Birth Plans...has this been discussed?

[happeeevraftr]

Maybe I need to search our ddc, since I haven't been on much and may have missed this. But I'm getting anxious about the birth, so I finally made up a birth plan. I posted an earlier version on Birth and Beyond, but maybe I'll get more feedback here, and you gals can post yours too and we can get a discussiong going.

Some things are noticably absent from my birth plan, for space sake--I don't want it more than a page--like I don't mention much about pitocin induction, because I don't think it's a likely scenario. My first labor was only 4 hours, and I'm already dilated to a 3, 75% effaced, and her head is engaged, and that was at my 36 week appointment Monday. So I didn't mention it in my bulleted list, although I mention it in passing with some other "routine interventions" that I want discussed before they are done down at the bottom.

I also didn't mention anything about food. I know they don't like it and it's 'agains the rules' at my hospital, but I don't want to put it in there that "I will be allowed to eat if I am hungry," or because I think the nurses will just laugh, or think I am going to be an antagonistic patient. I'm trying to come across as nice and cooperative, so that maybe they'll allow some of the other things I really want, like not making me get out of the tub to monitor me. But my husband knows that if I start lacking in energy, or if I say I'm hungry, he's supposed to make sure I get food, and tell any nurse to leave me alone, he's not going to starve his laboring wife! Do you think that's bad? I'd rather deal with the situation *if it presents itself* rather than make it an issue when it may not be one.

I'm also not saying a lot about infant care here because most of the infant care will be done by totally different staff on a different floor of the hospital anyway, and I don't want to take up valuable space. Also, I'm still not sure about some things, like whether I want Vitamin K shots, or the Hep B. Does anyone know if both of those are things they do right away? Like before we leave the labor/delivery room and go down to the mother/baby floor? If anything, I will request that those shots not be given for several hours after birth, so that we can have time for bonding and baby getting used to the world before she gets poked too much!

Anyway, here's my plan, after that longwinded background! Let's see yours, and hear some thoughts/critiques!

Birth Plan for Cathryn & Matt S.

We are happy to be planning the birth of our second daughter, and have chosen you to share this time with us. Below is an outline of our wishes and preferences. We appreciate your help in facilitating a natural labor and delivery, without the use of drugs or unnecessary interventions. We realize that many of the requests below are already routinely practiced, for which we are extremely grateful. Above all, we desire a healthy mother and baby, and you have our full cooperation in the event of an emergency and the need for intervention, upon the briefest of explanation.

Labor & Birth

We request:
•A calm and peaceful atmosphere so that I can concentrate on my Hypnobirthing and remain relaxed. We would like to keep lights dim if at all possible, and also ask that those in the room speak quietly and calmly.
•No mention of “pain” or “hurt.” Please do not ask me to rate how painful the contractions are or how badly it hurts. Alternatively, ask how comfortable I am.
•Please do not offer me drugs. I know what is available and will request it if I feel it is necessary. Please encourage me in my desire for a drug-free birth by suggesting natural comfort and relief measures.
•Freedom to walk around, use the tub or shower, and assume whatever position is most comfortable
•Intermittent manual fetal monitoring. If an underwater Doppler is available, we request that it be used instead of asking me to get out of the tub if that is where I am comfortable.
•Fluids to drink instead of intravenous hydration. (IV’s are very difficult for me)
•Mother-directed pushing. Please don’t count or “coach” me, except for gentle guidance if I am about to tear.
•Perineal support to avoid tearing. No episiotomy, please. I would prefer a tear to a cut.
•Allow the cord to stop pulsating before it is clamped and cut. Allow Matt to participate in clamping and cutting.
•Immediate skin to skin contact. Please help me open my gown and place my baby on my chest and cover her with warm blankets.
•Allow a non-managed third stage. I would like to deliver the placenta naturally. Please don’t use cord traction or artificial oxytocin to speed the placental delivery.

Infant Care

We request:
•A chance for breastfeeding and bonding by having all tests and procedures performed with baby on my chest or in her dad’s arms.
•I would like to give my baby her first bath.
•No eye antibiotics, please.

We realize that special circumstances may arise that will prohibit some of these preferences from being met, and that may require medical intervention. In such a case, we would like to know how urgent the situation is, along with all other options available. Please discuss these things with us before any intervention is decided upon, including such things as: starting an IV, using continuous electronic fetal monitoring, rupturing membranes, artificially inducing or speeding up labor, or any other medical interventions.
Thank you for taking the time to read our birth preferences. We sincerely appreciate your time, attention and care on our behalf. Thank you so much for sharing this beautiful event with us!

[OwensMa]

Your plan sounds very good. I've actually never made a plan, and I'm starting to re-think the idea. A very good way to express your wishes without forgetting anything during labour. About the eating and drinking: You could write something like "No restrictions on eating and drinking. I would like to give my body energy through nutrition and hydration as needed"

Subscribing to the thread, and going to make this my project for the weekend. Thanks!

[mcimom]

I'm a non-vaxer so take my opinion fwiw but yes, I believe procedure is to give hep B at birth and (obviously) would decline it. It can always be given at a later date.

I went w/baby for the vitamin K with dd3 and dd1 (or perhaps dh was b/c I had to be on mag sulf for 24 hours) - I was not there for dd2 and I regret it. I let them take her away for all her "stuff" b/c I was exhausted (went in at 9am for a routine visit and ended up at the hospital and there all day - delivered at 11:45pm) and I'm pissed I didn't know better. dd2 was actually my favorite birth, but that's one of the things I wish I had done differently.

[*guest]

I think I'd be just as irritated if someone asked me how comfortable I was. The point should be that you'll volunteer information about your sensations only if you need to, right? If you aren't comfortable, then you have to go into the headspace of saying "Not very." Unless I'm misunderstanding the point of that line. For myself, I'm envisioning not wanting to answer questions at all after a certain point of intensity.

I might put in preferences on pushing location or pushing positions unless you think it won't be an issue at the time.

Will you make a separate short plan to send with baby if baby goes to the nursery for tests? Even a sign like "no artificial nipples/formula/sugar water/circ" whatever those preferences may be?

[happeeevraftr]

The comfortable line: My hypnobirthing instructor told us that at this hospital they have to ask you to rate your pain on a scale of 1-10, 1 being no pain, and 10 being as painful as a C-section with no anestheasia. They have to ask it at least once, and then they will say, "do you want us to not ask you that question again?" and you can tell them yes. But she recommended we have them ask instead, "How comfortable are you, on a scale of 1-10, with 1 being the most comfortable?" This gives them the same information, but it makes me think, "hmm, how comfortable am I?" Instead of focusing on just how bad it feels. It's a mind trick, but I think just the wording makes a big difference.


I want to respond to more, but my keyboard isa driving me crazy because water was aspilled on it and it'sa throwing in ezxtra letteras everywhere!
So, later! Before I sacream!! aaak!

[*guest]

Oh, bummer that they have to ask the comfort scale as a matter of routine. Sounds like you've got it covered though!

[lisap]

Yours looks very similar to mine! I never thought about them asking to rate the pain. That's a good point to ask how comfortable you are instead.

[Caroline248]

I haven't done one, but I am thinking about it.

Yours sounds good, I would make something up for the baby just in case. If you do need to be separated, it is best to have all your plans outlined for her to send with her...

~C~

[papayapetunia]

Sounds good. I need to do one. We won't be allowing the Vit. K or Hep. B shot. Vit. K is to prevent blood clotting in the event that surgery is necessary. We wouldn't circumcize even if we were having a boy, so it's really not necessary. I feel like Drs./nurses give it routinely out of laziness. You can also take an alfalfa supplement in the last weeks of pregnancy and that will give the baby Vit. K. The Hep. B shot can always be given later. I don't see why they need to give it in the first few hours/days of birth, but my understanding is that they do. I'm new to questioning vaccination, so I don't know if we'll avoid them altogether, but I will definitely wait until the baby is older to do anything. We did everything the doctors wanted with my first dd. I wasn't very informed back then. I trusted way too much. She's fine and everything, but I still want to do better for this baby.

My doctor gave me a bit of advice, and that was to get the backing of our pediatrician and write that in our birth plan. Our pediatrician is very open to all sorts of things, so it's no problem. If you have that sort of pediatrician, maybe you could do the same.

Good luck.

[happydoulamama]

Vit. K is to prevent blood clotting in the event that surgery is necessary.

I admit to lurking.
But, I wanted to add that it is my understanding that Vitamin K is to help clot blood not just for surgeries, but because some babies, though rare, can hemorrhage. See this link for more info:

http://www.betterhealth.vic.gov.au/b...s?OpenDocument

Good luck with your births!

[rikiamber]

I have to say that your introduction is very non-threatening, I really like it. My intro is similar I will add my birth plan to this post so that you can see others. My plan is 2 pages because I added something about c-section, knowing that that could be a possiblility due to bad choices that I made as a younger woman. I am not planning on going into the hospital until my contrx are 2 min apart or I am at 8cm, that way they really can't offer you drugs cause your to far along, also I will have gotten to eat and drink all I want during my labor and have labored in the comfort of my own home. We are only about 10 mins from our hospital and my MW will be there for me so I have my bases covered. My OB is on track with us and has a copy of our birth plan also, we went over it together and she finds it reasonable and agreable, its the nurses we have to watch out for but like I said if I wait until the last min all will be fine, just a little bothersome checking in and all.


Hospital Birth Plan

Birth Team:
Riki C., Mother/patient
Jason C., Father/partner
Loritha F., Midwife

If I am in the hospital because of such conditions as gestational diabetes, pre-eclampsia, or being beyond my midwife’s care due to being over due or fetal heart arrhythmia; and my baby is not in distress or his health compromised then,
I want the freedom to:
•Walk around,
•Not birth on my back,
•Use a birth ball, push on the toilet, or use the shower for relief
•Eat and drink,
•Have the lights dimmed,
•Limit or deny vaginal exams and constant electronic fetal monitoring

I do not wish for an epidural or other pain killer.

I do not wish for the use of interventions, i.e.; pitocin, forceps, episiotomy or vacuum.

I do not wish to be coached in pushing; I would like to push as my body tells me.

I want to delay clamping and cutting the umbilical cord until it quits pulsating, or if the doctor feels comfortable then I do not wish it to be clamped or cut until the placenta is delivered, also I would like to cut the cord.

I want to see my placenta after things have calmed down.

I want baby handed to dad, and kept in the room for all exams.

I would like to delay baby exams for at least 30 mins.

I do not want my baby to receive the Hepatitis B vaccine.

I would like emediate skin to skin with my baby.

I would like to bathe my baby in my room with dad.

I want my baby left in the room with me at all times.

I will be breastfeeding; please do not give my baby a pacifier or bottle.

If baby must leave my room I or his father would like to go with him.

In the case of a C-section,

I want my partner to be in the operating room.

I would like to use Duramorph instead of morphine.

Request for treatment of my baby after the c-section is the same as with a vaginal birth,

no Hepatitis B vaccine, no bathing and I want my baby brought to me as soon as possible.

I want my partner to stay with me before, during, and after the operation as much as possible.

I would like Loritha F. to be with me during recovery also.

I want Loritha F. to stay with my baby while he is in the nursery to insure my requests are respected.

I will breastfeed exclusively, if I am incoherent Jason or Loritha will help the baby latch on.

I do not want a bottle or pacifier given to the baby at all.

I want the baby to stay in my room.

The only visitors I want are Jason C., Loritha F., the staff of Alaska Family Health and Birth Clinic, any other surprise visitors are to be approved by Jason C.