"just in case" transfer birthplan? thoughts?

[Quirky]

Has anyone written a "just in case of transfer" birth plan that they'd like to share? I saw one mentioned in a birth story just now and I would love to see anyone's example.

I had a birth plan last time for having ds at a freestanding birth center. I don't think it made a hill of beans of difference - I ended up with all sorts of interventions anyway.

I don't live in a particularly homebirth friendly state, and my CNM's backup hospital is an hour away, so if I have to transfer I'm going to get whoever's on call at our local hospital. Is it even worthwhile to write a birthplan? I assume if we transfer we're just going to be treated like crazy homebirthers, and that waving a birthplan around will just make the medical staff roll their eyes and ignore us even more.

But maybe I'm wrong....maybe I should write one anyway? At least for the "no Vit K no eyegoop no Hep B no separation no bottles" part?

WWYD? What have you done?

[Patchfire]

I've been trying to think about this lately... I finally decided it was not worth it to write out the 'birth' part of the birth plan. However, I think I am going to take the five-ten minutes to write out the 'baby' part of the birth plan - "Sam [dh] will be with baby at all times, even if s/he must be separated from me. Kelly [doula/friend] will stay with me. Do not circumcise if it's a boy. No HepB shot. No eye drops. Do not circumcise if it's a boy. Breastfed baby - no bottles, no pacifiers, no sugar water, no formula. DO NOT CIRCUMCISE! Breastmilk ONLY!"

And, yeah, I think I will repeat the circumcision thing that often... just in case. My thought is that if we have to transfer, chances are the birth plan is SO far out the window that's not worth my time to even think about how I'd write it, KWIM? But my baby-care preferences are pretty much the same regardless, so.

[Quirky]

So, I take it you're opposed to circumcision? :LOL

I should talk to my midwife and see what she thinks, but I think I will probably follow the same approach the more I think about it....i.e. don't concentrate on the birth part so much as the baby part.

[JanetF]

I think the birth part is just as important as the baby part. As you note, hospital staff may be somewhat hostile to you anyway so having a birth plan isn't going to change that. BUT! It does mean that *you* have a plan which you can pin to your chart, stick on the wall next to that poor excuse for a bed, stick on the door of the room, and insist that everyone read.

I went to hospital for a transfer and didn't take my plan because I naively assumed that having my MW with me (wellknown and respected in this city) and also having DP and best friend (both extremely welldrilled in our plan) with me, would help ensure I got what I needed. I also had a backup booking in their socalled 'HB liaison unit" which promised me a "seamless transfer". It didn't. Now maybe a written plan wouldn't have either but the combination of plan plus people around me saying, "You have to stick to our plan" may have saved me from the worst of PTSD caused by my wishes being ignored. I recommend having a hard think about what is and isn't acceptable to you, given that statistically, most women who transfer still birth vaginally - in Australia at least and we have the same c-sec rates as the US, roughly. I am most traumatised by the things I "allowed" to happen (well under extreme duress...) because I hoped to build rapport with the staff. I still have nightmares about having my membranes ruptured unnecessarily, for example. Should I have to transfer again, I'm clamping my legs together and being very particular about who, why, when, how anyone gets access to my body. My birth story is in the story section here, "Another HB transfer story."

One of the many problems with hospitals is the lottery of who you get on the day. A friend recently transferred and got a MW on duty who is a HB mama herself so she had a great time. I, on the other hand, well... let's just say that unless I catch fire during birth I won't be going back...

Preparation is important, if only to be clear in your own mind what is acceptable to you. And practice saying loudly "I DO NOT CONSENT TO THIS!!!" for just in case

I bet you'll have a beautiful, empowering birth at home but it's always good to think about Plan B.

Best wishes with it!

[Clarity]

I would do one, but since it would be a last minute sort of thing, I'd keep it to a one-pager and focus on the major issues for you. Stranger things have happened - while I'd suspect they'd just attach it to your chart and ignore it, there just might be some staff that take the time to look at it. And maybe save yourself one more time of having to repeat things. And yeah, in both oo our experiences the baby part is probably more of an issue - it's easier to defend what's attached to you, so once the baby is born, it's trickier.

[Full Heart]

I guess its not on this computer but I always had one and was very thankful when I did have to transfer once. I included things like wanting a mirror when I pushed. Delayed cord cutting, no eye drops, no vax, no circ, no pacifiers, cloth diapers, No pku, I asked for a horizontal incision in case I need a c/s. I have problems with IVs so I asked for the kind you can take on and off. When I transfered I got most of what I wanted. The dr announced the sex but I forgot to include that in our plan. He cut the cord adn ruptured my membranes without my consent and against my birth plan but at the time no one seem to care. EVen me. But the most important parts were the no vax, no bottles, no eye goop, no vit k, no pku. I had to sign waivers for that stuff so I was glad it was in my birth plan because I would not have remembered till it was too late.

michelle

[mimim]

I included a short "in case of transfer" section in my home birth plan. I figure that it's really unlikely that I willl transfer, and I don't want to "jinx" myself. My providers have a 1 - 2% transfer rate of low-risk multiparas, so I kept it really brief.

Here it is:

During labor:
I hope to maintain a quiet and relaxing atmosphere during labor. Please remind anyone present to keep conversations and distractions to a minimum.
I plan to labor in water and would like to have a water birth if it feels right at the time. I have a pool ready for this purpose.
It is important that the pool temperature is comfortable for me so, unless it is outside normal safety limits, I will choose the temperature myself.
I would like to keep internal exams to a minimum.

During the birth:
I would rather not have an internal examination to confirm whether or not I am ready to push. If there is any reason to suspect that I might have a premature pushing urge then I would like to discuss this on the day.
I would like to push to my own comfort level without direction, unless perineal damage seems imminent. If your guidance can help me avoid tearing, I’d appreciate advice.
I would like the lights dimmed when my baby is born, and for the minimum amount of noise to be made.
Please do not announce the baby's sex as I would like to find out for myself
When my baby is born, please pass him or her straight to me. I want to maintain constant skin contact and initiate breastfeeding as soon as possible.

After the birth:
We wish to delay cord clamping and have a non-managed third stage of labor. I probably will want to keep the placenta.
We do not wish to have eye ointment administered and may decline vitamin K if the birth is non-traumatic.

In case of hospital transfer:
I wish to stick as closely to the home birth plan as possible and only have those interventions that are absolutely necessary.
It is extremely important that my baby stay in my arms as much as possible. I or my husband will accompany our baby at all times.
We want our baby to recieve no artificial nipples and only breastmilk and no circumcision!


At the beginning of this plan I also included the people who wil be my support team. Not to hijack the thread, but if anyone has feedback on this plan I'd love some! Actually, nevermind, I'll start a new thread on it!