Childbirth, Doula, Midwife, Purple Pushing, Episiotomy, Pitocin, Cesarean Section, Induction