Post your birth plan here - Page 2

[Bay Area Babe]

Originally Posted by BetsyS

And for circ...you have to sign a consent form for circ. It's checked and double checked before it's done. So, why mention it?

Okay, so this is a friend of a friend story, but a friend of ours (and poster on MDC) lives in NYC and their friend's son was in queue for a circ without their consent.

Regarding your other thoughts - I'm on the same page about the necessity of writing *everthing* down, yet for the major things it's certainly important. We're delivering at a hospital that is friendly towards natural birth and most of the things we'll be discussing/agreeing with our OB on before anyway (eating, limited fetal monitoring, no episiotomies, no inducement for 'failure to progress').

The things I think are important are mostly after the birth (skin to skin, delaying cord clamping, delaying tests, no vaccines/injections/eye goops, no formulas or binkies in the case of emergency nursery care).

Everything else I see as 'birth wishes' and follow along the lines of KC in KS's birth plan - it covers the major points. The blanks can/should be filled discussed with your Dr/Midwife. Even with a MF and an emergency hospital transfer, most likely the MF will be able to be present as your labor support and can advocate your wishes on your behalf.

[3_angels]

Thanks mamas! These helped me so much in writing mine!

[AmieV]

KC out of curiosity why do you prefer general anesthetic if a c/s? Just being nosy!

This was mine for the hospital birth I didn't end up having...if I were to do another I'd make it a lot shorter and just have my H and doula advocate for me. Truthfully knowing what I know now about how overworked and busy the nurses are I'd keep it to the most important few sentences. They just don't have time to read a 3 page thing. And the newborn care stuff, it's not going to be the L&D folks dealing with that anyway (as far as rooming in and whatnot). Just my two cents. I know I wanted to put EVERYthing in mine at first. I'm having a homebirth this time and I don't think I'm going to do a birthplan. If we do transfer it will either be a major emergency and I'm not that concerned with what happens as long as we both make it out alive, or we'll be going to the hospital where my midwife has good relationships and I'm confident she can advocate for me. (she's a licensed midwife but the OB's and nurses have turned their heads there before and let her deliver babies if it's a matter of mom needing pit or something just to get labor really moving).

oh and I do know someone whose baby was administered the hep B shot without consent and didn't find out until they were checking out. But I think a better way to prevent that is to just insist the baby stays with you or insist that your partner go with the baby to the nursery if they say they "have to" go. I honestly wouldn't want to let my baby out of my sight at the hospital (barring them having to go to the NICU or something).

anyway here it is...
General Message:

We are so happy to be delivering at __________ and appreciate the excellent care and facilities we will have there. Thank you in advance for all of your assistance. The following plan details what we would like to have happen, as far as possible. I understand that not all of my wishes may be possible in my particular birthing situation. I am more than willing to work with the medical staff in order to make my birthing experience as safe as possible for the baby.

Labor Options

Activity in Labor:
 Hope and plan to have unmedicated childbirth, please do not offer any medications including the epidural. I will ask for them if I change my mind after trying natural methods.
 Would like intermittent electronic fetal monitoring rather than continuous, since I would like the freedom to move, change positions and walk around during labor.
 I will need IV antibiotics because of being Group B strep positive, but I would prefer a heplock to have this medication administered rather than an IV pole.
Food and Drink:
 Would like to be free to eat and drink at will
 Would like to be able to use tub/shower during active labor

Birth Options

Pushing Techniques:
 May want mirror
 I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch
Perineal Care:
 Warm compresses and perineal massage
 No episiotomy (prefer some tearing), unless emergency

After Birth Options

General Preferences:
 Immediate skin-to-skin contact for first hour, would prefer to delay routine procedures including eye ointment until after first hour. If this isn’t possible, please perform all procedures in room (barring emergency) and return the baby to parents as quickly as possible.
 Father wants to cut cord – please wait until cord stops pulsating
 Would like APGAR tests done while baby is in mother’s arms
Contact with Baby:
 Expect that baby will be rooming in
 Father would like to give baby first bath (or participate, at least)
Feeding:
 Plan to breastfeed, please do not give baby any bottles or pacifiers

No Vaccinations including Hepatitis B are to be given

The Unexpected

Difficult Labor:

 If labor is not progressing, I would like to have the amniotic membrane ruptured before other methods are used to augment labor

Cesarean:
 Want father and doula to be present
 Would like to hold baby right away, skin-to-skin

[Henry's_Mamma]

FWIW ... I wrote out a VERY long and detailed birth plan with all of my before, during, and after wishes outlined. It had reasons for everything and covered every imaginable thing. I shared it with my mw and we talked about everything. It was a good reference for both of us to discuss my past negative birth experience (a c/s) and what my hopes are for this hopeful VBAC. I am giving her a copy of the long form to put in my records. I am also giving a copy to my doula for her review.

I have a very detailed section on c/s if anyone wants to look at it (PM me). If you really want to "plan" for that event, even if very unlikely, you really need to understand what common hospital policies are and discuss them with your caregivers before hand. And you need to understand anesthesia options. General is ONLY used in the most dire of emergencies. It is very dangerous to the baby and will mean your partner will not be allowed to witness the birth (and you won't witness it either). It will severely limit your ability to see or breastfeed your baby for many, many hours after the birth. Most drs. prefer spinals, but I've known of too many people who have had them wear off during the procedure and they cannot be redosed (leading to GA). Epidurals can be adjusted and they can also give you longer term pain relief. Just a few thoughts.

For the hospital, I will be bullet pointing everything and only discussing the issues that will be of concern to the hospital staff during and after labor (use of pain medication, circ., newborn procedures, baby care while in the hospital, etc.). In addition, I will be giving a copy of the baby care portion to my ped. We have a strong likelihood of ABO Blood Type Incompatitibiliy Jaundice (which ds#1 had quite severely) and I have specific requests that need to be filtered through my ped's office.

DH will have a copy of the long-form with him to remind him of what he's supposed to do.

[veganf]

Originally Posted by BetsyS

That makes sense...

I am curious about the no footprints one, though. Is there a reason? I do think that they are pretty cute, and most of my friends (even homebirthers) have sent out baby announcements or thank you cards with footprints on them.

I don't mind the ones where they use the press-through kind that doesn't leave ink on their feet. But the ones where they ink up baby's feet bothers me, because it takes a while to wash off. My SIL's baby still had ink on his feet when they left the hospital. I just really don't like that. Just a personal preference.
I've never had any desire to do footprints. Though I have photographed their little feet right after birth.

[veganf]

Originally Posted by Azreial

When I was in the hospital with ptl the nurse go annoyed when I had to go to the bathroom becuase she'd have to find the hb's again.

Alright, that's just RUDE!!! Maybe she'd have preferred it if you'd just pee'd on the sheets instead, then she could find the HBs again AND change the bedding, haha. :

[amybw]

I havent finished mine, but when i went to a VBAC class at my hospital, I got a blank outline. I thought that was a nice addition! I didnt get one when i was pg with my son ( 3 yrs ago) although the instructor said they've had them for years.

I am so gald the hospital expects a birthplan.

It has check boxes and bullets, plus blanks to write your own thing.

If anyone wants a copy of it I can fax it.


Amy

[KC in KS]

Originally Posted by BetsyS

I guess I'm of the short, really short, crowd, but tell me why I need to write all that stuff down.

Because if your doctor signs it and includes it in your chart, it becomes official doctor's orders. Otherwise, if you want to do something that contradicts standard hospital policy, the nurses have to call your doctor and get the okay. And while you can certainly DO what you want while they're on the phone, it's a hassle for you, the nurse, and the doctor.

Here's a live example. I'd discussed with my doctor the fact that I wanted to be able to eat and drink during labor. She thought it was unrealistic (figured I wouldn't want to), but didn't object. I didn't include that in my plan, though.

So when DH went to the fridge and brought me a protein shake, the nurse tried to stop me. I sent her off to call the doctor, and downed the shake before she came back. Turns out the doctor okayed it, but it was a distraction none of us needed.

[rebeccalizzie]

Originally Posted by BetsyS

Maybe I'm naive.....

But, I just don't see it as necessary to write, "no IV unless necessary." Um, they have to be touching you to give you an IV. So, why can't you just say no right then. Why does it have to be a birth plan thing? Same with artificial rupture of membranes or excessive vaginal exams. These things aren't going to happen without you knowing that they are happening. (If I'm so out of it that I don't know someone is checking me...well, we've got much bigger problems than excessive vaginal exams) So, I guess I just don't see the point of having it written down.

I guess I'm of the short, really short, crowd, but tell me why I need to write all that stuff down.

For me personally, it's because the last thing I want during labor is to be pestered every two minutes. I don't want to have to refuse interventions over and over, I want the nurses to already know my answers. It's distracting. And I agree with KC--my doctor is very hands off, but he's not going to be there the whole time. So every single time I go against "standard" procedure, they'll have to call him. I'm sure he'd prefer to just sign off on my preferences in the beginning.

Anyway, here is mine. The one thing I left off is rooming in--the hospital I'm delivering at does not have a well baby nursery, only a NICU. So I don't have to specify anything about rooming in, and all tests and procedures are done in my room.

Hi there! We are so thrilled to be delivering at M. Hospital We’ve heard wonderful things about your LDR department, and we’re sure our experience will be wonderful as well. The following are our preferences for the birth of our child. We understand that not everything can be planned out. In the event of an emergency, we will consent to any necessary procedures but please explain to us what needs to happen and why. If at all possible, we’d like Dr B or C (midwife) to directly make all decisions regarding what is necessary.

Labor and Birth:

We request:
•Please do not offer pain medicine. We know what is available, Rebecca will ask for pain meds if she decides she needs them. Any natural remedies or ideas for reducing pain without meds are welcome!
•Please no IV. R will drink fluids often to stay hydrated. Prefer to avoid a hep lock as well, but consent if it is needed.
•I would like to labor in the tub as long as possible and as much as possible.
•I would prefer intermittant monitoring.
•I would like to be able to move around the room freely.
•Minimal internal exams. There is an excellent chance that dilation will take a long time. Unless I ask, I would prefer not to have my dilation announced for fear it will discourage or upset me.
•I would like to push in any position comfortable to me at the time
•No episiotomy. I would prefer to tear naturally
•Please allow the cord to stop pulsing before cutting
•No pitocin injection after birth. I would like to deliver the placenta naturally.

Post Partum

We request:
•I would like to nurse immediately after birth. If at all possible, I’d like to nurse baby through any painful procedures such as the heel stick and vit K injection. I would like to delay these procedures until we have had a chance to bond with and cuddle the baby.
•Our 10 year old daughter will be in the waiting room with her grandma. We would like her to be called to the room immediately following the birth so she can meet her brother.
•No Hep B vaccination
•Absolutely no circumcision
•R will be breastfeeding, so please do not give the baby anything by mouth without our consent.

[KC in KS]

Originally Posted by AmieV

KC out of curiosity why do you prefer general anesthetic if a c/s? Just being nosy!

S'okay, I don't mind.

It's because I really don't do well *mentally* with a local anesthetic. I keep searching for sensations I know should be there, and reacting to imagined pain. And I totally flip out if a doctor says "you'll feel a bit of pressure".

In case of a cesarean, which will already be a stressful moment, I can't guarantee I won't lose control and go into screaming hysterics right there on the table. I'd rather they put me out than tie me down, you know?

However, I know a general has it's own set of concerns, and I can't really say that a local + sedative isn't a better choice. It'll depend a LOT on the circumstances that lead to the c-section decision, which is why I gave the doctor full latitude to make the decision based on medical conditions. If the safest thing for me and baby is to use an epidural block, then tie me down and get it over with, you know?

I will say - simply putting that preference down in my birth plan raises eyebrows with the doctors and nurses. But I think that's a good thing - it catches their attention, makes them note there's something that needs to be discussed here. And that's always a good thing.

KC

[libbylu]

I think one of the most important things about a birth plan is that it is a way of communicating with the hospital staff. As they read it, it gives them a picture of you. Hopefully this will communicate that this mother is knowledgeable and has clear preferences, but at the same time, if it gives the impression that the mama is angry and demanding it might backfire. We had and are planning another homebirth, but I know plenty of people who work with hospital births, and it sounds like there are a lot of professionals out there who don't respect birth plans, especially if they give the impression that the mother is ready to get mad at the staff, and doesn't respect them. This might be true of her; they might not deserve her respect. Still, giving this impression might not help create a relationship of trust and cooperation.

On the other hand, assuming the best of the staff, it's a great way to let them know what you want if they care. I know when I was in labor, I did not find it possible to make good decisions for myself. I was totally well-informed and had strong opinions ahead of time, but I was otherwise occupied during labor! I needed to be in the other parts of my brain! When I had to give decisive answers, much less demand or request anything, I think it worked against the work of the labor.

Anyway, my realization was that it is so great to be able to fully trust the people around me in labor, and know that they wouldn't go against my wishes, but not have to weigh options myself while it was happening.

[libbylu]

oops! sorry, I doubled it.

[peilover010202]

Well, here is ours. We ran this by our dr first (whose a friend) and it was well-received by him and he thought the medical staff at the hospital would respond well to it also...

Stephanie and Chris are looking forward to another natural, nonmedicated and intervention-free birth. If medical assistance becomes necessary, we’d appreciate it if all medical staff would review this birth plan and understand our wishes. Our most important wishes are listed below.
We understand that we may need to adjust our expectations for Stephanie or our son’s health. If medications, medical procedures, or restrictions become necessary, we ask that you discuss them with us in advance so we can participate in decision-making. We greatly appreciate your helping us have a calm, safe birth.

During Labor and Birth, We Prefer:
To remain together throughout labor, delivery, and postpartum.
That Stephanie be allowed to labor in any position she wishes, with no restrictions on movement, to include access to the shower during contractions.
Please use intermittent fetal monitoring.
Stephanie prefers not to have an IV, but will actively focus on staying hydrated during labor. Prefer to avoid hep (or saline) lock as well, but will consent if it becomes necessary.
That the room remain quiet and dim and the focus be on Stephanie during contractions. We prefer to have a minimum of hospital staff in the room (no students/observers, please).
That Stephanie not be offered any pain relief medication. We will ask for it if we choose to use it.
To exhaust natural alternatives before considering medical induction or augmentation.
That Stephanie push when she feels the urge to do so, and use gravity-enhancing and/or gravity-neutral positions for pushing. She does not want to push lying on her back or semi-sitting.
That Stephanie’s perineum be supported as baby crowns and that her caregiver(s) offer coaching and/or care to help prevent a tear. No episiotomy, please (except for fetal distress); Stephanie would rather have a tear.
That Chris be offered the opportunity to cut the cord.

After Birth, We Prefer:
That the baby be placed skin-to-skin on Stephanie’s belly immediately after birth. Please suction baby’s mouth/nose only if necessary. Please allow Chris to cut the cord.
Local anesthetic if perineal stitching is needed.
That Stephanie nurse the baby as soon as possible and remain with the baby in her arms at least until he has nursed. We’d like any necessary newborn assessment/care to happen in Stephanie’s arms.
That our son be fed breastmilk only (no water, glucose water, or formula) and be given no artificial nipples (or pacifiers) at any time.
That our son remain with us (24-hour rooming-in) after birth; if he must be removed from our room, Chris will stay with him at all times.
We decline eye treatment, the Hepatitis B vaccination, and any other immunizations.
We prefer that our son receive the Vitamin K by injection and heel sticks to test for genetic diseases after he has nursed for the first time. Stephanie would like to nurse him during both procedures.


In Case of Emergency Cesarean, We Prefer:
To give our express consent before initiating this procedure.
To have our wishes stated above respected to the greatest degree possible.
Epidural rather than general anesthetic.
That Chris be with Stephanie during the procedure and be with our son once he is born.
To keep Stephanie’s hands free.
To lower the sheet so that Stephanie and Chris can watch the birth of their son.
Assessment and cleaning of baby while lying on Stephanie’s chest before going to recovery (unless our son is in distress.)
To initiate skin-to-skin contact and breastfeeding as soon as possible.
To be kept fully informed of all our options and kept abreast of what is happening to Stephanie and the baby.

In Case of a Sick Baby, We Prefer:
To be very involved in the care of our son.
To begin breastfeeding as soon as possible. Stephanie will express milk to be used until then. Please consult us before formula is considered or administered.

We want to thank the entire medical staff for helping us have a safe, natural birth and for celebrating our son’s birthday with us.

[2 in August]

Ok, I've been working on mine on and off the last couple days. See what you mommas think. I'll show it to my dr next week and she what she says.

Birth Plan For Jen, her husband D and their baby boy

Thank you for being a part of this special time for us. We want to have as natural of a birth as possible and this is our plan for an ideal birth experience.

If at any time an emergency situation arises, please let us know what is happening. We will change any of these plans as needed to protect the health and well-being of Jen and the baby.

During labor & birth:
•No cytotec, Jen would prefer a Foley catheter or cervidil or other methods of cervix ripening.
•Jen would prefer to tear than have an episiotomy.
•Jen will be using self-hypnosis for pain management. Please keep lights dim and use quiet voices. If I am concentrating, please ask D questions.
•Jen would prefer a Hep-lock, instead of a continuous IV.
•Jen would like to keep vaginal exams to a minimum.

After birth:
•Please let the cord stop pulsing before cutting.
•Jen would like to be given the baby immediately and hold him while Apgars are done and he is being wiped down.
•No Eye Ointment.
•No Vitamin K shot. We will have oral drops to give our baby.
•No Hep B vaccination.
•Jen would like to breastfeed immediately and on demand after that.
•No formula, glucose water, bottles or pacifiers.
•If there are breastfeeding problems, we request the use of a Supplemental Nursing System or to finger feed or syringe feed our baby. We would also like the use of a breast pump to give our baby breast milk instead of formula.
•No circumcision or retraction of our baby’s foreskin.
•If our baby has to leave our room for any reason, D will accompany him.
•We would like to give our baby his first bath.

In case of a c-section:
•Jen would prefer pain meds that allow me to be awake for the birth.
•Jen would like to touch/see our baby as soon as possible.
•We would like D to be able hold our baby as soon as possible.
•If our baby needs to go to the nursery D will go with him.


How does it sound? Did I miss anything glaringly obvious?

[Azreial]

Jen you can probably take out the bit about cervical ripening since that would be an induction thing not a labor thing

[2 in August]

The only thing is that my hosp/birth center still uses it and I'm scared to have it again. What would be a better way for me to address the issue?

[Azreial]

the use it in labor? Or just inductions? If its inductions, I would just bring it up your provider if induction comes up

[2 in August]

Ok, I see what you mean. With my dd my water broke, we freaked out and went straight to the hospital and labor didn't start right away so I got the cytotek & pit. I keep forgetting that wasn't really a normal part of labor and birth. FWIW, I told my dh that if my water breaks 1st this time we are staying home for awhile to try to avoid a lot of what happened last time.

[Azreial]

ok that makes sense.
I would def. stay home as long as possible if my water broke too. I seem to have sacs of steel though With ds they broke the sac, with dd I wanted it to break on it own. It broke and woosh out came dd less than 5 minutes later

[ambotchka]

My hospital gave me a "birth options worksheet" in which you check what you want. They have astericks next to the "recommended" options -- amazingly, this military hospital recommends many natural things. Considering what military medicine is notorious for, I am surprised the recommended options are the ones I wanted. (They even have a birthing bar to help if you push while standing.) It's a good sign if the military suggests the more natural route. Of course...it's cheaper for them!

I'm going through a certified nurse midwife, but I won't know which one will be on duty (I have a 1/10 chance it's the one I've had for prenatal). Anyway, here's what I checked on their list:

++++++++++++
Prior to Active Labor:
I would like to walk
I would like to move around and change positions frequently *
I would like to drink fluids

Labor:
I will bring music and a player with me
I would like the lights kept low
I would like these people supporting me: dh

Pain Control:
I know that several options exist for management of my pain in labor, and I will ask for them if I want them *
I would like to avoid pain medications

Delivery:
I would like to use different positions to help when I push *
I would like my baby to be placed upon my abdomen after it is born*

Episiotomy:
I would prefer not to have an episiotomy unless absolutly needed * (I added: I'd rather tear)

After Delivery:
I would like to hold my baby while the placenta is delivered *
If my baby needs closer observation in the nursery, I would like my partner to go with him/her *
I would like to feed my baby as soon as possible after delivery *

Feeding Baby:
I plan on breastfeeding my baby *

Circumcision:
I do not want my baby boy circumcised
++++++++++++++++