Gentle Caesarean Birth Plan/Preferences

I’ve had a few requests now for a sample birth plan for a gentle caesarean (otherwise known as a natural or family-centred caesarean), so here it is. ***edited to add info on seeding the Microbiome (see here for more info) ***

Not all the options here will be applicable to all families or all births and in some areas I have given a couple of options to choose from. I also haven’t included options you may want to implement before the day of your baby’s birth, such as visiting the operating theatre ahead of time and meeting the consultant who will be carrying out the operation, as well as the anaesthetist and midwife. Doing these things can increase your comfort level with a planned caesarean. If you are expecting multiples, then you will want to think about the logistics – e.g. do you want Dad/Doula to have skin-to-skin with 1 baby? If 1 baby needs to go to SCBU, do you want to keep the babies together?

[Mama & Dad]’s Caesarean Birth Preferences

Mother’s name: [Mama]
Birth partners’ names: [Dad & Doula]

Thank you for taking the time to read our Birth Preferences sheet. [Intro ~ I think it is nice and helpful to explain briefly here who you are and why these preferences may be important to you. If you have had a previous negative experience, it can be helpful to let staff know this and if you have specific triggers relating to Birth Trauma, do list them here.] If a Caesarean is needed, we want as gentle and family-centred a Caesarean birth as possible, to benefit Baby and our family.

If a Caesarean birth is needed, we expect there to be clearly documented evidence of a medical emergency that necessitated an immediate Caesarean, with no viable alternative / I want to wait until labour starts naturally before baby is born.

We are happy to have 1 student present/We would prefer the number of people in theatre and recovery to be kept to a minimum (no students).

We really want to have photos of the entire procedure and will be bringing our camera. This can be done unobtrusively by our Doula/Birth Photographer/the midwife.

• I would like to seed baby’s microbiome with vaginal bacteria. Please support me to place a piece of sterile gauze moistened with sterile water into my vagina 1 hour before the caesarean [in the case of a planned caesarean], to remove this with sterile gloves before the anaesthetic is placed and to keep this in a sterile dish until after baby is born.

• I would like both [Dad & Doula] to be present in the OR.

• I would like to have a mirror available to enable me to see more.

• I would like one member of staff with a good view to provide a running commentary for me on what is happening [from the point at which the baby’s head is born].

• Please avoid unnecessary noise and chat. I may find it helpful to have hypnotherapy music/my playlist playing.

• Drip to go in my left (non dominant) arm to help me hold Baby once he/she is born.

• Please place the ECG Dots away from my chest (e.g. back of shoulders & sides) to facilitate easier skin-to-skin contact after birth.

• After the spinal has been done, please remind me to move one arm from my gown to facilitate skin-to-skin after birth.

• After the head has been delivered, I would appreciate the screen being dropped so I am able to watch the birth / I want to dispense with the screen. Raising the head of the bed will help me.

• Deliver baby slowly to allow Baby to ‘walk his/her way out’. Allow my uterus to ‘squeeze’ baby out.

• Please delay cord clamping for as long as medically possible and at least until the cord has stopped pulsating.

• After the cord is clamped, bring Baby directly to my chest, for skin-to-skin, with minimal number of people touching Baby.

• I would like to give Baby the opportunity to feed while in theatre, so please support me to do this.

• Perform necessary checks on Baby (breathing/colour/movement, APGAR) whilst Baby is on my chest (if possible). All midwifery checks should be able to be performed whilst Baby is on my chest, without separation. Baby can be weighed whilst I am transferred to a normal bed / later.

• Wrap Baby warm whilst on my chest but do not interrupt the skin-to-skin or rub vernix off Baby’s skin.

• If I am unable to have skin-to-skin in the OR, I would like [Dad] to do skin-to-skin with Baby.

• Please minimise Baby’s separation from me as much as possible during the first hours after birth.

In the event of a general anaesthetic being needed, my wish is that as many of the above points as possible should be carried out.

  • Please deliver baby slowly if possible to allow baby to ‘walk his/her way out’ (helping reduce fluid issues), delay cord clamping for as long as medically possible and give baby to [Dad] for skin-to-skin as quickly as possible after birth.
  • I want [Dad] to be present in theatre so that one of us witnesses Baby’s birth.
  • I want to meet Baby in their newborn state (so not cleaned/dressed while I am unconscious).

I would really appreciate your support for my wishes during what will be a very difficult time for our family.

After Birth

  • Dim lights down in the recovery room to provide a soft & warm environment.
  • I would like to have an extended period of skin-to-skin in Recovery. If this is not possible, baby should be given to [Dad] for skin-to-skin if possible.
  • I plan to breastfeed and baby should not be given infant formula. I will have a supply of frozen (antenatally expressed) colostrum with me if needed.
  • If I have to be separated from Baby, one of my birth partners will accompany Baby.
  • If I have to be separated from Baby, please do everything possible to facilitate the quickest possible reunion.

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