please share your transfer birth plan with me

[huggerwocky]

I want to get done with mine and I'm feeling a little overwhelmed, google is no help, all you find are those targeted at planned hospitals births and that won't be applicable to my situation.

I will not be transfered for prolonged labour or something like it. Also, I don't want to have internal exams from a male doctor or while a male is in the room. Actually, the whole spread eagle with a strange man is not to happen.Can I write that into the plan or won't it help? I've suffered from physical and emotional abuse by my ex-partner years ago and this is a real problem for me. And what about c-sections, can I request to leave my legs down or is there some medical reason to have them in stirrups?

[alegna]

I didn't do a transfer birth plan. I figured the only way I'd transfer would be a major emergency and in a true emergency your plan is going to go through the window anyway.

-Angela

[mary3mama]

I think it would still be good to be clear about your past, that way if it can possibly be accommodated, they will know.

And as far as I've ever seen or experienced myself, you are flat on your back for a c/s, no spread eagle legs. In fact except to the anesthetist (sp?) you only exist abdomenally to the surgeon.

[huggerwocky]

Originally Posted by alegna

I didn't do a transfer birth plan. I figured the only way I'd transfer would be a major emergency and in a true emergency your plan is going to go through the window anyway.

-Angela

Hm, there's some truth there. But what if you needed to transfer after the birth for some reason like strong bleeding?

[huggerwocky]

Originally Posted by mary3mama

And as far as I've ever seen or experienced myself, you are flat on your back for a c/s, no spread eagle legs. In fact except to the anesthetist (sp?) you only exist abdomenally to the surgeon.

I thought they used stirrups, I know at least from some women that that's how it was done. And what about inserting the catheter ?!

[mary3mama]

My legs weren't in stirrups and I've not seen that in any of those birthing shows...and there are LOTS of c/s births there. I can't imagine why the legs would be up for any type of abdomenal surgery...

As for the catheter, a nurse inserted that before we went to the surgical wing...and she never even had to look. All my care pre and post operatively was from women and the surgeon was a woman, only the anesthesiologist was male.

[huggerwocky]

Thanks so far, but I still need some kind of staring point or template....please?

[alegna]

Originally Posted by huggerwocky

Hm, there's some truth there. But what if you needed to transfer after the birth for some reason like strong bleeding?

If you transfer after for bleeding then almost nothing that would be in a birth plan would apply. The baby wouldn't ever even be admitted.

-Angela

[Lousli]

I can think of an emergency where a birth plan might be useful-prematurity. You could have a totally normal labor, and want to give birth vaginally without pain meds, IV's, constant monitoring etc., but you might be giving birth at 29 weeks, or 32, or 36. My best friend had a homebirth planned, but her water broke and she started contracting at 34 weeks. Most homebirth midwives would transfer to a hospital for a preterm birth, so that might be an instance where a birth plan could be used.

[huggerwocky]

Originally Posted by alegna

If you transfer after for bleeding then almost nothing that would be in a birth plan would apply. The baby wouldn't ever even be admitted.

-Angela

Almost....but if I am admitted the baby can't stay home, can it?

[alegna]

Originally Posted by huggerwocky

Almost....but if I am admitted the baby can't stay home, can it?

I wouldn't leave the baby at home, but the baby would be in your dh's care. The hospital wouldn't do anything with him/her as they would just be a visitor.

-Angela

[TurboClaudia]

Originally Posted by alegna

I wouldn't leave the baby at home, but the baby would be in your dh's care. The hospital wouldn't do anything with him/her as they would just be a visitor.

-Angela

most hospitals would try to coerce an admission for the baby if you reported it as born that day. so actually, having baby remain outside the hospital might be a better choice than bringing baby in with you.

as for a starting template for a birth plan for a cesarean, a true emergency would necessitate some loss of personal control from you to the care providers at the hospital.

i would make a hospital transfer plan very clear to your partner and your care provider at home (if they will be able to join you in the hospital as your doula or friend). put a big black sharpie marker and a stack of plain white paper in your purse or bag or car so you can write notes on the door of your room. for example, Female nurses and physicians only, please OR Latex allergy.

have you checked the cesarean section sticky in the general birth & beyond forum? it definitely has planned cesareans more in mind, but there are some good points (like have the catheter inserted afteranesthesia is administered, request from the anesthesiologist that your partner be with you throughout the whole procedure, including preparation and anesthesia administration, limit conversation to the only topics related to the birth of your baby and the procedure).

i agree that creating a written plan seems more of a self-fulfilling prophecy to me, and all the things that were truly important to me are things that i could list on one hand and that my partner and my midwife would know from me beforehand. i would also be scared out of my mind to be there so likely my labor would stall and i would be mostly sane and able to communicate those most important things.

i remember reading the best "unexpected events" birth plan on a woman's site who was expecting twins, one of whom had already died in utero. wish i could find it now... i will look later today.

~claudia

[Mama Poot]

Do you mean what reasons will I transfer?? *A little confused on the question* I actually did make a list of reasons I would feel the need to transfer. Some of those would include:

Profuse bleeding at ANY point- especially when the baby is being born, as this is indicative of a serious tear. I really don't want to bleed to death.

My labor exceeds somewhere in the neighborhood of 24-30 hours. This is my second child, and my first labor from very beginning to very end took around 20 hours- so this one should not take that long, especially since it will be unmedicated.

cord prolapse ( will call 911 in this event )

Keep in mind that we are planning a Uc, so our approach to certain situations will be different from yours. I am in the process of writing up my "hospital" birth plan, should we need to transfer.

[kawa kamuri]

I came across this template last night

http://earthmamaangelbaby.com/birth_plan.html

[alegna]

Originally Posted by Mama Poot

My labor exceeds somewhere in the neighborhood of 24-30 hours. This is my second child, and my first labor from very beginning to very end took around 20 hours- so this one should not take that long, especially since it will be unmedicated.

Why would you transfer just because of a long labor? Sorry- don't understand. My understanding is there is nothing dangerous about a long labor.

-Angela

[heidi_m]

Seems like perhaps this was already resolved, but I have never heard of having feet in stirrups for a c/s, and I can't even think of a reason why they would be. Stirrups are to make your genital area available to a practitioner; they don't need access to that area for a c/s, and in fact I would think having your feet up at all would create restricted access to your lower abdomen.

I had a c/s with my first and one of the straps that secured me to the operating table was just below my hipbones, at the top of my thighs. Don't see how you could even be properly secured to the operating table (which they must do since you have no feeling and therefore no control over your lower extremities) with feet in stirrups. Is it possible you're thinking of someone who had a hysterectomy? Sometimes they do that surgery vaginally and that would require stirrups (and I assume an abdominal strap to the table).

Heidi

[*guest]

Well, I just had to transfer last Friday. I didn't write a plan in advance since I knew the only reason we'd transfer would be a true emergency (which it was, dammit), but my midwife went with me and brought my medical records and advocated for us. She also called ahead to let them know we were on our way in, and that helped. My husband knew our preferences for newborn care, and I told him that his job was to never let the baby out of his sight, and he didn't. I don't think a written plan wouldn't have even been read since the transfer was for fetal distress and things moved quickly. After a biophysical profile it was clear to me that a c-section was the safest way to proceed for the baby. I did request that the catheter be inserted after the spinal, as that was the one big thing that squicked me. No one had a problem with that. There were stirrups on the table now that I think about it, but I was flat on my back with my legs sort of frog-like. The mother is totally draped except for the belly anyway. I was going to ask to have one hand free, but my arms were numb anyway, so it didn't matter. It really all went fine. If you have support people with you and are polite to the staff, chances are that things will be fine. One nurse hassled us about skipping the eye ointment and told us we'd need a court order to do that, but the pedi had no problem with skipping once we asked him. We also breastfed immediately in the recovery room, although my midwife had to help me since my arms were still rubber. I wish I'd asked to see the placenta. Random, but I feel like I missed something.

As far as a hospital stay, just remember that you can kick people out of your room at any time or say "come back later, please." They'll deal. You can ask for a different nurse, etc. Also, our backup hospital is a "baby friendly" hospital so they are big on stamping "no formula/no pacifiers" on anything to do with the baby, but if I didn't know the hospital's policies, I would have brought my own signs.

[flyingspaghettimama]

If you poke around on Penny Simkin's site, I'm pretty sure she has tips on how to make a hospital experience more comfortable for abuse survivors; and how to make the best of a c-section experience, during and after. I utilized things I found from her site for my back-up plan. My first birth was an unexpectedly early, no-birth-plan birth at a hospital, and things probably would have gone much smoother had I had something written down, and known my options ahead of time. On the fly wasn't the best way to discover some protocols...for me, at least.

[huggerwocky]

Originally Posted by mommitola

Well, I just had to transfer last Friday. I didn't write a plan in advance since I knew the only reason we'd transfer would be a true emergency (which it was, dammit), but my midwife went with me and brought my medical records and advocated for us. .

I want the plan if just to make sure they don't do anything with the baby I don't want. I don't actually trust my husband not to get intimidated by the staff.

[huggerwocky]

Originally Posted by mommitola

. We also breastfed immediately in the recovery room, although my midwife had to help me since my arms were still rubber. I wish I'd asked to see the placenta. Random, but I feel like I missed something.

They routinely whisk babies away after vaginal births in hospitals, the idea I have to have a c-section and they just take the baby away is really stressful, it's not like I'll be in a position to get up and take it back.