Hospital Birth Plan - Page 2

[joyakshi]

my m/w said she used to not do the vit K shot so much, but now she does, seeing what is really does. and she's an old-school, birthing in a van on an island lady. so, I felt like I could trust her opinion/experience about it.

Originally Posted by Friendlee

Harmony96: Thanks for the explanation.

So I was looking at an acquaintance's birth plan on facebook and she declined the silver nitrate eye drops citing the whole chlamydia/ghonorrea thing. And then someone responded (a nurse) who said it isn't only for preventing blindness in the case of STD's but also to protect from "any other bacterias that have been introduced into the vagina that can affect the newborn upon descending down the birth canal."

Is that bogus?? Anyone know?

She also says this about the Vitamin K shot:
"The vitamin K injection is given to the newborn because they have a so-called "sterile gut", which in other words means they have little to no clotting factors. Infant's blood (even after receivng the injection) takes an extreme amount of time to clot. Hospitals do this because the benefis outweigh the risks"

Again, is this bogus? I always wonder what they did in the old days with the non-clotting baby guts??? Was there some epidemic problem with it that was remedied with the vitamin K shot?

[joyakshi]

I am quite happy with my birth plan and it's been reviewed and approved by my m/w, who was quite happy to have me include everything that I felt was important. I really don't need it to be edited by anyone I haven't asked for feedback from, thanks anyway.

Originally Posted by mysticmomma

This is what your hospital should see. While your thoughts are coherent and well thought out, and it's clear you've done lots of research into what you prefer, anything more than a page is not going to be looked at. Most of what you wrote is provider specfic, so your long version is a great jumping off point for discussion with your provider.

Family name at top.

We are planning a natural birth, which involves no medical intervention to instigate, progress or assist the labor and delivery, except in the case that there is an imminent, real threat to the health and well-being of the mother or baby.

In the event there is an emergency, we are aware plans may change as needed. We expect to be included in any decisions that divert from this plan, but we place the safety and health of mother and the baby over all other expectations and wishes we have for the birth.

Minimal staff, no students please.

We would like all stages of labor and delivery to occur in their natural timeframe with no time limits or expectations to progress or deliver by a certain time assuming the health of the baby and myself.

Delivery
H. I would like to have a mirror available and adjusted so I can see the baby's head crowning.
I. I would like the opportunity to touch the baby's head as it crowns.
J. I would like (father) to help catch the baby.
K. I would like the option to help catch the baby.
L. We would like to take pictures and/or video during labor and birth.

Postpartum care
Unless there is something wrong with my baby, she should be placed on my abdomen immediately. All newborn procedures/exams should be done in my arms.
I am breastfeeding.
Father to give bath.
Please remove my IV/Heparin lock/catheter (if necessary) as soon as possible after delivery.
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.

NEWBORN CARE
A. If the baby must go to the nursery/NICU for evaluation or medical treatment, please show me the baby first. (father), or someone I designate, will accompany the baby at all times.
B. Please delay eye medication for the baby until we are well past the initial bonding period (a couple hours after the birth). If available, I would prefer erythromycin eye treatment or other antibiotic eye drops instead of silver nitrate.
C. Please do not give the baby supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
D. I would like to delay the PKU screening and Vitamin K injection for as long as possible after the birth, and have it done just before we leave.
E. Please do not give the baby a pacifier.

Cesarean Section Delivery
B. If a cesarean is absolutely necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
C. I would like (father) to be present during the surgery.
D. Please explain the surgery to me as it happens.
E. I would prefer epidural anesthesia, if possible, in order to remain conscious through the delivery.
F. I would like to have a respectful atmosphere without chatter during any part of the surgical procedure.
G. If possible, please do not strap my arms to the table during the procedure.
H. Please suture my uterus in 2 layers, not one.
I. If conditions permit, the baby should be given to (father) immediately after the birth.
J. If possible, I would like to breastfeed the baby immediately after the birth.
K. Please lower the screen just before delivery so I may see the birth of the baby.
L. I would like our plans outlined here for postpartum and newborn care for after the birth to be followed as closely as possible.

[Friendlee]

I have to justify it to myself in order to decide if I want it or don't want it. I'm not so worried about justifying it to "them". Although I do want to be prepared for which preferences tend to cause more fuss from nurses. That way I know where to direct efforts while educating myself. In the throes of labor or while adoring my newborn, I'd love to be confident in what I say rather than hem and haw as I convince them. If I know WHY I'm doing it, I will be perfectly satisfied giving them one line and then asking them to leave.

[Friendlee]

Joyakshi: I didn't get to read your last posts (I must have been posting at the same time). What did she say about what the vitamin K really does?

[mysticmomma]

joya , it wasn't a personal attack.

[MerelyGod]

I am trying to find my birth plan from my last birth. I know there are a few things I want to change, and I'd like to have time to look it over before I go into labor.

A few suggestions I've read that seemed helpful were to keep it to one page, front side only. The more information there is, the less likely people are to read it and you don't want to confuse the issue. Bullet points keep things very clear. I would leave explanations OFF the birth plan. Keep it to how you want things done, very simple and straightforward. If you want your explanations handy, print out a second document that has those and you can hand it out if you need to. Because really, it is your RIGHT to refuse these things, and you don't need to offer an explanation. If you can't get it down to a single page, consider having a birth plan, with a separate "cesarean plan" and another one for postpartum care (since you will have different nurses then anyway). Also, bring multiple copies to your birth and have someone who is attending give one to every person who comes into the room. I have read that it is helpful to have it printed on colored paper, but we just did mine on white and that worked fine for us.

I think it is very important to have a birth plan and I don't really understand people who say you are setting yourself up for disappointment. My birth plan is not an outline of my ideal birth, it is a document which explains to the staff who will be helping me deliver my baby what interventions I do/do not want because I know that when I am in the middle of labor, or have just given birth, I may not remember to tell them these things.

[MerelyGod]

Vitamin K helps with blood clotting. I believe the injection carries a very slight increased risk of getting leukemia (although I haven't researched this since my last pregnancy, four years ago, so I could be confusing it with something else!). I think the oral Vitamin K is preferred, but I can't remember why.

I believe we opted for no Vitamin K unless the baby was born with bruising (like from forceps or something. My understanding is that the mother's prenatal levels of Vitamin K make NO difference in the baby's levels at birth. That tells me that whatever babies have when they are born is what they need. I have read that it's a good idea to make sure there is plenty of Vitamin K in your diet before and after birth though, so the baby will get it from your breastmilk.

[joyakshi]

I posted my birth plan at Friendlee's request, to be helpful. My birth plan was not open to critique, feedback or editing.

Originally Posted by mysticmomma

joya , it wasn't a personal attack.

[mysticmomma]

wow... I"m gonna let this drop.

[Asiago]

My husband and I have been interviewing pediatricians this last month or so.
After some of my interview questions (the last Dr. we interviewed), I asked him if he has any advice for us. His immediate reply was "make sure that you have a birth plan and let it be known in the hospital as well as discussing with your OB prior to birth". I asked, should I hand out copies to staff? Get it signed? His reply: "no, not really neccessary, but do make it known that you have a written plan and have it with you".

He was head of hospital pediatirics dept for years, so I would imagine his advice is based upon experiences he has witnessed. I was grateful for his response, and strong feelings regarding having a birth plan.

[Friendlee]

Well, isn't that interesting! Sounds like a good doctor. My OB visibly cringed when I asked when would be a good time to run my birth plan by her and then told me that, "Women with birth plans just jinx themselves."

I have good news though!!! Even though I am 28 weeks pregnant...I found a new doctor who IS willing to look at my birth plan and supports natural birth and has experience managing pregnancies of women who have doulas. It's a huge victory. This will be my THIRD Ob/Gyn so far this pregnany. But hey! I don't think it's too much to ask that I trust and feel respected by someone who will see me through such an event, right?!?!

Asiago, I'm glad you have some good ped options, that's awesome!

[joyakshi]

I have also been through 3 care providers - OB, midwifery group, homebirth midwife, and back to the midwifery group. It's important to make sure you are comfortable and happy, even though they act like you're crazy for switching so much. It's still not perfect, but I feel I've made the best choice overall.
I hope you've found someone that makes you happy.

Originally Posted by Friendlee

This will be my THIRD Ob/Gyn so far this pregnany. But hey! I don't think it's too much to ask that I trust and feel respected by someone who will see me through such an event, right?!?!

[JordanKX]

My bplan is similar to what's been posted here - esp. the Vit K, that it should only be administered if trauma occurred during delivery.
Thank you guys for adding the C-section wants in there - something I hadn't considered, but Oh so important just in case.

My OB/practice is unfortunately one of those where whoever's on call, that's your delivery Doc. I've looked into changing, but at this point, I really like my MD despite that she might not be there. She's been Wonderful about helping with my bplan and letting me know what the hospital procedure is -- they don't cut the cord before it stops pulsating, give you the baby immediately for skin on skin for an hour/do procedures bed-side, etc. These are still on my list, but it's good to know their procedure ahead of time.

Going to the birthing center was KEY for me, meeting the nurses and talking to them about my wants. And luckily my doula has witnessed many births at the center, so she had great help to offer.

One of the nurses did say that they'd had a few doula's who essentially cut off communication b/w mom & nurse... which I found a bit odd. Immediate question for my doula then :-) And she said that her role will be to speak for me when I can't answer a question, but by no means to dissuade the nurses from talking to me directly.