Anyone have sucecss with presenting birth plan signed by care provider?

[Helen White]

My first birth, I had difficulty getting many of the arrangements my care provider had verbally approved before labor began, because it was against the norm for the hospital, and it was the hospital staff, not my doctor, I was dealing with. I've just read in a couple places that it can be helpful to have your care provider sign the birth plan ahead of time so that it's available to present to the nursing staff upon arrival at the hospital. This sounds like a great idea, but I wonder how often it actually works. Anyone have success doing this?

[blessed with boys]

Thats a wonderful idea, I'm going to ask my ob about that at my next visit!
Jackie

[earthmama369]

The family practice I go to sends the signed birth plan over to the hospital from their office around 36-38 weeks. I didn't have a problem either time doing it that way. (I suspect it looks all official-like coming from the office. ;) )

[maxmama]

A signed birth plan means exactly zip more than an unsigned birth plan. There is no legal weight to either. In the absence of written orders, the institution's protocols will be followed. A birth plan is NOT your labor admit orders.

Sorry, but legally your nurses are bound by written orders, or, in their absence, by protocols. If I follow the requests in a birth plan and they contradict the orders given by the provider, it's my ass legally on the line for any bad outcome. If you want certain things, have your provider fill out your admit labor orders with you there, and send those over.

On our unit, we always review the birth plan and the orders together, and if there's a discrepancy I call the provider to ask for the orders to be changed, but in the end a birth plan has no weight at all.

[OnTheFence]

My first birth, I had difficulty getting many of the arrangements my care provider had verbally approved before labor began, because it was against the norm for the hospital, and it was the hospital staff, not my doctor, I was dealing with. I've just read in a couple places that it can be helpful to have your care provider sign the birth plan ahead of time so that it's available to present to the nursing staff upon arrival at the hospital. This sounds like a great idea, but I wonder how often it actually works. Anyone have success doing this?

I have with my last 2 csections, but since they are planned, my doctor is the one that actually does them. However I do show them to the nurse and the nursery nurses there -- I also have my pediatrician sign off on it as well.

[mimiharshe]

I had to switch from a midwife to a doc at 38 weeks pregnant with my first daughter due to a stuck breech position. He was wonderful and signed off on my birth plans for vaginal birth, c-section and care of the baby and gave it to the nursing staff as well. Because of this we had no problems at all. I ended up with a C-section. You should have seen the nurses running around looking for a mirror b/c I requested one on my birht plan. Lucky for them I changed my mind about that. Then, when they "delivered" her, my doctor thought they were giving her eye gel and he turned around and said, "no, no, no, they don't want any of that!". They weren't doing that though. Also, I think she was the first baby to stay with mommy in the surgery room and temporary recovery room for c-section mommies. She NEVER left my side.

Needless to say, I did not have a birth plan signed for my second son and it was a home birth turned emergency c-section. Let's just say it did not go well at all. Getting a signed birth plan is a great idea!

Hope this helps :shy

[frenchie]

With my first, I actually didn't bring the birth plan that my Dr. signed off on because he crossed a lot of things off and absolutely wouldn't compromise. When we presented an unmarked one to the nursing staff, they were very receptive. My L&D nurse was very supportive, and did all she could to make sure our wishes were carried out. She followed our lead. It really does depend on the nurses and I believe HOW you present your birth plan to them. Wording is key IMO.

[mary3mama]

With DS#2 my signed birth plan was sent to the hospital with my file at about 36 weeks along. My OB had agreed to everything I requested and we discussed, between the 2 of us, what types of things might require a change in plans. I felt good about the relationship I had with her.

Once we were at the hospital for delivery, the nurses read the plan, and several of them commented on how impressed they were at the research and forethought I'd put into it. And even then, it was clear that a birth plan, signed or not, would not change hospital protocol.

The best nurses would tell me what the protocol was and let me know that it ran contrary to my birth plan. In each case, they told me that protocol took precedent, but they told me in ways that made it clear that all I had to do was refuse.

These great nurses were so happy when my OB actually got there, because then they could ask her what to do when protocol disagreed with birth plan and she'd give an order to follow my birth plan.

So, yes, I'm glad they had my birth plan, and maybe it made a little difference that it was signed. But really, other than making them aware of my preferences and allowing them to better assist me, it didn't hold any weight. It was only upon the arrival of my OB that they could disregard hospital protocol.

[pageta]

It all depends on your hospital.

I have a signed newborn care plan. I intend to use it as a deflector so I have less hassle after the delivery. We've discussed the issues with our ped and he told me we would just need to decline the procedure and they would call him since it was against their protocol and he would give appropriate orders. I don't see the care plan as doctor's orders - I simply see it as a list of things they can see that we have discussed with our ped and intend to refuse and they can make the necessary phone call to get the orders they need without coming down and trying to run the test and our having to tell them to no, go call the doctor.

Ultimately, protocol and doctors orders need to be followed. A birth plan is just an outline of what you intend to decline or request that you know goes against protocol. They will still need to call your doctor and get "orders" to do something other than their protocol, but the birth plan can stand between you and them so that they can get the replacement "orders" without having to pester you.

The difference between having it signed and not having it signed simply indicates to the staff that you have discussed it with your doctor so they should expect the answer from your doctor to match the care plan. Otherwise they may try to convince you that your doctor won't agree to a certain item and you'll have to argue with them in order to get them to call your doctor and ask.

So does a care plan help? Yes. Does it replace doctors orders? No. It's power is limited to shortening the hassle of declining routine procedures. It gives the nurses an idea of what you plan to refuse so they can just call the doctor and get the orders they need and save themselves the trouble of walking down to your room and arguing with you...if they're smart.