I hate to even be thinking about this...C-section birth plan?

[paradoxia13]

But, maybe I should be.

Baby is breech. I'm 40 weeks 4 days. My delivery plan all along has been to use a free-standing birth center with my wonderful midwife and have a natural birth. She is *absolutely* fine with delivering breech and very, very supportive.

My insurance doesn't cover any of this, and after a very rocky couple of prenatals with them at the very beginning I have not been using them at all during this pregnancy. So, they have NO idea what's going on with me. As far as they are concerned I just disappeared - and would love to stay that way for this pregnancy!

So here's my question/concern. If I hit 42 weeks I opt out of my midwife's care. It's not her fault, it's just how it is. If I hit 42 weeks, my option will be to go with my insurance provider. I don't have a specific OB as the one Doctor I saw was awful/rude/patronizing/insulting. At the point I have to turn to them a c-section will be the only option anyway. They will not allow even an attempt at vaginal breech delivery. At that point, I don't much care what doctor I get, as long as it's not the one I saw before, and I will make sure of that.

Where I really need help is this - I feel I should write up some kind of birth plan. Obviously it would have NOTHING about labor or vaginal birth on it as that wouldn't even come in to play with them. I just want it to be known that I want my baby given to me directly as long as it is safe, that I don't want formula feeding, etc.

How would you go about writing this half birth plan? Anyone have this experience or have any ideas? I'm feeling clueless and braindead. I'm hoping I won't even need this, but I guess at this point I should be prepared.

Thanks,
~heather

x-posted to I'm pregnant

[steffanie3]

I was just wondering if you have been able to try the Webster technique chiro? Sorry if you have addressed this before. I have also heard good things about the homeopathic pulsatia (not sure of spelling) and accupuncture. Just somethings to help get that babe to turn and ready to be born.

Anyway, I would definitally do a plan for a c/s if you end up there. I would include all things you would want for a hospital birth for babe afterwards and anything you would want to request for the surgery. I have had a c/s, somethings I would look at if I had been prepared: my DH being in there even to put in the spinal and Drs not talking about their plans and lives while doing the surgery~ that really bugged me. Things I did request and liked: my DH following DS so he could watch everything they were doing and take him as soon as he was wrapped and bring him to me to see~ we had told them no vitamin K if DH hadn't have been there he would have gotten at least that and I got to nurse/hold him in recovery. These are off the top of my head.

[paradoxia13]

Originally Posted by steffanie3

I was just wondering if you have been able to try the Webster technique chiro? Sorry if you have addressed this before. I have also heard good things about the homeopathic pulsatia (not sure of spelling) and accupuncture. Just somethings to help get that babe to turn and ready to be born.

Anyway, I would definitally do a plan for a c/s if you end up there. I would include all things you would want for a hospital birth for babe afterwards and anything you would want to request for the surgery. I have had a c/s, somethings I would look at if I had been prepared: my DH being in there even to put in the spinal and Drs not talking about their plans and lives while doing the surgery~ that really bugged me. Things I did request and liked: my DH following DS so he could watch everything they were doing and take him as soon as he was wrapped and bring him to me to see~ we had told them no vitamin K if DH hadn't have been there he would have gotten at least that and I got to nurse/hold him in recovery. These are off the top of my head.

I've been doing the Webster Technique since 36 weeks, and now at 40 plus a few days it just doesn't seem he's going to turn. Unless he surprises us in labor. The upside is at least my body feels good.

Thanks for your advice! And yeah, the talking/chit chat while doing my section would drive me buggy! Have to find a nice way (or not so nice, what do I care!? haha) of shushing that up!

~heather

[Benji'sMom]

i can't find mine but maybe post in the vbac forum b/c lots of moms there have "in case c/s becomes necessary" - type of things on their birth plans.

[dynamicdoula]

EVERY birthing woman should write a cesarean birth plan!!!

[paradoxia13]

Originally Posted by dynamicdoula

EVERY birthing woman should write a cesarean birth plan!!!

Yes, I understand this - which would be why I was asking for help and advice.

[dynamicdoula]

LOL ! Doh!

Here are some of the thigns we discuss about cesarean birth in my classes:

* having all team members introduce themselves
* recognizing that 'idle chatter' from the staff means eveyrone is relaxed, not disinterested in what is happening -- relaxed doctor means all is well!
* making sure that there is someone to stay with you after the baby leaves the room
* no one declaring the sex of the baby until you see him/her first
* no one speaking as the baby emerges so that the first voice baby hears is yours
* no one (family members) holding baby until you and your husband have had the chance to hold the baby out of the OR
* keeping the baby wrapped so that you and your husband can discover the baby together in privacy
* is there a spiritual or family practice you would like to incorporate?

[5thAttempt]

Originally Posted by paradoxia13

At that point, I don't much care what doctor I get, as long as it's not the one I saw before, and I will make sure of that.

I think that not all doctors are created equal. Since it will be c-section, please select the dr you trust. You still have time. I think that Dr's experience and your comfort with the person will make a difference in the process.

[kaylee18]

A breech birth with a physician does not have to be c-section, regardless of whether vaginal breech is a "service" the physician "offers."

Surgery without your consent is not legal, and EMTALA says they have to provide you with care if you request it while you are in labor. So if you want a vaginal birth and the baby is breech, don't sign the admissions consent forms (write individual consents and sign as needed) and do not consent to surgery. You'll probably also have to insist on your choice of birthing position (standing squat and hands-and-knees being preferable for breech) and warn the doc not to give your baby spinal injuries by pulling on it. But it is your choice, not the hospital's, not the doctor's. I know this can be hard. Littleteapot's preemie birth story provides a vivid example of an experience to avoid; make sure your husband or and/support person is present and able to advocate for you.

It makes me so sad to see resignation and acceptance of the idea that "the doc says no, so we have to do it her way." It's your body. If you don't want it cut, she's not allowed to cut it. End of story.

[paradoxia13]

Originally Posted by 5thAttempt

I think that not all doctors are created equal. Since it will be c-section, please select the dr you trust. You still have time. I think that Dr's experience and your comfort with the person will make a difference in the process.

Unfortunately, I have Kaiser healthcare, you don't much get to select your doctor as much as take whoever is thrown at you. Which is why I was avoiding them in the first place. :

I haven't given up on my birth center birth yet, just thinking ahead to make it as pleasant as possible if it comes down to it.

~heather

[paradoxia13]

Originally Posted by kaylee18

A breech birth with a physician does not have to be c-section, regardless of whether vaginal breech is a "service" the physician "offers."

Surgery without your consent is not legal, and EMTALA says they have to provide you with care if you request it while you are in labor. So if you want a vaginal birth and the baby is breech, don't sign the admissions consent forms (write individual consents and sign as needed) and do not consent to surgery. You'll probably also have to insist on your choice of birthing position (standing squat and hands-and-knees being preferable for breech) and warn the doc not to give your baby spinal injuries by pulling on it. But it is your choice, not the hospital's, not the doctor's. I know this can be hard. Littleteapot's preemie birth story provides a vivid example of an experience to avoid; make sure your husband or and/support person is present and able to advocate for you.

It makes me so sad to see resignation and acceptance of the idea that "the doc says no, so we have to do it her way." It's your body. If you don't want it cut, she's not allowed to cut it. End of story.

This is not resignation or acceptance...this is the backup plan if I reach 42 weeks without going into labor on my own and can't stay with my midwife.

[katt]

I'd make mention of being stitched up with Double Layer Sutures instead of single, and silk thread if possible. Makes for stronger scar, better healing, and lessens the chance of ruputure later.

[LeahLea]

Hi - I'm kind of straddling this DDC and January's and don't post very often, but I wanted to respond because I had the same feelings about writing up a c-section birth plan. I really didn't even want to consider it, but after I wrote mine I felt so much better and could then think about other things knowing that if it had to happen, I had done some preparation so it could still be as close as possible to what I wanted.

I found this website extremely helpful in maintaining the feel of natural birth in my c-section plan: www.birthrites.org/caesarean.html

I went over my c-section plan along with my regular natural birth plan at the same OB visit. No problems. Each plan is one page long, in list form - it was important to me that it was clear and concise, so that the things that really mattered didn't get 'lost' in a sea of words. For me, it was important that I (and my DH) be able to be an active participant as much as possible.

So now that it's done, I feel relief that all my hopes for this birth are not lost if that's the way things have to go. I hope that helps!