High Risk Birth Plans? - Mothering Forums

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Old 08-02-2008, 12:13 AM - Thread Starter
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Anyone have one of these I could glance at to have some help writing one myself? I'm 32 weeks and trying to get ready and I have NO CLUE how to do this!

I didn't have a birth plan with my first. I had her at home and figured we'd play it by ear. (Though in retrospect even then it would have been good to have fleshed out my preferences a little more, for my own sake if nothing else.) I was planning a home waterbirth this time, but then I found out I am Rh sensitized and will require extra monitoring to make sure the baby doesn't become anemic or ill. My comfort level is such that even if it remained technically ok to stay out of hospital, I prefer to have this baby in the hospital. Partially because I don't want a last minute or postpartum transfer (I had a postpartum transport last time and found it somewhat traumatic). Partially because I just feel like I will be too nervous to get comfortable at home knowing that there's this complicating factor. I just feel hospital is the right choice for me this time, just in case anyone was going to try to persuade me otherwise.

If my titers stay low, the plan is to birth with some very naturally-minded hospital CNMs. Several of them have homebirth private practices, so REALLY naturally minded! They even have waterbirth available through their practice, and if everything is fine, that's what I'll plan on doing. If the titers go up or something else comes up, they will consult with my perinatologist as well. Probability is, I'll be able to go to 40 weeks or whenever I go and have the waterbirth with the CNMs. There is a possiblity that an earlier induction may be medically necessary for the baby, OTOH, so I want to mentally prepare for either scenario.

The CNM I spoke to on the phone told me that as long as everyone is healthy and fine, they do intermittent monitoring with dopplers (yay!) other than a hospital-required "strip" on admission. IV only if it's indicated for some reason. There is the birth tub, and also stools and birth balls. They put the baby on mama's belly and start nursing as soon as the baby is interested. She had very positive things to say about the nursing staff and the peris I am working with. So, I don't anticipate this to be an adversarial situation in the slightest. I'm lucky to live where I do, honestly.

But...other than that...I do know I will do better if I flesh out some specifics of what I prefer in a hospital setting. I know I am fine with eye ointment and vitamin K but want to postpone the hepatitis B vax. I know I prefer to be able to move into crazy positions. Other than that, I'm at a loss. What do I need to put in there, but with a mind to the fact of the bottom line being that this *isn't* a 100% straightforward situation with no complications and that I will not only accept but welcome medical interventions that will help monitor the baby's condition and keep him or her safe given the unusual circumstances?

So if anyone has written one of these, please let me know what you put on it!
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