I revamped my bp...can ya read it again

[its_our_family]

I took into consideration the suggestions given. I think thisis much better than my rough draft!

Birth plan for:
Megan Moore (DOB: 3/1/79, vbac)
Benjamin Moore: spouse
:doula

In the birth of my child I am looking for what is best for both baby and mother. In the event of any emergency I am very open to discussion. I do request that things not be done before they are explained if that is at all possible. I will not put my child or myself in jeopardy.

General
*I will have a doula present
*If interventions are medically necessary they must be fully explained to Benjamin, my doula, and myself before anything is to be done.
*I insist that the word PAIN not be used in my presence. I have spent many months erasing this term from my vocabulary and would rather not have it introduced so close to the finish line. Yes, I fully expect it to not be a walk in the park but I prefer the terms stretching and intensity.

Labor
*I prefer not to have Continuous Fetal Monitoring. I do not want to be strapped down to the bed and restricted for a monitor. If a telemetry unit is available I prefer it. I would rather discuss intermittent monitoring.
*I know that an Epidural is available. Please do not offer one. If I would like one I will ask.
*I do not want to have my water broken as “routine procedure”. It may be discussed.
*I do not want an IV for a “just in case” scenerio. If an IV is necessary I prefer a heparin or saline lock.
*I refuse Pitocin.
*I refuse all meds unless they are explained to Benjamin and myself.
*I request being mobile during my labor and to have access to food and drink.
*I refuse an episiotomy.
*I would like to be allowed to push in whatever position works best. I may not want to push on my back.
*I prefer gentle guiding in pushing not a drill sergeant. I would rather not push until I feel ready.
*Please do not clamp and cut cord until after it has stopped pulsing.
*I would like Benjamin to announce the baby’s sex.

After Birth
*Please do not do the infant bath—baby can be wiped off and vernix rubbed in; a “bath” can happen later
*We refuse routine eye ointment
*We refuse the Hep B vaccine.
*We will be exclusively breastfeeding. Please do not offer baby a pacifier or bottle.
*All routine procedures can wait until we have had to bond as a family.
*Do not take baby to nursery for warming. I can do this.
*If in the event that the baby is in need of immediate attention Benjamin will accompany the baby.
*We prefer rooming in.



In case of Caesarian Birth

*I prefer epidural or walking epidural NO spinal.
*Benjamin will be present while epidural is given.
*Do not strap down my arms. I would like to have at least one arm free.
*No sedatives are to be given before, during or after surgery.
*I request NON- drowsy benadryl if I have problems with itching.
*I request NO drugs be administered unless they are discussed.
*I would like to discuss pain control with the anesthesiologist before getting a lot of things pumped into me.
*I would like to have a mirror in order to watch our baby being born if I choose to.
*I would like the c/b explained as it proceeds. I prefer a “friendly” atmosphere in the OR.
*I would like for Benjamin to announce baby’s sex.
*Baby will be given to Benjamin after birth to hold.
*Unless there is a medical reason that this cannot happen I want the baby in my arms as I am wheeled to recovery.
*I will breastfeed in recovery but may need help depending.

[Lucky Charm]

I like this one better than your first.

I know your caregivers and the hospital/birthcenter staff will get a copy, but what about the anesthesiologist, should you need a repeat c-section?

I hope you get what you want!

Good Luck!

[its_our_family]

Thanks-- I know my first one had problems but I just couldn't figure it out, probably because I had written it myself and it was late!

Thanks for the feedback. I'm sure about the anesth. getting a copy. I'll have to ask.

[Defenestrator]

Hi --

I read the first version of your birth plan but did not comment. I also like this one a lot better. There are still a few things I would change, though.

RE: moving, food, and drink. I would delete this line entirely. It is unreasonable to be confined to bed without good medical reason, so I would just stay out of it and move around as much as my heart desired. If the nurse tried to stop me, we could argue about it then and there. I guess that if the hospital has a policy about not letting mamas out of bed, having it in your birth plan is not going to get them to agree to free movement, while if they don't, it is kind of pointless to put it in there in the first place. I also have found in my work as a doula that if we are going to challenge hospital policy with something that is totally under the mom's control, like moving around, it is best not to put it in the birth plan. It is easier for the nurse to look over the birth plan and say, like checking off a list, "this is not going to happen, can't do this, etc." where if you just do what you want it takes more assertiveness on their part to try and direct you to change what you are doing mid-contraction.

Along the same lines with food and drink -- nurses are out of the room a lot. If you are going to a hospital that does not allow food and drink, putting it in your birth plan that you want food is just going to get you immediate instructions not to eat. If you just leave it out and follow your instincts about eating and drinking, you will probably get plenty of opportunities to do so when there is no nurse around. If you get "caught" you can just play dumb.

I don't usually advocate going against hospital policy, but I know that policies against eatiing are so random and out of date that when my clients want to eat in my presence in the one hospital I work in that disallows food for moms, I just tell them that it is not my job to enforce hospital policy If they do need surgery later, though, I encourage them to be honest about the last time they have eaten. (not that it matters anyway because studies show that moms in labor often digest food very slowly, so the meal of 12 hours ago might still be in your digestive system anyway)

I would take out the line about being coached like a drill sargent and replace it with something like "I prefer to be guided by my own spontaneous pushing urges rather than being coached to push for a specific length of time during each contraction. Feedback about the success of my pushing efforts is welcome." I think that the "drill sargent" phrase is just going to offend without really conveying what you want.

Look over your birth plan too, and consider editing out anything that you think you might have the time and frame of mind to discuss in the moment. That way, what remains will be competing less with other items for the attention of the staff. One example would be the non-drowsy benadryl. I would assume that if you are having itching and ask for a drug, they will tell you what they suggest and you can bring up your concerns then.


Hope this is helpful and not too convoluted.

Good luck!

[USAmma]

It looks great! However it might be good to shorten the sentences down quite a bit because they will not have time to read word for word, just scan it. Put important things in bold letters too.

Example:

-- Intermittent monitoring only, ever 20 minutes or as necessary.

-- Do not offer pain medication. Will ask if I need it.

-- No rupture of membranes

-- No routine IV. If one is needed I want heparin or saline lock.

-- No pitocin

-- No meds shall be administered without my permission and an explanation.

-- No episiotomy


Also, break it down further. Have a "Labor" section that discusses pain manangement and monitoring, etc; a "Delivery" section that covers the pushing stage to the delivering of the plancenta, and an "Aftercare" section that discusses what you want in the recovery period. Have them under bold headings. Have the infant care requests on a separate sheet of paper so you can give a copy to the nursery for the baby's file.


Darshani
(who was a technical writer in her last "life")

[its_our_family]

Thanks gals! I took out the drill sergant part..I thought the same thing you did.

I took it to my first appt today and the np said that all of this was very doable (since the hospital is very laid back and non-interventionst as long as the patient wants that. otherwise they are very involved. It all depends on the wishes of the patient)

She said a few things to take out and leave for the moment (double suture and stitches no staples) She was also not sure about not wanting the hep b vax and the eye ointment and I should call the ped about that. It doesn't matter because we will NOT have them done. I'll call ahead though....

[Greaseball]

I would not worry about saying "I refuse." True, they may resent you, but I think being resented is better than saying "Please don't do this unless it is medically necessary" because then you know it will be "medically necessary.": In my hospital plan, I said "I absolutely refuse" and "You do not have my permission to" and "If you ___ I will walk out." With the midwife plan, I am nicer - I say "please," and "I would like."

Remember, hospitals and doctors are our employees! We have the right to tell our employees what to do. If they can't or won't do it, we can fire them. It's never too late to go to a different hospital, even if you are already in labor!

If you don't want the word PAIN used, I would also suggest asking (telling) them not to use the word RUPTURE. That way they won't get you all worked up over something that almost never happens unless Pitocin is used - which you have refused! Good for you!

[roseselene]

"non drowsy benadryl"

just curious ....what is that? I'm an RN and I work on a post partum unit and I have no idea what that refers to??
Amy

[Gitti]

I would definitely add two more things to after care:

No PKU - in the hospital. It should be done at 1 week of age. The infant must have consumed three or four days of breast-milk or formula before PHENYLALININE shows up. The optimal time for testing appears to be five or six days after birth. Brain damage can occur as early as ten to fourteen days after birth. But there is a window of a week or two for the PKU test. It will be more precise if done at 1 week of age. And it is not necessary or beneficial to have a child's heel pricked twice for the same test.

No Circumcision - on either male or female baby. Either way, it is strictly cosmetic surgery, very painful, and takes away part of a sexual organs that rightfully belong to the child and no one else. It removes a normal, functioning body part, and leaves a scar. 85% and 95% of all men and women respectively in the world are not circumcised. No World Health Organization recommends it, most speak out against it, and many Governments have outlawed it.
It is time we abandon this antiquated practice.

No Vitamin K instead you could take alfalfa tablets before breast-feeding for a few days. Alfalfa is high in Vita K.

Good Luck!

[Gitti]

I would definitely add two more things to after care:

No PKU - in the hospital. It should be done at 1 week of age. The infant must have consumed three or four days of breast-milk or formula before PHENYLALININE shows up. The optimal time for testing appears to be five or six days after birth. Brain damage can occur as early as ten to fourteen days after birth. But there is a window of a week or two for the PKU test. It will be more precise if done at 1 week of age. And it is not necessary or beneficial to have a child's heel pricked twice for the same test.

No Circumcision - on either male or female baby. Either way, it is strictly cosmetic surgery, very painful, and takes away part of a sexual organs that rightfully belong to the child and no one else. It removes a normal, functioning body part, and leaves a scar. 85% and 95% of all men and women respectively in the world are not circumcised. No World Health Organization recommends it, most speak out against it, and many Governments have outlawed it.
It is time we abandon this antiquated practice.

No Vitamin K instead you could take alfalfa tablets before breast-feeding for a few days. Alfalfa is high in Vita K.

Good Luck!

[Greaseball]

How about no Cytotec? This drug is still being used and may be even more dangerous than Pitocin.

[BrooklynDoula]

This looks good. We spent a lot of time on ours and it seemed to work really well with the staff - they all read it and weere really respectful about all our wishes. I pasted a copy of it below incase it gives you any ideas (K and eye drops are state law here and will get you sent to CPS if you refuse).

GOOD LUCK!

Megan

We are very excited about our upcoming birth at Wilson and have really enjoyed our experiences with the UHS Midwives and all of the staff at Wilson. In order to help make our birthing experience as enjoyable and positive as possible, we have written this birthing plan. While we hope there are no complications during the birth of our child, we understand that circumstances may require us to re-evaluate our desires. If the need does arise for medication or medical procedures we hope to avoid, we would like to have everything explained to us as fully as time will permit so that we may give informed consent.

We have been taking Bradley classes to help both of us prepare for a natural childbirth experience with as few medical interventions as possible. We request that no medication be offered to us during our birthing so long as both Megan and the baby are doing well.

We would like vaginal exams and fetal monitoring to be kept to a minimum. Our preference for exams would be one at our admission to the hospital and one when Megan has the urge to push. We do not want to use electronic fetal monitors, rather, our preference is for a fetoscope or doppler to be used only when necessary, so long as Megan remains low risk.

Megan would like to eat and drink light foods and fluids throughout labor as long as she wishes. Megan does not want an IV during labor and delivery and if it is necessary to have IV access, our preference is for a saline lock to be put in and used only when needed.

We would like labor to progress at its own pace without any artificial measures to accelerate the process such as pitocin or artificial rupture of the membranes. So long as both Megan and the baby are okay, we would like to have as much time as needed to labor and deliver.

Megan does not wish to have an episiotomy and would prefer to tear. We ask for you assistance in minimizing the possibility of a tear through hot compresses and suggestions for appropriate birthing positions if necessary.

When our baby is born, it is very important to us that it be immediately placed on Megan’s torso, with the cord unclamped until it stops pulsating. We would like to breast feed the baby as soon as possible, both for bonding and to help naturally deliver the placenta. We request no artificial hurrying of this process so long as Megan is okay.

We would like the baby to have ample time to bond and nurse on Megan’s torso, so we request that eyedrops and Vt K not be given until after the first hour or two. Further, we request that these be given to the baby in our room. At that time, weight and length may also be taken.

We would like 24 hour rooming in and desire not to be separated from the baby at anytime for any reason. One of us will be with the baby at all times. Our preference is to bath our baby in our room with warm wash cloths rather than sending the baby to the nursery for bathing.

We will be exclusively breast feeding our baby and request that no water, formula, or pacifiers be given to the baby. Megan will express breast milk if it is necessary to feed the baby by bottle.

In the event that a C-section is necessary, Megan would like to be awake if time allows, with one hand free to touch the baby. Shawn will remain with Megan for the delivery.

Megan’s mother, Karen Davidson, and the baby’s god-mother, Julie Seymour, will be arriving as soon as possible and we would like to have them with us as much as possible.




THANK-YOU!

[its_our_family]

"NON DROWSY BENADRYL" (stupid cap lock...)

You know the bendaryl you take when youa re sick. they have drowsy and non drowsy. This is what they gave to stop the itching but it also nade me very very sleepy!

I'll add the cytotec (maybe I should say NO LABOR INDUCING DRUGS OF ANY SORT

As for the pku...it is required by state law here before you leave the hospital. Which I'm fine with. As long as they aren't putting in anything...

As for circing...we are (don't lecture I've done the research) we just don't when. We may try and wait the 8 days or so so we can skip the vit K because we really don't want it.

Vitamin K...depends on when the circ is done.

Thanks for including your Megan! I love to see what other have written!

[roseselene]

Originally posted by its_our_family
"NON DROWSY BENADRYL" (stupid cap lock...)

You know the bendaryl you take when youa re sick. they have drowsy and non drowsy. This is what they gave to stop the itching but it also nade me very very sleepy!

To be honest, I really don't think there is anything like "non drowsy benadryl" "benadryl" is the trade name for diphenhydramine which is a powerful antihistamine and very good for allergic reactions and things like itching and so forth.... diphenhydramine causes drowsiness as a side effect....there is no "non-drowsy" version to that....if the company "benadryl" has a non-drowsy thing on the market with their name, then I'd be willing to bet that it does not contain the ingredient diphenhydramine. I couldn't think of anything that they could give you to combat itchiness associated with the spinal narcotics except benadryl....and benadryl is going to make you drowsy.
Amy

[its_our_family]

All I know is that they said they had a non drowsy something they could have given me instead....

[Greaseball]

What about Narcan?

[roseselene]

Yeah, they can give Narcan too.....the problem with narcan is that it is designed to counteract the narcotics.....sooo....it does that....the narcotics are the cause of the itching so your itching stops....but usually your pain comes back then....ya know? but then again, I had a patient who had terrible itching due to spinal narcotics and they had her on a narcan drip and it didn't work at all....she still itched and itched and itched.......
i felt very bad for her.
benadryl didn't work for her either.