Cesarean Birthing Plan

Home › Child Development › Birth › Cesarean Birth
,

THE BIRTH PLAN

We understand this plan consists of our goals for our baby’s birth. We intend to be flexible and consider mother’s and baby’s health and safety our top priority. We hope you will work with us as a team to achieve the birth we envision. We would appreciate all your help in achieving a natural birth with minimal interventions. Please discuss any proposed interventions with us in advance, explaining risks, benefits, and alternatives. We prefer evidence-based practices and time to decide unless it’s an emergency.

Labor Environment (New Section)

  • Dim lighting, quiet atmosphere, and minimal interruptions (e.g., no unnecessary staff entering).
  • Play our personal playlist or calming music.
  • Allow use of essential oils/aromatherapy (e.g., lavender for relaxation) if not contraindicated.
  • Hydrotherapy: Access to shower or birth tub for pain relief and labor progression, if available.

Notes for Father/Birthing Partner:

  • Ask: “Can we adjust the room lighting/music to make it more comfortable?” or “Is hydrotherapy an option here, and is it safe right now?”
  • Advocate: If the environment feels chaotic, remind staff of preferences to reduce stress, which can aid natural labor.

FIRST STAGE

Heparin/Saline Lock

  • Mobile IV if needed.
  • Placement: Forearm or hand preferred.
  • No routine IV unless dehydration or medical need; prefer oral hydration.

Monitoring

  • Doppler preferred for intermittent checks.
  • One 20-minute external electronic strip on admission.
  • Intermittent external fetal monitoring once every 2 hours (or less if low-risk).
  • Continuous external fetal monitoring only if necessary (e.g., if induced or pain meds used).
  • Allow some mobility during monitoring; no internal monitors unless essential.

Positions for Labor

  • Freedom to change positions/walk around.
  • Confined to bed only if medically required.
  • Encourage upright positions (e.g., walking, swaying on birth ball) to promote gravity-assisted labor.

Dealing with Pain

  • Natural methods: Positions, comfort techniques (e.g., massage, breathing, TENS unit if available), hydrotherapy.
  • Medication only at mother’s request; discuss options first.
  • No offers of epidurals or narcotics unless requested; focus on non-pharmacological relief.

Enhance or Speed Labor

  • Natural methods: Visualization, walking, position changes, nipple stimulation.
  • Empty bladder regularly (walk to toilet if possible).
  • No artificial rupture of membranes (AROM) or Pitocin unless medically indicated and discussed.

Fluids and Food

  • Mother’s choice: Juice, water, electrolyte drinks, Popsicles, ice chips.
  • IV fluids only if necessary.
  • Light foods/snacks as tolerated (e.g., fruit, yogurt) to maintain energy.

Cervical Checks

  • If membranes have ruptured, minimal checks—no more than 2.
  • Overall, limit to essential only (e.g., every 4 hours or on request) to reduce infection risk.

Notes for Father/Birthing Partner:

  • Monitor mom’s comfort and energy; suggest position changes or snacks.
  • Ask: “Is continuous monitoring truly needed, or can we stick to intermittent?” or “What are the risks/benefits of speeding labor now? Can we try natural methods first?”
  • Advocate: If interventions are suggested, request a private moment to discuss with mom.

SECOND STAGE

Positions for Pushing

  • The mother has learned Instinctive Pushing. Encourage whatever position is most comfortable (semi-sitting, sitting, side-lying, hands and knees, standing, squatting, etc.). Discourage lithotomy or supine positions unless forceps, vacuum, or episiotomy are necessary.
  • Mother’s choice: Vertical, hands/knees, squat, side-lying.
  • Stirrups only as a last resort.

Bed for Birth

  • Birth chair, bean bag, floor, bed, toilet.
  • Hospital bed/labor bed preferred over delivery table.

Pushing Techniques

  • Physiological/Instinctive pushing: Spontaneous bearing down in response to urges, with short efforts (5-6 seconds) and breathing in between.
  • Spontaneous bearing down preferred over directed pushing (e.g., no counting by attendants).

Speed Actual Birth: Pelvic Floor Relaxation

  1. Suggest position changes if progress is slow.
  2. Remind her to bear down with the urge, not push without it.
  3. Remind her to relax the pelvic floor.
  4. If needed, ask her to bear down longer/more forcefully.
  5. Patience for natural methods (position changes, visualization, intense coaching).
  • Slow panting/blowing for controlled delivery.
  • Side-lying if needed.

Care of Perineum

  • Aim for intact perineum: Massage, supportive positions, hot/cold compresses.
  • No routine episiotomy; only with consent and local anesthesia if unavoidable.

Baby Catcher

  • Doctor or midwife.

Cord Cutting

  • Clamp and cut after pulsating stops or cord goes white.
  • Father cuts cord if desired.

Placenta Birth

  • Spontaneous/natural (breast stimulation, baby suckling).
  • Fundal massage only if necessary.
  • Want to keep placenta for encapsulation (provide container).

Notes for Father/Birthing Partner:

  • Support mom’s positions; help with counterpressure or reminders to relax.
  • Ask: “Can we delay pushing until the urge is strong?” or “Is an episiotomy necessary, or can we try perineal support/compresses?”
  • Advocate: Hold space for instinctive pushing; if directed pushing is pushed, question alternatives.

In Case of Cesarean Section

  • Allow labor to begin on its own if possible, then surgery within 1-2 hours.
  • Vaginal seeding: Perform per our protocol (gauze prepared pre-antibiotics, applied within 1-2 minutes post-birth to lips, face, thorax, arms, legs, genitals/anal, back—avoid eyes). Use sterile materials; we’ll handle independently as approved.
  • Playlist downloaded and played in OR.
  • Silence during birth so our voices are first heard.
  • Clear drape to see baby.
  • Events explained as they proceed.
  • Partner in OR at all times.
  • Photos: Give nurse our camera.
  • Delayed cord clamping until pulsing stops.
  • Partner cuts cord if possible.
  • Immediate skin-to-skin on mom’s chest in OR.
  • Cuddling and breastfeeding in OR/recovery.
  • No separation from mother and father; family-centered care.
  • Screen for infections pre-procedure to minimize seeding risks.

Pain Medication for C-Section

  • Regional with little/no premedication preferred.
  • Regional with premedication if needed.
  • General only as last resort (NO MORPHINE—ALLERGIC).
  • Discuss post-surgery options: Effects on breast milk/baby; consult pediatrician/lactation consultant.

Post C-Section

  • Ankle pumps every hour in bed.
  • Early walking.
  • Belly binder.
  • Promote microbiome: Immediate skin-to-skin, breastfeeding; avoid unnecessary antibiotics.

Notes for Father/Birthing Partner:

  • Stay with mom/baby throughout; prepare gauze in advance.
  • Ask: “Can we confirm no infections for seeding?” or “Is delayed cord clamping possible?” or “What pain meds are safe for breastfeeding?”
  • Advocate: If separation is suggested, insist on family togetherness.

BABY AFTER BIRTH

  • NO VITAMIN K ON EYES (discuss oral alternative if needed).
  • NO HEP B SHOT FOR BABY (delay or decline).
  • SKIN-TO-SKIN ASAP with mother (or father if mom unavailable).
  • Keep with mother and father at all times—NO NURSERY.
  • Lactation consultant ASAP.
  • Delay bathing for at least 24 hours; no routine procedures (e.g., eye ointment, injections) without discussion.
  • Breastfeeding exclusively; no formula/pacifiers unless requested.

Notes for Father/Birthing Partner:

  • Initiate skin-to-skin if mom can’t; support breastfeeding.
  • Ask: “Can we delay this procedure? What are the risks/benefits?” or “Is a lactation consultant available now?”
  • Advocate: If nursery is mentioned, reiterate no separation.