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Can you share your hospital transfer birth plan? - Page 2

post #21 of 35
To the OP who asked about the cut and dry birth plan---as an L and D nurse, I LOVE them. Quite honestly, I don't really care WHY most people choose the things they do--the point is I want to help ensure they get what they want as much as I can. So I really like the:
I would like:
blah blah blah

I do not consent/please do not do:
blah blah blah

Especially because I have to ask lots of those questions if it's not stated, so specifying whether or not you want things like:
Hep B
Circ
Erythro
Vit K
Tdap/other vaccines for mom
pacifier

And I actually would recommend listing it out in different catagories like the Yes, I want and the No, I don't rather than in paragraph form. It's visually easier to see and remember and ultimately that's what's important. For example, MamaJen--your plan is worded very nicely and is very thorough but having read it once, nothing sticks out--I'd rather see it divided up more--and the paragraphs were long enough that I started skimming.
post #22 of 35
My transfer birth plan was long, but inclusive. I labeled individual sections so that nurses and other care providers could find what they were looking for quickly. I did not get everything I wanted, but it did give people a heads up, and they were very sensitive when dealing with me.

Quote:
Care Preferences in Case of Hospital Transfer
A and DH
We have had a very normal pregnancy and plan for a home birth. If for some reason, however, our midwives recommend that a hospital transfer is the best decision for A’s and the baby’s health, we will be transferring into your care. We understand that this may place us at a higher-risk category and necessitate certain interventions that we would otherwise try to avoid, however we do have some preferences for ourselves and for our baby that we would like to convey to you on paper.

Pain Relief:
We may be transferring in order to obtain pain relief for A if her labor has been prolonged to the point that she is exhausted and unable to continue without assistance. However, we would like to use an epidural as a last resort, and instead use narcotic pain medications or sterile water injections first if that is deemed appropriate to our situation.

IV Access:
If an IV is required, we request that a heparin lock be placed for the administration of mediations and left unattached to a constant fluid drip. As long as A is still able to eat and drink on her own, she would like to be able to do so.

Fetal Monitoring:
Our transfer may be out of concern for the baby’s well-being; however we would like to avoid constant fetal monitoring if at all possible. As long as intermittent monitoring is appropriate, we would prefer that method of monitoring our child. We would also prefer the use of the fetoscope over the Doppler whenever appropriate, and that ultrasound exposure, whether for a test or to obtain the heart rate, be constrained to a minimum.

Antibiotics:
We decided, after a careful review of available literature, to decline the test for Group B Streptococcus. We realize that it is the policy of the hospital to treat all untested mothers as if they were positive; however we do not consent to antibiotics for A or the baby without a positive culture and symptoms of illness. We also do not consent to testing for GBS disease in the baby unless s/he shows symptoms of illness; at a minimum this means two consecutive high temperature readings taken four hours apart.

Vaginal Birth:
In the case of a vaginal birth, A would like to avoid directed pushing, lithotomy position, and episiotomy. We have not discovered the gender of our child during this pregnancy and would like for DH or A to announce it. We would like skin-to-skin contact immediately after birth. During the third stage, we request that cord clamping be delayed until after the cord has stopped pulsing, and that cord traction not be used at all in assisting with placental delivery. We would like at least an hour be given between the birth of the baby and the birth of the placenta before intervening.

Cesarean Birth:
If a c-section is indicated, DH would like to be present for the entire procedure. He has extensive experience in the operating room environment and would like to be present and able to witness the surgery, even if general anesthesia is used. We would like to be able to photograph the birth. We would like for DH to announce the gender of the baby. If possible, we would like the baby placed on A’s chest or abdomen until the cord has stopped pulsing before clamping and cutting it, and for the placenta to be allowed to detach naturally.

If the baby needs to go to a special nursery, we ask that DH accompany the baby at all times. If DH and the baby leave the operating room and A is not under general anesthesia, we ask that one of A’s support people be allowed to join her in the operating room for the remainder of the surgery.

Newborn Care:
We do not consent to the administration of antibiotic eye ointment, since A does not have gonorrhea or chlamydia. We do not consent to the administration of Vitamin K, either orally or by injection. We do not consent to the administration of the hepatitis B vaccine. We will sign any legal forms that are necessary for the hospital in order for us to decline these procedures.

We ask for suctioning be avoided if at all possible. We want to minimize separation after birth. If a vaginal birth, we would like the exam delayed until after breastfeeding occurs. If birth happens by cesarean, we ask that the examination be as quick as possible, and that baby is wrapped up and handed to DH as soon as is reasonable. If DH or A is unable to hold the baby at any time during the first several hours, we ask that an available staff member hold the baby until one of us is available. We do not want our child left in a bassinette or a warmer, especially during its first hours of life. An exception to this is during hallway travel from room to room, when we understand that safety regulations may require that the baby be in a bassinette. However, as soon as possible, we would like the baby to be picked up and held again.

We are planning on exclusively breastfeeding and would like to avoid any artificial nipples or formula being given to our child.

We thank you for your expertise and assistance in welcoming our first child into the world. For all of these requests, we are willing to discuss our options at any stage as the situation may demand that we compromise. We would ask, however, that any changes be made only after consulting with us and allowing us time in private (when possible) to make a decision. Thank you again.
post #23 of 35
Quote:
We have not discovered the gender of our child during this pregnancy and would like for DH or A to announce it.
We never thought about including this in our birth plan, and we should have - DH was disappointed that the Dr. announced the sex of the baby before anybody else had a chance. This is a really good idea; I'm stealing it for my next baby's birth plan!
post #24 of 35
I like the nurse's suggestion: make it easy on the staff to get you what you want by listing it out.

Anyone put the kind of cut they want in the C section part? (low transverse)
post #25 of 35
Quote:
Originally Posted by greenthumb3 View Post
I like the nurse's suggestion: make it easy on the staff to get you what you want by listing it out.

Anyone put the kind of cut they want in the C section part? (low transverse)
I don't think it's necessary. The standard of care is now the low transverse incision, and you could have a lawsuit on your hands if you did it any other way without a damned good reason.
post #26 of 35
Subbing/bumping!
post #27 of 35
Quote:
Originally Posted by aylaanne View Post
I don't think it's necessary. The standard of care is now the low transverse incision, and you could have a lawsuit on your hands if you did it any other way without a damned good reason.
Don't count on it. Apparently with large women, it's the vogue to perform a vertical incision. I have every intention of specifying transverse if for whatever reason I need a c/s, I'm not about to take that risk.
post #28 of 35
If one transfers do the medical staff *actually* read these, let alone care to follow them? Does anyone have any experience with using such a birth plan in case of a transfer? I'm finding it hard to imagine that in the case of a transfer (where something has gone wrong or at least someone has decided that something is not right), that the hospital staff would take the time to read these plans. For this reason, I haven't bothered to write a plan at all. Anyone have any insight?
post #29 of 35
Quote:
Originally Posted by francesmama View Post
If one transfers do the medical staff *actually* read these, let alone care to follow them? Does anyone have any experience with using such a birth plan in case of a transfer? I'm finding it hard to imagine that in the case of a transfer (where something has gone wrong or at least someone has decided that something is not right), that the hospital staff would take the time to read these plans. For this reason, I haven't bothered to write a plan at all. Anyone have any insight?
One of the first things the nurse said to me when I transferred was, "So, I was just looking over your birth plan..." But my hospital is rather unique, so not the standard.
post #30 of 35
I read them--but in a true emergency, you're right that there will probably not be time. But if it's a transfer for any other reason, I'm more than happy to take 2 minutes---that's other reason why I advocate only having the MOST important and MOST relevant things on a transfer plan.
post #31 of 35
Quote:
Originally Posted by cileag View Post
I'm more than happy to take 2 minutes---that's other reason why I advocate only having the MOST important and MOST relevant things on a transfer plan.
I agree. I just can't picture things like letting mom and dad discover the sex, artifical nipple use, etc to be important or relevant in a true emergency.

I honestly think a big "Dad or mom is to be with baby all of the time" would help with most of it.
post #32 of 35
Thread Starter 
If it is a true emergency then they don't read anything they just do what it takes to save mom and baby's lives. But in the case of maternal exhaustion and other non-emergent transfers they usually read them. They already know that you desire a natural childbirth obviouslly because you are transferring from home. So it is not necessary to list every little detail. I try to focus on the really important stuff and the afterbirth stuff involving baby's care.
post #33 of 35
I plan to make two (one for emergent and one for non-emergent).

The one for emergent will say

WE DO NOT CONSENT TO:
Hep B
Vit K
Antibiotic eye ointment
Circumcision
Bottles/ Formula
Pacifiers
Single-layer repair for a c-section
post #34 of 35
I need help with the C-section part as well. I have placenta previa (or did at 20 weeks), so a C-section is a definite possibility, unfortunately.
post #35 of 35

Does anyone mind if I use some of the things you have listed. I haven't been able to think of much and this is great!!

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