How does this Birth Plan look?

[filiadeluna]

I waited pretty long to finalize it, and I'm turning it into my Midwife (CNM) at my appointment tomorrow. The birth will be at a hospital. She will likely tell me if there's anything unnecessary on there, i.e. things that they routinely don't do anyhow. I still would like some opinions on it, though. It's rather long, but I wanted to get every single point across. I don't know for sure which CNM will be there for the delivery, let alone how the nurses will be.

Our wishes for Childbirth

LABOR
• I would like to be free to walk around during labor.
• I would like the environment to be kept as quiet as possible.
• I would like the lights in the room to be kept low during my labor.
• I would prefer to keep the number of vaginal exams to a minimum.
• I would like to avoid a saline lock, but prefer this to an IV.
• I would like to continue laboring for any length of time that we are comfortable with as long as no serious signs of distress arise.

MONITORING
• I do not wish to have continuous fetal monitoring unless it is required by the condition of the baby. • I do not want an internal monitor unless the baby has shown some sign of distress.

LABOR AUGMENTATION/INDUCTION
• I would prefer spontaneous rupture of membranes.
• I would prefer natural methods of induction (walking, nipple stimulation).

ANESTHESIA/PAIN MEDICATION
• I respectfully request consent to any and all procedures and medications to be obtained before they are performed/administered.

EPISIOTOMY
• I would prefer to tear than to have an episiotomy.
• I would like a local anesthetic to repair a tear.

DELIVERY
• I would like to be allowed to choose the position in which I give birth, including squatting.
• I would like the chance to touch the baby's head when it crowns.
• Even if I am fully dilated, and assuming the baby is not in distress, I would like to try to wait until I feel the urge to push before beginning the pushing phase.
• I would like to have the baby placed on my stomach/chest immediately after delivery.

IMMEDIATELY AFTER DELIVERY
• My husband would like to cut the cord.
• I would prefer that the umbilical cord stop pulsating before it is cut.
• I would like to hold the baby while I deliver the placenta and any tissue repairs are made.
• I do not want a routine injection of pitocin after the delivery to aid in expelling the placenta.
• I would like to delay all routine procedures until after our first breastfeeding session.
• I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.
• If the baby must be taken from me to receive medical treatment, Justin, or some other person I designate will accompany the baby at all times.
• I would like delay bathing, and to give the baby her first bath myself.
• I would prefer to hold the baby rather than have her placed under heat lamps.
• After the birth, I would prefer to be given a few moments of privacy to urinate on my own before being catheterized.
• We decline eye treatment, Vitamin K, and the Hepatitis B vaccine.

POSTPARTUM
• Unless required for health reasons, I do not wish to be separated from my baby.
• I would like to have the baby "room in" and be with me at all times.

BREASTFEEDING
• I plan to breastfeed the baby and would like to begin nursing very shortly after birth.
• I would like to meet with a Lactation Consultant. Please, NO pacifiers, bottles, formula, sugar water, or artificial nipples, etc.

CIRCUMCISION
• We decline circumcision in case our ultrasound proves wrong and we have a son instead of a daughter.

OTHER
• My support person is my husband, and I would like him to be present during labor and/or delivery.
• I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth. • I would prefer all visitors to remain in the waiting room until I request for them to visit.

**seperate page below**

CESAREAN
• Unless absolutely necessary, I would like to avoid a Cesarean.
• If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.
• I would like my husband to be present at all times if the baby requires a Cesarean delivery.
• I wish to have an epidural for anesthesia
• So I can view the birth, I would like the screen lowered just before delivery of the baby.
• If the baby is not in distress, the baby should be given to my husband immediately after birth.
• I request a double-layer suture to close the uterine incision.


***A lot of things listed that I would otherwise have bolded (i.e. breastfeeding, induction, etc), but I feel confident that the CNM practice at this hospital is in sync with my wishes on these anyhow.

[justbishop]

Definitely seems long to me. I had a REALLY tough time shortening mine as well, though. It helped me to try to word things more broadly, so that one statement could kind of blanket cover lots of more specific details. I plan on making DH a cheat sheet of all of those details, and he will be expected to watch out for those things and speak up before anything "bad" happens

[Malva]

Seems too long to me as well.

[nuwavemomma]

Luna, that's why I did two - because if I have the normal vaginal birth I'm prepared to have, a whole lot of things will be able to just be articulated by me and don't really need to be written down. What needs to be in writing are the choices you make in hard labor and the choices you make in the immediate postpartum moments. Everything else you will probably be able to say for yourself. Really unless you're at a really horrid place, they will actually ask you about things before they do them - or at a bare minimum say, "Now it's time for eye goo" (for example) at which point you're definitely able to speak up or have DH speak up because things are much quieter by the time that happens. I would definitely have everything down for your DH, but in terms of giving the staff something to go off of I agree that it's too long.

So I think you can edit out stuff that you'd be able to say yourself in a normal birth:

• I would like a local anesthetic to repair a tear - this is a no brainer. I also have it in mine - as a joke!
• I would like the chance to touch the baby's head when it crowns. (Just do it, don't ask permission to touch your own baby!)

• I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.

• I would like delay bathing, and to give the baby her first bath myself.
• I would prefer to hold the baby rather than have her placed under heat lamps.
• After the birth, I would prefer to be given a few moments of privacy to urinate on my own before being catheterized - I have never heard of this being done *after* a vaginal birth! Where did you hear this???
• We decline eye treatment, Vitamin K, and the Hepatitis B vaccine - this can go in notes for your DH, because unless you are separated or seriously drugged you are definitely able to participate when this comes up.
• We decline circumcision in case our ultrasound proves wrong and we have a son instead of a daughter. - same for this.

HTH!

[filiadeluna]

Thanks for the tips, ladies! Well, I didn't have time to edit this morning, but I showed it to my Midwife, and she said it looked really good. She didn't think it was too long.

Actually, the one thing my CNM said might be an issue is the bathing, because they are afraid of other people holding her if she still has bodily fluids on her. So I want to make sure *I* give her a bath when *I* feel enough time has passed for some of the vernix to soak in.

Also, RE: eye goo: apparently my state is very strict about this, and at this hospital they will NOT ask you about it, the Vit K shot, or Hep B unless you have it in your plan or bring it up yourself. They will just do it.

My DH hasn't done any of the research with me, and is pretty much relying on me to know what is what. I doubt he would know if one of the nurses asked him about something what my feelings would be on it, so he might just go ahead and OK something unless it is in my birth plan specifically.

[nuwavemomma]

Well you always have the option of a DH cheat sheet. My DP has my birth plan at work with him and he's memorizing it.

[Xiaguan]

OK I had a long response almost ready to post & my puter when woonky!

1st: Which CMN did you talk with?

2nd: Since I just had Seth where you are going Andrea caught Seth~ It was amazing! My BP did not make it in the room But the only thing I can say that she did not do was wait to cut the cord~ Otherwise it was if she had read my BP~ No anything 'normal' LOL! no pit afterwards! No routine shots! The nurse was wonderful & did not do anything except take him to the scale about 20-30 mins after he was born(in the room!) She did his footprints & gave him back~ He still has not had a full bath~ He has been cleaned up with a warm rag on his vital spots(face, hands, neck & bottom!) No one said anything about him not being clean! Also I had to sign a waiver about the goo & Vit k shot. I did have to explain why I did not want the routine but once I told them they were cool! I hope that you get Mary M in L&D for your nurse! She was amazing! She even told me I love getting to see a natural CB since I don't get to that often Kelly in the nursery was even more amazing! She went above & beyond for us!

I hope that you get Mavis or Andrea for you MW on call They are both just amazing women! Emma is pretty cool as well!

Melissa

[filiadeluna]

^ My CNM is Erin. She's fabulous. I really hope she gets to be there, but chances are I'll end up giving birth when she's not on call. Who knows. Funny about the cord cutting... Erin said it is routine at Vandy to wait 2 minutes at least, or longer if you request it. She also told DH he can catch the baby if he wants to... to just let them know ahead of time! :

Originally Posted by nuwavemomma

Well you always have the option of a DH cheat sheet. My DP has my birth plan at work with him and he's memorizing it.

Yeah, I will probably at least make him a copy, and one for me to keep beside me too just in case!

[Xiaguan]

Originally Posted by filiadeluna

^ My CNM is Erin. She's fabulous. I really hope she gets to be there, but chances are I'll end up giving birth when she's not on call. Who knows. Funny about the cord cutting... Erin said it is routine at Vandy to wait 2 minutes at least, or longer if you request it. She also told DH he can catch the baby if he wants to... to just let them know ahead of time! :

She probabyl let it be for about 2 minutes~ Last time I we waited longer but I was so wrapped up in the moment that it was too late to say anything at the time She did let #4 child cut the cord(which is who wanted to ) I do remember her asking who was in charge of the kids that came in to see Seth born~ I told her that my 16yo would take them out if necessary~ She was great about telling the girls what angle to be at to see the best view of the birth though They really seemed to get a kick out of it

I think that you will be (hopefully) pleasantly surprised with the staff at Vandy

Melissa

[filiadeluna]

^ Great to hear! I'm excited! :