Could you please look over my birth plan?

[StephandOwen]

And let me know if there's too much info, if I forgot something, if I should leave something off, etc. I'm having a brain fart right now and I'm not sure if I want to leave this how it is. Thanks!!

LABOR

• I wish to walk around and move freely during labor.
• I wish to have fluids by mouth during labor.
• I do not wish to have an IV. If necessary, I will consent to a heplock.

MONITORING

• I do not wish to have continuous fetal monitoring, unless it is required by the condition of my baby.
• I do not wish to have an internal monitor unless the baby is showing signs of distress.
• Please use intermittent monitoring, unless the baby shows signs of distress.

PAIN MANAGEMENT

• Please don’t offer me pain medication. I am aware it exists and will ask for it if needed.

DELIVERY

• I would prefer to not have an episiotomy, unless absolutely necessary for the safety of my baby.
• I would like to be able to push and deliver in whatever position is working for me. This can include, but is not limited to, squatting or hands and knees position.
• Please place baby immediately on my chest. Unless the health of the baby necessitates otherwise, baby will remain on my chest while I deliver the placenta and for at least the first hour after birth.
• Please allow the cord to stop pulsing before my husband, Jason, cuts it.

IMMEDIATELY AFTER DELIVERY

• Baby will remain with mom, as long as the health of both allow it, the entire time. All newborn exams should be done with baby on my chest.
• If the baby must be removed from me to receive medical treatment, my husband will accompany the baby at all times.
• NO HEPATITIS B VACCINE
• NO ANTIBIOTIC OINTMENT (eye drops)
• Please ask Stephanie about Vitamin K shot. She will determine whether it is necessary, based on how the delivery went.
• NO CIRCUMCISION

POSTPARTUM

• The baby will stay with mom the entire time, unless it is medically necessary to transfer the baby to the nursery.
• If the baby does need to leave mom’s room, dad (Jason) will accompany baby at all times.
• I plan on breastfeeding the baby, starting immediately after birth.
• Please do not offer the baby any bottles (including sugar water or plain water).

C-SECTION

• In the event that a c-section is necessary, I would like my husband (Jason) and doula (Kristen) to accompany me. Unless medically necessary, baby should remain with mom the entire time. If that is not possible, Jason will remain with the baby and Kristen will remain with me.
• I would like to hold and breastfeed my baby as soon as possible after surgery.

DISCHARGE

• Unless the health of baby or mom requires extra care, I would like to be discharged 24 hours after delivery.

[Auntie Sapphire]

Quote:

• I do not wish to have continuous fetal monitoring, unless it is required by the condition of my baby.
• ...
• Please use intermittent monitoring, unless the baby shows signs of distress.

These two points say basically the same thing.

[~pi]

Argh. Just lost a whole post. Summarizing: A lot of this is probably unnecessary, depending on your hospital. The most important thing when writing a birth plan, IMHO, is to find out what is standard procedure at the hospital. It does no good (and can set up power struggles, lack of trust, etc.) to tell people what to do when they already do things that way. I would remove anything that can just be dealt with in the moment (e.g., If baby is whisked away, I assume your DH knows to go with. No need to put that in your birth plan.) or that would require discussion anyway and won't matter if it's in your birth plan (e.g., discharge time.) Other things, like no bottles, are kind of weird to include. If you aren't going to have the baby leave you unless necessary for medical reasons, when would they have a chance to give a bottle?

Basically, try to avoid writing a birth plan that could be summarized in one line: "I prefer not to give birth in the 1960s." (Unless, of course, your hospital is stuck in the 1960s!)

My suggested edits:
 

Originally Posted by StephandOwen 

And let me know if there's too much info, if I forgot something, if I should leave something off, etc. I'm having a brain fart right now and I'm not sure if I want to leave this how it is. Thanks!!

I am aiming for as natural a birth as possible. Please help support me in these ways:

LABOR

• Help me to walk around, move freely, stay hydrated by drinking, and let me decide when to discuss pain medications.

DELIVERY

• Help me push and deliver in whatever position is working for me.
• Help me avoid an episiotomy. I would rather tear.
• Help me hold baby immediately on my chest after birth, while I deliver the placenta, and for any newborn exams.
• Please allow the cord to stop pulsing before my husband, Jason, cuts it.

BABY CARE IMMEDIATELY AFTER DELIVERY

• NO HEPATITIS B VACCINE
• NO ANTIBIOTIC OINTMENT (eye drops)
• Please ask me before giving Vitamin K shot.
• NO CIRCUMCISION

POSTPARTUM

• I plan on exclusively breastfeeding the baby.

C-SECTION

• If a c-section is necessary, please help my support people know where to go so that they can stay with me.
• I still want to hold and breastfeed the baby immediately after birth.

[newyorkmommy]

I like pi's edits a lot.

Also, hopefully you will avoid a c-section altogether, but on the off chance that that happens, just be prepared that they are not likely to allow your doula into the surgery with you. I speak from personal experience both as a mom and as a former doula. But obviously the most important thing is that your dh would be with you during the actual surgery.

[StephandOwen]

Originally Posted by ~pi 

Basically, try to avoid writing a birth plan that could be summarized in one line: "I prefer not to give birth in the 1960s." (Unless, of course, your hospital is stuck in the 1960s!)

Unfortunately, I've heard some good and bad things about this hospital.... depending on what nurse(s) you get. My doctor is on board with anything I want, pretty much. But he even said himself that our biggest hurdle will be the nurses. The nurses will push for an IV (even though the dr says a heplock is fine), the nurses will push to take the baby away immediately to clean and assess (even though the dr has no problem leaving the baby on my chest), the nurses will push for continuous monitoring (even though the dr is fine with intermittent). That's mostly why it's so detailed, is because the doctor says he'll sign it saying that he agrees with these decisions and it will hopefully keep the nurses at bay because I'll be able to show them that the dr agrees with my plan (if we happen to get a crappy nurse).

Thanks for the suggestions! I'll look over them all later tonight and see what I can tweak!

[Amy May]

Steph- I would go with your gut on this one. Yes, you could shorten it by saying, for example "I plan on exclusively breastfeeding" and just leaving it at that, but I do think it may be beneficial to add the part about not offering the baby any bottles.  I would personally also specifically include not offering any formula or pacifiers either. 

That was just one example- you have a better sense than any of us about what your hospital and OB staff are like, and you know best of all how explicit you should be. 

It is awesome that you're having a doula- it sounds like you've already talked about your birth plan with her (which is great to have yet another advocate on your behalf). 

[tutucrazy]

You can ask them to put the monitor patches on your shoulders and back instead of your chest so that baby can be skin on skin on your chest with no wires in the way in the event of a c/s

[sunanthem]

You may want to include, no first bath at the hospital, if that is something you'd rather do yourself.

[corrabelle]

I wouldn't edit your list-There are hospitals in our area where you would need a list exactly like this-where babies are still offered sugar water, and fetal heart monitoring is routine. If this is your plan, have it written out clearly, like you do, so that there are no misunderstandings.
What seems like common sense to one nurse or doctor may not be to another.