Birth Preferences, which matter most? - Page 2

[kltroy]

I went for the "keep it short and sweet" strategy with my birth plan. First, check and see what is standard operating procedure. Is rooming in the norm? If it is, don't put it on your birth plan. Same with everything else.

Next, think about what really matters to you and what's easy to simply remind people of at the time. Like having the lights dim in your room is easy to simply DO. Don't bother putting things like this in your plan. Same with consenting to internal exams etc - just say no, or that you'd rather wait, to please not ask you again etc. Don't clutter up your birth plan with this sort of nonsense.

Then there are what I consider "comes with the hospital terretory" things - like wearing a hospital gown. Get over it. The gowns are pretty comfortable, practical, and you don't have to do the laundry. All in all, that's not a bad thing. You check into the hospital, you are partly buying into that system.

In another of my prev. posts about birth plans (in the VBAC forum maybe?) I posted mine, with my own comments about why I included each item. You should be able to find it. I will say that my own plan was followed to the letter, and I had a really nice intervention-free hospital VBAC.

ETA: here's the thread with the annotated birth plan:
http://www.mothering.com/discussions....php?t=1236164

[MegBoz]

Originally Posted by kltroy

Then there are what I consider "comes with the hospital terretory" things - like wearing a hospital gown. Get over it. The gowns are pretty comfortable, practical, and you don't have to do the laundry. All in all, that's not a bad thing. You check into the hospital, you are partly buying into that system.

Wow, gotta say, I'm surprised to read that.

First off, with your last sentence, that sounds very similar to that old phrase, "You buy the hospital ticket, you take the hospital ride." I didn't expect to read people on MDC actually advocating/ arguing in favor of "just deal with it - just accept what the hospital wants."

But second, I DID have "no hospital gown" on my birth plan, so I've got a little something to say about it.

I've had surgery under general anesthesia twice prior to giving birth. Wearing the gown in the hospital would have reminded me of those times where I was a "patient" - a sick person in need of doctors to "do something" to me (first was to remove wisdom teeth, second was to remove tonsils.)

When I was birthing, I wasn't sick, and if all progressed normally, I didn't need anyone to "do anything" to me. I actually viewed it as an athletic endeavor! So there's a crucial distinction.

Plus, it would have been a tangible & visible reminder to me of my status as "patient" which I felt would have strengthened the dynamic of me feeling "controlled" or "at the mercy" of the nurses. It just made me uncomfortable emotionally.

So, wearing a gown would have bothered me emotionally. How is that different from requests such as??
-dim lights
-we want to play our own music
-no students present
-etc.


& actually, I remember in I think the movie "Orgasmic Birth" I think it was Dr. Marsdan Wagner who commented that "In the US we take a woman out of her environment, surround her by strangers in a strange place & put her in strange clothes.." (He was elaborating on how our system is not conducive to the natural progression of labor & birth.) I remember that he commented on the clothes thing, so I was glad to hear I wasn't the only one emotionally bothered by the gown.

I had it on my birth plan & my MW (a CNM) actually sorta chuckled when I said I'd wear a big, baggy t-shirt. She said, "Well, it'll probably get ruined."
I replied, "Oh, DH has plenty of big, free Ts, so we don't mind."
(Turns out that not only was it not ruined, it has the smallest, barely visble blood stain on the upper back, of all places, so I can still wear it & it is, of course, a treasured item.)

I had no problem with not wearing a bra - in case they suddenly need to shock me with AED or something & obviously I didn't wear anything on the bottom (panties or shorts) when it was time to push. But otherwise, I chose a big, baggy T instead of a hospital gown.

While I would agree that if they had a problem with this, it's probably something I would not fight too hard on because it's not a huge deal. However, I also wouldn't declare it inconsequential & insignificant either. & I must say I'm surprised at your dismissal of the issue. As if I'm frivolous & silly to have cared about it.

[nia82]

I didn't wear a hospital gown. We bought a cheap pack of men's tees at Costco and I wore those. Much more comfy than those nasty gowns! Plus those things are way too baggy and big for me! We threw the one away that got blood stains, no biggy but a huge comfort measure for us! No patient-y feel. The hospital couldn't care less what I wore, seriously.

[kltroy]

Originally Posted by MegBoz

However, I also wouldn't declare it inconsequential & insignificant either. & I must say I'm surprised at your dismissal of the issue. As if I'm frivolous & silly to have cared about it.

Sorry if it came across that way -- it wasn't my intention. My point was simply that I think in the hospital one needs to pick one's battles, and that that IMHO there are much more important things to argue about than wearing a gown. However, I also don't personally have any particularly negative associations with wearing a gown (and when I was in labor I couldn't have cared less what I wore or even IF I wore anything at all!)

I generally am also of the opinion that if you want to have your baby at home you should do so, and not go into the hospital. Now, I realize that for various reasons this isn't always possible/realistic for everyone, but if you truly do not want a single thing that the hospital has to offer you, IMHO the hospital -- gowns and all -- is not the best environment for you to birth in.

Anyway, again, sorry if that last post came out sounding judgmental in any way.

[WifeofAnt]

I'm going to bring some of my own clothes but depending on the style of the gown I might just go ahead and wear it. I've been hospitalized once before (ovarian cyst ruptured and got infected) but was more uncomfortable about not having underwear during the diagnosis process than not wearing my other clothes. I guess when I give birth I won't really have the option of keeping those though, lol.

I've heard though for the 'psychological' aspect to wear something else that makes you stand out as a person (colorful headband, ect) rather than a patient if you choose to wear the gown.

I would like to home birth but the enviroment (apartment with thin walls) and hubby's comfort level along with the price tag are against us. Its okay with me to be at the hospital. I like my doctor, I'm not afraid of hospitals, and I'll have my doula.

[MegBoz]

Originally Posted by kltroy

Sorry if it came across that way -- it wasn't my intention. My point was simply that I think in the hospital one needs to pick one's battles, and that that IMHO there are much more important things to argue about than wearing a gown.

<snip>
but if you truly do not want a single thing that the hospital has to offer you, IMHO the hospital -- gowns and all -- is not the best environment for you to birth in.

Thanks, I understand what you were saying. & I agree the gown is way down low on the list of importance. I also agree that if you find you are having to 'battle' on many things, you probably ought not to be in the hospital in the first place --or at least not that particular hospital - which is one of the very first things I thought of & posted on this thread.

I think the difference amongst hospitals is another important thing to note. For example, friends of ours said one hospital like red-lined half their birth plan! So they switched to another, smaller hospital with CNMs.

So it's not always an issue of hospital vs. OOH, but can also be 'good' (NCB-friendly, evidence-based) vs. 'bad' hospital (stupid, non-evidenced based procedural intervention.)

[KaylaBeanie]

I personally would refuse to consent to the heplock. I know it's hospital "policy", but they cannot force you into it. I know that doctors like to pull the emergency dead baby/dead mama card, but the chances of you suddenly having something so utterly catastrophic happen that they can't take twenty seconds to put in an IV are virtually non-existent. If an EMT can quickly place an IV into a person who is cut to shreds and hanging upside down in a car, a doctor can certainly place an IV in a woman lying on a bed. I've had IVs and they hurt, they get in the way and essentially make that hand useless.

I'd also refuse the gown, I remember reading in research for an essay that wearing your own clothing helps you maintain control and ultimately makes you more likely to have the birth you want. Makes sense to me.

[Magali]

Originally Posted by kltroy

I generally am also of the opinion that if you want to have your baby at home you should do so, and not go into the hospital. Now, I realize that for various reasons this isn't always possible/realistic for everyone, but if you truly do not want a single thing that the hospital has to offer you, IMHO the hospital -- gowns and all -- is not the best environment for you to birth in.

Anyway, again, sorry if that last post came out sounding judgmental in any way.

I understand where you are coming from. But it still is a sore spot for me because I live in an area of Canada where women have such limited birth options. Choices like UC 45 mins or more away from hospital, or in a hospital. I absolutely don't think the hospital is the best place for me to birth in. Just better than so far away from emergency care should we need it.

That being said, I am going for the short but sweet birth plan too. I figure there are a ton of things that I can't even imagine hospital staff would do, so I have a blanket statement at the top...something to the effect of "please ask my permission/discuss with me all procedures for myself and my baby so that I may decide if I want them or not". I get detailed when I mention how I want my newborn treated/what I don't want to be done to my baby.

[crystal_buffaloe]

Originally Posted by MegBoz

"I would like to meet with a lactation consultant."

Just a warning, but the MWs & Nurses at my hospital were awesome! However, I repeatedly met with all 4 of the LCs & all but one were DREADFUL! I mean, awful. Terrible. Thankfully we persevered in spite of them, but just a heads-up. I feel stupid for it now, but it honestly just didn't occur to me to be as suspicious of the quality of care I might receive from an LC as I was from nurses & MWs.

I was fairly insistent in my birth plan and in person that I wanted to meet with an LC before discharge -- but it turns out one of my nurses gave much better help (and she was able to be with me for several feedings). The LC showed up while I was already nursing (babe already latched on) and was just really not helpful.

[phathui5]

On the hep lock: If it's something you don't want done, you not NOT have to allow them to do it. I just had a doula client who didn't want a hep lock or an IV and didn't get either, even though the nurses tried to talk her into it.

Then there are what I consider "comes with the hospital terretory" things - like wearing a hospital gown. Get over it. The gowns are pretty comfortable, practical, and you don't have to do the laundry. All in all, that's not a bad thing. You check into the hospital, you are partly buying into that system.

I have to disagree. When I've had clients in labor, they've worn whatever they've wanted to. For some moms this does mean the hospital gown, but generally it ends up being something that they've brought with them.

I guess when I give birth I won't really have the option of keeping those though, lol.

Underwear: I did have a client who wore underwear at the hospital all throughout her labor because she felt more comfortable with them on. She took them off for vaginal exams and when it was time to push.

[WifeofAnt]

Well I shortened it a little and showed it to my doctor...

1. He said they really don't do that many cervical checks. Maybe once at admission, once every 2-4 hours, and once to make sure I'm at 10 before pushing.

2. He's not sure the nurses or any other doctor who might have to cover for him would know what to do if I ended up wanting a squatting birth so he said he can't guarantee it.

But other than that he thought it was a-okay and put it in my file. He reminded me to make more copies and to always keep a copy with me in case I need to go to L&D for any reason.

[Turquesa]

Forgive me if I missed this in all of the posts, but have you hired a doula? I could go on and on extolling the virtues of having a doula present , but for now I'll say that I made two versions of my birth plan--a longer one for the doula and a short one for the baby-catchers.

The doula took the time to review my special wishes and agreed to work with me, to a reasonable extent, to uphold them. A doula can give you more personalized attention; hospital staff will be too busy to read anything too long.

Originally Posted by WifeofAnt

1. He said they really don't do that many cervical checks. Maybe once at admission, once every 2-4 hours, and once to make sure I'm at 10 before pushing.

IMHO? That's a LOT. Some women request none at all. I requested one at admission and one when they were pretty much positive that I was ready to start pushing.

Great links on this topic of VEs during pregnancy AND labor:

http://icanwesternmd.blogspot.com/20...ing-labor.html

http://pregnancy.about.com/cs/interv...aginalexam.htm

[MegBoz]

Originally Posted by WifeofAnt

2. He's not sure the nurses or any other doctor who might have to cover for him would know what to do if I ended up wanting a squatting birth so he said he can't guarantee it.

So I take it they don't have 'squat bars' on the beds?
Squatting up on the bed might be a great compromise - you could have your DP behind you supporting you with his arms under yours. That way they doc could have a look without having to lay down on the floor.

[kltroy]

Re: squatting for the birth -- there are lots of great positions to actually push the baby out in, and I would just plan on going with your instinct. I actually instinctively wanted to be semi-reclined and that worked great for my VBAC (bonus: I was able to catch my baby). My sister found she wanted to be on her hands and knees. I think the key isn't to "get permission" for one position or another, but rather to have a discussion about the fact that you're just going to do what seems right to you at the time, and it's the doctor's job to figure out the best way to catch the baby for however you're positioned.

[WifeofAnt]

Yeah I have a doula.

Squat bar? As in over the bed or on the side? I didn't see anything over the bed but our tour was pretty short.

I'd like to not have really any VEs but I don't plan on getting to the hospital earlier than I have to (although it is a 30-40 minute drive). I hope by having a doula I'm not the crazy paranoid first time mom running up to the hospital at the first contraction. If I'm only up there for the last 3 hours of labor that only gives them time to do the admission and pushing checks