back-up cs birth plan?

[gret the great]

Hi all- I am planning a vbac in a free standing birth center, but want to be mentally prepared IF I need to have to go to the hospital for another c-section- I want to get my head around it now in case. Not assuming I'll go that route, but I know if I had known anything about cs when I had ds I think it would have been less traumatic. The back up hospital won't do vbacs so if we go there it will be anoter c-birth. With DS I didn't even prepare for a .005% chance of going to the hospital (planned homebirth).

So, we are going to go tour the hospital L&D unit, but I was wondering what people think about writing a birth plan for cs? Did you have one? Why or why not? If so what did you include.

Thanks-
I will push this baby out. I will I will.

[Sandra Dee]

That stinks about your hospital not doing VBACs!

As for a birth plan for cesareans, I don't think you can really have much of one. The hospital protocol is set to protect them from law suits, so they adhere to it strongly. You can call ahead of time and see what their policies are, though, to familiarize yourself with it. I'm fairly certain that it will allow your significant other in the room for the delivery - but not the initial stuff - and they will allow your DH (?) to be with the baby at all times, although not with you, necessarily. My DH had to pick between me and our very sick newborn. It was really difficult.

Primarily, the birth plan is for comfort measures and intervention preferences anyway - and most OBs throw them out the window should *anything* (any thing at all) arise. :P

Stupid medical profession!

[chichimama]

Here was my c-section birth plan. I did have a homebirth this summer with my son, and I had had a c-section with my daughter. I really felt that if I were to go to the hospital, it would be for something that needed a c-section. So I did not go for anything else, and the birth was at home as planned. Patience and support was all I needed.

Anyway, here is what I had:
Hospital/Cesarean Birth Plan

If the cesarean is emergency and general anesthesia is used:

1.If general anesthesia is the only option, then my husband, should be with me at all times while I am unconscious, in order for him to be able to tell me about the birth of our baby.

2.Daniel Royer, my husband, should be with the baby at all times.

3.Please do not bathe the baby, this is something that Daniel and I will take care of at a later time.

4.Please do not give formula to the baby, even if I am unconscious, if the baby needs to nurse, please allow the baby to nurse from me.

5.We do not consent to Hepatitis B Vaccine.

6.We will consent to Vitamin K injection after the baby has nursed and bonded well, several hours after the birth.

7.We do not consent to PKU testing. We will have this taken care of at our baby’s appointment with her pediatrician, Dr. David Springer.

8.We will consent to blood sugar testing, if the baby is showing signs of low blood sugar, only after baby has breastfed, please check with us at the time.

If the cesarean is NOT under general anesthesia

1.If there is time, I would like to consult with the anesthesiologist prior to administration of anesthesia.

2.I would prefer spinal rather than epidural anesthesia.

3.I do not want any extra narcotics in the spinal, especially ones that will make me drowsy. I only want enough so that I will not feel the cesarean surgery.

4.Please do not administer any pain relieving narcotics without first discussing them with Daniel and I.

5.I want my husband and/or support person to be with me during administration of the spinal anesthesia and during the surgery.

6.One of my support persons will take pictures of the birth.

7.Please wait to make the incision until Daniel indicates that I have no sensations of feeling.

8.If during the surgery, I do feel pain, please stop activity until the anesthesia can be adjusted to take care of this.

9.Please keep in mind that this is the birth of our child, and try and keep all extraneous conversation out of the operating room.

10.My arms should not be tied down, or at least one arm should remain free.

11.I would like to view the birth of my baby by having the screen lowered, or by having a mirror angled so that I can see my baby being born.

12.Please do not call out the sex of the baby, this is something that my husband and I prefer to find out for ourselves.

13.If possible, please do not remove my uterus from the abdominal cavity for suturing, please suture in place.

14.Do not ask me if I wish to have my tubes tied during the surgery.

15.If Possible, please cut along the same incision lines as my previous cesarean.

16.Please do not staple the outer incision. Please suture.

17.Please do not bathe the baby, this is something we prefer to do ourselves at a later time.

18.In order that the baby get immediate skin to skin contact with mother, please do not swaddle and diaper the baby.

19.Unless there is a medical emergency, please hand the baby to my husband as soon as possible so that he can bring the baby to me.

20. No formula is to be given to the baby.

21.We do not consent to Hepatitis B Vaccine.

22.We will consent to Vitamin K injection after the baby has nursed and bonded well, several hours after the birth.

23.We do not consent to PKU testing. We will have this taken care of at our baby’s appointment with her pediatrician.

24.We will consent, if baby is showing signs of low blood sugar, to blood sugar testing of the baby, only after the baby has breastfed, please check with us after this has happened.


Thank you for your care and support of our family during this time.

[JessicaS]

It is standard to be given morphine after a csection. I had no idea at the time and they didn't tell me till much later that I had been given it. I wouldn't take the morphine again..it was awful!!

[MamaOui]

The hospital I VBACed ds#2 in had a separate floor for C-sec, so I went to visit and asked questions like:

-I see there are two beds in each room, does that mean we have to double up if it's crowded?

-Can dp room in w/ me?

-What is you policy on nursing ASAP after a c-sec?....

-A birth plan, like chi chimama, suggested

I would go for a visit. Not to freak you out, but the hospital I VBACed my babe in was not "c-sec friendly". There was actually the possibility of having someone else share a room with you after surgery and having to establish a nursuing relationship w/ your new babe. My friend had a c-sec there 6 weeks before I had my ds and the nurses on the c-sec floor did not encourage rooming in, recommened a paci the first day, horrible nursing advice was doled out....One nurse actually told me that she thought I should have my baby somewhere else when I wanted to know why I couldn't pay for a private room if I were to have a c-sec and it got crowded.

Gret the great VBAC vibes being sent your way

[dotcommama]

I've thought about doing this too. Mostly b/c in the event of a emergency c-section for rupture (worst case scenario) I'd be knocked out completely - so I want to make sure that my wishes are written down somewhere b/c I won't be able to communicate them. I also plan on discussing them ahead of time with my midwife and/or doula assuming that one or both of them would be able to be with my DH and I in the OR - but I have to check that out b/c I'm not sure they would be. If I can't have the midwife and/or doula with me during the c-section then I am going to give DH my signed written instructions - mostly things like:

-No formula, pacifier, etc
-Do no circ
-I want my DH to remain with the baby (I plan to tell DH if I have to be knocked out call my Mom to come be with me, but he should stay with the baby)

Of course, like gret the great - I know I can have this baby vaginally. I don't think making a "what if" plan mean that I believe any less in my ability to have a sucessful VBAC. But as with any birth - not just a VBAC - you could end up with a section and it is better to be prepared and have things go the way you would like them to then be surprised and disappointed at how things were handled.

[ladylee]

"Birthing From Within" has a small section about getting what you want out of a cesarean delivery. I think you're very smart to be prepared--and you can push this baby out, you can! Good luck!

[gret the great]

Thank you all for your speedy responses! ChiChi mama would you mind if I used your birthplan as guide for putting one together? It is so detailed- thanks you for sharing.

I hadn't even considered what would happen in the case of general anesthesia! With DS, my husband stayed with him and my HB midwife stayed with me while I was sewn up...I can see that it would be totally important to have it in writing in that case especially.

BUT..I will push this baby out. I will I will! (I am the affirmation queen these days)

[chichimama]

Gretel,

(or anyone else) Please feel free to use it all, or whatever works for you. I didn't make a regular hospital plan because I vowed I wasn't going unless it was an emergency, and that meant c-section.

I had a friend give me a gift, some inspirational birth cards that I posted all around the house that were great. I think you can buy them online somewhere, or you could make some of your own.

Since it was only 7 months ago, and I am still so so very proud of myself, I have to add that my homebirth VBAC son weighed 12 pounds 1.6 ounces.

And there is nothing special about me. If I can push out a baby, you can too.



Joanna

[Cloverlove]

We share very similiar stories!

I had prepared for a homebirth with ds. After many hours of pushing the midwives suggested transport. We went to the hospital (completely unprepared) and wound-up with a c-sect. I was treated like some naive hb hippy chick from off the street. I guess, in a way I was.

For dd, I prepared for an hbac BUT I also saw an ob a couple of times and toured the hospital. I did not have a birth plan because I felt confident in my dh and midwife to advocate for me and the babe. You know what? I DID have an hbac! It was amazing and very healing. You will push your baby out- you will!

Blessings~

Clover

[OnTheFence]

I had a CSection birthplan

I will most likely always be a csection momma but I can tell you that I did have a birthplan and it was followed to the letter. Not one thing was disreguarded.
Having had a planned csection I am sure that that the success of it had something to do with that. I had had many discussion with my doctor about what I did and did not want.
Also I wanted to say that I did not have morphine at any time. I also had no preop or post op drugs, no sedatives, no anxiety medication, no mind altering drugs, even during the suturing portion of the csection. I also requested stitches instead of staples, did not have my arms fastened down, and was able to view the "birth".

[karendrema]

..I had a part of my birth plan for cesarean and the doctor sat down and went over it with me. Naturally a lot of it was either 'of course we do that' or 'we can't do that' but since I didn't know the doc beforehand it didn't hurt to have it written down. (Having one hand free was one thing that they said - well of course we would!) I felt like my requirements got at least noticed if not followed to the letter. I'm okay with making changes, but I don't want things to happen that weren't discussed beforehand kwim?

One thing I would mention that I didn't have on my plan, but did get a chance to mention to the surgeon is a two-layer closure. One study has shown the a single layer closure increases rupture rates in a later VBAC by 4 or more times. So I asked specifically about it (thank goodness I remembered!), but this is something you may want to add to your birth plan, so you don't forget.

[dotcommama]

Originally Posted by karendrema

One thing I would mention that I didn't have on my plan, but did get a chance to mention to the surgeon is a two-layer closure.

That's an excellent point!

[gret the great]

I pushed her out!

My daughter was a 10 lb 13 oz vbac on April 13, 2003. She's now a toddler who is learning to run, make jokes and practice the word NO! I am glad I had my c-section plan in place. My midwife thought it was terrific. VERY glad I didn't need it though!