Writing and presenting your Spanish birthplan It is not yet very common for women to present birthplans in Spain and some institutions are reluctant to accept them. However, things are slowly changing, and if you want the hospital/clinic to be aware of your wishes, then it's certainly worth a try. The vast majority of hospitals and clinics in Barcelona tend towards medical interventionism even in normal births, so a birthplan is particularly relevant if you are looking for a more natural birth. Before writing your birthplan you should find out as much as possible about the the procedures you can expect to find at your hospital/clinic. Discuss this with your gynecologist or midwife and talk to other women who have given birth there. It's worth doing this early on in your pregnancy in case you decide to change hospital/clinic or even need to find a midwife/gynecologist more sympathetic to your wishes. If you find yourself in the position of having to justify your wishes, it may be useful to be familiar with the World Health Organisation's Recommendations for a Normal Birth and SEGO's (Spanish Society of Gynecologists and Obstetricians) new guidelines. The organisation El Parto es Nuestro suggests that you send three copies by registered post, one to the Servicio de Atención al Usuario at the hospital, one to the Servicio de Ginecología y Obstetricia and another to the Servicio de Neonatología. Ask that your birthplan be added to your notes. On the day of your birth also take one copy with you to give to the person attending you if necessary. Following are some suggestions for what you may want to include in your birth plan, with example phrases in Spanish. You can also find some example birth plans at www.elpartoesnuestro.es in the section "Vas a tener un bebé", "Plan de parto". Acompañantes (Birth companions) Who do you want to be with you in labour? Do you want this person to stay with you all the time? Do you mind people you do not know (students in teaching hospitals etc) coming into the room?
- Deseo estar permanentemente acompañada por mi pareja (I would like to be accompanied all the time by my partner) - Deseo ser atendida por una matrona, a ser posible siempre la misma, y no por un ginecólogo, excepto que alguna complicación justifique su presencia. (I would like to be attended by a midwife, if possible always the same one, and not by a gynecologist, unless there is a complication that justifies a gynecologist's presence) - Me gustaría que no entrara ninguna persona del hospital a mi parto, excepto la matrona que se encargue de supervisarlo. Si alguna persona extra es requerida, deseo que se presente y que justifique su presencia. (I would like that no one enters the room during the labour except the midwife who is in charge. If someone else is needed I would like them to introduce themselves and to justify their presence.) Alivio del dolor (Pain relief) What kind of pain relief do you want to use, if any? - No deseo anestesia alguna, incluida la anestesia epidural. (I do not want any anesthesia, including an epidural anethesia) - Prefiero no tener epidural pero informaré a la persona que me atiende si siento que lo necesito. (I would prefer not to have an epidural but will inform the person attending me if I feel I need it.) Movimiento durante el parto (Movement during labour) Which position would you like to use during labour? How active would you like to be: would you like to remain upright and mobile for as long as possible, for example, or would you prefer to be in bed?
- Desearía poder moverme y cambiar mi posición durante todas las etapas del parto y caminar durante todo el proceso de dilatación. (I want to be able to move and change my position during all the phases of labour and to be able to walk around during dilation.) Procedimientos médicos (Medical procedures) Are there any procedures that you would like to avoid if possible? - Quiero monitorización fetal intermitente y externa, no continua. (I would like intermitent, external fetal monitoring, not continuous.) - No deseo ningún tipo de inducción ni estimulación del parto: gel de prostaglandinas, oxitocina sintética (I do not want labour induced or stimulated in any way: prostaglandin gel, synthetic oxytocin etc.) - No quiero que se me practique rasurado de pubis. (I do not want my pubic area to be shaved.) - No quiero que se me practique enema. (I do not want to have an enema.) - Solicito que se limiten los exámenes vaginales a los estrictamente necesarios. (I ask that internal examinations are limited only to those that are strictly necessary.) - Quisiera que no se me practicara, sin mi consentimiento expreso, una episiotomía; agradeceré cualquier tipo de ayuda para evitarla, especialmente paciencia por parte del personal médico así como paños calientes en la zona. (I do not want an episiotomy to be carried out without my express consent; I would appreciate any kind of help to avoid an episiotomy, and particularly ask for patience from the medical staff and warm cloths applied to the area.) - Prefiero un desgarrro natural a una episiotomiá. (I would prefer to tear naturally rather than receive an episiotomy.) - Si consideran que la bolsa debe romperse en algún momento, debe discutirse primero conmigo. (If it is considered necessary to break my waters, this must be discussed with me.) El parto (The birth) Where would you like to give birth and in what position? - Desearía dar a luz en la sala de dilatación. Si esto no fuera posible, aceptaría el traslado a un paritorio siempre que se llevara allí una cama o camilla convencional. No deseo dar a luz en el potro obstétrico. (I would like to give birth in the dilation room. If this were not possible, I would accept being transferred to a birth room, so long as there is a conventional bed that I can use. I do not want to give birth in an obstetric chair.) - Deseo poder estar semisentada en el expulsivo mientras sea posible, ya sea en el potro obstétrico o en una cama. (I want to be semi-seated when I give birth in so far as this is possible, either in the obstetric chair or in a bed.) - Quisiera estar libre de adoptar la posición más cómoda para el expulsivo. (I would like to be free to adopt the most comfortable position when I give birth.) Cordón umbilical (The umbilical cord) Do you want to avoid early clamping of the cord? Would your partner like to cut the cord?
- Mi marido desea cortar el cordón. (My husband would like to cut the umbilical cord.) - Desearía que el pinzamiento y posterior corte del cordón umbilical se realicen cuando éste haya dejado de latir. (I would like the cord to be clamped then cut after it has stopped pulsating.) Placenta (Placenta) Do you want the placenta to be expelled naturally? -Solicito que se espere un tiempo prudencial para el alumbramiento espontáneo de la placenta, evitando el uso de oxitocina como primera opción. (I request that I am given sufficient time for the placenta to be expelled spontaneously, avoiding the use of oxytocin as a first option.) Contacto con el bebé (Contact with the baby) Do you want to have your baby with you all the time? - Quisiera tomar a nuestro bebé en brazos en el momento del nacimiento mantenerlo ahí piel a piel durante la expulsión de la placenta. (I would like to take our baby in my arms as soon as he/she is born and keep him/her there, skin to skin during the expulsion of the placenta) - A menos que sea por razones de salud, no deseo estar separada de mi bebé durante todo el tiempo que permanezcamos ingresadas en el Centro. En caso de que no pudiéramos estar juntas, me gustaría que mi pareja estuviera con él/ella en todo momento, especialmente cuando se le hagan las primeras revisiones. (Unless there are health reasons, I do not want to be separated from my baby at any time during our stay at the hospital/clinic. If we are not able to be together , I would like my partner to be with him/her at all times, particularly when the first tests are carried out. - Si el bebé necesita ir a una incubadora, por favor, permita que mi acompañante acompañe al bebé y que él/ella realice todos los cuidados ordinarios del recién nacido. (If the baby needs to go to an incubator, please allow my partner to accompany the baby and help with all of his/her care.) Lactancia materna (Breastfeeding) Be clear about whether you want to breastfeed or bottlefeed. Also be clear about whether your breastfed baby is allowed to have any bottles. If you definitely don't want her to have bottles, say so. - Quiero poder dar el pecho desde el primer momento sin horarios ni restricciones. (I want to be able to breastfeed right from the beginning, without timetables or restrictions.) - Quiero que no se administre al bebé alimento ni biberón alguno, sin mi consentimiento expreso o el de mi marido si yo no pudiera darlo. I do not want my baby to be given any other type of feeding without my consent, or my husband's if I am unable to give it.) El bebé (The baby) Do you have any particular wishes regarding the care of your newborn? - No quiero que se aplique ninguna vacuna a mi bebé (I do not want any vaccines to be applied to my baby.)