Birth Plan Advice, Please?

[Apiana]

I'm going to see my OB on Thursday & I'm going to show her my birth plan & get her approval/feedback. So far, it is a page & 1/2. I'm really trying to whittle it more to just one page. I dunno if I can. Nevertheless, I'd REALLY appreciate any advice & feedback on it before I print it to take. :lol
TIA!! :shy
******************
This birth plan is intended to express the preference and desires we have for the birth of our baby. It is not intended to be a script. We fully realize that situations may arise such that our plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options. I expect to actively participate in all decisions to ensure my ability to provide informed consent. Thank you.
We are a quiet & private couple excitedly anticipating meeting our first baby boy. We would like to do so as naturally as possible with as little intervention as possible. I am hoping to work with a nurse who believes in natural childbirth. We truly appreciate any help you can provide in helping us achieve this. We are ecstatic to share this momentous experience that we will remember forever.
Sincerely,

If there are no medical contraindications and mother or baby isn’t in distress, I would like the following:
Labor
~Free to walk/move around & change position at will during labor.
~To eat & have fluids by mouth throughout the first stage of labor.
~To avoid an IV unless I become dehydrated.
~Environment to be kept as quiet as possible & the lights in the room to be kept.
~My labor allowed to progress free of stringent time limits.
Monitoring
~Intermittent fetal monitoring.
Labor Augmentation/Induction
~To avoid rupturing the amniotic membrane artificially.
~To have the amniotic membrane ruptured before other methods are used to augment labor, if labor is not progressing.
~To try changing position and other natural methods (walking, nipple stimulation) before pitocin is administered.
Anesthesia/Pain Medication
~Please do not offer me pain medications, I realize that many pain medications exist & I'll ask for them if I need them.
Cesarean
~To avoid a Cesarean.
~To be fully informed and to participate in the decision-making process, if a Cesarean delivery is indicated.
~To have an epidural for anesthesia, if a Cesarean is needed.
~My son to be given to me or my husband immediately after birth.
Episiotomy
~I would prefer to tear than to have an episiotomy, unless absolutely required for the baby's safety.
~Please help me to protect the perineum. I am practicing ahead of time by squatting, doing Kegel exercises, and perineal massage. I would like to use perineal massage, positioning, & warm compress to help avoid the need for an episiotomy.
~Local anesthetic to repair a tear or an episiotomy.
Delivery
~Pushing stage to be allowed to progress free of stringent time limits.
~To choose the position in which I give birth, including squatting, hands & knees, etc.
~To have a mirror available so I can see my son's head and the chance to touch my son's head when it crowns.
~To try to wait until I feel the urge to push before beginning the pushing phase, even if I am fully dilated.
~Avoid using forceps or vacuum extractor.
~Having the room as quiet as possible & having the room lights turned low for the actual delivery.
~To have my son placed on my stomach/chest immediately after delivery so I can breastfeed.
Immediately After Delivery
~To have my husband cut the cord.
~That the umbilical cord stop pulsating before it is cut.
~To hold my son while I deliver the placenta and any tissue repairs are made.
~To avoid a routine injection of pitocin after the delivery to aid in expelling the placenta.
~To have my son evaluated and bathed in my presence.
~If my son must be taken from me to receive medical treatment, my husband will accompany my son at all times.
~To delay the eye medication for my son until a couple hours after birth.
~To be given a few moments of privacy to urinate on my own & avoid being catheterized.
~To donate the umbilical cord blood if possible.
~I would like to take the placenta home with me, if possible.
Breastfeeding
~I plan to breastfeed my son and would like to begin nursing immediately after birth, whether I deliver vaginally or by Cesarean, & I would like to meet a Lactation Consultant.
~Unless medically necessary, I do not wish to have any bottles given to my son (including glucose water or plain water) or given a pacifier.
Circumcision
~Please do not retract the foreskin of our son; I do not want him circumcised.

[pageta]

Looks great to me! I don't think you need to worry about making it shorter - I think it is very concise as it is. Great job!

[Xiaguan]

If there are no medical contraindications and mother or baby isn’t in distress, I would like the following:
Labor
~Free to walk/move around & change position at will during labor.
~To eat & have fluids by mouth throughout the first stage of labor.
~To avoid an IV unless I become dehydrated.
~Environment to be kept as quiet as possible & the lights in the room to be kept.
[/b][/QUOTE]
2 things I noticed :o The sentence I underlined is not complete~ How do you want the lights? I know you wanted to say low but it is missing~

2nd: I would put in a sentence about in the event of my son having to go the nursery my DH is to reamin with him at all times~

Something that I will never forget is seeing a second time dad being told to leave the nursery & that the nurses would take care of eevrything~ It was all I could do not to speak up & say "You know that is your son~ If they are not doing life saving measures or surgery you have ever right to be stading there next to him" :angry Broke my heart for both the child & the dad! :crying

Other than that it looks great! I am trying to get myself motivated to do anther birth plan~ My last child I had a 5 page BP that I spent a lot of time & energy on & thought it was on my computer but cannot find the file :(

HTH's
Melissa

[tsk_mum]

Looks good! I may copy some of it since Im already making notes (planning ahead) ... I have a list of things started to include in my plan!

[nighten]

Here's a site I bookmarked ages ago that had some good things in it:

http://www.itcs.com/elawley/baby/birthplan.html

It's considerably longer than yours but it covers a lot so it's a good reference I think in terms of making sure you don't forget anything.

But your plan looks good to me. :) My only comment is did you have a preference in terms of Hep B Vaccine or Vit K shot? I'd include a note about those too with the eye ointment, if you do.

Good luck!

[Treehuggin'Mama]

I think it looks great. My own plan is already three pages long... is length really an issue?

[nighten]

I think it looks great. My own plan is already three pages long... is length really an issue?


I dunno -- from my experience, people tend to not read something if it's really long. They skim and whatnot and I"d rather them not miss something important, you know? I think if you're going to make it longer than a page, then doing it in list form with bullets and bolded topics is the way to go.

When in doubt, keep it simple, and I think the OP has done a good job with that. :)

(Now if only I could take my own advice....)

[be11ydancer]

Your birth plan sounds nice but I think your jinxing yourself by having such a long one. Murphy's Law, you know. It seems like the longer the birth plan is, the less it gets paid attention to. My birth plan with baby #2 was a little longer than that and very thorough... I ended up with a c-section. And no one seemed to pay a lick of attention to it, as they decided on their own to put the crud in baby's eyes, do the hep B vax, etc anyway.

Try and shorten it to a page if you can. And remember that it all can't be planned ahead of time. Childbirth is unpredictable.

You might also consider hiring a doula who can help you get what you want at the hospital.

[Bellasmom]

I am using CNM's at a hosptial, and two I've spoken with about birth plans encourged them highly but warned to keep them short - one said that in her experience more than a page or so seems to correlate with a c-section. The midwife I saw this week reminded me that they cannot do anything I refuse - if they do it is assult and battery. I am planning on signing the waivers for things that I don't want before I am admitted in labor, so that things are already on record.

[nighten]

For what it's worth, here's the short version for mine (I have a longer one that I plan on giving my midwife to review but I figure concise is best in terms of the one that the general staff sees -- this is still a work in progress, but it's less than one page, which is miraculous for me haha).

What do you think?

-----------------------------------



Birth Preferences for Renee & Brad _____ (edd 4/12/06, expecting a girl!)
Caregiver: Amy ____, CNM

We respectfully refuse the following procedures:

For Renee:
Episiotomy unless child's life is in danger
Induction/augmentation of labor unless mother or child's life is in danger
Constant monitoring unless cordless
Pain medication of any form unless requested between contractions
Caesarean delivery unless absolutely necessary

For Baby (see waivers):
Circumcision (should it be -- surprise! -- a boy)
Vit K shot
Heel stick prior to 24 hours
Hep B vaccine
Eye ointment (Renee tested free of all STDs)

We prefer the following:

Natural childbirth with lights, noise and examinations minimized
No medicinal forms of augmentation nor induction
No students nor extraneous staff members present
Staff members knock prior to entering room, please
No IV (heparin lock okay)
No medication nor procedures without express permission of Renee or Brad
Perineal support with compresses and massage during delivery
Non-directed pushing
Bonding time for breastfeeding immediately following delivery
Baby to remain with a parent at all times
No catheters nor pitocin post-delivery
No bottles nor pacifiers for Baby
We would like to meet with a lactation consultant
We are banking the baby's cord blood with _______

Thank you!
Renee & Brad
ETA: Because forgot to add cord blood note.

[tsk_mum]

Very helpful site w/ birth plan info::
http://www.childbirth.org/articles/birthplans.html

[Apiana]

I just wanted to dig out this post to thank you all for your responses! What great input!:D
I've revised the plan, & here is my finalized version, just 1 page.:) Again, thanks everyone for your help!:thumb
***********
The following is our “ideal” birthing. It is not intended to be a script. We fully realize that situations may arise such that our plan cannot and should not be followed. We trust in your expertise and sensitivity, and ask that you please consider our choices and keep us informed and aware of our options. I expect to actively participate in all decisions to ensure my ability to provide informed consent. Thank you in advance for your support, encouragement, and patience.
We are a quiet & private couple excitedly anticipating meeting our first baby boy. We would like to do so as naturally as possible with as little intervention as possible, and we truly appreciate any help you can provide in helping us achieve this. I am hoping to work with a nurse who believes in natural childbirth. I am using self-hypnosis techniques and ask for the staff to kindly use low voices and avoiding references to negatives such as “pain”, “hurting”, etc. These words are disruptive to my hypnosis process, and we sincerely appreciate you for respecting our unique needs.

If there are no medical contraindications and mother or baby isn’t in distress, I would like the following:

Labor
* Free to walk/move around & change position at will during labor, having only intermittent fetal monitoring.
*To avoid an IV by having fluids by mouth & eating as desired. I’m happy to accept a Heparin Lock.
*Environment to be kept as quiet as possible & the lights in the room to be kept low.
*My labor allowed to progress free of stringent time limits.
Labor Augmentation/Induction
*To avoid rupturing the amniotic membrane artificially. If labor is not progressing, to try changing position and other natural methods (walking, nipple stimulation) before AROM & AROM before pitocin is administered.
Anesthesia/Pain Medication
*Please do not offer me pain medications, I realize that many pain medications exist & I'll ask for them if needed.
Episiotomy
*I would prefer to tear than to have an episiotomy, unless absolutely required for the baby's safety, with my permission first.
*Please help me to protect my perineum. I would like to use positioning, oil, & warm compress to help avoid tearing.
*Local anesthetic to repair a tear.
Delivery
*Pushing stage to be allowed to progress free of stringent time limits.
*To choose the position in which I give birth, including side-lying, squatting, hands & knees, etc.
*To see (with my mirror) and have the chance to touch my son's head when it crowns.
*To wait until I feel the urge to push before beginning the pushing phase, even if I am fully dilated, & to first try mother-directed pushing.
*Avoid using forceps or vacuum extractor, please ask my permission.
*Having the room as quiet as possible & having the room lights turned low for the actual delivery.
Immediately After Delivery
*To have my husband cut the cord, possibly catch our son, & that the umbilical cord stop pulsating before it is cut.
*To hold & try to breastfeed my son while I deliver the placenta and any tissue repairs are made.
*To avoid a routine injection of pitocin or use of traction after the delivery to aid in expelling the placenta. Please ask my permission, first.
*To have my son evaluated and bathed in my presence, delaying the eye medication & heel stick until a couple hours after birth. I’m requesting Vitamin K to be given orally & not to be given the Hep B injection (he’ll get it at his first checkup).
*If my son must be taken from me to receive medical treatment, my husband will accompany my son at all times.
*To be given a few moments of privacy to urinate on my own & avoid being catheterized.
*I would like to take the placenta home with me, if possible.
Cesarean
*To avoid a Cesarean; to be fully informed and to participate in the decision-making process, if a Cesarean delivery is indicated.
*My son to be given to me or my husband immediately after birth.
Breastfeeding
*I plan to breastfeed my son and would like to begin nursing immediately after birth, whether I deliver vaginally or by Cesarean, & I would like to meet a Lactation Consultant.
*Please ask my permission before any bottles are given to my son (including glucose water or plain water) or he’s given a pacifier.
Circumcision
*Please do not retract the foreskin of our son; we do not want him circumcised.

[sapphire_chan]

Have the OB write as much of it as possible onto your charts as doctor's orders. The staff cannot go against doctor's orders and that will make the rest of the birth plan shorter so it's easier for everyone to read.

Also, for a lot of this stuff, you might be better off stating that either the you or your dh must be with the baby at all times and no procedures are to be done to your baby without your express, written consent.

I believe on my little brother's chart the doctor started off with "There is no standard operating procedure for this infant...."

[BetsyS]

I think my birth plan might be the shortest one out there.

(hand written; typing falls under Murphy's law of needing a c-section. LOL)
Please don't count while I push.

If I need a section, please do a double layer closure on the uterus and please put my muscles back together.

Thank you.

[JamieCatheryn]

My birth plan was recieved incredibly well at the hospital, I could tell every doctor and nurse who saw me had looked it over and payed attention to what I asked for. Keeping it to one page is definately important, mine was bulleted 10pt font. I'm not sure it was important but I kept each item phrased politely with all the pleases and "I would like" and such on each line. I pared it down by leaving out the stuff they wouldn't care about medically like lights and music, I just had DH adjust things as needed. Your preferances on fetal monitoring, pushing instruction, and newborn procedures seem to be the most important info to get across. When it comes to informed consent stuff, have someone (DH, doula, friend, or family) read and approve anything you're asked to sign. Also, if you're willing to let them use a heplock (IV needle not hooked up to tubing - just in case it's needed) then put that with the note about IV's, it will save you a big disciussion. Good luck!