Birth Plans (more about baby than mom) « Back to Group Discussions

[abouttobe5]

I was reminded when talking to my midwives at my last appointment about all the things that we have to think about with regards to bringing a baby into the world.  Of course, depending on where you live in the world, it will vary.  For example, I don't have to worry about vaccines as they don't do them immediately after birth in Ontario but some moms might have to depending on where they live.

Thought we could start a thread about the concerns you have to watch for if your'e in a hospital and nurses/doctors are taking your LO after the birth to do whatever (clean up, take measurements, etc.)  They can be pretty sneaky and assuming thinking that ALL moms want the  same thing (which in their eyes would be considered the right steps to take after a baby is born).

Anyhow, here is my list that I can think of that they think as normal but some moms might not want. Please add to it so that we can all be mindful of what we want or don't want!  

1)  Cutting the cord (how soon after)

2)  Erythromycin in the eyes of newborns (to "prevent" transfer of STDs such as gonorrhea or chlamydia - obviously if you don't have those, not at all necessary to give your newborn the eyedrops)

3)  Vitamin K shot (synthetic) to prevent clotting disorders ( prevention due to the 1/10 000 that have a hemorrhagic disease at birth)

4)  Vaccines (if applicable in your area)

5)  Heel prick tests (testing for enzyme deficiencies, hormone deficiencies, bilirubin for jaundice, and others)

Any else I'm missing/forgetting?

thanks!

andrea

[guen]

Bathing.  I know many hospitals, particularly in the U.S. and, I think, in the UK, like to bathe the baby right after birth.  It's much less common, at least in my experience, here in Germany.  Many people (including myself) are opposed to bathing baby right after birth. 

[MrsKoehn]

Hmm, *planning* a HB, but at the hospital if we have to go, I want the baby to be placed on my bare skin right after he's born too unless there's a compelling medical reason not to.

[finnegansmom]

This is the birth plan I wrote for my second son that we used last time with #3 as well except for the water birth.  Simple but it was adhered to both times (thankfully we gave birth in "baby friendly" hospitals).

LABOR:

No labor augmentation, no stripping of membranes, Pitocin, etc.

No IV unless medically necessary.

No Pain medication.  No sedatives.

Able to drink / eat as I wish.

Able to use tub / shower for labor as I wish.

Limited internal checks, as needed.

Quiet environment, no extra staff, dim lights, door closed.

BIRTH:

We are planning a water birth.

No episiotomy.

Delay cutting of cord, Mom prefers to cut cord if Dad does not want to.

Breastfeed as soon as baby is born.

I do not want residents or students present during my birth.

No Pitocin for delivering of placenta. 

No tugging or pulling on placenta for delivery.

BABY:

No eye ointment.

No Vitamin K injection.

No vaccines.

We are exclusively breastfeeding, so please no artificial nipples or bottles / formula.

We prefer the baby to stay with us in the room while in the hospital. 

No bath for baby, we will bath when baby comes home.

We plan to leave the hospital same day as delivery.  We have made arrangements with our pediatrician for check up 48 hours after birth.

[sere234]

Originally Posted by guen 

Bathing.  I know many hospitals, particularly in the U.S. and, I think, in the UK, like to bathe the baby right after birth.  It's much less common, at least in my experience, here in Germany.  Many people (including myself) are opposed to bathing baby right after birth. 

Yup, that's what I was going to say. 

[faithsstuff]

Circumcision. I'm not trying to start a debate. The hospital was already planning ds' circ before he was born. That's one thing we took care of right away.

[finnegansmom]

Originally Posted by faithsstuff 

Circumcision. I'm not trying to start a debate. The hospital was already planning ds' circ before he was born. That's one thing we took care of right away.

My midwife doesn't even offer that, I don't think we could even have it done if we wanted to?  We were told IF we wanted it to take him to our primary ped after the fact.

Which is why it wasn't even on my birth plan, thankfully a non issue for us. 

[JodiAriel]

My hospital does not encourage birth plans but since I have concerns over a potential emergency C-Section with general anesthesia I am writing one anyway.  My concerns are more for myself if I can't communicate and to assure I do not miss key moments of the initial part of the babies lives.

So far I have:

For the birth of Jodi and Jason's twin girls:

For Jodi:

Please minimize the use of adhesive tape on Jodi as she is very sensitive to the tape.

Jodi is very sensitive to narcotics, if they must be used please give anti nausea medication with any narcotic. I would prefer the use of Toradol over Morphine unless absolutely necessary.

During the time in the OR, Jodi would like to remain upright as much as possible if a c-section is not needed. 

For our girls:

Baby A is Emerson Lily and Baby B is Ellis Willow

We do not consent to the Hepatitis B Vaccine for either of our girls

We do not consent to Erythromycin ointment for either of our girls

In the case of an emergency c-section under general anesthesia, please do not weigh the babies or bath them until Jodi is awake.

If Jodi is unconscious, Jason is to be present for any testing done on the babies.  He will accompany the babies to the NICU if necessary. 

If general anesthesia is used, please initiate skin to skin contact with Jason as soon as possible.

Randi (Jodi's mother) is to remain with Jodi until she has awaken from anesthesia.

Is there anything glaringly obvious that I am missing?  I am actually more concerned with a birth plan for a c-section than for a vaginal birth since most of my wishes for a vaginal birth are standard at our hospital.

[finnegansmom]

Jodi, what about feeding?  Are you OK with them giving your girls a bottle of formula if you are sleeping after a c section?  or pacifier?

If you plan to nurse I might let them know.

Also, you might want to address vitamin K vax if that's something you do not consent to.

[fayebond]

Great plans ladies!

I keep drafting birth plans and scapping them.  I don't really need one if all goes well since my HBMW does all the things I want as a matter of routine anyway.  But, if we needed to go to a hostpital, I definately have different ideas than what ours considers routine, even though it would be an emergency and I'd probably not have much say if any.  Then, if there's a need for RCS, I have some preferences for that as well, but, last time I made those requests and was ignored, so I feel like its pointless to write one for that.  

[JodiAriel]

Originally Posted by finnegansmom 

Jodi, what about feeding?  Are you OK with them giving your girls a bottle of formula if you are sleeping after a c section?  or pacifier?

If you plan to nurse I might let them know.

Also, you might want to address vitamin K vax if that's something you do not consent to.

Our hospital has a baby friendly initiative so they do not have pacifiers at the hospital and they can not provide formula without your signature.  My midwife and husband have already agreed to try to latch the girls even if I am still out from anesthesia as long as they are stable. 

As for the Vit K, I think we are going to do it especially running the risk that the girls might still be premature and I have had bleeding/clotting issues in the past (Nothing they can diagnose just a slow clotter) so I am not sure it is worth not doing it. 

Thanks for your thoughts... those are all really good points!

[guen]

Thankfully, circumcision is not done routinely on infants here and you'd have to jump through hoops to get it done, so no worries for me on that score, should this birth end up in hospital like the last one did. (Don't even know if it's a boy or girl, actually.)

I haven't written a birth plan because, even in hospital, all births must be attended by a midwife (even c-sections) and their routines tend to fall in line with my own preferences anyway.  Even when my last baby was born prematurely in hospital, my midwife made it clear that it was MY birth and I called the shots, one of which was that I was the one to catch my own baby and that I should discover the sex, not have it announced by anyone.  I will have the chance to discuss my preferences with my midwives in advance of the birth and they'll note it all then.  Also, DH is pretty well versed by now on what my preferences are! ;-)  However, one thing I want to ensure, wherever baby is born, is that the cord is not clamped or cut until after the placenta is delivered. This is a big point for me and only I will only allow the cord to be clamped and cut before-hand in an actual emergency that necessitates it.

[eggsandpancakes]

at the hospital i last gave birth at, they tried to slip the circ consent form in a stack of hospital admission paperwork, and just handed it to me saying i needed to sign these papers.

[faithsstuff]

Originally Posted by eggsandpancakes 

at the hospital i last gave birth at, they tried to slip the circ consent form in a stack of hospital admission paperwork, and just handed it to me saying i needed to sign these papers.

I hear you! Nobody at the hospital was pushy about circ, they were all just shocked that we wouldn't routinely consent. Several nurses verified that 1) we knew what circ was and 2) that we actually meant to with hold consent.

Interestingly enough, our ped ( who is not crunchy) refuses to circ, she doesn't even offer it.

I suck at iPhone typing

[guen]

Originally Posted by eggsandpancakes 

at the hospital i last gave birth at, they tried to slip the circ consent form in a stack of hospital admission paperwork, and just handed it to me saying i needed to sign these papers.

That IS sneaky!  I have heard U.S. hospitals can be very pushy about it, even to the point of bullying parents. I honestly would be afraid to birthe a boy in a U.S. hospital.  I'm sure it's not that way everywhere (I hope!) but I've heard too many stories that make me shudder.

[fayebond]

I don't think US hospital staff are being sneaky, they're just assuming that what they think is what's right for you is darn near gospel truth.  Heaven forefend you should aruge withthe scientists.  They don't even listen when you say no (or try to say no and they do whatever tehy were planning to do anyway).  Its very hard to get a non-"normal" hospital thing here.

[wendelberry]

Originally Posted by fayebond 

I don't think US hospital staff are being sneaky, they're just assuming that what they think is what's right for you is darn near gospel truth.  Heaven forefend you should aruge withthe scientists.  They don't even listen when you say no (or try to say no and they do whatever tehy were planning to do anyway).  Its very hard to get a non-"normal" hospital thing here.

I wouldn't blame it on the scientists (having been one in a past, prechild life!).  There are so many things about hospital birth that are routine that have been shown by scientists to be ineffective and/or harmful--I'm sure everyone in this group is familiar with the harmful nature of constant fetal monitoring, prompt cord clamping, sugar water for baby, etc., etc...  I read an article recently (can't remember if it was posted on here or not) about Routine Care vs. Evidence-Based Care and they are totally NOT the same thing in the U.S.

I remember calling all the hospitals within a 5-hour drive of our rural area and asking about IVs (I HATE IVs and they give me massive bruises, plus I can't imagine trying to move around comfortably in labor with a needle sticking in my arm, ugh).  So many of the nurses I talked to said that my only option for avoiding an IV was to come in to the hospital at the very last minute!  Now that doesn't sound like a supportive environment!  I had visions of dodging around the delivery table/bed, avoiding a nurse advancing on me with a needle as the baby crowned...anyway, we've had birth center or home births since then!

That is seriously awful about the circ consent being in a pile of papers to sign.  Hopefully at least those were available for reading and signing ahead of labor, or I could see people just flipping through and signing everything-- especially if they had waited until the last minute to go in, in order to avoid other unhelpful routine interventions. <sigh>  I have heard but can't say for sure it's true that hospitals make good money from selling infant foreskins, which kind of freaks me out as well.  If I did want my son circ'ed, I might be tempted to ask for the remains, or at least a refund for their value!  

[guen]

Originally Posted by wendelberry 

I wouldn't blame it on the scientists (having been one in a past, prechild life!).  There are so many things about hospital birth that are routine that have been shown by scientists to be ineffective and/or harmful--I'm sure everyone in this group is familiar with the harmful nature of constant fetal monitoring, prompt cord clamping, sugar water for baby, etc., etc...  I read an article recently (can't remember if it was posted on here or not) about Routine Care vs. Evidence-Based Care and they are totally NOT the same thing in the U.S.

I couldn't agree more!  Real science has little to do with many commonly accepted practices and routines.  And scientific results can be manipulated in any way the person "interpreting" them likes.  And then again, you also have to look at how the research itself was carried out.  Scientific results are only as good as the research they're based on and, too often, the research methods are flawed. :-(  My DH is also a scientist and when it comes to getting to the bottom of things, we go straight to the actual research papers and do our own research review.

[abouttobe5]

When our daughter was born (in the States), she was in the ICU for the first 10 days.  I was SHOCKED when at discharge they said "because she was in the ICU we didn't do any of her vaccinations".  And I was like "uh, well, yes, but we didn't want her vaccinated anyhow.  It was in our consent when we first arrived."  and her response was "oh, well, I don't have any of that paperwork anywhere."

So, it scares me considering how many times she was alone with the nurses at night or whatever...I can't believe they had "lost" the paperwork that said we didn't want her vaccinated and it was just by chance that it wasn't the case.  Lesson learned!  Never EVER leave her alone unless all paperwork is checked and with her at all times.  And no test (other than of course life saving ones) are to be done without our consent at the time of the test.  

[MrsKoehn]

Originally Posted by abouttobe5 

When our daughter was born (in the States), she was in the ICU for the first 10 days.  I was SHOCKED when at discharge they said "because she was in the ICU we didn't do any of her vaccinations".  And I was like "uh, well, yes, but we didn't want her vaccinated anyhow.  It was in our consent when we first arrived."  and her response was "oh, well, I don't have any of that paperwork anywhere."

So, it scares me considering how many times she was alone with the nurses at night or whatever...I can't believe they had "lost" the paperwork that said we didn't want her vaccinated and it was just by chance that it wasn't the case.  Lesson learned!  Never EVER leave her alone unless all paperwork is checked and with her at all times.  And no test (other than of course life saving ones) are to be done without our consent at the time of the test.  

Wow.