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#1 of 19 Old 07-31-2011, 08:50 AM - Thread Starter
 
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Anyone start writing a birth plan?  I had one with my first, since he was born in a hospital.  Not that the nurses listened anyway.... But this time my "birth plan" is more of a manifesto for my out-of-hospital birth.  I found it was therapeutic to first write down my birth story from DS and then write down a few things I want different for this time as well as some plans in case of transfer or emergency c-section.  I have a different care provider (we moved from Ohio) so I think it's good for her to be able to read my thoughts in light of my last birth experience.

I thought it would be fun to share, and maybe toss around a few ideas.  Since this is my first out-of-hospital birth (freestanding birth center) we don't really know what to put on our list (I don't really like calling it a plan, you know, since the best laid plans....)

 

Be sure to put where you are birthing (hospital, home, unassisted) and who your care provider is (midwife, ob, etc)

 

Can't wait to see what everyone is thinking!

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#2 of 19 Old 07-31-2011, 09:43 AM
 
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While I'm not going to write a birth plan, I do plan on doing things a bit differently this time.

 

With my first birth, I was young and didn't care who was around.  I lived with my mother and siblings at the time and they were all present at the birth.  There ended up being my mom, sister, brother, 2 midwives and a doula in training.  We ended up needing every one of those people to help me during the 3 hours of pushing at the end of labor.

 

With my second birth I felt like I needed a lot of people to be present and help me (because of my first experience).  I ended up having my best friend, her toddler, my mother, my DS, my DH, 2 midwives and an apprentice at this birth.  IT WAS WAY TOO MANY PEOPLE!  Everything went very smoothly and I didn't require any help at all really.  I simply ended up with a lot of people standing around staring at me.

 

My plans for this birth are to have my DH and my midwives present, that's it!  My MIL (who is great) will be staying with us around that time to help with my other kids.  She's probably going to take them to a hotel for the night, but we're going to play that by ear.  I now know that my body can deliver a baby without any intervention and I've decided that this is going to be a private time between my DH and I.  I will welcome visitors the next day I'm sure, I really love to show my babies off asap!  :)


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#3 of 19 Old 07-31-2011, 12:24 PM
 
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I'm not writing a birth plan. I wrote one three pages long with my daughter, and I think it set me up for a lot of disappointment come birth time. Some things can be planned, birth just isn't one of them. 

 

That being said, as a doula, I have my clients write out their "preferences" and I have them keep it to 3-5 main points, and most importantly, to discuss your wishes and preferences with your OB or MW. Find out what their standing orders are, and what the hospital policies are. Many birth plans are incredibly redundant in that nobody does routine shaves and enemas for vaginal births any more, etc

 

Personally, I've just discussed what my ideal birth looks like to my midwife and she's agreed to do what she can (within reason) to help me achieve it. 

I'm trying for a home birth after cesarean. My MW is on board, and has discussed her success rates with me(95+%). I have asked for VEs to be kept to a minimum. As we are having a home birth. I don't need to discuss IVs or nurses/residents. I'l call her when I feel I need her, she'll make sure we're all doing fine and let us do our own thing. She's totally okay with being hands-off in the even t that everyone is doing fine, and she's been practicing for 25+ years, and is the most experienced midwife in the city and I trust her judgement. If she thinks that she needs to step in, then so be it. I won't risk a rupture or a sick baby over an "ideal" birth. 


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#4 of 19 Old 07-31-2011, 02:08 PM
 
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I'll probably have a "birth plan" written out. Some things I know I'll want to include...

 

I'll start making cookie dough in early labor (if possible) and someone.. dont care who, dh, doula, apprentice.. someone finish the dough if either I can't start to begin with, or can't finish :P and stick them in the oven once baby is crowning. I expect warm homemade chocolate chip cookies when I'm done! 

 

Since we don't know the sex, I don't want anyone to announce it or say he/she until I've peeked for myself on my own time.

 

If for whatever reason I choose to push flat on my back again, I want to be helped/encouraged to change once the head is past the pubic bone. 

 

Those are just a few.. can't think of anything else for now. 


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#5 of 19 Old 07-31-2011, 05:53 PM - Thread Starter
 
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I hear you , MsVyky.  That's why this time it is more of a manifesto instead of a plan :)  There are a few things I want to remind our midwives of, though, like not announcing the name (they know it) and a few other things related to transfer and emergency c-section (double suturing, immediate skin time with husband while I am recovering, etc).  Hopefully the hospital/transfer suggestions will never be needed, but just in case I feel good knowing I am prepared in that event.  As for the "planned" birth, I think we are on the same page with our midwives re: procedures and such, and we still have time to discuss a lot of things we prefer as we get closer to the date.  

I like the fresh cookie idea, Lilstar!!  I'm sure you will have very vivid memories every time you eat chocolate chip cookies from then on :)

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#6 of 19 Old 08-01-2011, 05:37 AM
 
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I plan on writing out a plan if for no other reason than to get things straightened out in my head.  I'll use it as an exercise to think through how I'd like or expect things to go. 

 

I'm planning a homebirth and don't really see much need to have a birth plan to take with me to a hospital in case of transfer b/c if I transfer it will be an emergency situation...they'd be doing their own thing anyway. 

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#7 of 19 Old 08-01-2011, 08:14 AM
 
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I'm not writing one out. Seems a little redundant for a UC, lol! And if we transfer it'll be emergent and you can't plan for that, IMO. DH would just stay with baby to make sure our wishes for them are met.


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#8 of 19 Old 08-01-2011, 11:49 AM
 
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Quote:
Originally Posted by LiLStar View Post

 

I'll start making cookie dough in early labor (if possible) and someone.. dont care who, dh, doula, apprentice.. someone finish the dough if either I can't start to begin with, or can't finish :P and stick them in the oven once baby is crowning. I expect warm homemade chocolate chip cookies when I'm done! 

 

While I was in labor last time, my mom and DD made cupcakes. They finished the frosting after he was born and we knew the gender. Not only was it awesome to have fresh cupcakes after all that hard work, it kept my 2 yo nice and busy. I totally plan on doing the same again!


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#9 of 19 Old 08-01-2011, 12:42 PM - Thread Starter
 
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regarding emergency transfers- nobody has preferences especially for a c-section?  I mean, my husband and midwives will all be with me still, so I figured having a few key points that they know about (like I said, I'd want double suturing of incision, one hand free, and baby (if well) to be given to husband for immediate skin time while I recover) would be beneficial, so my birth team could facilitate those things if they know my wishes.  Something re: no formula maybe?  I might be a little too idealistic here but I think it makes me feel better to still 'be in control" if that situation occurs.  

 

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#10 of 19 Old 08-01-2011, 12:54 PM
 
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I am planning a home birth this time and probably not writing out a birth plan. My midwives are on the same wavelength as me and if there's anything specific I want/need, I'll let them know ahead of time or when it comes up. In over two years they've never had to transfer someone to the hospital during labor (they're not anti-hospital and have referred people during pregnancy or gone in after baby is born to get something checked out on mom or baby) so I'm counting on transfer being pretty unlikely and if it does happen, the midwives and my husband will be with me and things will be so up-in-the-air that I'm not sure a written plan would be much benefit.

 

I did write one for my first, a hospital birth, and it was helpful and I'm glad I did it. Helped me communicate with my doctor and the nurses.


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#11 of 19 Old 08-01-2011, 01:04 PM
 
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Even if I had an emergency transfer for a c-section, I would be seen by my family doctor (he does c-sections), and the hospital I'd be going to is great with not giving formula without express consent, etc. Plus, DH would be with the baby...there's no way he'd let them take the baby and stay with me. 


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#12 of 19 Old 08-01-2011, 01:09 PM
 
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JBK- when it comes to c-sections, many times the hospital policies will supersede your wishes. I ended up with a c-section and all of my requests in my birth plan regarding surgical birth were denied- my hands were restrained, the screen was not lowered and I was not able to have baby with me in recovery- she was admitted straight to NICU for unknown reasons .

 

As for suturing, recent studies show that the type of sutures used are more important than the type of closure being done, vicryl sutures being preferable over gut. Lower rates of rupture were found in women with vicryl sutures and a single layer closure than double layer with gut. (Anecdotally my closure is single lyered with vicryle, and I was "promised" VBAC by both the OB who did the surgery and my current midwife)


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#13 of 19 Old 08-01-2011, 01:57 PM
 
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Its a good idea to learn about the hospital policies ahead of time and transfer to one that has the least archaic policies if transferring is necessary. Hospital policies are "policies".. not laws.. sometimes making a big enough stink can get you your way. Luckily, the hospital nearest to me is a baby friendly one, so in an emergency thats where I'd go. No worries about routine separation or unwanted formula. I have family who is very much "go with the flow and do what the dr says" who have had c-sections there and baby never left their sight. These are people who definitely wouldn't ASK for that. Unfortunately this hospital has one of the highest c-section rates in the state, so if I were transferring for a non-emergency in which there was still hope for a vaginal birth, I'd be going elsewhere! 

 

Also, don't assume that if you transferred it would ONLY be for an emergency. My first birth we tried EEEEVERYTHING at home. I'd gone 2 full nights, 1 full day and most of another day (it was like 5-6pm) in active labor.. not to mention being awake all day before labor started at night! So before transferring it was all that horrendous back labor, no sleep, stubborn malposition that wasn't budging, almost a full 24 hours of being fully dilated, and purple pushing in half a dozen positions the entire afternoon as a last ditch effort. It was TIME for an epidural and a nap. And I think most sane people would have transferred for just that long before I did!! lol. No emergency.. dd was never in any distress.. but it was time to give up on the home birth :( I do have comfort knowing that I really did try everything  and had the best chance. And my amazing midwife, arriving when I'm around 8-9cm, probably thought she was going to sleep in her own bed that night, stayed with me well over 24 hours! Anyway, I have no idea whats just the norm/standing orders in that hospital and what is "policy" but I DO know that I rocked their routines, hard core :) They didn't do ANYTHING to that baby that I didn't explicitly consent to. She stayed in the OR while I was stitched, and she came to recovery with me and nursed. Oddly, one thing that I did not request that was offered to me in a "this is against policy, but we're letting you" way, was my mom coming into recovery with me. She had just flown across country when I told her I was in labor, changed her flight and everything, and walked into the hospital right as I was being wheeled into the OR. So I don't know if having the baby avoid the nursery was against POLICY or against "routines" and "preferences" , but mom in recovery with me WAS against policy.. and it still happened. This is far, FAR from some amazing lovely mom/baby friendly hospital. I might have just gotten lucky and dodged a bullet. But what was a really shitty situation was prevented from being shittier than it had to be..


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#14 of 19 Old 08-01-2011, 04:47 PM
 
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I have a midwife and a student will be present at the time of birth as well (they also attend the appointments).  I am a little apprehensive because you have no idea which midwife you will actually have attend your birth, nor which student.  Thankfully though, this time there are only 3 different midwives, versus when I was at the hospital with a CNM there were a half dozen or so!  It is a little unsettling to me to not know who will be attending!

 

My husband will be there, of course, and while my mom was at my first birth, I think I just want to have my husband this time.  My mom was perfect and just stayed in the background last time, but I guess I just don't feel the need this time.  My daughter will either go with her auntie or to spend the night at a friend's house--she decided she didn't want to be at the birth after all, which I am fine with.  Other than that, I don't really have a plan.  I'm almost positive we'll be going to the birth center, but my midwife assured me that it is completely fine if I decide I'd rather be at home in the midst of actual labor.  Because my daughter was born in under 9 hours, they are anticipating a quick birth so a birthing tub is unlikely to be an option, although there is a nice big bathtub at the birth center.

 

I guess I'll see how I feel closer to the time!

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#15 of 19 Old 08-02-2011, 01:16 PM - Thread Starter
 
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This is great to think about, Lilstar.  I certainly hope that we don't have to go to the hospital for ANY reason, but you bring up great points.  And I don't really know what hospital policies are here.. I'm almost afraid to check just because I don't want to jinx my birth :) But it would be good to know... I'm in Portland, OR so I'm sure they are pretty flexible and very mama/baby friendly. 

 

If you don't mind me asking, what position was he presenting in?  I just read lots of books about this, so I'm just curious :)
 

Quote:
Originally Posted by LiLStar View Post

Its a good idea to learn about the hospital policies ahead of time and transfer to one that has the least archaic policies if transferring is necessary. Hospital policies are "policies".. not laws.. sometimes making a big enough stink can get you your way. Luckily, the hospital nearest to me is a baby friendly one, so in an emergency thats where I'd go. No worries about routine separation or unwanted formula. I have family who is very much "go with the flow and do what the dr says" who have had c-sections there and baby never left their sight. These are people who definitely wouldn't ASK for that. Unfortunately this hospital has one of the highest c-section rates in the state, so if I were transferring for a non-emergency in which there was still hope for a vaginal birth, I'd be going elsewhere! 

 

Also, don't assume that if you transferred it would ONLY be for an emergency. My first birth we tried EEEEVERYTHING at home. I'd gone 2 full nights, 1 full day and most of another day (it was like 5-6pm) in active labor.. not to mention being awake all day before labor started at night! So before transferring it was all that horrendous back labor, no sleep, stubborn malposition that wasn't budging, almost a full 24 hours of being fully dilated, and purple pushing in half a dozen positions the entire afternoon as a last ditch effort. It was TIME for an epidural and a nap. And I think most sane people would have transferred for just that long before I did!! lol. No emergency.. dd was never in any distress.. but it was time to give up on the home birth :( I do have comfort knowing that I really did try everything  and had the best chance. And my amazing midwife, arriving when I'm around 8-9cm, probably thought she was going to sleep in her own bed that night, stayed with me well over 24 hours! Anyway, I have no idea whats just the norm/standing orders in that hospital and what is "policy" but I DO know that I rocked their routines, hard core :) They didn't do ANYTHING to that baby that I didn't explicitly consent to. She stayed in the OR while I was stitched, and she came to recovery with me and nursed. Oddly, one thing that I did not request that was offered to me in a "this is against policy, but we're letting you" way, was my mom coming into recovery with me. She had just flown across country when I told her I was in labor, changed her flight and everything, and walked into the hospital right as I was being wheeled into the OR. So I don't know if having the baby avoid the nursery was against POLICY or against "routines" and "preferences" , but mom in recovery with me WAS against policy.. and it still happened. This is far, FAR from some amazing lovely mom/baby friendly hospital. I might have just gotten lucky and dodged a bullet. But what was a really shitty situation was prevented from being shittier than it had to be..



 

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#16 of 19 Old 08-02-2011, 01:16 PM - Thread Starter
 
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I should say she, sorry!  I'm used to my boys!

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#17 of 19 Old 08-02-2011, 01:25 PM
 
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OP and asynclitic. Whats interesting is, I always heard that babies who favor LOA have an easier time getting into OA, and ROA babies have to turn OP before they get to OA.. (and then might get stuck there?) based on the direction they tend to rotate. I wonder if my babies like to rotate the opposite direction or something. dd favored LOA, and SHE was the one stuck OP! ds favored ROA, and it bugged me just a little.. I was more than a little paranoid about malposition again and not eager to face another back labor. I considered encouraging him to hang out more LOA, but then I was like, eff it, I had a baby who favored LOA and look how THAT turned out, might as well give ROA a shot! Sure nuff, that kid lined himself up perfectly for the exit :) I was very thrilled to palpate his back in the dead center of my abdomen.. NO limbs! 


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#18 of 19 Old 08-02-2011, 01:27 PM
 
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Oh, and portland is a nice place! thats where ds was born. Birth option wonderland! From what I hear, transfers are handled respectfully there as a general rule. Who's your MW out of curiosity?


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#19 of 19 Old 08-02-2011, 10:37 PM - Thread Starter
 
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Our MW is Stephanie S. at Alma midwifery :)

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