Just in case . . . hospital birth plan

[OMama]

I'm planning a homebirth, but would also like to have a written hospital birth plan just in case we do wind up there in an emergency situation. The hospital is actually pretty progressive and as far as hospitals go it wouldn't be the worst place in the world to be, but I still want to have some information written out. In part, just for my peace of mind.

I know some of the basic stuff we want to include, especially about what we want and DON'T want to have done to the baby after he is born, but there are just some areas I am totally ignorant about. Mainly I need info about c-sections. I remember there was a post a while back (I couldn't find it today) about the style and sutures used in a c-section and whether it was good to be knocked out all the way or just have some type of epidural. There was some reference to not having your hands tied down too. (Okay, that is really scary to me. Do they really tie women down?!)

Basically I know that I may have little control if we are in the hospital for an emergency, but I am assuming that I still do have some choices on these matters. Does anyone have current information about what I should include in a hospital birth plan, especially the c-section stuff? I don't want to write "don't tie hands down" if that is an outdated practice anyway. I want to seem somewhat like I know what I'm talking about. And what about double sutures versus one? I read something about that a while back too. Any info on this would be helpful. Thanks!

[maxmama]

I have never in my experience working OB seen a woman's hands tied down during a section, unless she had a general and they were falling off the armrests. Even then, it's taped, not tied.

I would always go for a regional block over a general. Spinals give better coverage for most women and set up faster than epidurals. In a true emergency, though, you're getting a general.

It's community standard around Seattle to use double-layer sutures (there were a few studies that linked double-layer sutures to a lower risk of UR in a future VBAC).

Your partner can always come in the room, but if it's not an emergency I'd ask the anesthesiologist (not the surgeon; the two "leaders" in an OR are the anesthesiologist and the circulating nurse, no matter what the surgeon thinks) if you can have an extra person in the OR. Then someone can be with the baby while s/he's being weighed/checked (usually just a few feet away, but I think it's nice anyway) and someone can be with you. Also, then there's an extra person for pictures.

You may want to concentrate mostly on postpartum stuff, because there's not much you can request about the surgery itself that will actually change how it's done. If you're at Evergreen (just a guess), they're very good about getting the baby latched on in recovery, and they don't have a well-newborn nursery, so that's not really an issue.

Hopefully you'll never need any of this!

[AmieV]

Will your m/w go with you if you transfer? I honestly wouldn't worry too much about a hospital birth plan if so. Mine would have and been there in basically a doula capacity so I trusted that things would have been handled the way we wanted with her advocating for us.

Honestly if you're having a true emergency csection no one is going to be spending time reading a birth plan or what kind of sutures you want. It will be just that, an emergency. I think you'd be better off just talking to some folks at the hospital and finding out what the protocol is and seeing if you're comfortable with that. I did have a hospital birth plan for my first and I think the only stuff I wrote about a csection is that I wanted H with the baby at all times and that I wanted to nurse as quickly as possible afterward. Then as far as aftercare, just don't let that baby out of your sight and it should be all ok.

[OMama]

Thanks to both of you for your responses. Yes, we'll be at Evergreen, so I feel pretty good about that if indeed we do wind up in the hospital. Really, that was very helpful info from both of you. I think I have what I need to finish up my plan, print it out, and then not have to worry about it anymore. All part of the process . . . thanks again.