Response from Annette Avery
Read Annette's VBAC after three previous cesareans
story here.
What made the difference between my preparation
for my first three births (which turned into unnecessary
"emergency" C/sections in the middle
of labor) and my fourth birth (which was a wonderful,
successful VBAC)?
I got educated. I learned the facts about all
the things the medical professionals had scared
me with the first three times. I read and read
and read- not mainstream literature, but gentle-birth
literature. I read my medical records from my
three C/sections. I talked to women who had seen
every side of it. I talked to midwives, doulas,
mothers of many children, mothers who had had
VBACs. I read actual VBAC stories. I changed my
point of view.
I opened my mind to possibilities instead of
fearing the "risks" of stepping beyond
the modern way of doing things. I decided I was
having the baby and stopped asking for permission
from medical professionals.
I changed the way I worded things- I stopped
talking about delivery and started planning birth;
I stopped calling myself a patient and instead
called myself an employer.
I hired a doula. I had someone with me who would
be there for me throughout labor, both at home
and in the hospital, who knew what birth is like
from her own four children's births as well as
the many she had attended. She knew what I wanted
and was able to remind the hospital staff of my
written, OB-approved birthplan when I was beyond
speaking coherently. She was able to reassure
me when--even after all my learning- things arose
that I still wasn't prepared for.
I hired a birth attendant who would take a supporting
role. I interviewed many CNMs, direct-entry midwives
and OBs and chose the one who was willing to take
the job the way I offered it. He demonstrated
no fear in our initial interview, he accepted
my decisions after discussing each choice fully
with me, and he treated me respectfully as an
individual woman at all times.
I wrote a specific, authoritative birthplan and
got it approved by my OB and filed in my pre-registration
chart at the hospital. I had many copies with
me during labor and referred staff members to
it when they tried to talk me into deviating from
it. I signed waivers of many hospital routines,
even some against medical advice. I took responsibility.
* * *
BIRTH PLAN
Mother:
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
Birth (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.
Thank you very much.
SIGNATURES
mother
father
obstetrician
pediatrician
hospital representative
professional labor support
Also by Annette A., FTMom:
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