Look at my Birth Plan, please!

[spiralmg]

There was a great suggestion in Kir's C-section thread about bringing your birth plan and waving it around to make sure everyone understands what you want. This inspired me to actually type up my birth plan since we will be in the ABC room at the hospital.

I wanted to keep it really simple so that anyone could understand it. Have I forgotten anything or is there anything else I should consider? I haven't actually decided about vitamin K yet, but thought I would make that a "NO" too in the meantime. Also, everything fits on one page in big 24 point type, except for the attendees and things in parentheses which are 12 point.

OUR BIRTH PLAN:
• No drugs
•*No episiotomy
• No cutting of cord (until placenta delivered and mother okays it)
• No washing baby

• Give baby to mother immediately (for breastfeeding)
• I do not consent to being separated from my baby (even in case of C-section)

•*No eye drops/ointment
• No Hep B
• No heelsticks
• No vaccinations
• No circumcision
• No vitamin K

We anticipate the following people to be in attendance
(there may be others not on this list):
(names go here)

[hunnybumm]

My only thought is to be more specific as far as "No Vaccinations", I would specify the vaxes you don't want, the only vax they give not listed is the Hep B right? It looks good to me though I would definitly be prepared to have it tore apart by every OB and nurse you show it to. They will probably say "Well, if your baby is purple and not breathing they will have to go to the NICU." or "We would have to cut the cord if X were to happen." etc.

[sunshinesister]

your birth plan looks straight forward and to the point, which is good. take this with a grain of salt as i've never given birth (soon!!), but i figure using more positive language might help the nurses and docs and whatnot be more inclined to support it. the way we've written ours, each bullet point says "we prefer..."

[amelissam]

I have mine birth plan all ready to go, too! I gave it to my midwife's office last week, and they said everything looked good. They are putting it on file for whichever midwife is on call when I deliver, and they asked that I also bring a copy to the hospital to share with the nurses.
Here's a link if anyone wants to see :): http://ellasdiapers.com/pages/testing.php

[spiralmg]

These are great suggestions. amellissam's plan is so nice. Gosh, I didn't mean mine to come across so negatively, just wanted it to be clear. We WILL be working with the midwives and they ARE the ones in charge (and totally in tune with what we want), so this is more for the nurses on duty (and hopefully there will be no OB). I'm afraid of putting to much information in it though...I don't want it to be too hard to read. Hmm...anyone else care to share?

[kris10s]

I will upload our hospital plan in a sec -- I want to make it PDF first so you can see it on the page -- we got a lot of compliments on the format last time!

[IncaMama]

i would add the words "rooming in" or "room in" since that kind of lingo is readily understood by most hospital staff. it's a typical phrase you always hear.

i can post my birth plan too, in a minute. :)

[kris10s]

Here's mine:
http://www.thisclassicallife.com/kristen/Birth%20Plan%20Lexi%20MCV.pdf

[Taedareth]

I think you should leave it with "No such and such" for the sake of clarity. If you change it to "We prefer..." then it sounds wishy-washy and the hospital staff won't think twice about ignoring your "mere preferences." But then, they may or may not respect any birth plan no matter how clearly you write it, so who really knows? :) It probably all depends on the individuals who happen to be at your birth.

[kris10s]

My last birth, everyone complimented the clarity AND the tone. They did follow all of our directives as well. Politeness goes a long way, but we also had a pretty supportive hospital where such requests weren't completely unknown, even if they weren't ordinary.

[spiralmg]

Wow, Kristen, that plan is awesome. I think the way you broke everything out by topic really helps - everything is easy to find. Yet you still have polite language to explain things. Okay, unless I go into labor tonight (which I would prefer not to do as I seem to have a touch of hte flu...) I am going to redo mine.

Its great to get this feedback and input.

[kris10s]

Our Bradley teacher showed us an example birthplan with a similar grid format our last birth, which we based ours on. Since then, two Bradley teachers on another board I am a part of have shared an anonymized version of ours with their classes, so I feel like we should keep it passin' around. The grid really helps to organize things. :thumb

[Treasuremapper]

I got your PM and am replying on the thread. Good luck. I'm sure you will have a wonderful birth!

I have a few thoughts.

The concepts are great, but I would use the language "I do not consent" to the things you really don't want to have happen.

I would also put something in there about all medical procedures occurring at bedside with you. Any needles should be done while you are nursing the baby (this greatly reduces pain, as shown in a Journal of Pediatrics article a few years ago, and it really works).

Put language in there about how you do not want to be separated from the baby... to think of you and the baby as being attached by velcro.

Make sure you give a copy to the chief pediatrician or neonatologist, not just your OB.

Kangaroo care is preferred over warmers, etc. NO RESIDENTS, INTERNS, OR OTHER PERSONS OBSERVING WITH LESS THAN FULL PRIVILEGES IN THEIR CHOSEN FIELD. I put that in caps because it is really important to me, but some people are OK with that. I put that I did not consent to anyone with less than full privileges to practice in their chosen field to observe or touch me or my baby. I had weaker language before and they let students practice on my dd, saying I didn't use the magic words "I do not consent" and they also claimed they never got it because I only gave it to the OB, not the neonatologist (which tells me there was some b.s.)

So with my next baby, I got a written commitment from the director of LD, the nursery, mother and baby, and the chief neonatologist months in advance that my birth plan would be honored. I suspected my VBAC would not work out because of various reasons I won't go into here, so I had that written commitment by early July when my baby was due in September.

Because of that, my second dd remained with me in the OR and in recovery, nursed through a heel stick without a tear or even a flinch, and had all procedures done at bedside. Instead of a warmer, my dh stripped down to his bare chest in the OR and held her on his chest. this was really important to me because parents were not allowed in the nursery and the hospital had a reputation for babies born by cesarean going into the nursery for hours while parents made repeat requests to have the baby returned.

[Treasuremapper]

I think you should leave it with "No such and such" for the sake of clarity. If you change it to "We prefer..." then it sounds wishy-washy and the hospital staff won't think twice about ignoring your "mere preferences." But then, they may or may not respect any birth plan no matter how clearly you write it, so who really knows? :) It probably all depends on the individuals who happen to be at your birth.

I would use an even stronger preface:

I do not consent to heel sticks.

I do not consent to Hep B vaccination.

I do not consent to having anyone who does not have full privileges in the hospital observing, assisting, or practicing on me or my baby.

etc.

[spiralmg]

The point about people without full priviledges is a really good one. At DS's birth, I was attended by a midwife in training who I had only met once before. My own midwife was there too, but this woman was the one really driving. It caused some problems...it was her last birth before obtaining certification, and she wanted to do an episiotomy (I said no) and wanted to inject a local anesthetic before making my ONE stitch for my one tiny tear. It was really annoying. As far as I know, there are no such people around this time - but better safe than sorry.

I also think the "Do not consent" language is a good idea too.

I am trying to get my husband fully on board with all of this. He does support everything I want, but I can see him being easily bowled over by "experts" in a medical situation. For example, if they want to take the baby away, like they did last time. He hasn't done any of the research I have, so also for his sake, I want to make it as clear as possible.

Even if I leave my "no" and "I do not consent" language in there, do you think that there is a way I could make it friendlier, so as not to offend or set anyone off (? The hospital is used to dealing with "the midwife patients", but I would like to hopefully at least get on the nursing staff's good side. But there is a fine line between hoping they like you and not being assertive enough.

[phaeon]

I had my first in the hospital and we did a birth plan. I won't post it, since everyone else has already given you all great ideas that were in mine :lol .
The only suggestion I would share is that hospitals tend to dislike birth "PLANS" because births never go according to PLAN. Your plan is pretty rigid, and that may make them very nervous because of the liability issues. For example, you say no drugs-- but, what if you're hemmorhaging after birth and they want to give you something to clot your blood? Maybe you can include a comment that you are willing to CONSIDER procedures on the "banned" list if the staff feels they may be beneficial or necessary, but that you MUST be consulted first. (For example: I ended up agreeing to a small local anaesthetic when I needed a few stitches after tearing. I was asked before it was administered- and was very grateful for it as the doc was sewing me up! Ouch!!)

And I totally agree with the PPs who suggest limiting the number and types of people who are allowed in the room. However, keep in mind that if you DO run into an emergency situation (not that you will!) you want the hospital to have enough flexibility to get you the care you need. If you're birthing at 3:15 AM on a Sunday morning, your hospital just might not have enough full-privilege staff available to attend you right away. Just don't limit yourself, I guess is my .02. One thing we did that was helpful was to find out who the head LDR nurse was, and go over everything with her so we knew (a) what was negotiable and what we might end up getting flak about (b) how to word things so that her nurses wouldn't be offended and become MORE of an obstacle, and (c) get her on our side so that our preferences would be taken more seriously. She was extremely helpful.

Good luck, mama!

[sunshinesister]

we also wrote a short paragraph in the beginning to try and get people on our side. part of it is here...

We understand that situations may arise such that our plan cannot or should not be followed. In that event, we would ask that the problem be explained thoroughly, that we are given time to question, discuss, and make informed decisions so that we may give our informed consent for any necessary procedures.

i think that informed consent part is SOOO important. that way no one would do an episotomy for practice on me or any such thing without having to tell me beforehand...

[spiralmg]

Yes - the informed consent intro is a great idea. I was just looking at Kristen's plan again and thinking about ways (okay, admit it - quick and easy ways) to make my current plan more like hers by at least providing an intelligently and kindly written intro paragraph. That phrase "informed consent" shows both openness to whatever situation presents itself, and yet a clear desire to be fully in the game vs. being a passive participant.

[bonbon mama]

I'd make multiple copies and keep them with you in your hospital room. I would also position a box of chocolates and some gum right next to it with the note, "Thanks in advance." It never hurts to bring a smile to the situation.