Birth Plan: Pushing Stage (wording suggestions...)

[jessjgh1]

I've met with our doula and the midwife to go over our birth plan and so far so good....
The only outstanding issue is Vit K, which the midwife recommends, but ultimatly leaves up to us.... but I know that we may be given a hard time about that from the pedi... so off to research that more....

Anyways, my doula brought up a good point about the pushing stage... I certainly don't want someone counting down and STRONGLY encouraging me to push- its not a contest.... I want to let my body feel an urge to push and push with what feels right.

Anyone have an suggestions on how to word this for the birth plan?

Mine is pretty brief, but I don't think I'll be able to get it down to one page... I'll have to try!

Jessica

[SleepyMamaBear]

if i had a written birth plan i would put "do not tell me when or how to push, my body will tell me on its own thank you"

[Juvysen]

I would also make it clear to my birth partner (whoever that may be) that you don't want any directed pushing and if someone is doing that then it's your birth partner's job to put a stop to it, unless you specifically ask for such help at the time.

[DoulaClara]

I wonder if you could word it as:

"During the pushing stage, I would like to listen to only my body for cues to begin and stop. I will need silence from everyone for this to occur. I reserve the right to ask my birth partner/husband etc. to ask whomever violates this agreement to leave the room. In the case of a malpositioned cord, where a birth attendant will need time to adjust the cord so that I can resume pushing, I ask that the attendant calmly inform me that they need a moment to do so."

Maybe a bit wordy, or not totally your intention, but you can reword it!

Clara

[jessjgh1]

Thanks, I was able to pick some key terms out of what everyone suggested. I'll be able to mix and match something that will be suitable for our situation... I'm fully expecting that the norm of my midwife is NOT to direct pushing or count, etc.. but I want to have it down there anyways.

Directed pushing was one term I was searching for... and with my son's birth I didn't necessarily want silence but the nurses gently guided me and did not count- and that was fine. Of course, I had an epidural so they kinda had to let me know when to push, since I couldn't even tell.

THANKS!!

Jessica

[riomidwife]

Originally Posted by jessjgh1

I'm fully expecting that the norm of my midwife is NOT to direct pushing or count, etc.. but I want to have it down there anyways.

In my experience it's the nurses who typically do the "coached" pushing with all the counting, etc. Some are more into it than others. For many staff people it's just such a routine habit they don't think twice about starting in.
I think it's really helpful to have an advocate/partner who can kindly say to this person, you know, she really would prefer not to be coached/counted at unless XYZ, or something to that effect. Another way to avoid the pressure to push prematurely is to limit cervial checks; typically once the cervix is discovered to be 10cms the pressure coaching begins (as well as the clock). ~Erin

[ahdoula]

I like to use bullets for birth plans (more reader freindly and less likley to be tossed aside without being fully read) and is was my pushing section:

□It's important to me to push instinctively, I want to push how and when feels right without being coached
□I would like to be encourage to blow, pant and breath properly for slower crowing
□I would like to be encouraged to try different positions for pushing if needed

Oh, I also always try to keep it positive. Instead of saying "I don't want to be told how to push" I phrase what I WOULD like... Or instead of I do not want an IV I rephrase to I would like to keep my freedom of movment and therefor delcine an IV. It Keeps staff from feeling on the defense. Whenever possible make it things you do want (I would like to risk tearing, instead of having a rountine epesiotomy. Instead of I do not want an episiotomy....)

[phathui5]

I'm fully expecting that the norm of my midwife is NOT to direct pushing or count, etc.. but I want to have it down there anyways.

Definately talk to them about your wishes about it before you get down to the actual birthing. I had my first in a hospital with a midwife and the midwife and nurse did the loud, annoying (to me) counting for pushing. I didn't need them to count and didn't want anyone talking at that point.

[riomidwife]

Originally Posted by ahdoula

Oh, I also always try to keep it positive. Instead of saying "I don't want to be told how to push" I phrase what I WOULD like...

I agree that is the best approach. With some people though (e.g., nurses who are particularly set in their ways), you really have to spell it out to get your needs met.

[jessjgh1]

Thanks, I agree about the positive wording. That's something I might fiddle with, but I have it 'done' for the most part and that was also important to me.

Good suggestions on the pushing part... it was hard to figure out what to say, and it ended up long too.

My midwife and the hospital is supposed to have a wonderful reputation amongst the natural birth crowd... every time I run into someone and hear they used her, I feel more and more positive about this choice.

So I probably should try to phrase it positively just because that honors the environment they try to creat anyways!

Thanks!

Jessica

[bdavis337]

Unless you're birthing at home, alone, you're probably always going to find someone in your room who wants to tell you when to push, how long, how hard and how to breathe through it. IMO, the best way to handle this is just to have your partner, spouse, mom, friend, doula, etc. be at the ready to say "let's back off and let her listen to her body".

[mysticmomma]

Originally Posted by bdavis337

"let's back off and let her listen to her body".

beautiful!

[geography]

episiotomy without consent

Many shift doctors and nurses seem to pay little attention to a woman's birth plan. Many women have found this to be the case.

Of course, it sounds like you're making a great birth plan, so this isn't intended to discourage that. But when it comes down to dealing with the hospital, I would slash out and initial any forms consenting to an episiotomy--even in the case of a claimed emergency. You can give express written consent at the time should you judge the emergency compelling. Anaesthesiologists will make you give your express consent in writing for an epidural---even with contractions.

This is just my opinion on the subject. I've spoken to women who said they were given episiotomies without their consent. There are women in the forum who said they screamed "no" at the time.

There's a lawsuit that addresses this on Findlaw:


APPELLATE COURT OF ILLINOIS

SECOND DISTRICT

RACHEL CURTIS,

Plaintiff-Appellant,

v.

DAVID G. JASKEY,

Defendant-Appellee.

[mamaverdi]

How about "silence please"?

(Oops, sorry I didn't see this was your DDC.