Paulina Therese Ng's Birth Plan

I had a birth plan for my 2nd and 4th birth but Paulina's birth plan was for the benefit of the midwives and nurses who would attend to my birth at the labour ward so as they'll know my history and understand what I want for my birth. The birth plan is acknowleged by Dr Paul Tseng and then faxed over to the Mt Alvernia's labour ward.

Pamela Vanessa Lim

Doctor: Dr Paul Tseng

1st EDD: 8th October 2009

2nd EDD(by Dr Paul Tseng): 10th October 2009

Birth Plan

This is my fourth pregnancy.

1st birth: It was an uneventful birth as I was induced at 41 wks, had an artificial rupture of my water bag, an epidural was given when I was already about 7-8cm dilated and ending with an emergency c-section as baby did not come down/engage. I remember that the dosage for induction was increased very often and quickly and I was dilated from 2cm to 10cm within 3 and 1/2 hours. The whole proccess was out of control as I could not manage my own birth. I was made to lie in bed and being monitored with the CTG upon admission. I was not given the chance to adopt any comfortable position for labour. Baby was born at 4.070Kg.

2nd birth: Estimated time from start of labour till birth took about 9 hours. Baby was OP at birth and labour was long and painful. Nevertheless, it was drug-free but assisted by vacuum suction. Baby was born at 4.270Kg.

3rd Pregnancy ended with a stillbirth at 34 weeks due to a twisted umbilical cord. Baby was about 2.300kg.

I am definitely more careful and alert with this pregnancy. I would like to keep myself positive and focused though at times I may be more paranoid than usual due to the previous stillbirth. I want my labour to progress naturally and for my baby to be born in an atmosphere of calm, quiet and love. I believe, with your support, I can achieve this totally natural, memorable and beautiful birth. This is my birth plan.

Note: At any stage of my labour, should the need arise, please discuss any proposed intervention with me before proceeding.

First stage of labour:

I may have a birth assistant present at the birth.

I want an atmosphere of privacy, calm and quiet, with dim lighting, soft music and light aromatherapy scents while in labour.

I do not want to have an enema upon admission.

I do not want to be shaved upon admission

Because I want to be free to adopt any comfortable position for labour, I would prefer not to have any drips inserted, unless medically necessary.

Please do not offer me any form of pain relief.

I do not want any vaginal examination unless really necessary.

Please do not rupture my waterbag artificially.

I understand that I will be monitored with the CTG upon admission. Please monitor this for only 10 minutes.

Second stage of labour:

I will adopt any position where I am comfortable to labour in. I will indicate if any support is required.

Please do not perform any episiotomy. I would prefer to tear naturally.

I would like to see the baby crowning through a mirror. I would like to touch and feel baby’s head as baby crowns.

I would like my gynae to assist to catch the baby.

I will hold the baby immediately after birth even while the umbilical cord is still attached.

Do not clamp the cord until it has stopped pulsating.


Third stage of labour:

I want a natural third-stage with no syntometrine injection to facilitate placental expulsion. Please do not perform fundal pressure or cord traction.

I would like my husband to cut the cord.

Baby’s care in hospital:

Please do not suction baby at birth, unless medically necessary.

Please delay all routine administrative matters eg weighing, measuring etc, until an hour after the birth.

I will nurse my baby immediately after birth.

I will room in with my baby for the duration of my stay in hospital.

I will breastfeed my baby exclusively. Baby should not be offered any formula, water, glucose or pacifiers at any time, under any circumstances.

In the event of a medical emergency during birth:

If an emergency C-section is required, I will also undergo the operation by epidural. I will nurse my baby immediately after the operation. Unless medically necessary, I do not want to be separated from my baby at any time.

In the event that baby has to stay in the Neonatal ICU or requires specialized medical attention that requires our separation, or in the event that I am not able to provide her with breastmilk, my family will arrange for my baby to receive donated expressed breastmilk.

Noted by:



(signature & date)



___________________

Dr Paul Tseng

Consultant Gynaecologist & Obstetrician