or Connect
Mothering › Groups › November 2011 Due Date Club › Discussions › Birth Plans

Birth Plans

post #1 of 21
Thread Starter 

Has anyone else done their birth plan? I posted all three to my blog. If you're a nerd, you'll like the homebirth one. ;)

http://healingcesareanscars.blogspot.com/2011/09/birth-plans.html

post #2 of 21

Since I'm debating having a hands off hospital birth because of risk of MRSA infection, I gave my OB a birth plan. It mostly consists of no continuous monitoring, letting me be up and around, having spontaneous rupture of membranes, birthing in the position I want, no episiotomy, delayed clamping and immediate contact with me and baby.

 

The OB was so awesome about talking with me about the monitoring, and talking about his belief in no episiotomies. He The ONLY thing the OB didn't agree with was delayed clamping of the cord. He said something about baby being higher than the placenta and his blood going back into the placenta and being anemic. He said that he would basically push the blood out of the cord, and into the baby and then clamp it. Are there negative effects to this? I don't know if I'm comfortable with that, but I haven't heard anything positive or negative.

 

 

post #3 of 21
Thread Starter 

I've never heard of them "compromising" by squeezing the blood into the baby before clamping...that doesn't seem like a good idea though. Maybe ask him to point you to research about "the baby being higher than the placenta and his blood going back into the placenta and being anemic". It sounds like a bunch of BS to me...This fb page is a really good resource http://www.facebook.com/#!/delayedcordclamping, maybe you could find a medical study and take it to him?

post #4 of 21

I'm not sure whether we're going to do a birth plan or not.  I chose the hospital and midwifery group because their standard protocols line up with my birth plan.  Other than having about a 50% rate of pain medication, everything else is pretty much what I would want.  They don't do episiotomies unless baby needs to come out immediately for some reason; they let you birth in any position and every room has a birthing ball and birthing stool; they don't do coached pushing; baby goes on your chest immediately and testing is done there, unless there is a medical emergency; they have a standard of at least 1 hour (but I'm told usually 2) of parent newborn bonding alone before anyone is moved; they encourage breastfeeding and don't provide formula unless asked to; they have intermittent fetal monitoring, and the monitors are wireless so you can move around (and even get in the tub) while monitored; the hospital provides circumcision, but I'm told it's not the norm and I've been to L&D a few times and that's one of the first questions they ask.

 

My doula is strongly encouraging us to write out a birth plan, but I feel weird doing it.  I really trust my midwife, and I don't want to insult her by saying "I do not consent to stripping of the membranes" because I could never imagine her doing that without discussing it with me thoroughly.  On the other hand, I'm worried I'm being naive by thinking the this hospital and midwifery practice will actually do what they say they will do.  So I don't know.  But time is running out to decide! 

post #5 of 21
Quote:
Originally Posted by crazykittymomma View Post

I've never heard of them "compromising" by squeezing the blood into the baby before clamping...that doesn't seem like a good idea though. Maybe ask him to point you to research about "the baby being higher than the placenta and his blood going back into the placenta and being anemic". It sounds like a bunch of BS to me...This fb page is a really good resource http://www.facebook.com/#!/delayedcordclamping, maybe you could find a medical study and take it to him?


Thank you for the resource. I was going to look it up, but the last few days have been hectic.
 

 

post #6 of 21

Personally, I'd definitely write out a birth plan if birthing in the hospital.  Your MW will understand your desire to have one written out, and even if you are redundant with hospital protocols, it's nice to have them clearly stated.  I'd also have a chat with your DH about what he'll do if a nurse or even your MW does something that you had clearly stated you'd like them not to do.  You won't be in any position to argue with anyone, so it will be DH (or your Doula) who will be the one to "argue" on your behalf.  

Hospital protocols are kind of lip service, if you ask me.  I birthed in the hospital with DS1, and while I had some nurses (2 out of 4) who were very excited about my natural birth plan and so accomodating, I also had 2 out of 4 who were AWFUL.  One kept offering drugs though it clearly stated that we did not want to be offered drugs, and the other would not let me push in any position besides flat on my back.  Even when I demanded it.  Seriously.  She also took my baby to the nursery even though my MW had worked out with the nursery beforehand that I would be rooming in completely.  She kept saying "well I've never done that before, so he is going to the nursery"  for TWO HOURS!  Luckily DH went down and got him back after just a couple of minutes (I couldn't walk) but I was furious with the nurse. 

 

So, everyone on your birth team needs to be clear on what your wishes are, and there needs to be a plan for how to make sure nobody tries to coerce you into anything.  Also, know that you can "fire" any nurse and ask for a new one.  You can also file complaints with the hospital re: your nurses if need be.  

Sorry if that all sounded really negative, but I think often times hospitals want to sound really mama-friendly and they know what women want to hear.  But individual nurses can be a whole different story.  Just be prepared!

post #7 of 21

Er, that doesn't really make sense about the baby being too high up to get the blood from the placenta.  That's not how blood flow works. I mean, in a healthy person, blood does not have trouble getting back up to your heart from your feet when you're walking around!  The anemia would come from the baby not getting the volume of blood he's supposed to get, because of early clamping. I've never heard of squeezing blood out of the cord and into the baby!  That's not necessary, nature knows how to take care of it. Oh my.

 

I am planning a UC again, so I haven't written a birth plan. But it just occurred to me that maybe I should write one for my husband!  The last time we had a baby (also UC), he came home from work at 5 pm, just when the contractions were starting to get difficult.  I was on my knees, leaning on the couch, humming, that kind of thing.  I don't scream or show much pain until push time, so I guess he couldn't tell that I was really working hard then- he was hanging out in his chair, reading on his computer etc.  Maybe I need to be shouting "OK, I need you to start getting SERIOUS, come here and focus on me!"  Or maybe I will write up a birth plan that just says

 

Once I am in labor, cater to me at all times.

post #8 of 21
Quote:
Originally Posted by Lula's Mom View Post

Er, that doesn't really make sense about the baby being too high up to get the blood from the placenta.  That's not how blood flow works. I mean, in a healthy person, blood does not have trouble getting back up to your heart from your feet when you're walking around!  The anemia would come from the baby not getting the volume of blood he's supposed to get, because of early clamping. I've never heard of squeezing blood out of the cord and into the baby!  That's not necessary, nature knows how to take care of it. Oh my.

 

I am planning a UC again, so I haven't written a birth plan. But it just occurred to me that maybe I should write one for my husband!  The last time we had a baby (also UC), he came home from work at 5 pm, just when the contractions were starting to get difficult.  I was on my knees, leaning on the couch, humming, that kind of thing.  I don't scream or show much pain until push time, so I guess he couldn't tell that I was really working hard then- he was hanging out in his chair, reading on his computer etc.  Maybe I need to be shouting "OK, I need you to start getting SERIOUS, come here and focus on me!"  Or maybe I will write up a birth plan that just says

 

Once I am in labor, cater to me at all times.


Well, just that one thing made me want a UC even more. Not only that, but it seemed like a scare tactic to get me to not do things as naturally as I wanted and to hurry up the process so the OB could leave to tend to another patient sooner.

 

And LOL at your DH needing a birth plan. I'm a moaner, so DH knew with the other two when I needed help the most.
 

 

post #9 of 21
I'm birthing in a hospital with a midwife. Many of her philosophies are in line with my preferences so I don't feel the need to detail everything. These are my most important wants:

Labor & Birth Expectations

- I prefer to have minimal internal exams and not be told the number cm of dilation.
- I would like silence and darkness in the room.
- It's important to me to push instinctively and wait until I feel the urge to push.  I do not want to be told how or when to push.
- I would like to have my birth photographed/filmed/videotaped.
- Intermittently monitored to allow for as much mobility as possible.
- I would like to catch my baby and pull it onto my abdomen as it is born.
- Please delay cord clamping and cutting until the cord has stop pulsating (5-10 min is preferred). 
- Please delay all essential routine procedures on my baby until after the bonding and breastfeeding period.
- Please do not administer eye drops to my baby, I am willing to sign a formal waiver if need be.
- I prefer any immunizations be postponed to a later time.
- Please do not bathe my baby at all.

And I like the idea of a birth plan for DH! lol

And Sarah - that first birth plan is cute!
post #10 of 21


Does your hospital allow you to videotape?  Ours didn't :-(  I'm not sure if we'll tape it this time- we're at a birth center.  That would be pretty cool though if you can tape it in the hospital- it's usually hospital protocol that you can't because of liability issues.

 

Quote:
Originally Posted by FaithF View Post

I'm birthing in a hospital with a midwife. Many of her philosophies are in line with my preferences so I don't feel the need to detail everything. These are my most important wants:
Labor & Birth Expectations
- I prefer to have minimal internal exams and not be told the number cm of dilation.
- I would like silence and darkness in the room.
- It's important to me to push instinctively and wait until I feel the urge to push.  I do not want to be told how or when to push.
- I would like to have my birth photographed/filmed/videotaped.
- Intermittently monitored to allow for as much mobility as possible.
- I would like to catch my baby and pull it onto my abdomen as it is born.
- Please delay cord clamping and cutting until the cord has stop pulsating (5-10 min is preferred). 
- Please delay all essential routine procedures on my baby until after the bonding and breastfeeding period.
- Please do not administer eye drops to my baby, I am willing to sign a formal waiver if need be.
- I prefer any immunizations be postponed to a later time.
- Please do not bathe my baby at all.
And I like the idea of a birth plan for DH! lol
And Sarah - that first birth plan is cute!


 

post #11 of 21
Quote:
Originally Posted by Ablemec View Post

IMy doula is strongly encouraging us to write out a birth plan, but I feel weird doing it.  I really trust my midwife, and I don't want to insult her by saying "I do not consent to stripping of the membranes" because I could never imagine her doing that without discussing it with me thoroughly.  On the other hand, I'm worried I'm being naive by thinking the this hospital and midwifery practice will actually do what they say they will do.  So I don't know.  But time is running out to decide! 


I would recommend having one written out b/c when it comes down to it, you may not be in a place where you are able to thoroughly discuss everything and it's very important that your dh and doula have a reminder of what it is that you want so they can talk with the midwife and any other care providers (like nurses or other doctors, if necessary) about your wishes. Midwives at hospitals care for a lot of laboring women and often at the same time. Plus if it's a midwifery group, you probably get whatever midwife is on call that day and she may not be 100% familiar with what you want. It can get confusing to remember who wants or does not want what and occasionally when a situation presents itself a care provider may just act before you realize what's happening b/c they don't see it as a big deal worth discussing.

My birth plan for my "in between UC" consists of: I will allow you to check FHT when you arrive and when my water breaks, otherwise please leave us alone until after the birth unless needed. lol.gif
post #12 of 21
Quote:
Originally Posted by Lula's Mom View Post

;Maybe I need to be shouting "OK, I need you to start getting SERIOUS, come here and focus on me!"  Or maybe I will write up a birth plan that just says

 

Once I am in labor, cater to me at all times.

LOVE!

As I've been helping other ladies with their birth plans lately (I'm a doula), I just realized that I haven't even thought of a birth plan for myself. Since it's my 3rd homebirth, I think it might be something like this: "I am going to birth my baby. You may help me if I desire, sit back and watch/take pictures, or go read in another room. You'll know when I need you." Sound alright? wink1.gif
post #13 of 21

Luckily, the standard policy of the midwives coincides with everything I want for labour. My doula is also totally in the know with what i want, and fully open to verbally intervening for me, should anything start to happen that I wasn't interested in, if I am having trouble vocalizing myself. The hospital that I am registered with (in case of homebirth transfer like my first birth) is a very progressive hospital that doesn't even have a nursery for healthy babies - rooming in only. It's actually a strict rule - one or the other parents must be with baby at all times while in hospital. 

 

I just needed to specify my desires for newborn procedures in advance, and this time I made sure they wrote down that I wanted to keep my placenta. Last time it got shipped away while I was all involved in bonding with my baby. So, ladies, if you want to keep your placentas, be sure they know of this in advance!

post #14 of 21
Quote:
Originally Posted by jbk21 View Post


Does your hospital allow you to videotape?  Ours didn't :-(  I'm not sure if we'll tape it this time- we're at a birth center.  That would be pretty cool though if you can tape it in the hospital- it's usually hospital protocol that you can't because of liability issues.

 



 


The first one I delivered in did allow it. I still have to check on this with my midwife, tho I think she'll be cool with it. I hope! This is a different hospital.
post #15 of 21
Quote:
Originally Posted by FaithF View Post


The first one I delivered in did allow it. I still have to check on this with my midwife, tho I think she'll be cool with it. I hope! This is a different hospital.


I hope so too!  That would be so cool.  Personally, I'm not sure who I'd have manning the camera....

post #16 of 21

I'm starting to wonder about this too.  I already told all my friends that I didn't want them at my birth and my best friend (for whom I might make an exception) it a TERRIBLE photographer..  I really don't want to pay someone either.  Maybe my midwives will do it?
 

Quote:
Originally Posted by jbk21 View Post

I hope so too!  That would be so cool.  Personally, I'm not sure who I'd have manning the camera....



 

post #17 of 21


I'm going to talk to my MWs about it this week.  Maybe I'll just have a standing "order" that if the camera is just sitting around, someone could pick it up and use it :-)

Quote:
Originally Posted by Abraisme View Post

I'm starting to wonder about this too.  I already told all my friends that I didn't want them at my birth and my best friend (for whom I might make an exception) it a TERRIBLE photographer..  I really don't want to pay someone either.  Maybe my midwives will do it? 

 



 

post #18 of 21

Yeah, I think that I'll ask too.  I could probably coax my dh to take a few pics too!
 

Quote:
Originally Posted by jbk21 View Post

I'm going to talk to my MWs about it this week.  Maybe I'll just have a standing "order" that if the camera is just sitting around, someone could pick it up and use it :-)

 



 

post #19 of 21

Okay, seriously, I think EVERY OB should see these clips from a OB/Pediatrics seminar done at a college. It's about delayed cord clamping and the BENEFITS vs RISK(which equals zero risk!) There are studies out there proving so many OB's wrong about polycythemia and that "stripping" the cord is worse than delayed cord clamping. I'm going to be pointing my OB towards these videos during my next visit since he's against delayed cord clamping and wants to "strip" the cord and then clamp it.

http://academicobgyn.com/2011/01/30/delayed-cord-clamping-grand-rounds/

post #20 of 21
Quote:
Originally Posted by IwannaBanRN View Post

Okay, seriously, I think EVERY OB should see these clips from a OB/Pediatrics seminar done at a college. It's about delayed cord clamping and the BENEFITS vs RISK(which equals zero risk!) There are studies out there proving so many OB's wrong about polycythemia and that "stripping" the cord is worse than delayed cord clamping. I'm going to be pointing my OB towards these videos during my next visit since he's against delayed cord clamping and wants to "strip" the cord and then clamp it.

http://academicobgyn.com/2011/01/30/delayed-cord-clamping-grand-rounds/



My DD spent 2  days in the NICU because of polycythemia. :(  They also measured her platelets as really low, which was the main concern, but that test ended up being faulty and her platelets were fine the whole time. Even just 2 days with a pretty much healthy baby was traumatic, and the entire reason I birth at home now.

 

Mothering › Groups › November 2011 Due Date Club › Discussions › Birth Plans