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Birth Plans - Page 2

post #21 of 34

Chapsie, 
Thank you for your advice. I am very interested to see your friend's plan! 
It is procedure to deliver in an OR, unfortunately. 
And I am going to reword the testing/assessment part of my plan. Thank you for letting me know love.gif
 

post #22 of 34
Quote:
Originally Posted by Chapsie View Post

With Little Lungs--

 

This is the only thing that might be tough: " All testing/vaccines to be done while Mom, Dad, or doula holds babies"  Measurements and assessments are really hard to do if the baby is being held (rather than laying in your lap in bed or in a crib nearby).  Maybe just make them know that all testing is to be done in your presence, instead of only in your arms?  Other than that, it looks great-- clear, concise!  Very well thought out!  

Assessments can be done with baby in your arms, weighing and measuring not so much. BUT, there is no reason you can't delay weighing and measuring. Baby is super alert right after birth and there is no reason that they can't wait to weigh baby until after baby is asleep. My OB was very supportive of that and it made a big difference in comparison to when the whisked my first away, gooped up his alert eyes so he couldn't see me, and handed me the baby buritto, discouraging me from unwrapping him. My daughter never left my chest and initiated nursing on her own 20 mins after she was born. They wiped her down, but no shots, eye gunk, weighing, measuring, or bath. The hospital was fine with it. The L&D nurse came back in about 2 hours later and baby was still asleep in my arms. 

post #23 of 34
Quote:
Originally Posted by Melany View Post

Assessments can be done with baby in your arms, weighing and measuring not so much. BUT, there is no reason you can't delay weighing and measuring. Baby is super alert right after birth and there is no reason that they can't wait to weigh baby until after baby is asleep. My OB was very supportive of that and it made a big difference in comparison to when the whisked my first away, gooped up his alert eyes so he couldn't see me, and handed me the baby buritto, discouraging me from unwrapping him. My daughter never left my chest and initiated nursing on her own 20 mins after she was born. They wiped her down, but no shots, eye gunk, weighing, measuring, or bath. The hospital was fine with it. The L&D nurse came back in about 2 hours later and baby was still asleep in my arms. 

As the nurse who does all those annoying things to babies in the delivery room, I'll tell you that I LOVE skin to skin contact and immediate bonding with the mom.  I try to keep the mom and baby (or babies!) together as much as I possibly can.  I really dislike the "baby burrito" swaddle (which was commonplace in my hospital until I wrote a paper with journal articles discussing the safety and benefits of immediate skin to skin contact!  And now everyone tries to get baby skin to skin in delivery room!!!  Yay for small victories!).  

 

And I agree that it is best to wait to do a newborn assessment/weight/measurements/footprints/ID bands/medications until after initial bonding and breastfeeding, but to be realistic, it's not always possible, depending on the busyness of the unit.  I am supposed to attend every single delivery on the floor (which can be up to 8-9 births per 8 hour shift... My record is attending 4 births in an hour! CRAZY busy) which means that I cannot wait to get the ID bands and footprints done (Those must be completed before I can leave the room so that baby is identified to mom).  It is really hard (and quite frankly annoying to the mom, haha, and very awkward) for me to do that stuff on her abdomen while she is getting cleaned and stitched.  It usually works out well for me to take 10 minutes to get all that stuff done quickly and efficiently during the third stage (birth of placenta) and any perineal repair that needs to be done (on the radiant warmer) and then return the baby to mom's chest for uninterrupted time for breastfeeding and skin to skin after all that is done.  Of course, I try to read the situation, and do what the mom wants.  If baby is transitioning well (good apgars, no need for any resuscitation), I will wait a good 5 minutes or so and then just ask the mom if she wants me to take the baby for a weight and assessment or if she'd like me to wait a while longer.  If she wants to wait, I respect that as much as I can.  :)    In my state, it is law for me to give the baby meds (erythromycin and vit k) within one hour of birth, so I can't wait *too long* anyway.  

 

Of course, if this is your desire (to wait an hour or so before any baby stuff is done), It IS a very good idea to word that in your birth plan so that the newborn nurse knows ahead of time!  :)   :)   Good points, Melany!  

 

In the delivery room, I really have to get a GOOD look at the baby, head to toe.  I am the first medical professional to look at the baby.  If there was a problem that I missed, I would be in BIG TROUBLE.  It is really hard to do a thorough check of the baby (for the initial assessment) while the baby is held, just my two cents.  :)   (I can do my assessment in a matter of only like two minutes, it doesn't take long and then baby goes right back on mommy's chest!!  (where baby belongs!!!!)

post #24 of 34

Oh... and a lot of times, the OB WANTS me to take the baby to the warmer, because they need the baby's weight for their delivery summary paperwork and they don't like for me to wait around for that.  If your baby is healthy though, and your OB is cool with not knowing the weight ASAP, than yeah, it's totally fine to wait for that.  :)   

 

Of course, in the situation where your baby may need to be admitted to a NICU and may need medication, a weight is essential for medication dosage.  That's why doctors like to know that right away.  

 

 

Just pray that you deliver on a slow day and the nurses have nothing else to do except read and respect your birth plan.  :)  :)


Edited by Chapsie - 2/13/13 at 1:30pm
post #25 of 34
Thread Starter 

Chapsie, as usual, your information is absolutely invaluable to me. Thanks so much for taking the time to share it!!! 

post #26 of 34
Quote:
Originally Posted by Chapsie View Post

I really dislike the "baby burrito" swaddle (which was commonplace in my hospital until I wrote a paper with journal articles discussing the safety and benefits of immediate skin to skin contact!  And now everyone tries to get baby skin to skin in delivery room!!!  Yay for small victories!).  

So awesome! YAY for small victories, indeed! smile.gif
post #27 of 34

Just another perspective on perineal massage:

 

http://evidencebasedbirth.com/what-is-the-evidence-for-perineal-massage-during-pregnancy-to-prevent-tears/

 

I was leaning against it and before I mentioned it to my MWs, they spoke a bit on the subject and basically did not recommend it.  They are HB CNMs, very much of the "if it ain't broke, don't fix it" mindset.  They do highly encourage women to put their hands on the baby's head during crowning, which they do feel helps prevent tears.

post #28 of 34
Quote:
Originally Posted by Chapsie View Post

As the nurse who does all those annoying things to babies in the delivery room, I'll tell you that I LOVE skin to skin contact and immediate bonding with the mom.  I try to keep the mom and baby (or babies!) together as much as I possibly can.  I really dislike the "baby burrito" swaddle (which was commonplace in my hospital until I wrote a paper with journal articles discussing the safety and benefits of immediate skin to skin contact!  And now everyone tries to get baby skin to skin in delivery room!!!  Yay for small victories!).  

 

So awesome! Good for you!

post #29 of 34

I'm having a home birth. Should I have a birth plan for if I transfer? Not sure why I haven't thought about this yet. We haven't discussed the details of what would happen if we needed to transfer. We're doing it at our next appointment. 

post #30 of 34
Quote:
Originally Posted by SamiPolizzi View Post

I'm having a home birth. Should I have a birth plan for if I transfer? Not sure why I haven't thought about this yet. We haven't discussed the details of what would happen if we needed to transfer. We're doing it at our next appointment. 

I am planning on having a birth plan just because I've had 2 hospital births and I know what I liked and didn't like last time. I also know how much it helped having everything down in writing, but as a transfer your on-call OB may or may not agree to your requests. So, I don't know how much of it will be taken into account. I'm counting on my MW taking on the doula role if I am transferred to help with that, so I will likely go over it with her and give to her for her files. I'm also planning to have the pre-registration paperwork filled out just in case, too.

post #31 of 34
Quote:
Originally Posted by Melany View Post

I am planning on having a birth plan just because I've had 2 hospital births and I know what I liked and didn't like last time. I also know how much it helped having everything down in writing, but as a transfer your on-call OB may or may not agree to your requests. So, I don't know how much of it will be taken into account. I'm counting on my MW taking on the doula role if I am transferred to help with that, so I will likely go over it with her and give to her for her files. I'm also planning to have the pre-registration paperwork filled out just in case, too.

I am also planning a home birth. I don't particularly feel an overwhelming need to write up a birth plan, but might jot down a few things just in case.

A lot of times, home birth transfer patients are assumed to want a natural birth and non-separation with their babies.

If you did transfer and didn't have a birth plan, "non separation" is a great buzz word to use. It will tell the nurses that you want the baby with you at all times, and they should try to respect that.
post #32 of 34
Melany, great idea to have preregistration forms filled out in case of transfer. I never would have thought of that!
post #33 of 34
Thread Starter 

Yes, great idea about preregistration. Here is my draft. I welcome any input or suggestions if you think I left something important out...

 

 

Birth Plan for Baby Rowan

XXX and I fully understand that labor and birth does not always go smoothly and we are happy to discuss any necessary changes to our plan at any point. Thanks.

Vaginal Labor

  • I need a dim, quiet labor room unless there is a medical reason for bustle.
  • I need to be free to move spontaneously, including during pushing.
  • I do not want IV fluids unless I am officially dehydrated and if I require an IV, I want a saline port in my hand.
  • I do not want pain medication. Please do not offer it.
  • I do not want artificial ROM at any point.
  • I do not want an episiotomy. I would rather tear naturally.

Cesarean Section

  • Please ensure all medications are suitable for breastfeeding.
  • If it possible, I’d like a warm blanket in OR to keep from shaking so much.
  • Please lower the screen just before delivery so I may see the birth of baby.
  • I ask that the cord NOT be cut until it stops pulsing on its own.
  • Please do not bind my arms down or release one so I can touch baby.
  • Please reinforce my uterus and use dissolvable stitches for closing me up (double suture on my uterus and suture on the outside instead of staples.)
  • PLEASE: Immediately place baby on mother for skin to skin, no swaddle.

 

After Baby is Born

  • I want to practice non-separation.
  • Please allow for immediate skin-to-skin contact and the initiation of breastfeeding BEFORE weighing, making prints, or any other evaluations.
  • Do not wash or swaddle baby. If baby is cold, cover with blankets on me.
  • No Eye Gel, No Hep. B vaccine, No Vit K shot unless requested for bruising.
  • Absolutely NO FORMULA, NO PACIFIERS, NO INCUBATER. If baby needs heat and mother cannot give it, father should have immediate skin to skin.

 

 Recovery

  • No sedatives after birth. I want to remember my baby’s first day of life.
  • I want to be up and walking ASAP and eating/ drinking normally ASAP.

 

In Case of Malpostion BEFORE Labor Begins

 

  • I would like reasons for malposition to be investigated via u/s.
  • If possible, I would like position to be monitored in the hospital and wait for labor to begin naturally.
  • If necessary, I would like to try to reposition baby during labor.
  • If repositioning doesn’t work, I will consider a c-section.
  • If I cannot be monitored in the hospital before labor begins, I will consider scheduling an ECV and induction on my EDD March 13.
post #34 of 34

Writermama-- very thoughtful and thorough (while staying concise and easy to read!)  Nice job!

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