S1 EP 07: Creating a birth plan (w free downloadable birth plan template)

[Music] Hi guys! Welcome back! Or if this is your first time here, then thank you for joining us. This is the doolars guide to dot dot dot with me Meg, also known as the Dungare doola. This is the podcast where we talk about all things pregnancy, birth and first part of sharing unbiased information to ensure you go into birth feeling confident in the informed choices you've made for yourself and your baby. If you missed the first couple of episodes and would like to know more about me, then go and check out episode one for a little introduction and a big chart in hypnobarthym and the following episodes for some more great birth preparation to. This episode I'm going to talk you to making a birth plan so it's a little bit different than usual because it's more practical. You can of course listen to this as you usually would so maybe that's on your commute to work or in the kitchen while you're doing the potsoar something but it might also be helpful to sit down and listen to this with a physical copy of your birth plan so you can make some notes on it before you go away and finalise it. In the show notes I'll pop down a link to download a free birth plan template that I've created and I'll be referring to this template throughout the episode two so let's get into it. I hope you really enjoyed this episode and I hope you find it incredibly useful too. So people love to say that there's no point in birth planning or that you simply cannot plan for birth. They also love to say that it's pointless because everything just goes out of the window once you're inlay about and I just rebuke this. I totally, totally rebuke this. I think it's fiamon green nonsense. The power in making a birth plan is in the planning bit because when you sit down and you consider all of your options for birth and all of the different scenarios that you might be faced with you can go away and you can research all of your options and then you're able to make really informed decisions about anything that might come up. So of course you have no real idea of how your birth will go but making a birth plan ensures that even if it does go a bit skew-wiff and it doesn't turn out how you'd planned it's okay because you've done the research and you've planned for the scenario so you can still feel in control of those situations so hopefully that will become even clearer as we work through the episode. So to start with I always recommend putting your basic details just at the top just so you can identify that it's your birth plan and that the midwives don't have to keep asking questions like what's your birth partner's name, when was your due date, has there anything else that we need to know? So I would put your name and your pronouns, your birth partner's name and their pronouns, your duelers name and their pronouns, your estimated due date and then a little section that says any other notes and in this bit I would put maybe if you have a high risk pregnancy, if you're being induced what you've been induced for, if you have any medical conditions that might affect the birth or the period immediately after birth, if your baby has any medical conditions or anything like that maybe you'd put your blood group in it, anything like that could go in this other note section just things that might be handy that wouldn't necessarily fit into any of the other categories. The other categories that I do recommend having, bigger so I recommend having environment, pain relief, monitoring, positioning, second stage, third stage, then a preferences section, so the preferences section is just like little statements with yes or no sort of checkboxes after them, so we have vaginal exams, cord clamping, placenta, immediate skin to skin, understabbed gold and hour, feeding and vitamin care and we'll go through all of those in a minute and then you back up plans, so what happens if you have an instrumental delivery, what happens if you have to be induced, what happens if you have a cesarean and what happens if you have to transfer from your chosen place of birth, so for example if you're at home and you need to transfer into the mid-reffle unit or if you're in the mid-reffle unit and you need to transfer into the labour ward, so I'll take you through each section and I'll give you some top tips for filling them in and some sort of little handy things to consider, different phrases that you might want to use and things like that, so first of all environment, so obviously you would put here where you plan to give birth, so the environment you would put home, mid-reffle unit, labour ward and then how are you going to tailor that environment, so for oxidising to floor and for your uterus to contract efficiently, we need the environment to sort of be conducive to that, it's not about creating a stereotovical hypnobething environment, if that's not right for you, it's not right for you, but there are certain things that do help oxidising to floor better, so one of those things is it being dark, so it doesn't have to be pitch black obviously, but if you can have dimmed lighting, that's really helpful for the sort of cocktail of hormones that stimulate the uterus to contract, so that might be something that you pop in the environment that you would like the lighting to be dimmed, and this can happen anyways, can happen at home, obviously in the mid-reffle unit, but it can happen on the labour ward too, you're more than within your rights to turn the lights off and to put out some LEDT lights or some fairy lights or something like that, so if you want the lights to be dimmed you'd pop that in the environment, you could also just put that I wish for the environment to remain calm, so we know that obviously having a lot of people around, having the models sort of chatting and being loud and stuff like that isn't particularly helpful, you want to feel as unobserved as possible, so you might put in the environment, I would like to maintain a calm environment where people talking low voices or take conversations outside of the room, something like that, if you're planning on using certain specific things and you might pop that in there, so something like I wish to have my affirmations in plain view at all times, I wish to have fairy lights up, anything like that that you might be taking, you can pop in this box, I wish to use certain room sprays, I wish to have my speaker on with playlist throughout, anything like that pop into that environment box, and all it does is it just ensures that anyone that's supporting you in labour can contribute to that, because sometimes people coming into the bare space will just expect you to be having, sort of the bare fact we see on TV, so bright lights lid on the bed, things like that, they weren't necessarily know that you're planning anything different, and so it's really handy to just have it down, and it's also handy for bare partners as well, so bare partners like I say should know your bare plan inside and out, they should be completely confident in everything on your bare plan, but they do have a lot to remember, so if they do forget it and you've got it written down, then they can just refer to it quickly if they need a little reminder, so anything you want in this box that you think is going to help get the oxytocin flowing, pop it into the environment box, the next box is pain relief, so you definitely need to go and listen to a couple of episodes of the pain relief episode of this podcast, because we break down the pros and cons of every single pharmacological and non-pharmacological pain relief option that I could think of anywhere, so go and listen to that, and then you can make an informed decision about where you stand on each of the pain relief options that you might be offered, and you can pop down how you feel about it in this box, so for some of us, some of us don't want any pain relief at all, and for those of you that I feel this way, I would recommend just writing in this box, please do not offer me any pain relief, I know my options, I will ask for something if I need it, because that way you're not putting like a firm stamp on it, you're not saying 100% no pain relief, because like I said something might come up, and if it did then you could make the decision to ask for it, but you're not being offered it, because when we're in labour, we're more susceptible to say yes to things, if you was in the middle of a particularly quite painful contraction or sensation or surge, and somebody says to you, do you want this xy or z pain relief, it'll make everything a lot better, you're a lot more likely to be like yeah go on then just do it, this is painful get it over with, if you have it on your barefoot plan that it just says please do offer me pain relief, I know my options, I'll request it if I need it, then it's not going to get put into your brain, it's not going to get presented as an option, and you're not going to be likely to do something that you didn't necessarily want to do, and that's not to say that anyone having pain relief is a failure, but it's just saying that if these are your views on it and you don't want to be offered it and you only want it as a last resort, then it's definitely helpful to have it down so that you're not getting sort of, you're being infiltrated with these, these views of pain relief has been some sort of savior. If you do want some pain relief, then write down the ones that you're happy with, so you could write down, under no circumstances do I want blah blah blah, so maybe under no circumstances do I want pathody not opioid drugs, but I am open to try and gas and air and an epidural should I request it or something like that, it's also really handed to put in this box, what other things you're going to try, so if you do inhibit it in, definitely write it in this box, write down, I'm using inhibit in techniques as pain relief methods, and it's really handy to have this because people who are using hypnobirthing tend to present more calmly during labor and then when you go into labor and you're just breathing really deeply and you really can't, made works content and not believe that you're quite far along because they're used to people getting to quite a prolonged stage of labor and being really stressed out and sort of grunting and moaning and just wanting it to be over, people in hypnobirthing just tend to be taking it in the stride, tend to be a lot more chilled out, so having it written down so that the midwives understand that that's what you're doing and that's the reason you can't, ensures that they're not going to just dismiss you and they're not just going to say no, you're not in labor, we didn't believe you, so I'd write down that you're using hypnobirthing and write down what else you want to use, so for example, I want to use water, I want to use a room of therapy, I would bring my own diffuser and my own blend please because someone facilitate this for me, you might put, I'm going going to use light touch massage. I would really like to have my hips squeezed. Anything like that that you're planning to use, write it down in this box. The next box is monitor in. So this covers a couple of things. So monitor in for you and monitor in for your baby. So when you go into the hospital, or when the mid-row's come to you at home, you will ask to be monitored. So they will check your blood pressure and your temperature. And then they will check baby with the CTG monitor in. If you go into hospital and you're quite early on, or they will just check with a handheld Doppler, just to check the heart rate. They tend to like to do this every 30 minutes during active labor. I think anyway, they're doing leads. I don't know if that varies trust from trust. I assume it's the same or roughly the same and everywhere in the UK. So every half an hour or so, they just like to have a quick check of your temperature, your heart rate, your blood pressure, not your heart rate. And baby's heart rate. So you would write in this box, whether you want that to happen or not, it's completely up to you. For some people, if you're really in the zone, this is gonna really take you out of it and you might not want it. So if that's you, then you could write in this box something like accept or I do not accept whichever, you feel like 'cause obviously you don't have to have it at all, you can just completely decline if you want. And in that case, you would write, I decline all monitor in of me and my baby, or you could write, I accept monitor in of me, but not every half an hour, I will request it when I am ready. Or you could just write, I am happy to be monitored, but please seek informed consent every time, which just means that they will obviously ask you without just going ahead and trying to do it. For your baby, you could also write the same thing, so they'll do the same thing like say, every half an hour. And then when you get into the second stage of labor, the pushing stage, it becomes either every 15 minutes or sometimes even after every contraction, so it just depends like check what your trust is offering. So again, you can write in this box, I'm happy for baby to be monitored after every contraction. Or I'm only happy for baby to be monitored when I request it, or I'm not happy for baby to be monitored at all. The next layer of this is thinking about a fetal scalp electrode. So if your midwife cannot get a good reading on baby's heart rate through your bump, maybe you're moving around a lot, maybe baby's position is going to be awkward. There's loads of reasons why they might not be able to get a decent trace of your baby's heart rate. They will ask if they can put a fetal scalp electrode on your baby. And that is, they describe it as a clip, but it's definitely not us clip. It's a screw. It's, I mean, you can Google an image if you want, they're quite horrifying to look at because what they do is they screw it into your baby's head. They will literally put the hand inside your cervix and screw it into your baby's head. And it's, yeah, it's about as a grim as it's on. And it's never presented to people in this way that it's a screw and it's never presented to people as having any sort of risks, but there are risks involved. And it's just not a particularly nice procedure, whether it's necessary or not is for you to decide for some people if you can't get a reading of your baby's heart rate, then you would feel comfort having this because you would know that they can track it constantly, but some people, the discomfort and the side effects of getting this far out where the benefits have been able to get a decent reading. So it's for you to decide, but I would definitely Google what it is and do some more research. In fact, I'll put some research in the show notes on fieldscarf electrode so that you can look into it yourself and decide. I just feel like it's really handy to have this in this section because not all of us will be offered it. But like I said, the power of a birth plan is that you've done the plan. So that if you are offered it, you've already made a decision on whether you would accept it or not. And then finally, the last thing to consider in the monitoring section is continuous feats on monitoring. So this is where instead of checking every half an hour or whatever they're doing, they want to be able to check baby's heart rate consistently. And to do this, they would need to put, some of you might have had this already, if you've been for monitoring in the hospital, but they put two pads on your bump and they secure them with bands around your stomach and then they can track continuously your heart rate and they can also check contractions and things like that. So it's on a CTG machine. The reasons that they might want to do this, if you're being induced or if you've had nepe jurals, if you're having any sort of assistance like that, then they like to check that baby's curping with it basically. So especially here on like the synthetic oxytocin drip, they like to check that baby's curping and the way that they need to do that is for your continuous monitoring. But again, this is a choice. You don't have to accept continuous feet on monitoring. Sometimes we also just get it recommended for things like, maybe if it's IVF pregnancy or if you're a high risk pregnancy or a plus size pregnancy, there's loads of reasons why you might be on offered continuous feet on monitoring. But again, it's completely up to you. It's really restrictive because you have to be somewhere where they're gonna stay on and they're not gonna fall off. So they'd prefer you to be laid on your back if you have continuous feet on monitoring. And actually the research on continuous feet on monitoring is not great. It doesn't suggest that having continuous feet on monitoring leads to better outcomes for baby. I will leave the links to that as well in the show notes so that you can read them for yourself. So that's everything I'd recommend putting in this box. The next box is positioning. So this is about how you want to utilize positioning and movement during your day of birth. So you can put all sorts in this box really. Most of us are sort of doing birth prep and listening to these sorts of podcasts and stuff like that will be opting for using active birth positioning. So active birth positioning refers to being able to move around and being upright and being open and not being restricted to just lay it on the bed. So a lot of the time you would write in this box something like, I would like to utilize active birth positioning throughout my labor. If you want planning a water bath, you could pop that in this box as well. I would like to use the pool so that people that you're going to be in the pool and the buoyancy of the water is going to help you get that extra space in your pelvis just as the upright and open positioning would as well if you were on dry land. So you would write that in this box. You could also write things like, if I get tired, I'm happy to lay on the bed, but I do not want to be laid on my back. I will lay on my side and would request the use of a peanut ball. So a peanut ball is like sort of like a small bath ball, a small long bath ball and you can put it between your knees when you lay on your side to open up that space in your pelvic outlet as you would if you were upright. You could also write things like, I wish to use a bath ball to help with my positioning. I wish to use a ribosa to use squatting to have the help of my bath partner and you could put something like, I wish to be encouraged to move around and change position or I wish for no one to comment on my positioning. Wherever you feel like. So there's lots of stuff that you can consider using in this like bath stools, all sorts of things. So have a look into it and see what sort of stuff you would like to utilize and write it down. And then also have a look what your local facilities have got on offer as well. So if you are planning to give bath in the hospital or in the middle of the June it, then what sort of things do they have to aid positioning that you might like to try? And if you're having a home bath, what sort of things can you look to hire or to buy that you could get in a new to last year in your labour as well. Then we move on to the second stage. So this is the pushing stage of labour as most people refer to it. And this is about your options around how you want the pushing stage to go. So the first thing that I was told people to consider is coached pushing. So when we see people giving birth on TV or in the media, we generally see them laid on their back being coached to push by someone. So a midwife shouting push, push, push. And then somebody laid on the bed going, "Ah, push!" And they're like really straightening and it's awful. That's not what we should be doing. When we really strain and physically push we're putting so much pressure on our poor pelvic floor where doing lots of damage, where putting ourselves at a higher risk of tearing. So we shouldn't be physically pushing it. Oh baby, it's like, "Oh, bodies will do it for us." So if you feel happy about that and your happy is just like it happened and you don't want anyone to start coaching you or anything like that, then you could put in this stage, I do not wish for coached pushing. Obviously if you're happy to be coached then you could pop something down like a trust in my body but I would like a little bit of coaching or I'm happy for a coached pushing. But like I said, you really do not need coached pushing. You don't need somebody telling you when to push. It's just a reaction that your body does that you cannot control. You don't have any control over it. So what's the point in putting more pressure on it? The other things to consider are hands on or hands off. So this is to do with your perinium. So some midwives and some trusts really like to support your perinium when you're in sort of the crowning stage and the baby's head is about to be born because they think that this reduces tearing and the jury's completely out on this. There's research that suggests this is true and there's research that suggests this is false. So again, it's just about you doing that reading and thinking about what you would prefer. It can feel quite invasive to have someone's hand, especially someone's hand that you don't know on your perinium when you're pushing your baby out and it can also be quite awkward to facilitate. So those are things you might want to consider but for some of us we might like that safety net. I feel like there's somebody there that's supporting us. So it's however you feel. So I would put hands on second stage or hands off second stage in this bit as well. other things to consider are who's going to catch the baby. So is it going to be you? Is it going to be your bed partner? Is it going to be the midwife? Are you not really bothered? And who's going to bring them up to your chest? So I will say that if you're bathing in water, it's a lot easier to catch your baby yourself. Because obviously when you push your baby out, they kind of float under the water and you can lean down and grab them and pick them up. If you're on dry land and you're pushing your baby out, especially if you stood up or you're on your knees or anything, it's a lot harder to reach down and catch your baby. Just logistically and also because a lot of the time if we are nearly not ready for anything, we'll lean against something so we're using our hands for that. So in those situations it might be sensible to think about maybe your birth partner catching them or your midwife catching them and then passing them through to you so you can bring them up to your chest. So you'd put that in the second stage as well. See that? You want to catch your baby or you're happy for the midwife to or yada yada yada. So they're the most important things they're putting this stage. Then moving on to the third stage, this means giving birth to the presenter. So you have a couple of different options so giving birth to the presenter. So you can have a physiological third stage. So this is where you give birth to the presenter, completely yourself. Nobody comes near you, people just leave you to it and you birth the presenter. Or you can have active management. So active management is where you have an injection into your thigh of synthetic oxatocytosis, which stimulates you to risk to contract. And it attaches the presenter from the presenter wall and lets it be born that way. So it's completely up to you. It's up to you to go away and read and decide which is best for you. What I will say is that obviously if there's nothing wrong with you, you're not losing a lot of blood, you're really well after birth. Then there's absolutely no rush to bet the presenter. You can wait around for as long as you need to for it to be born unless obviously you've been waiting for hours and hours and hours and hours. Then you might start to worry a little bit. But you can wait for a long time for your presenter to be born. There's no rush and as long as you feel well and you're not losing a lot of blood, there's no need for you to have the injection to bear the presenter. What happens is that our uterus does start to contract again, but these contractions do not feel like the contractions we've just felt during giving birth. There are a lot milder, a lot of us were even noticing them. The presenter detaches from the uterus wall and then he's birthed out and it's kind of like, it's quite strange feeling, it doesn't hurt. It's just like this big sort of dinner plate size blob really. I don't know how else to describe it. And it just kind of slides out, it doesn't hurt. So yeah, you can wait around and if you would like that to happen, you would write in the third stage, I would like a physiological third stage of labor. The other option, like I said, active measurement is where they give you an injection and they're eager to do this if you've been waiting around for a long time or if you're losing a lot of blood. The only situation where this is actually sort of medically necessary and probably a good idea is if you are losing a lot of blood because this can stop that and it can get the presenter out quite fast and it can make sure that everything can sort of start to heal and close up. But otherwise, the risk involved with it is synthetic oxytocin, so the same risks as using synthetic oxytocin for an induction. So it's completely up to you how you feel about this, but definitely have that written down. And then you might want to pop things in, like bring baby, straight up to chest for skin to skin and things like that in this box as well. You might also want to write what you're doing with the presenter. So if you're planning to have it encapsulated, then you would write that you have a cool box ready and waiting for it to be put in. You might write that you want it just burst or straight away and you don't even want to see it. Anything that you're planning to do with it, I would write in this box. And that's sort of it for the first page, kind of the main thing. And then I would go on to the preferences section. So in the preferences section, the first thing that I have written is "Budgynal exams." Yes or no. And you would just cross out the one that you don't want. So if you want "Budgynal exams," as far as completely your choice, you might want to write a little note next to this bit that says, "Yes, but only at my request." "Oh, yes, please offer every two hours or every four hours or whatever." And it was standard at first. They offered them every four hours. And then as you progress more, I think it gets shorter. Maybe every two hours, then maybe every one hour, not 100% sure I've never had one. But I know that did you leave you quite a while at the beginning. So either yes or note about your legs arms. Again, completely your choice. I won't go too much into it except to say that. But your legs arms don't actually serve much of a purpose. They don't tell us anything. What they're telling us is how many centimeters dilated you are based on the specific midwife that's assessing you. So what they do is they put two fingers inside of your vagina and they reach for your cervix and then they stretch their fingers out to see how far your cervix is dilated. And this is kind of guesswork, right? Imagine putting your fingers somewhere and then trying to stretch you two centimeters or three centimeters. I don't feel like you'd really have a clue. I have no idea how far apart my centimeters, my fingers are in centimeters. So it does depend on the midwife. Also, if you do find out, it has no bearing on your labour. You could find out that you're two centimeters dilated and they get really, really disheartened and be really upset about it and it could send your labour off cause. Well, actually, if you just been left to it, you would have dilated really fast and you would have had your baby within two hours. On the other side of that, you might find out that you're eight centimeters dilated. But you might still have four or five hours left of labour. So yeah, they're not really the most useful things. It's completely up to you. If you feel like you would like to know and you feel like it would give you a little boost of confidence and that is completely your choice. If you think that they just sound horrible and you'd rather not, then again, that's your choice. Like I say, they don't really have any bearing on labour. I do have an episode coming up that's all about bachelor exams and tearing and pelvic floor and all of that sort of stuff. Well, it's not more about it in that episode. Then we discuss chord clamping. So do you want immediate chord clamping? Do you want delayed chord clamping? Do you want to wait for the chord to go? Why are you having a lotus bear? So a lotus bear is when you bet the placenta and you keep that placenta and chord attached to baby until it detaches itself. So somewhere between three days after bed and up to 12 days after birth. And you carry around the placenta with your baby and just let it happen naturally. I just thought I'd mention that there because a lot of people have never heard of it. So take off what you're going to do. Are you going to do delayed chord clamping? Are you going to do what is optimal and wait for the placenta and wait for the chord to go fully white, which ensures that the baby's received the full quarter of blood? Because when your baby's born, a third of their blood is still in the placenta. So if you wait for the chord to go white, then you're ensuring that all that blood has gone into your baby. Underneath is a placenta key poddispers. So like I said, you'd probably mention it's in the third stage, but it's hard to just have it here again because if you are not keeping it, but you want to see it, you need to tell them because otherwise they'll just disperse a bit straight away. So I would always make a little note that says, I'm not planning to keep my placenta, but I would really like to see it. Because it is quite cool to look at it. Like it's kept your baby alive for nine or ten months. It's quite an incredible organ that our body just grew from scratch to look after our baby's. So it can be quite cool to have a look at it and ask you to explain the different parts of it and stuff like that. So make a little note of that. Are you going to have immediate skin to skin? Yes, on no. There's tons of benefits to immediate skin to skin. And you're going to have it in any situation, even after cesarean sections, you can still have immediate skin to skin. Do you want an undisturbed gold on our work? So this is the immediate hour after giving birth. Would you like to have your baby in skin to skin to initiate, feeding to regulate their temperature, to regulate their heart rate, to facilitate bonding? If so, you want an undisturbed gold on our. So yes, on a feeding. Are you breastfeeding or bottle feeding? This is just so the midwives can ensure that they're giving you the correct advice and helping you to facilitate whichever way of feeding your punning. And then vitamin care. So will you accept the vitamin care by injection, by oral drops or none at all? I won't go too much into what vitamin care is in this episode. Because we're going to talk about it later on. But if you do want more information on vitamin care, I will leave a link to a really, really great article by Dr. Sarah Wickham who is just like an expert in vitamin care. Like she's written books about it and stuff like that. So I'll leave some links to that in the show notes. And then finally, you want to put down your backup plans. So in the beginning, everything that you've been writing is basically like your dream birth. Right? So it's how you want everything to go. But we're not naive. We do know that sometimes things don't go to plan. So we want to plan for those situations too. So first of all, you should a mental delivery. So these are in case your baby needs assisted delivery with four steps of on two. So in this section, you would put something like, well, which ever wants your preference? If we need assisted delivery, I would request that to be by four steps, rather than one two's, of on two's, rather than four steps. Four steps kind of look like big salad tongs that they sort of insert into your vagina. And the grip on to baby's head and they pull baby out. Literally like big salad tongs. And the one two kind of looks like a plunger. And again, it's not great image. This is it. But they insert that into your vagina and they sort of plunger onto baby's head and pull baby out that way. Neither are obviously great. They're both sort of last resort scenarios. But they can be life saving and you do really need to think about sort of if you have a preference. and when you would be willing to accept them as well. So that's what these backup plans are really important for. It's about making a decision about what sort of scenarios you would go down these routes in. So thinking about in this section, I would be willing to consent to an instrumental delivery. If for example, there was a medical emergency which required getting baby out immediately, awesome thing like that. And then I would always put a little comment that just says, in the case of an instrumental delivery, I would like as many of my previous preferences met as possible. So for example, you would still want to have immediate skin to skin. You would still want to have waiting for white with your cold compine. You would still want the environment to be in curve, a physiological third stage and things like that. Again, for induction, you would write really similar things so you would write about which form of induction you would be willing to try at which point. So for example, you could write that, I will not be accepting induction for perstates. So this is sort of going over to you. I would not accept induction for episodes of reduced movements. I would only accept induction if it was a medical necessity or something like that. And then you would write your plan of action for an induction. So if I were to be induced, I would consent to a stretch and sweep and then I would go home and give myself 24 hours to go into labor. If this hadn't happened, I would like to have a pressery and then give myself a further 24 hours for things to progress. If things hadn't progressed at this point, I would go on to the synthetic oxytocin drip. Yadda yadda yadda. I'm not telling you to write those exact things. I'm just giving you examples. So when we talk about induction in one of the common episodes, you'll understand more about it. But again, go ahead and do some research because there are loads of different methods and they all come with different benefits and different risks. So it's about which ones you'd be happy to try out. One thing I do like to mention about induction is that think about the reasons why you're being offered an induction. And the reason I say this is because a lot of the time people are offered an induction and told that it's a medical necessity or a medical emergency that you have an induction. But actually, if there was a medical emergency, you would be getting whisked away for a cesarean because induction take a really long time for most people. Some people can go and be induced and it can take sort of five to seven days. So if there was a medical reason for you to get that baby out, they wouldn't be waiting five to seven days for it to happen. They would be taking you for a cesarean. So definitely just consider that when thinking about if an induction is actually necessary or not. Just a pop up little note that says I was really like all of my previous preferences still met. I would like the environment to remain calm with dimmed lighting and very lies and music on. I would like to have active bare position in. I would like to have intermittent monitoring and things like that because all of these things can still be facilitated even if you're having an induction. So I would write all of that sort of stuff in the induction box. And then one of the last things is cesarean. So again, you want to plan for an unplanted cesarean and a plant cesarean. So for example, some people are really unwilling to be induced because like I say, the induction process can be really lengthy and really hard for a lot of people. So a lot of the time people will just have, I would not consent to an induction under any scenario. I would have a cesarean if there was a medical necessity for me to bring my baby F side quicker or something like that. You could also write in this section how you would want the cesarean to go. So for example, things like, do you want there to be a music play in? Do you want to see your baby being born? So do you want the cat and up? Do you want the cat and down? Do you want someone to talk you through what is happening? Or do you want there to be quiet? Do you want there to be a video recorded or any photos taken? Do you want your baby to be placed right on your chest for immediate skin to skin? All of these sorts of things. Do you want them to keep the card attached so they don't just immediately cut the card, things like that. So what sort of stuff would you like to facilitate if you did end up needing or requesting a cesarean and under what circumstances would you be willing to accept a cesarean? And then the last sort of thing is just transfer. So this is for if you're planning to give birth at home or midwife, if they're doing it, thinking about what scenarios would you be willing to transfer for? So for example, if you're planning a home birth and there's not enough midwives, would you be willing to transfer in Zospore for this? If you're on the midwife, they do unit and there's a problem with monitoring, would you be happy to transfer to the labor ward for that? Think about a lot of different scenarios where you would be willing to transfer and different scenarios where you would decline in transferring. And then write about how you would want to keep your birth on trackser. I would be willing to transfer from home in the case of X, Y and Z, but I would request that all of my previous plans are adhered to and I would really like to still bear as undisturbed as possible. Something like that. Again, I'm not telling you exactly what to write. I'm just giving you examples so you can start to get some different ideas of the different things that you might want to include. That sort of everything I wanted to talk about, really. As I said, good to the showners and download the birth contemplate and have a look at all the links that I'm going to include. I hope that was helpful. I really, really recommend that you go through with your birth partner. They should know, like I said, they should know your birth partner inside and out so that they can advocate for you. And then show that you get what you want. So just make sure you feel this in really thoroughly. Do your research and then go through it completely with your birth partner. If you have any more questions and come home on Instagram, where I'm at the Dungaree Doohler, and let me know if you enjoyed this episode. Thank you for listening. If you enjoyed this podcast, please do stick around, like, follow and subscribe. I'll leave a little review if you don't mind. That would be very, very helpful. And speak soon. See you next week. Bye.