36 Week Midwife Appointment & Birth Plan

I am actually 35 weeks, 5 days today, but since my weeks change on Sundays and my appointments fall on Fridays, that's close enough!

I was a little less excited going into this appointment since I would be doing the Group B Strep test and let's face it, appointments where you get to see a midwife/ob fully clothed and covered are always much more exciting than the alternative. However, Linda, my midwife, let me do it myself! I had a regular appointment (weight (not as high as I was expecting!), blood pressure (good), fundal height (she didn't say this time, so I assume right on track as usual), Doppler (136)) and then we went over our birth plan that we brought in. I am going to copy and paste it into the bottom of this post in case anyone is interested in seeing what our wishes are. Linda read over our plan and I was a little nervous because I felt like it was long (2 1/2 pages). She said it was great though and felt that everything was normal and very doable! Yay :) I was most worried about requesting no IV or even Heplock and requesting that I be allowed to eat and drink freely, but that was all okayed! She also reminded me that if I am negative for GBS that I can stay home for as long as I'd like before coming to the hospital.

Anyway, after we talked about that she told us that we needed to start having sex 3 times a week to get things ready and Sunday, at 36 weeks, I am to start Evening Primrose Oil capsules (one in the morning by mouth and one at night vaginally - ugh). So we picked those up at Whole Foods on the way home and I'm ready to go!

It was surreal how she talked about the fact that I'm at the point where if I were to go into labor it's likely everything would be just fine and they would not do anything to stop it. We could seriously have a baby in the next couple weeks in theory! Crazy, but so exciting. My husband is even more excited than I ever expected (Not that I didn't expect him to be, but he's definitely showing it which is sweet).

Then she let me do my own swab for the GBS test and leave my swab in the room and head out. It was no big deal at all and I really felt more comfortable doing it myself.

Now I go back every week! I have to see another midwife next Friday because Linda won't be there which I really don't love, but I know it's good b/c there is of course a good chance Linda won't be on call for our delivery and I will at least want to meet the other midwives.






Here is our birth plan if it interests anyone!

Birth Wishes
Jenny and Matt XXXXX

Estimated Due Date: August 30, 2009
Patient of Linda XXXXX
Pediatrician: Dr. Terri XXXXX– XXXXXXXXXXXXXXXXX



We're looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments. Thank you!



Labor
- I would prefer a nurse(s) that is familiar with, and accepting of, natural childbirth and would be a good fit to help us achieve that if at all possible.
-I would like the hospital staff to discuss all procedures with me or my husband before they are performed.
-I would like to be free to walk, change positions and use the bathroom as needed or desired.
-I prefer to eat and drink throughout labor, as desired.
-I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
-Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary. I would prefer a heparin lock before an IV.
-Please limit the number of vaginal exams to take place as only medically necessary or as requested by us.
-I wish to labor freely in the birthing tub (if available) or shower.
-As long as our son is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or Doppler, even if the membranes have ruptured.
-I would prefer that I be allowed to have my labor progress naturally and not be augmented with Pitocin, etc.




Anesthesia/Pain Medication
-Please do not offer any type of pain medication.
-I would like to avoid all narcotics, if possible.


Cesarean Section Delivery
-If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
-I would like my husband to be present during the surgery.
-If conditions permit, I would like to be the first to hold our son after the delivery.
-If possible, I would like to breastfeed our son immediately after the birth.
-I would like our plans outlined here for after the birth to be followed as closely as possible with a C Section.


Perineal Care
-I prefer not to have an episiotomy unless it is medically indicated.
-To help my perineum stretch, please help guide my pushing efforts by letting me know when to push and when to stop if things are moving too fast.
-I would rather tear than have an episiotomy.
-Please administer local anesthesia when repairing any episiotomy or tear(s).
-Please suture tears only if necessary.
-I would like to be allowed and encouraged to push in positions that are most favorable to my perineum and baby.


Delivery
-Even if I am fully dilated, and assuming our son is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.
-I prefer to push or not push according to my instincts, but would also like some guidance from my midwife as well.
-I do not want to use stirrups while pushing.
-I would like the freedom to push and deliver in any position I like.
-I would like a soothing environment during the actual birth, with dim lights and quiet voices.


After birth
-Please place our son on my stomach/chest immediately after delivery, unless an emergency does not permit this.
-I would like to breastfeed our son immediately.
-Please allow the umbilical cord to stop pulsating before it is cut.
-I prefer to wait for spontaneous delivery of the placenta and do not want the cord pulled on.
-I do not want a routine injection of Pitocin unless medically necessary.
-Please remove my IV/Heparin lock/catheter (if applicable) as soon as possible after delivery.


Newborn Care
-I would like to hold our son skin-to-skin during the first hours to help regulate baby's body temperature.
-I would like to hold our son through delivery of the placenta and any repair procedures.
-If possible, please evaluate our son on my abdomen.
-If our son must go to the nursery for evaluation or medical treatment, my husband will accompany our son at all times.
-I would prefer to bathe our son myself, at my discretion.
-I would like to waive the administration of eye antibiotics.
-I would like to waive the administration of routine Vitamin K, unless medically indicated through birth trauma or recommended by our midwife.
-I would like to defer the PKU screening until we have had at least a few hours of bonding. (I have this in there, but was told they don't do it until right before we leave anyway)
-I would like to waive the administration of the following vaccinations:
Hepatitis B
-We are not planning to have our son circumcised.



Postpartum
-I would like to have our son room-in with me at all times.
- I would like to be released from the hospital as soon as possible following the birth if both our son and I am healthy.



Breastfeeding
-I plan to breastfeed and want to nurse immediately following the birth.
-Please do not give our son supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
-I would like to meet with the staff lactation consultant as soon as possible after the birth and various other times throughout our stay if their time permits.