Can anyone critique my birth plan? - Mothering Forums
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#1 of 8 Old 07-19-2012, 06:58 PM - Thread Starter
 
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I finished the birth plan for my hospital birth and was hoping to get some feedback. If anyone is willing I would really appreciate it. TIA

 

 

Birth Preferences for Male-Female Dizygotic Twins

 

The information that follows is a copy of my birth preferences.  I prefer as little intervention as possible if labor is progressing normally. My husband, Cliff, and I have given careful consideration, based on my previous birth experiences and personal research, to each specific request and understand these choices presume a normal twin birth. We wish to have clear explanations (risks and benefits) of all procedures, of the progress of labor as it is assessed, and of any possible special circumstances if they occur.  In the absence of special circumstances, we ask that the following requests be honored.

 

XXX is my birth attendant and I request her presence, along with my husband Cliff, with me and/or a separated baby at all times during labor, delivery and post-partum care.

 

Labor

 

·        I would like to have as natural experience as possible including freedom of movement, intermittent fetal heart rate monitoring and minimal vaginal exams.

·        I understand that my GBS+ status means I must receive IV antibiotics. I request that antibiotics be administered as quickly as possible after admission and the IV line to be switched to a Hep-Lock after administration.

·        I understand that pain medications are available to me. My goal is to deliver vaginally without the use of any medications; to that end please do not offer any pain medications.

 

Delivery

 

·        I prefer to push and deliver in whatever position feels best at the time.

·        It's important to me to push instinctively. I do not want to be told how or when to push.

·         I prefer to have no episiotomy and risk tearing.

·        I would like to hold Baby A skin-to-skin until labor begins for Baby B. When labor begins for Baby B, my husband Cliff would like to hold Baby A skin-to-skin.

·        Please wait for the umbilical cord to stop pulsating before it is clamped.

 

Newborn Procedures

 

·        I decline the following routine procedures for both babies: Erythromycin eye drops, all immunizations, including Hepatitis B, and Vitamin K. I am willing to sign a formal waiver if need be.

·        I decline newborns baths. I will bathe the babies at a later time. I understand that hospital staff may need to wear gloves when handling the babies until they are bathed.

·        I decline circumcision for my son.  

·        If either of my babies must be taken from me to receive medical treatment, my husband or XXX will accompany the baby at all times.

·        I expect to breastfeed any stable, healthy baby as soon as s/he exhibits feeding cues.

·        If any or all babies require NICU care, I would like to initiate breastmilk expression (pumping) within 1 to 3 hours of birth.

 

NICU

 

·        No matter what situation arises during any baby’s NICU stay, we expect to be part of any discussion of, and to give permission for, any medical intervention being considered for our babies.

·        Breastfeeding/lactation: My goal is to exclusively breastfeed both babies and we want our babies to receive as much of my colostrum and milk as possible. We request the assistance of the NICU staff and lactation consultant in facilitating this goal.

·        I would like help to initiate breastfeeding as soon as any baby shows signs of interest or begins to coordinate sucking and swallowing.

·        If I do not obtain enough colostrum/expressed milk for both babies initially, we want to explore other options before offering formula.

·        Please do not offer formula or pacifiers.

·        Kangaroo Care: We would like to initiate skin-to-skin care as soon as possible. If I am not able to provide kangaroo care, Cliff or another person we designate will do so.

·        Co-bedding: If both of our babies require NICU care, we would like them to be co-bedded in a single crib as soon as medically stable.

·        If co-bedding is not yet possible, we would like our babies’ cribs/isolettes to be placed side-by-side. 


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#2 of 8 Old 07-20-2012, 02:39 PM
 
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Looks like a great plan.  Just hope you can have it respected!

 

Best wishes!


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#3 of 8 Old 07-21-2012, 12:41 PM - Thread Starter
 
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Thanks Gena! I have had discussions already about most of the things on the birth plan and the hospital is designated "baby friendly" so I am not too worried about the kangaroo care or breastfeeding. I'm not sure what the response will be to the intermittent monitoring and the moving during labor and delivery. I am taking it to my appointment on Friday, so we'll see what happens.


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#4 of 8 Old 07-23-2012, 09:31 AM
 
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Stick to it!  Glad to hear you've got supportive help and a baby-friendly hospital.  And you'll have a lot more leeway than some MoMs who (like me) were first timers.  You know your body and with luck things should go quickly and smoothly. 

 

I've got nothing to compare our birth with, but it didn't seem much more complicated than a singleton would have been.  Moving during labor and birthing upright made all the difference to me.

 

The only twin-related trickiness for us was positioning.  My girls were both head down, but the chin of one girl blocked the shoulder of the one trying to descend.  Like they were hugging upside-down.  We solved things by having an assistant gently hold Baby B up through my belly.  Seemed to work.

 

Oh yeah, one thing you might give some thought to is the interval between births.  If it becomes an issue, might be good to know ahead of time whether you'll be pressured to deliver Baby B in a certain amount of time, and what your personal preferences are.  Most hospitals have a few minutes between twin births, but many twin labors are medicated and augmented.  There were various things going on with us, but FWIW, there was just over an hour between my girls.  Baby B monitored the whole time and very happy.  We choose to AROM to get things moving.  Something to mull over!


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#5 of 8 Old 07-23-2012, 02:34 PM
 
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I think it looks great - nice, polite, and concise. I'm going to 'borrow' some of this if you don't mind :D

 

The only thing I noticed was that I didn't read anything about delivering in a labor suite, versus in an OR. I've heard at some hospitals that is the preference. Maybe it's not a contention point for you. I think I'll call it out... 

 

I was also planning on including something about delivering Baby B breech if necessary (both are currently vertex, but in the case that Baby B's position is changed while delivering A?) Maybe that isn't very common, and not worth mentioning. 

 

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#6 of 8 Old 07-23-2012, 04:43 PM
 
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Thanks so much for posting this. I was really wondering how I was going to address some of these things. You've done it so eloquently and with the understanding that you are aware that everything could change at a moments notice. It's obvious that you know that some medical interventions may be necessary, but you want to be included in decision making- that comes across nicely.

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#7 of 8 Old 07-23-2012, 05:03 PM - Thread Starter
 
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Quote:
Originally Posted by Gena 22 

 

Oh yeah, one thing you might give some thought to is the interval between births.  If it becomes an issue, might be good to know ahead of time whether you'll be pressured to deliver Baby B in a certain amount of time, and what your personal preferences are.  Most hospitals have a few minutes between twin births, but many twin labors are medicated and augmented.  There were various things going on with us, but FWIW, there was just over an hour between my girls.  Baby B monitored the whole time and very happy.  We choose to AROM to get things moving.  Something to mull over!

 

Oooh, good point. I had not thought of that. I will bring it up on Friday and see what they say. I think I would be comfortable with AROM if Baby B is hanging around too long, but other than that probably not.

 

Quote:
Originally Posted by ~Caitlyn~ View Post

I think it looks great - nice, polite, and concise. I'm going to 'borrow' some of this if you don't mind :D

 

The only thing I noticed was that I didn't read anything about delivering in a labor suite, versus in an OR. I've heard at some hospitals that is the preference. Maybe it's not a contention point for you. I think I'll call it out... 

 

I was also planning on including something about delivering Baby B breech if necessary (both are currently vertex, but in the case that Baby B's position is changed while delivering A?) Maybe that isn't very common, and not worth mentioning. 

 

thumb.gif

 

I'm glad you think it is nice and polite. Our goal is to go in and develop a rapport with the nurse right away, we don't want to seem arrogant or confrontational. Thankfully DH and my birth attendant are really good at that. 

 

As far as the OR, that is their hospital policy and we have made the choice not to fight it. I know that many others have though and have been successful. If you want to deliver in a L&D room, fight for it!!

 

I've had discussions with my Drs and some nurses about positioning and they have assured me, without hesitation, that as long as Baby A is head down, they will turn Baby B head down if s/he is breech so I can deliver vaginally. If Baby B is vertex, they said it depends on positioning and how other things are going. 

 

Please take whatever will work for you. I scavenged lots of things from other sources. No sense in reinventing everything. Here are some of the sources I used: 

 

 

http://www.earthmamaangelbaby.com/free-birth-plan

 

http://www.karengromada.com/wp-content/uploads/2011/02/Multiple-Birth_Plan_Rev_01.11.pdf

 

http://www.spiritualbirth.net/birth-plan-for-twins

 

http://seaurchinsadventurescontinued.blogspot.com/2011/02/writing-my-birth-plan_06.html


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#8 of 8 Old 07-23-2012, 05:05 PM - Thread Starter
 
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Quote:
Originally Posted by Adaline'sMama View Post

Thanks so much for posting this. I was really wondering how I was going to address some of these things. You've done it so eloquently and with the understanding that you are aware that everything could change at a moments notice. It's obvious that you know that some medical interventions may be necessary, but you want to be included in decision making- that comes across nicely.

 

Thanks!  orngbiggrin.gif


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 You can't get a cup of tea big enough or a book long enough to suit me. ~CS Lewis

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