Birth plans « Back to Group Discussions

[crystal_buffaloe]

Something amysue said in the weekly chat made me curious, and I thought it deserved its own thread. How many of us are writing birth plans? Why or why not? Who are they for, exactly? Are they detailed? Bare-bones? What kinds of things are you including/not including?

If anybody wants to share theirs (past or present), I'd be really interested in seeing them and hearing how they worked out.

[MadiMamacita]

Last time I found an online checklist sort of thing that was pretty detailed and had space to write in things they didn't include. I can't remember what site I used but I liked it.

[MissE]

There are just a few things that I want, like no Hep shot, delayed cord clamping if possible, bonding with baby and nursing before a bath, no bottles at the nursery, no bottles WHATSOEVER etc. I guess it's nothing really 'out there'.

For me, it's the usual. Having a hospital VBAC I know I will be on a heart rate monitor at all times and most likely get an IV too. I know I can get up and stand up, be on the birth ball (even though DD didn't like that at ALL last time). I know what I want, I pretty much know what to expect at the hospital so I just need to put it into writing and take it to my OB with me.

[katt]

I didn't write one last time, as my midwife knew what was going on.  I MIGHT write up an Emergency Transfer Plan.  Most of the 'homebirth' plan will go out the window cause if I transfer it'll be an emergency and then well, all bets are off.  However, there are AFTER birth things that need to be known.  Treatment and Care of both me and baby.  Info I'll need to make DH aware of too.  Not that he won't know, but that he'll need to be more aware of in a hospital setting.

[teegan db]

I'm with Katt - hoping for a homebirth, in which case the midwives will just know everything, but will wait on their advice as to writing anything down in case we do end up at the hospital.

[Monkey Keeper]

I'm a hospital VBAC like MissE. I have been with my OB since 2008, through what will be 3 pregnancies, so we have a great relationship, and she knows my birth preferences quite well. I found with my last birth (primary VBAC) that it was helpful to have her note them in my chart/orders rather than show up with my own piece of paper. She even has said this time that she will note RN preferences for me. I will be doing some "unconventional" things for a VBAC like intermittent monitoring and hopefully a waterbirth, so it helps to have that endorsed by my OB.

In addition, I have a doula who knows the L&D staff and protocols very, very well and does an awesome job of creating space for us to make our wishes known. Last time, we made a point of telling the RNs that we did not consent to anything until we had been asked specifically about *that* intervention/procedure. It worked quite well, and I really owned the decision making in the birth. We do not do Hep B or eye ointment or a bath and we delayed the newborn exam until breastfeeding had been established.

[MadiMamacita]

Originally Posted by Monkey Keeper 

we made a point of telling the RNs that we did not consent to anything until we had been asked specifically about *that* intervention/procedure.

That is a great idea!

The plan I made was because I was transferring care to the hospital from my midwife at 37 weeks and had no relationship with anyone over there. I was hoping not to end up in a section, but had no idea if we would or not so it was things like, in the event that I am not able to be conscious, baby is not to leave DH's sight, baby stays with us at all times, no circ, no shots, no eye goop, etc.

[goin' green]

 I won't because we're doing a home birth.  And in the case of the transfer, my midwife and doula will be with me as advocates, so I'm not really worried about needing it then either.

[hyde]

Yep, Katt pretty much said it all! I voted 'no' thinking about plans for birth at home, but the streamlined backup stuff will be in place.

[Ava's Mama]

I am not writing a birth plan.  I am having a home birth.  I asked my midwife about it a month or so ago and she said it is up to me but I hired her because we have the same views on birthing.  She said even iff I got transfered to the hospital she would be there to keep the drs in line.  If I was going to a hospital I probably would.

I had a birth plan with DD.  I ended up delivering in an ambulance and I am not sure if anyone ever looked at the birth plan.  The hopsital we went to is not overly medically and follows a lot of the requests we had made anyways.  I do not remember anyone ever asking to take DD away, asking about shots etc.  So maybe they read it and just plain respected it!

Edited by Ava's Mama - 6/12/12 at 7:28am

[crystal_buffaloe]

I'm working on one -- perhaps more for my dr than for the hospital -- I'm supposed to take it in to discuss with her sometime soon. I'm not 100% sure on some things, though. I'll post it here later if anyone is interested (or is interested in giving some feedback).

[momtoafireteam]

I don't really need a 'birth' plan, but I definitely need to start doing my post birth/ baby plan. Since we deny almost all newborn procedures, we like to put it in writing and tell everyone so no one gets "accidentally" anything done. :)

[rnra]

No, I'm not writing one because I don't see any reason to write one.  I feel like they create unnecessary hostility between me and the medical staff.  I have an OB that I trust, I'm not afraid to speak my mind, and everything works out just fine without one.

[MamanFrancaise]

No. I'm having a home birth with a midwife who worked closely with my last midwife. My last home birth was great so we're all on the same page about things.

[help007]

The instructor for my birth class I took during my first pregnancy (taught by a Doula, based upon Birthing From Within) suggested that if we thought an official 'birth plan' was a useful tool, it should be kept to the size of a single index card. If we have a whole page or pages of expectations for our birth, we are more likely to be disappointed, because during birth new information becomes available, and we should be educated about the process, and able to make decisions based on our individual realities. This is why it is important to be using the care providers whose practice aligns (as well as is available) with your priorities. It is also important to have people who can advocate for you (a doula in a planned hosp birth, your HB midwife when a transfer is necessary) when unexpected things happen.

With that advice, I looked through the birth plan samples and checklists so I knew what to talk about ahead of time with my hospital and later home birth midwives. No where in my birth plan could I have anticipated that I wouldn't be having regular contractions 24 hours after my water broke. I would never have considered how things would change when my second son needed TONS of encouragement to start breathing.

[ilovejeff]

I'm having a birth center birth with my HB midwife from last time, so my birth plan with her is "everything the same as last time, minus the retained placenta" . But I may do a newborn/mommy care plan in case of transfer.

[dmpkmom]

HB momma here too (I think) but instead of a plan its more of a honey-do (midwife-do) plan. No one, including me, had the wherewithal to get many photos of baby in the early days. My MWs broke my kitchen saftey locks last time looking for a pot to boil water, so this time there will be a very specific tour of the house ahead of time and I'll set out way more towels/peroxide/puddle pads and pots/pans and food than they can possible ask for. I also didn't feel relaxed after the birth (I had a funky tear that kept us all busy) so hopefully that can be avoided and I can have some soft music and candles going. I had bought candles and cds last time but they didn't get noticed. LOL

I did make a list and posted on the fridge of ideas for DH to try if I was having trouble coping (like try a heating pad, shower...)

IF its a transfer, I have a small plan..like if its a c/s, baby will not be bathed w/out us there (baby can be dried but not bathed), baby will be kept up at my head if at all possible during the stitching and hubby will bring the pump so I can express IF I'm in recovery w/out baby (and/or I may hand express colustrum before birth as a backup). Having had a c/s before..I think I'm more aware of what I can get some wiggle-room out of hospital's protocols. There's no reason glucose water be given  for low sugar if I can get some early milk to baby. I also will NOT eat anything at all until I can fully pass gas or otherwise..trapped gas was horrid!!!! worse than labor by far.

[crystal_buffaloe]

Well -- here is my tentative plan. It's longer than I want it to be, but I'm not sure what I can cut (hopefully the Hep Lock line -- I know that it's standard procedure for FTMs, but it might not be for VBACS). Unfortunately, intermittent monitoring is also standard for FTM's but not for VBACs so that needs to be on there (and hopefully is not a conflict when I discuss it with my doctor). I *think* I can remove all initial exams on my chest, since I'm fairly certain that's already hospital procedure (and I know that the "golden hour" is standard procedure - to delay vit K and eye goop if breastfeeding) but I'm paranoid -- I'll ask my doctor.

This is something that she'll sign off on and it will be placed in my chart prior to delivery, and then DH & my doula will have copies when we go in. It's mostly in case she is not there when we check in/deliver. I do have her personal cell phone number, and she's VERY good about making it to births (family practice docs don't get a whole lot of babies, and they catch most of them -- it's not this everyday thing like it is with some OBs).

I know I do need to add a line at the top with my name, DH's name, doula's name, and baby boy's name. Any feedback at all is appreciated. (I mean it.)

[Faliciagayle]

Looks good - do you want to add anything about movement in labor/birthing position? 

[crystal_buffaloe]

I don't think so (though if you have an opinion/experience, let me know for sure). My reasoning is that that's not something my doc needs to sign off on or that I'll have to ask permission for and I do want to keep it as short as possible -- limited to those things where my care plan differs from standard protocol in the hospital. Though as I'm typing, I supposed that standard protocol in the hospital is probably lithomy position. I labored/pushed with DD mostly on hands and knees with some squatting and no one had a problem with it (though one nurse kept covering up my exposed bum in the air with a towel -- it didn't even register with me while it was happening, but in retrospect, her concern for my modesty was funny) -- I was thinking that it was more of a "don't ask, just do" type thing .... but maybe it wouldn't hurt to put something? Ideas on wording?

• Freedom to choose position for pushing (hands and knees, squatting, etc.)