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Gentle Caesarean Birth Plan for Triplets

Triplet's Birth

Amy has shared her gentle caesarean birth plan for her triplets. I would like to thank Amy for sharing her birth plan. This example of a birth plan may help you with writing your own birth plan. Jane Palmer

We understand that the following is for a best case scenario. This birth plan is intended to express our preferences and desires we have for a vaginal birth, if AT ALL possible, of our triplets. We fully realize that situations may arise and that our plan may not be able to be followed and medical interventions may become necessary for the safety of mother and babies. We request that, barring any extenuating circumstances, we be informed of procedures and be allowed to ask questions before accepting or refusing and intervention. Thank you for helping achieve our birthing goals and we appreciate you and acknowledge your support!

Personal Wishes

We would like to photograph or record the babies’ births on videotape

Hospital Admission

Triplets Birth 1

The opportunity to discuss our birth preferences with our assigned nurse.

To be assigned a nurse who is partial to natural/vaginal birthing

To choose wheelchair assistance or to walk to my room

Labour and Birth

Baby A: We prefer as little intervention as possible if labour is progressing normally

I want my husband and labour support person to stay with me at all times, including during admission, examinations or any medical procedures.

I would like to determine optional positions for active labour

I would like to sip water or other clear liquids during labour

I prefer to push and deliver Baby A in whatever position feels best at the time

I would like to hold Baby A skin-to-skin until labour begins for Baby B

Each Birth

Triplets Birth 2

Assuming there are no complications

I would like each baby “kangaroo”, be placed on my abdomen or chest skin-to-skin, immediately after birth

My husband would like to cut each baby’s cord.

To avoid forceps and vacuum extraction, and only upon discussion and agreement with mom and dad.

Baby B (and C)

Once Baby B (and C) is engaged in a normal position in my pelvis and the fetal monitor is in place, I prefer to push and deliver that baby in whatever position feels best at the time.

If general anaesthesia is necessary for the birth, I would prefer the type and dosage be given in a way that allows me to regain consciousness as quickly as possible.

If I am unconscious because of a general anaesthetic, my husband would like to hold one/all newborns skin-to-skin until I regain consciousness.

Surgical (Caesarean) Birth (Gentle/Family Assisted)

Triplets Birth 3

I would prefer a regional anaesthetic (spinal block, epidural, etc.) if there is time

If general anaesthesia is necessary, I would prefer the type and dosage be given in a way that allows me to regain consciousness as quickly as possible.

I would prefer to be catheterized after receiving an anaesthetic.

I would like my husband present at all times for emotional support.

I do not want my arms strapped or tied down I request that the blood pressure cuff and all vital monitoring equipment be placed on my non-dominant arm (right side)

I would like to see and touch each baby, and have one placed skin-to-skin on my chest, and the others skin-to-skin on my husband’s chest immediately after birth.

If I am unable to have a baby placed skin-to-skin on my chest, we would prefer that all babies be placed skin-to-skin on my husband’s chest.

I would like to breastfeed all babies as soon as possible while in the operating room

Post-Birth Recovery

I prefer that each baby be placed skin-to-skin on my chest and on my husband’s chest during the immediate Recovery period.

I prefer that each baby remain with me in the birth and recovery room unless a particular baby requires special care due to its medical status.

I would like to delay having the babies bathed until requested by husband or myself

I prefer a private room, such as a labour room for the recovery period.

Breastfeeding

Triplets Birth 4

I expect to breastfeed any stable, healthy triplet as soon as the infant(s) exhibits feeding cues, which is usually within an hour of birth.

If any or all babies require NICU care, I would like to initiate breast milk expression (pumping) within 1 to 3 hours of birth.

I would like the staff’s help to breastfeed or pump within 2 to 3 hours of birth if I experience a complication that interferes with immediate breastfeeding or milk expression.

If necessary, I would like the staff to actually pump my breasts or teach my husband or another support person to do it until I am able.

Postpartum Unit Care

Rooming-in/non-separation: To care for multiple infants, I would prefer a private room. I expect any stable, healthy triplet to be admitted to the unit with me and stay in my room with me as soon as possible. (I understand that the degree of rooming-in depends on the condition of each baby and my condition after birth)

Temperature stabilization: We prefer that each baby stabilize physical systems via skin-to-skin contact on my chest and/or on my husband’s chest and that initial baths be delayed until each baby’s temperature has stabilized for several hours. We want the babies placed back on my/our chest(s) immediately after their initial baths.

We prefer that no artificial infant formula, bottles of any kind or pacifiers be given to any baby, unless found medically necessary and only after consultation with us.

Support person: I would like to have my husband or another support person remain in my room around-the-clock.

NICU

Triplets Birth 5

No matter what situation arises during any baby’s NICU stay, we expect to be part of any discussion of, and to give permission for, any medical intervention being considered for our children.

Breastfeeding/lactation: We want our babies to receive as much of my colostrum’s and milk as possible. Further, I would like help to initiate breastfeeding as soon as any baby shows signs of interest or begins to coordinate sucking and swallowing.

Kangaroo Care: We would like to initiate skin-to-skin care as soon as possible, as supported by research evidence and implemented at high-level NICU centres.

Co-bedding: IF two or more of our babies require NICU care, we would like them to be co-bedded in a single crib as soon as two are medically stable.

If co-bedding is not yet possible, we would like our babies’ cribs/isolettes to be placed side-by-side. If not implemented, we expect to receive an evidence-based explanation immediately.

Thank you for respecting our wishes to the extent that is safely possible for the best outcome for all involved and for providing the research evidence-based rationale when any of our preferences cannot be met.

Sincerely,

Amy and Adam Buteau

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