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Can you read my birth plan and give me your opinions??

2K views 38 replies 18 participants last post by  Peppamint 
#1 ·
I know that I am missing things but my mind isn't working quite right these days! I am switching care providers and there are 4 women in this practice. I should have time to cycle through all of them and go over my birth plan with them each personally. (Which makes me happy.) I want them to be aware of what I want and expect (I'm told this is the type of practice that wants to know so they can give their moms the birth experience they desire).

So, here it is.....

General
*I will have a doula present, Jenni Rector
*If interventions are medically necessary they must be fully explained to husband, doula, and myself before anything is to be done.
*I insist that the word PAIN not be used in my presence. I have spent many months erasing this term from my vocabulary and would rather not have it introduced so close to the finish line.

Labor
I refuse Continuous Fetal Monitoring (I will discuss intermittent monitoring)
I refuse an Epidural
I will not have my water broken as "routine procedure". It may be discussed.
I prefer not to have an IV for a "just in case" scenerio. If an IV is needed I prefer a heparin or saline lock.
I refuse Pitocin.
I request no meds unless they are explained to my spouse and myself.
I request being mobile during my labor and to have access to food and drink.
I refuse an episiotomy
Do not clamp and cut cord until after it has stopped pulsing.

After Birth
We refuse the infant bath-baby can be wiped off; a "bath" can happen later
We refuse routine eye ointment
We refuse the routine Vitamin K shot
We refuse the Hep B vaccine
We will be exclusively breastfeeding. Please do not offer baby a pacifier or bottle.
All routine procedures can wait until we have had to bond as a family.
Do not take baby to nursery for warming. I can do this.
If in the event that the baby is in need of immediate attention my husband WILL accompany the baby.
We will be rooming in.

In case of Caesarian Birth

I prefer epidural or walking epidural NO spinal.
Benjamin will be present while epidural is given.
I would like to have a mirror in order to watch our baby being born if I choose to.
Do not strap down my arms
Unless there is a medical reason that this cannot happen I want the baby in my arms as I am wheeled to recovery
Baby will be given to Benjamin after birth to hold
I will breastfeed in recovery
No sedatives are to be given before or after surgery
I request NON- drowsy benadryl if I have problems with itching
I would like to discuss pain control with the anesthesiologist before getting a lot of things pumped into me.
I request NO drugs be administered unless they are discussed
I would like the c/b explained as it proceeds
 
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#2 ·
I would probably state things with "I prefer not to have" or "I want to avoid" rather than putting them on the defensive to start with.

Good luck with the PAIN word omission request. I'm not sure how that will work in the long run. How are you feeling about that word? Do you not expect any pain in your birth? What about nurses talking about pain relief or asking you about your pain levels? Does this include a cesarean birth?

You might want to find out about the monitoring. I know very few hospital staff are trained properly in intermittent monitoring with a doppler. You might want to find out what their bare minimum is for monitoring, then work around it. Also, being able to be monitored on the birth ball or rocking chair (rather than lying in bed) could be mentioned. I wouldn't trust most hospital staff to accurately monitor my baby with a handheld doppler (most just listen between contractions and stare at the digital readout). Also, being a VBAC, there might be a stronger policy in force. It would be good to know what it is.

You might want to say that you do not want medications or epidurals offered - that you know they are available and will ask for one if necessary. I know of few places that will give you an epidural without your request.


You can also say, "I would like my water bag to break on its own during the course of labor, rather than be artifically ruptured"

Also, if you're planning on circing your baby (and this, personally breaks my heart, but I'm sure you've seen the Circ forum here), you should rethink the Vitamin K injection. Unless you're planning on doing the surgery after the 8th day.

Just my immediate thoughts.
 
#3 ·
Quote:
Originally posted by pamamidwife

Also, if you're planning on circing your baby (and this, personally breaks my heart, but I'm sure you've seen the Circ forum here), you should rethink the Vitamin K injection. Unless you're planning on doing the surgery after the 8th day.

I agree, and I hope you will take a look at the circ board here before you do it.
It's unnecessary, painful, and damaging. At least watch a video first.

Other than that your plan sounds OK. I might change some of the "I refuse" to I do not wish or something less harsh. Also, your objection to the word pain concerns me. I think you need to be realistic. They often ask how your pains are so they know how labor is progressing or so they know how to help it. Just something to think about.

Good luck with your birth!
 
#4 ·
I would make some definite changes before giving that to any doc or hospital staff. Though I know your intentions are good, I have some things to add.

You are setting yourself up if you say We refuse. You need to reword it and gear it towards being a client looking for a specific outcome, rather than a bitch on wheels. LOL

Also since you are VBACing in a hospital let me STRONGLY suggest you get a heplock. If something goes wrong, the last thing you want in an emergency is trying to fool with stabbing you arm up and knocking you out.

I would have your monitoring word specific. My original birth plan had interment fetal monitoring every 20 minutes AFTER rupture of membranes.

About pain meds and epidural -- I agree with pam, reword that and say you know they are available. You dont know what things may be like -- I am in no way saying set yourself up to fail, but leave an avenue there for you to request anything you want and discuss things.

PLEASE give you baby the Vitamin K shot if you are going to circumsize him. I wish you would reconsider this proceedure because it is not necessary. I know you have another child but its not uncommon these days to have one and not the other intact. If this is a religious decision, at least consider waiting the full 8 days and have your baby get pain relief.
 
#5 ·
You may not want to put about circumsizing on your birth plan. When I was in prenatal class, we were told not to mention it to the nurses because they are very against it, and to bring it up with your dr after leaving the hospital. It really isn't medically necessary, but I understand you will make your own choices. I think the above posters make some really good points too.

Good luck with your birth
 
#6 ·
chiming in as a doula here! Good for you for knowing what you want.

When I am discussing birth planning with a client, if she shows as many preferences as you have here, I would first ask " have you considered homebirth or birth in a birthing center where these things are generally the rule?" or " is your practitoner known for gentle natural birthing?"

When I first started being a doula and cbe 7 years ago, I was all for the big birth plan, but honestly just cry every time I am at a birth and watch them all fall apart because the staff adopts the "we'll show her" mentality.

So, in all, I am anti-birth plan. I think that you have to birth where you feel safest, but that also means accepting your choice and all that comes with it ( like you don't ask for an epidural at home, or a natural experience in an unnatural hospital) I usually tell mothers to save their fighting for after the birth to protect the baby - or- who wants to fight this much during a birth? That is way too much negative energy.

Sorry to sound unsupportive, but unless the hospital you are going to is extraordinarily adept at gentle birth and tolerant of natural birthing, I see that your plan may just make enemies and leave you with a very hostile experience. Not that what you are asking for is wrong- it is not! But you may be asking somethings of the staff that they DON"T know how to do. SUch as - nurses HAVE to keep a pain scale and rate you on it. Yes they can say discomfort, or intensity, but nurses are 1 trick ponies and birth to them is all about the pain ( speaking very generally here!)

I would also suggest that you ditch the written plan, and discuss it with your partner and doula and ask for these things as they arrise.

Also, routine Vit K- yes avoid. But it would be medically neccesary for a circumsicion.
 
#7 ·
I agree with the above posters...I would change your wording to "I would prefer" and "I would prefer to avoid" instead of "I want" and "I refuse". It is important to make your birth plan worded in a way that you are working WITH your care providers and not just dictating to them how to do their job (I'm not saying that is what you're doing of course...just saying that's the way some care providers may perceive it). Also remember to keep your options open and mention something like "if an emergency or circumstances should arise where my plan can not be followed without endangering mine or my child's life, I would prefer all options be discussed if the time allows". Good luck!
 
#8 ·
I made changes....

"I refuse"--that is an interesting point. It was about 8 months ago there was a birth plan discussion and it was suggested to NOT use terms like...I prefer or want and to use the term "refuse" Oh, and there are some things I down right refuse..I refuse pitocin. It got me to the OR in the first place and is a dangerous thing on a scarred uterus. I refuse the Hep B. An idea...maybe I should use the "I REFUSE" for the things we actually refuse in any scenario.

As for the word pain omission. Yes, I am realistic. Yes, it does work. In my labor with Tracy not one ob or nurse used the word pain. I know it hurts I don't need them reminding me. I don't like the whole pain scale thing. I've been learning to think of it as stretching not pain. It worked with him and I'm thinking it'll work this time.

As for being anti-birth plan. I was with an ob practice that they ob that delivered ds was know as a natural guy. But he just let me think he was. Once we got into the hospital he ignored everythign I said to him.

I'm currently in a birthing center and I hate it. Why? Because the mw that run it are more medically minded than they want you to realize. They can't give straight answers about anything and pretty much ignore everything I've asked them. So, I'm leaving and going to a hospital where I know several ppl who have delivered there and after talking to an ob in that office I think this is a better place. I will not birth at home my first vbac. If ds had been a vag delivery I would.
 
#9 ·
Quote:
Originally posted by its_our_family

I'm currently in a birthing center and I hate it. Why? Because the mw that run it are more medically minded than they want you to realize. They can't give straight answers about anything and pretty much ignore everything I've asked them.
I know what you mean there. With my last I started out at a birth center and they were similar and had a lot of rules I knew I'd never pass - couldn't go past a certain date, meconium, etc. I fired them and went with a midwife practice that delivered in a hospital instead. That was much better than the birth center would have been because I would have ended up in the hospital there with an OB I'd never met.

You didn't say anything about circumcision in your last post so I'm assuming you want to avoid any debate so I'm just going to post some links and ask, no, beg
, you to look at them before you have it done.

Procedure,
http://www.circumcisionquotes.com/methods.html
http://www.intact.ca/video.html

General info,
http://www.mothering.com/10-0-0/html...cision85.shtml
http://www.circumcision.org/info.htm
http://www.noharmm.org/separated.htm
http://www.mensjournal.com/healthFit...cumcision.html
http://www.udonet.com/circumcision/ilearned.html

MGM vs FGM,
http://www.fgmnetwork.org/intro/mgmfgm.html
http://www.noharmm.org/comparison.htm
http://www.circumstitions.com/FGMvsMGM.html
http://www.circumstitions.com/Develop.html

Rates,
http://www.cirp.org/library/statistics/bollinger2001/
http://www.courtchallenge.com/refs/rate1m.html
http://www.icgi.org/Downloads/normal...ircumcised.htm

Medical communities,
http://www.nocircnc/medicalstatements.htm
http://www.circumcision.org/studies.htm
http://www.intact.ca/saskmemo.html
http://www.icigi.org/Downloads/FullDisclosure.pdf

Risks and Complications,
http://www.circumcisionquotes.com/complications.html
http://www.nocirc.org/consent/form.html
http://www.infocirc.org/uti2.htm

Breastfeeding,
http://www.nocirc.org/statements/bre...ement2002.html

Cancer,
http://www.cirp.org/library/statemen...s/1996-02_ACS/

Personal experiences,
http://circumcisionquotes.com/menumen.html
http://www.circumcision.org/mothers.htm

Intact vs Circed penis care,
http://www.nocirc.org/publish/4pam.pdf
http://www.nocirc.org/publish/5pam.pdf
http://www.tornwing.com/peacefulbegi...ysgenitals.htm

Hygiene & problems
http://www.cirp.org/library/complications/vanhowe/

News articles,
http://www.cirp.org/news/

Pain,
http://www.circumcison.org/response.htm
http://www.infocirc.org/babypain.htm

Sexual side effects,
http://www.boystoo.com/medical/conversion.htm
http://www.reserach/cirp.org/
http://www.noem.org/lost.html
http://www.norm.org/lost.html

The Royal Australasian College of Physicians 2002 Position Statement. Routine Circumcision of Normal Male Infants and Boys - Summary Statement.
http://199.88.87.143/position/racp2002.htm

The American Academy of Family Physicians 2002 Statement. Position Statement on Neonatal Circumcision.
http://www.nocirc.org/position/aafp2002.html

The American Academy of Pediatrics states: "Existing scientific evidence demonstrates potential medical benefits of newborn circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."
http://www.nocirc.org/position/aap1999.htm

The American Cancer Society, states in a letter to the AAP: "We would like to discourage the American Academy of Pediatrics from promoting routine circumcision as a preventive measure for penile or cervical cancer... Perpetuating the mistaken belief that circumcision prevents cancer is inappropriate."
http://www.nocirc.org/position/acs.html

The American Medical Association:
http://www.nocirc.org/position/ama2000.html

The Australasian Association of Paediatric Surgeons states, "It is considered to be inappropriate and unnecessary as a routine to remove the prepuce, based on the current evidence available."
http://www.nocirc.org/position/aaps.html

The Australian College of Paediatrics, citing the Australasian Association of Paediatric Surgeons, states: "Routine male circumcision should not be performed prior to 6 months of age." In addition, it considers that, "neonatal male circumcision has no medical indication. It is a traumatic procedure, performed without anaesthesia to remove a normal functional and protective prepuce."
http://www.nocirc.org/position/acp.html

The British Medical Association Guidelines advise "The BMA opposes unnecessarily invasive procedures being used where alternative, less invasive techniques, are equally efficient and available."
http://www.nocirc.org/position/bma.html

The Canadian Paediatric Society recommends: "Circumcision of newborns should not be routinely performed."
http://www.nocirc.org/position/cps.html

For more go to: http://www.cirp.org/library/statements/
 
#11 ·
Quote:
Originally posted by pamamidwife
I would probably state things with "I prefer not to have" or "I want to avoid" rather than putting them on the defensive to start with.
I agree with this. No reason to start on a defense mode.

KEEP IT POSITIVE; you want positive -- give positive; set your own tone. you want the birth positive; make everything positive-- includeing the birth plan.

Aother thing...."refuse"??; wellllllllllllllllllllllllll you might HAVE to have some stuff..................
 
#13 ·
I would definitely add two more things to after care:

No PKU - in the hospital. It should be done at 1 week of age. The infant must have consumed three or four days of breast-milk or formula before PHENYLALININE shows up. The optimal time for testing appears to be five or six days after birth. Brain damage can occur as early as ten to fourteen days after birth. But there is a window of a week or two for the PKU test. It will be more precise if done at 1 week of age. And it is not necessary or beneficial to have a child's heel pricked twice for the same test.

No Circumcision - on either male or female baby. Either way, it is strictly cosmetic surgery, very painful, and takes away part of a sexual organs that rightfully belong to the child and no one else. It removes a normal, functioning body part, and leaves a scar. 85% and 95% of all men and women respectively in the world are not circumcised. No World Health Organization recommends it, most speak out against it, and many Governments have outlawed it.
It is time we abandon this antiquated practice.

No Vitamin K instead you could take alfalfa tablets before breast-feeding for a few days. Alfalfa is high in Vita K.

Good Luck!
 
#14 ·
Excellent Birth Plan!

Alfalfa IS a great source of Vitamin K and also quite safe to take whilst pregnant. My midwife recommended it for my night time reflux as well. I coulda kissed her! It worked!

The following well-written article from Mothering addresses some common concerns about circ that may be of interest. It is fully-referenced by medical professionals.
http://www.mothering.com/10-0-0/html...cision85.shtml

You may also want to research which methods the doctor will let you choose from. I think the plastibell sounds like one with too many chances of complications.

Remember - It can be done past the neonatal stage as anesthetic has been shown on occasion, to interfere with the Babe's suckling reflex.

HopeThisHelps.

And Congratulations!
 
#15 ·
No PKU - in the hospital. It should be done at 1 week of age. The infant must have consumed three or four days of breast-milk or formula before PHENYLALININE shows up. The optimal time for testing appears to be five or six days after birth. Brain damage can occur as early as ten to fourteen days after birth. But there is a window of a week or two for the PKU test. It will be more precise if done at 1 week of age. And it is not necessary or beneficial to have a child's heel pricked twice for the same test.

This is old and outdated info. Ten years ago this was correct, but now newborn screening tests are designed to be done during a certain time frame, usually 24- 36 hours. There are diseases that are tested for that dietary chages could prevent damage that could occur even in a weeks time.

For the OP if you feel you need to instruct your careprovider on how women give birth best and not to use medicine, etc you are with the WRONG careproviders. Maybe the BC was also a bad choice, but keep searching for other options. All the things you don't want are simply how Drs practice, you learned this from your first Dr. They have this style of practice ingrained in them, they haven't changed for any of the other women who have come before you and they are not going to change for you. SOme Drs do practice more like a midwife, perhaps your Dr is one of these, but I doubt the entire practice is. You are searching for the Midwifery model; in a hospital setting and it is doubtful you will find it. Have you interviewed HB midwives, reasearched VBAC at home. I have helped at 6 VBACs ALL at home. Most midwives truly provide CARE watch and listen to you and your bodies signals, I strongly believe that the safest VBAC's are unintervened with (no pit, no drugs, etc) and just about the only way to get that is at home.
 
#16 ·
Yeah, Jen is right. In my state of Oregon, if a couple wants only one newborn screening test, rather than the usual two, we are advised to do it at 3 days. Evidently, with the 3 day only test, there might be a slight chance of missing some hyperthyroid issues. But, if a baby had PKU, it should come up.

We are also told that it's a misnomer that the testing has anything to do with what the baby eats or how long. It's more about the extrauterine metabolic process that occurs right after birth - and some of the disorders are present before birth, but only exacerbated after birth.

Hope this makes sense. There is a great website called http://www.newbornscreening.com that offers state by state help and information. Each state tests for different things. In Oregon, I believe we get tests from Hawaii, Montanta, Oregon, Idaho and .... I think Washington. Not sure.
 
#17 ·
We cannot afford homebirth and I'm on medicaid so everything is covered. I'm just trying to work with what I have. Plus, i'm not comfortable with my first vbac being at home. If I had had a vag delivery with ds and we were in a different financial situation I would but I'm not so I can't....

After talking to the obs these are all doable things. One ob I do not like from a vbac OR a non-vbac stand point. You can tell by talking to her she doesn't think the female body can do it. She basically told me that vbac was something she was "allowing" me to do and I should be greatful for that...blah blah blah....

Now my new issue is finding a doula this late. My doula broke her foot and I had to move to her backup. Well, her back up called and her dh is returning from Iraq Jan 15 and they will be gone till february. So, now I have to find a new one....
 
#18 ·
I'm going to be a minority voice here and fully support your use of the term "I refuse." In my opinion, hospital staff look at the words "I prefer" or "I would like" or "I want" or "I wish" and they think "gee that's nice" and then ignore it. If you refuse a procedure, and they disobey you, you have legal recourse. You should not have to beg for what you want. They work for you. It is your body and your rights.

I also support your request that they avoid the word "pain." That seems perfectly reasonable to me.

I'm sure you know that I do agree with the other posters about circ. Have you read the Fleiss articles? Not trying to start a debate, just wondering if you've read them or not.

Wow, I've never before heard a doula oppose the very idea of having a birth plan!

Overall, a very good birth plan. Here's mine, if you're interested:

http://devrock.5u.com/whats_new.html
 
#19 ·
My ds is circ'd (no debate please. I spent enough time sobbing about it as it is) and we did not do the vit k shot as our ped said he didn't need it. It was healed in three days and I actually thought something was wrong because the dr. office had never heard of one healing that fast. Be sure to insist on pain relief as it varies from ped. to ped. My dh had to watch and make sure everything was taken care of properly since he insisted on circ.


Otherwise, I think your birth plan sounds good. I hope you can find a doula quickly... I would never want to give birth in a hospital without a doula again (and hospital is last option for me now).
Remember, if the nurse pressures you etc... you CAN (and should IMO) request a new nurse!
 
#20 ·
My ds healed really fast too. in fact I don't even remember it being un-healed. I'm still not sure what we're doing about the vit K...is there some way that if we do get it to work it through his system faster? Massage?
 
#21 ·
IOF- haven't read the whole thing on your circ. decisions here, but was thinking that if you choose to have him circ'ed, and don't want the vitamin K shot, can you wait until he is over 8 days old? I know there is something about the fact that Jews do it on the 8th day, and that relating to clotting mechanisms.
 
#22 ·
Quote:
Originally posted by jess7396
IOF- haven't read the whole thing on your circ. decisions here, but was thinking that if you choose to have him circ'ed, and don't want the vitamin K shot, can you wait until he is over 8 days old? I know there is something about the fact that Jews do it on the 8th day, and that relating to clotting mechanisms.
I asked our ped. about it and he didn't want to wait, he said the clotting would be just fine early on.
It may vary from dr. to dr. or something because I had always heard 8 days and that was what my midwife suggested. Ds never really bled, there was a few drops of blood. The circ isn't much; as in not much skin was removed apparently because sometimes you can't even tell he's circ'd. Unlike my dh who had two circs because they didn't do the first one right and he doesn't have a bit of foreskin that I can see.

PS- I think ds was five days old though. He was born on Thursday and no way we were going to the ped office the next day
: so dh made the appt on Monday for the next day.
 
#24 ·
It must be a regional thing
The pediatricians around here want you to wait until around 2 weeks. At first I thought they were hoping that parents would not want to deal with it then- but then I thought if they didn't want to do it, they would just refuse, so I don't know- I have to assume it's about the clotting issues.

FTR- as you know I am having a c-birth and I am opting for the vitamin K just based on that part of it, they knicked my dd when they delivered her
 
#25 ·
y chiro had homebirths and he said that when his kids were born they were told the vit K ad something to do with transmission of syphillis....or seomthing like that. They didn't have it but he called a dr friend of his and said if we ant a circ in the hosital we need to have the vit k.

I have the same fear if I have a repeat...don't want baby knicked!! (A gal here had her bladder cut in half...literally! Through BOTH walls!!)
 
#26 ·
Quote:
Originally posted by its_our_family
We thought of finding a Moil (sp??) to do it
This might be a better option. I've heard they're a little more humane about it.
 
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