How to come up with a birth plan...

[FLMama092485]

Ok I did have the most perfect birth plan until my doc basicly told me that I couldn't do it. I am not sure why cause the reasons that he is giving me are not good enough.

Any way he told me to put together a birthplan so we can discuss it next apt. But I have no idea where to start. I looked a templates on line but I am out of in on my printer and cannot figure out how to organize this thing.

[tika]

UC isn't in the plan anymore?

I'm confused...you put together a birth plan and your doc shot it down and now he wants you to come up with another one?

[FLMama092485]

Originally Posted by tika

UC isn't in the plan anymore?

I'm confused...you put together a birth plan and your doc shot it down and now he wants you to come up with another one?

I am not going to UC if I am still at MIL when I have the baby. If I have my own place by then, then yes I am going to UC. I had come up with things like I didn't want to be confined to the bed with monitor and an IV . But he said I would have to be continuously monitored and have an IV just incase I needed to have a repeat c/s or if something went wrong. But that was what he shot down. Cause those were my 2 biggest things. So now I am just coming up with questions about things that I want that I forgot to address.

[Heather423]

birthplan

remember everything is YOUR choice.......

Here is what I have in my birth plan.... I haven't discussed it with my midwives or doctor, but you can always say "no thankyou" when they offer anything routine you are not comfortable with...

This Birth Plan is Prepared for:
”Natural Vaginal Delivery, "

My Name:
Husbands Name:
OB:
Midwife: .
Due Date:
Place of Birth:

Following is a statement of our birth plan and childbirth choices. We have educated ourselves prior to making these decisions and hope to carry them out, but we realize that complications do arise and in such instances would like the best information and options explained to us in detail. Thank you for taking the time to read this and helping us realize our birth plan. We hope to have nurses supportive of natural childbirth, who will not question our wishes.

Personal Preferences
Environment
Private Birthing room
Lights dimmed, peace and quiet (working with Hypnobabies course)
Wear my own clothes
My own music
Ability to videotape or take pictures of the birth
No students or residents
Minimal or no vaginal exams

Procedures and Labor
Maintain mobility (walking, rocking, bathroom, shower/bath)
I would prefer to avoid an enema
I prefer no restrictions (to be able to eat or drink what I want)
I would like ice chips available
I do not want an IV unless severly dehydrated
I would like to choose my positions for pushing and giving birth
I don’t want to give birth lying on my back, counter productive
I would like to be able to push when I feel necessary, no coach pushing
I would like labor to be able to progress naturally even if taking longer than hospital staff would like, no induction!

Monitoring
I do not wish to have continuous fetal monitoring unless it is required by the condition of the baby
In the event that I require fetal monitoring, I prefer a Doppler

Pain relief options
I plan to give birth naturally without medication (PLEASE DO NOT ASK ME IF I WANT MEDICATION) and will be coping with pain using the following techniques:

Hynobabies, Bradley method, acupressure, water (shower.tub), massage

I do not wish to have the amniotic membrane ruptured artificially unless there are signs of fetal distress.
I would prefer to be allowed to try changing position and other natural methods before any medical interventions.

Complications and Cesareans
Unless absolutely necessary, I would like to avoid a Cesarean
If my caregiver recommends a Cesarean, I would like a second opinion if time allows

Normal Vaginal Birth
I would like to have the baby placed on my stomach/chest immediately after delivery and left for AT LEAST one hour before being assessed/bathed. Partner to dry baby.
I would to deliver in a hands and knees position or whatever feels most comfortable for ME
Please dim the lights for birth
I would like to have the room as quiet as possible when the baby is born
Suctioning of the mouth and throat of the baby just before the delivery of the shoulders only if medically necessary

Placenta
I DO NOT want to be given and injection of pitocin after delivery to expel the placenta, (nipple stimulation and breastfeeding to encourage expulsion)

Episiotomy
Use warm compresses, massage, and positioning to help me prevent tears to my perineum. Prefer to tear.

Baby Care
Ubilical Cord
DELAYED Partner wants to cut the cord AFTER is stops pulsating or AFTER placenta delivery, to allow the extra 40% of blood volume to return to the baby

Eye Care – NONE

Vitamin K shot – NONE

Feeding baby
Breastfeading ONLY, right away, for possible low glucose levels, no heal testing
No pacifiers, glucose water or bottles

Separation
No separation, baby rooming in, baby to be left on my stomach for a minimum of 1 hour before any tests/assessments and allowed to breastfeed right away

Circumcision
In the hospital N/A

Sick infant
Breastfeeding as possible
Unlimited parental visitation for parents
Handling the baby- holding etc
If baby is transported to another facility move us as soon as possible

[Heather423]

The doc can't make you have constant monitoring unless you are having an epidural, and you can compromise on a heplock for the iv "just in case"... I am fortunate to have good midwives on my team. I would really stand firm on your decisions.. Seems like he is leading you on a path to a C-section... Is it too late to find a more natural birth friendly doc? Another option is to labor at home as long as you can before heading to the hospital.

[Sea_Gal]

Silly Docter man.
I've read that a birth plan carries more weight when it is hand written.
So being out of ink doesn't set you back really.
A cover letter is suppose to be helpful also.
But I'm confused, if he turned down your last birthplan
what is this one suppose to be?

For some helpful ideas:
I like the chapter on birth plans in "Hypnobirthing".
Also I like the ideas on http://www.earthmamaangelbaby.com/birth_plan.html

For some interesting perspective on birthplans
there is also a chapter on them in "Birthing From Within".

[BrooklynDoula]

I was told this by my Bradley teacher (a nurse for 14 years previously) and confirmed it with a bunch of MWs and nurses through the years in conversation -- NOT OVER ONE PAGE! If you come in with those crazy on-line templates that are 14 pages long, they will totally ignore you and your plan. We got everything we needed into one page (and had a great birth!)

[Full Heart]

Originally Posted by MSAX

I was told this by my Bradley teacher (a nurse for 14 years previously) and confirmed it with a bunch of MWs and nurses through the years in conversation -- NOT OVER ONE PAGE! If you come in with those crazy on-line templates that are 14 pages long, they will totally ignore you and your plan. We got everything we needed into one page (and had a great birth!)

Ditto this. I made mine short and sweet. There were things I was juts not willing to compromise on and those went at the top and I said I wasn't even going to discuss those things. They are: Circ, vit k, pku, Heb b, and eye drops. There were other things I would be willing to compromise on if I or the baby needed it. If I was for some reason unconscious I would allow bottles, if the baby was sick I would see not being able to bfed asap. If I was dehydrated I would go for an IV. I also didn't want blood sugar testing on the baby based on size alone. But if the baby was showing signs of low bs then I would allow testing. I would consent to an episiotomy only to save the life of my baby. I would rather tear.

I had a seperate sheet for c/s. I put on there double suture. Cath after the epi. Only wanted general if it was a true emergency and there wasn't time for spinal. Stuff like that.

[MamaAcorn]

Hey, I just taught the "birth plan" class last night (I'm a Bradley instructor too). I agree with sticking to one page, using positive communication, and prioritizing those things that are really important to you. I highly recommend using "The Thinking Woman's Guide to a Better Birth" by Henci Goer to read up on your choices for making your birth plan.

It seems the more pressing issue is that your doctor blew off your two most important desires already, so I have to wonder what he'll do with your new birth plan. Did he give you reasons for why it's in your baby and your best interest to have continuous fetal monitoring and an IV? (BTW, both of those are covered in the Henci Goer book with research to back everything up) If he's not even being open to what you want or willing to discuss things with you, you may be better off finding a different care provider, even this late in the pregnancy. I've had students change providers as late as 39-40 weeks, it can be done.

Pam

[Amari's Mama]

Your doc sounds like a real winner in the personality department.

Remember... what he is really telling you is not that "YOU CAN'T", but that "HE WON'T". YOU certainly CAN!!

[tika]

With both of those, you can go with the flow with your doctor then refuse once you get to the hospital. You'll be refusing mostly to the nurses, not to him anyway.

INSIST on a heplock instead of an IV.

REFUSE the CEFM, think about what kind of monitoring that you would feel most comfortable with (i.e. intermittent monitoring, a 20 min strip every two hours, or take paper out of the machine, etc etc)
CEFM has not been shown to improve fetal outcomes, but has been shown to drastically increase the likelyhood of a cesarean. The doctor just wants you to have this to cover his butt.

Remember, you can refuse anything that you don't want when you're in the hospital.

And of course, you know to stay home until you think you are close to delivery (and then probably a little longer to make sure!). Many moms make the mistake of going in too early.

Things on my hosp transfer birth plan:
vag exams only upon request, do not offer pain medication or epidural, no AROM, no episiotomy, prefer forceps or vacuum attempts be made before a cesarean, baby laid on my chest immediately after birth

For baby:
no eye ointment/drops, no PKU, no vitamin K, no hepatitis B shot, no circ, no formula, no glucose water, baby not to leave the sight of myself or my husband

Cesarean birth plan (separate page):
double layer suture, no morphine drip, arms not tied down, doctor narrate what he's doing, no chit chat amongst surgery staff unless it pertains to the surgery itself, nursing in recovery, second support person be allowed in the OR with me for when DH goes off with baby

[tika]

I have a suggestion, I know this is really out there and may not be within your comfort zone but I'm going to throw it at you anyway since you've considered UC...

Maybe you could get a hotel room near the hospital and UC at the hotel room?

A little less out there...labor at the hotel room until you feel pushy then go to the hospital to push the baby out?

OR get a hotel room and decide whether you want to stay there and birth or head to the hospital?

You might not want to stay home that long anyway, living with your IL's and all, making it so you end up at the hospital earlier than you would have liked.

[FLMama092485]

Originally Posted by tika

I have a suggestion, I know this is really out there and may not be within your comfort zone but I'm going to throw it at you anyway since you've considered UC...

Maybe you could get a hotel room near the hospital and UC at the hotel room?

A little less out there...labor at the hotel room until you feel pushy then go to the hospital to push the baby out?

OR get a hotel room and decide whether you want to stay there and birth or head to the hospital?

You might not want to stay home that long anyway, living with your IL's and all, making it so you end up at the hospital earlier than you would have liked.

hmmm that is not a bad idea. And then I could have a jacuzzie.(sp?)

Thansk mama's for all your help so that way I can make a birth plan that will make me happy.

[Heather423]

Well I discussed my plan with my doctor and wasn't happy with her response. She thought it was dangerous for me to not allow the glucose testing on the baby. (Insulin-dependent GD). After she said that, she seemed a little more open minded, but still very "medical" in her beliefs. but she did say that I could have the intermittent monitoring, and that would be fine unless there seemed like there may be a problem which would require more. I just hope the midwives are more on my side. I guess I have to knock my plan down to one page, but wanted to be very thorough. I think I may also get a hotel room since I am 45 min away, and want to stay away from the hospital as long as possible.