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Old 06-30-2011, 11:13 AM - Thread Starter
 
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One of my worst fears has come to life - our midwife practice has risked us out of a homebirth. We're simply not prepared to consider having a UC. So we're stuck in a hospital.

I'm devastated and I can't stop crying.

But in the end, it is what it is, and the only way I'm going to be able to start coping with this is to try to take what litle control we have of the situation and go with it. DH and I had talked a bit about a birth plan but didn't really consider it too important, but now it's jumped to the top of my list of absolutely-must-be-done-right-now type things.

Honestly, I barely know where to start. What kind of things do I need to cover? Does anyone have a list of interventions that I should make sure to include in the birth plan? Any samples/ideas/things to read that might help us get this done asap? I could really use some help to gather my thoughts and get started with it.

Thanks greensad.gif

Married to my wonderful DH 5/2010, Mom to DS1 Kayden 7-14-2011 wild.gif and DS2 Jakob 8-29-2013 babyf.gif


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Old 06-30-2011, 11:20 AM
 
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hug2.gif

 

Oh no!  It makes me feel a little panicky just to read this... :( :(  I'm so sorry to hear that!    It's probably more important than ever for you to do your positive affirmations/meditation/prayer etc. to keep your faith in your body and your baby.  Will your midwife at least accompany you to the hospital so you have a familiar and constant presence?

 

My mom had 4 natural, unmedicated births in-hospital, so I know it is possible.  Although she did have to fight tooth and nail to have some of her wishes honored, and even locked herself in the bathroom a few times when they wouldn't stop bugging her about inducing or c-section when she was taking "too long".  LOL

 

I will PM you all the info I have about birth plans and hospital plans. 

 

Blessings and peace! 

 

*edited to add:  I didn't have permission to attach documents to the PM, so please send me your e-mail address if you'd like the additional information I have, and list of interventions to include.  :) 


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Old 06-30-2011, 12:01 PM
 
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So sorry you won't be able to birth at home. hug.gif Earth Mama Angel Baby has a sample birth plan you could get some ideas from.

 

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


Christy wash.gif Mom to DS 4/21/04 reading.gif DD 9/20/09  dust.gif DD 7/2/11jog.gif

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Old 06-30-2011, 12:22 PM
 
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I just wanted to say I'm sorry mama, I know how you feel hug2.gif

 

 

You can still have a great birth in a hospital, and I'm sure the suggestions here will help you!


 

Lisa, Mama to two 2-26-09 and 6-15-11

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Old 06-30-2011, 12:28 PM
 
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I'm so sorry your homebirth didn't work out. :( When I did my hospital birth plan, just googling "sample birth plan" was pretty helpful. I also ran it by my doula and she had lots of helpful suggestions. If you have a doula, ask for her help, and if not, then see if your midwives will look over it for you. Will you still be attended by your midwives, or are you having to choose a doc too? If you are still being attended by your midwives, a detailed conversation with them may be more helpful than a birth plan (or helpful in addition to a birth plan.)

 

Here's a partial list of interventions, off the top of my head:

 

induction (preferences re: cervadil, cytotec (misoprostol), pitocin)

routine IV/ heplock

fetal monitoring

contraction monitoring 

blood pressure monitoring 

episiotomy

vaginal laceration repair

narcotic pain meds

epidural  

c-section (preferences re: closure type, non-separation from infant, etc.)

newborn procedures (hep B vax, vitamin k injection, circ, eye ointment, formula, artificial nipples)

(non) separation from infant  


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Old 06-30-2011, 12:42 PM
 
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DDCC

 

hug.gif so sorry mama.  i had a hard time coming up with ours.  so much i wanted to include, but wanted to keep it to one page (and not overwhelm the hospital staff too much).  here's mine.  if anything, it could be a jumping off point for you.  i recommend including the things that are absolute MUSTS or MUST NOTS.  be sure to review it with your care provider(s) ahead of time.  i also made sure i had several copies with me (and printed it up on pretty paper).  just a thought.

 

Our Birth Plan 

 

Mom:  mama              Dad/Coach:  papa                     Care Provider:  doc

 

Thank you for your assistance and participation in the birth of our baby.  We’ve prepared for an un-medicated, intervention-free birth with the Bradley Method.  We appreciate your support.  We understand that our plan is subject to change in the event of an emergency.

 

Labor – First Stage

     I would like to return home if I am less than 4 cm dilated upon arrival to the hospital.

     It is my goal to have an un-medicated labor – please do not offer pain medications.

     If I decide pain relief is necessary, I would only like epidural or spinal anesthesia.

     Please avoid any use of artificial means to augment labor.

     Saline or Heparin lock is to be used in place of IV.  I would like fluids by mouth.

     I prefer a minimum of vaginal exams.

     I plan to move around, walk and change position throughout the entire labor.

     I would like to use the tub and/or shower as desired.

     I prefer intermittent monitoring to be used.  If continuous monitoring becomes necessary, I prefer to use a telemetry unit to allow movement to continue.

     I prefer to not have my waters artificially ruptured.  If the staff or the doctor feels that it would be to my benefit or that of our baby, we would like to be given a few minutes in private to discuss it.

 

Labor – Second Stage

     If I am fully dilated and our baby is not in distress, I would like to wait to push until I feel the urge.

     I want to use various positions during pushing, including sitting upright, squatting and the hands and knees position.  I do not want to be lying down.

     I do not want an episiotomy.  I prefer the use of massage, warm compress and controlled pushing to avoid tearing.  A tear is preferable to episiotomy.

     I would like to have our baby placed on my chest immediately after delivery.

 

In the event of a Cesarean

     If the doctor determines that a Cesarean is indicated, we would like time in private to discuss it.

     I prefer epidural for anesthesia if a Cesarean is necessary.

     I prefer a double layer closure of my uterus.

     I want my husband and our baby to remain in recovery with me and for our baby to be put to the breast to feed as soon as possible.

     Please do not use sleep inducing drugs during recovery.

 

Labor – Third Stage (and immediately after delivery)

     Please wait to clamp the cord until after it has stopped pulsating.  Papa would like to cut the cord.

     I prefer natural methods to help deliver placenta, rather than drugs.

     I would like to hold our baby while I deliver the placenta and while any tissue repairs are made.

     I prefer to hold our baby rather than have him/her placed under heat lamps.

     Please delay all tests, baths, medications and injections for at least one hour and until after we have breastfed.  NO silver nitrate drops please!  Any routine procedures should be discussed with us prior to administering.

     If our baby is a boy, he will not be circumcised.

 

Breastfeeding

     I plan to breastfeed and would like to begin nursing immediately or as soon as possible after birth.

     I do not wish to have any bottles or pacifiers given to our baby.  Absolutely no formula or glucose water.

 

Postpartum and baby care

     If I tear and need stitches, I would like pain relief.

     We would prefer as few interruptions as possible during our postpartum stay.

     Baby will room with us for our entire stay.  If s/he needs to be take from our room, Papa will accompany him/her.

     Do not administer the Hepatitis B Vaccine.  We have chosen to delay this vaccination.

                  

btw - i birthed my 9lb 1oz son naturally in a hospital 13 days past my due date (and i was a vbac).  so, yes, you can get the birth you want in a hospital. 


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Old 06-30-2011, 01:55 PM
 
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I know this is stressful, but you can have a positive birth experience in a hospital.

 

So who is attending your birth?  Is it your midwife?  Do you have a pediatrician that will come to the hospital?  Try to find one ahead of time that will respect your wishes for routine baby care (see more below).  A pediatrician must release your baby before you leave the hospital.  If your midwife isn't going to be your primary care giver, maybe hire her as a doula or find a good doula ASAP.   Having a person that knows the ropes & is 100% dedicated to your well-being will be helpful.

 

Since I trust my midwives so much & they will be with me as soon as I get to the hospital,  I barely wrote anything regarding labor & delivery.  Keep it short & to the point, definitely no more than 1 page like the PP.  L&D nurses are busy & reading a long birth plan won't be effective.  Get all the important stuff on there without a lot of extra wording or details.  Bulleted points are better than whole sentences.  Think about reading the birth plan from the other end.   For example, I was a recruiter & liked nice concise to-the-point resumes instead of long wordy paragraphs with a lot of extraneous words.

 

The birth plan above looks good, but I added more about routine baby care that you may wish to include in your plan.

 

 

Hepatitis B Vaccine- Decline

Eye Prophylaxis- Decline
Umbilical Cord Prophylaxis- Decline

Vitamin K- Decline
Circumcision- Decline

 

Here is the rest of my birth plan.  I am a VBAC, water birth, have a doula, A- blood ..things which may not apply to you.

 

 

Personal Information

Provider Information

Name: 

Health care provider: 

Blood Type: 

        Back-up Doctor: 

Due date: 

Doula’s name: 

Spouse's name: 

Pediatrician’s Name: 

Baby’s Name: 

 

 

 

We would greatly appreciate your help with our preferences as follows.

 

LABOR & DELIVERY

 

I would like to have as natural a birth as possible and intend on laboring and giving birth in the tub.  Since I am a VBAC, I understand the need for continuous monitoring (preferably wireless) and IV access.  We understand that labor and birth are unpredictable and ultimately want the health and safety of both me and the baby to take precedence.  We will defer to the judgment of the midwives and our back-up doctor should any situations arise requiring medical intervention. In all non-emergency situations, all proposed procedures are to be discussed (benefits and risks) so my husband & I can direct the decision making with informed consent. 

  • We would like the room to be quiet with lights dimmed. 
  • We prefer to limit the number of people in the room as much as possible; no student or interns.
  • I would like to doula to have access to me regardless of hospital visiting hours as she is an important part of my overall birth experience.

 

BABY CARE

 

I would like to exclusively breast feed my baby.

  • Please do not give the baby supplements, pacifiers or glucose solution without consulting me.

 

We decline the following routine care for our baby.  These choices have been discussed with the baby’s pediatrician who will be visiting the hospital.

 

Hepatitis B Vaccine- Decline

Eye Prophylaxis- Decline
Umbilical Cord Prophylaxis- Decline

Vitamin K- Decline
Circumcision- Decline


"Unthinking respect for authority is the greatest enemy of truth."- Albert Einstein

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Old 06-30-2011, 02:21 PM
 
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all the things the PP's have said are good.
Here's my thoughts about birth plans as an L&D nurse..

the ones you get online that have standard things you just check off are useless. the birth plan is your way to help me get to know you and what you want. If your L&d nurse doesn't take the time to go through your birth plan with you line by line she's probably not the nurse for you. The ones that say I dont want an IV or a C section are basically the people you know are going to get a c section. You have to have IV access in case of emergency. The lawyers would not be happy if you were there and stuff went down and you didn't have access. You dont have to have a line running all the time, you just have to have a saline lock. And really no one wants you to have a c-section. (Most) doctors aren't going to suggest one unless they think it was necessary. While youre at the hospital its the nurse who is your voice and advocate. It is important to get one that works well with you. We all have our strengths. When a new shift comes on we look at who is laboring and pick and choose who we want to take. (some hospitals just give assignments and nurses dont get to choose. I'd ask about that when you have your pre-visit). Once you're there just ask to speak with the charge nurse and humbly let her know what your wishes are and that you would love if she could help get you a nurse that would be compatible with your wishes. Nurses dont take well to demanding things so if you just ask nicely and let them know you appreciate that they are willing to be flexible they will generally be such.
At a workshop I went to recently, a sample birth plan included the paragraph which I really liked-

"Nurse request... we hope for a calm, reassuring nurse who understands and supports my desire to have a natural childbirth and who will work in tandem with our doula. We also want someone who can be assertive in keeping our room and the birth of our baby quiet private and respectful."

For me most of the birth plan stuff comes after the delivery. Same thing as before, just ask nicely, but assertively, that any possible interventions be postponed for x minutes. where I work some of the nursery nurses are awesome and just do all the vital signs and assessment and everything right on your belly (as long as baby isn't born looking spent). Others are more regimented, they give you a minute then want to take the baby to the warmer to do their assessment, weight, etc. Those things are not necessary and are just a result of those nurses being inflexible. for instance, if they were to say "can I take your baby to the warmer for just a minute" instead of saying "cant she just stay here" I'd say "no, I want to wait". Dont give them an open end. If you dont want Vit K or the eye ointment, have the consent for refusal signed and in place ahead of time since those are standard things that they dont need your consent to do since they're basically a state mandated thing. The Hep B requires your consent so just dont consent if you dont want it.

Sorry that was a little rambling. I kind of got side tracked. with the right support you will be able to have a wonderful hospital birth. Although you should grieve the loss of the vision you had for this birth, just know that it is still possible to have that magical delivery and you will still become a mother no matter where you deliver.

Jenica- Wife to R & mama to C 8/27/09, my little blonde bombshell and D 7/23/11, whom we love so much we gave him an extra chromosome      cd.gifwinner.jpgfemalesling.GIF
 

 

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Old 06-30-2011, 02:49 PM
 
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I used the birth plan off of the nvic.org website.  It's a word document that I modified to what I needed it to be.  I also added some blank lines at the end and had it notorized.  Oh my OB just loved that.  LOL.


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Old 06-30-2011, 05:50 PM
 
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I really hope you get what you want even if it's not what you expected... Sorry you have to deal with this change :( hug.gif

 

My mom had 2 natural hospital births, too, and she's not very outspoken about most themes on MDC but when I found out I was pregnant I wanted to know how her births were - although I knew they were natural in that she always said she'd never take drugs for childbirth - and she said she told the doctor, You cut me and I'll cut you! My mama has a funny sense of humor but I imagine her wielding a knife saying that while birthing my brother & me :) Anyway, she was able to have 2 natural hospital births 7 - 10 days "late" both times.

 

Good luck to you mama-to-be!


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Old 06-30-2011, 07:41 PM
 
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this site has some sample birthplans, it helped me with wording and with some things I hadn't even thought about, I just took a little of what I needed from each one

http://www.birthingnaturally.net/birthplan/sample/index.html

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Old 06-30-2011, 10:27 PM
 
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Here is mine I got off a mw/doula website

 

Her biggest piece of advice:  KEEP IT SIMPLE

 

 

My Birth Preferences List

I understand that labor and birth are unpredictable and ultimately want the health and safety of both the baby and I to take precedence.

·      When possible, I request that procedures be explained thoroughly (benefits and risks) and also, when possible, I would like to be included in the decision-making process.

Below are items that are important to me. Your help with these is very much appreciated.

All of the requests are for a normal birthing time and postpartum period.

Birthing Time

·      I would like to have as natural an experience as possible - freedom of movement, intermittent monitoring, a saline lock instead of an on-going IV and food and drink as tolerated.

·      I prefer to bypass using the Pain Scale. If it is required for your job, please assign a number to me from your experience.

·      Being in the hospital, I know pain medications are available. Please accept my request that medications not be offered to me. For personal reasons, I am striving for an unmedicated labor and delivery. If I desire medication or an epidural, I will be the first to ask for it!

Birth

·      Please do not direct my pushing with counting or yelling "Push!" to me.

·      I strongly prefer a tear to an episiotomy.

·      I would like to be as active in the birth as possible, including bringing my baby up to my chest.

Cesarean

·      I am not squeamish and would very much like to watch the baby be delivered as much as possible.

·      Please use double-layer sutures when repairing my uterus.

·      I admire Baby-Friendly Hospitals and would like to create that type of environment as much as possible. This includes having the baby skin-to-skin (as health permits, of course), keeping the mother-baby dyad together during the repair and recovery and encouraging unlimited breastfeeding, even during the initial recovery period.

·      If my partner leaves the operating room with the baby, I would like to ask if my doula might step-in to help me during the repair.

·      I would like one of my major support people to stay with me at all times in recovery.

Baby Care

·      No Erythromycin eye ointment, please.

·      No vitamin K injection (unless bruising or birth trauma occurs).

·      We do not wish to have our baby circumcised

·      No vaccinations are to be given at this time.

·      We want to give our baby his/her first bath and understand you might have to wear gloves when handling the baby. This is an acceptable compromise to us.


Becky, homebirth.jpg momma to Rafe 8/2/2011,  wife to Sky & mom to our  dog2.gif   dog2.gifcorgis. 

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Old 06-30-2011, 11:23 PM
 
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On the other hand, you could fashion your birth plan like this :

 

http://www.mothering.com/community/forum/thread/1311648/made-my-birth-plan-today

 

 

(Forgive me, I am too tired to sleep :) )


 

Lisa, Mama to two 2-26-09 and 6-15-11

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Old 06-30-2011, 11:40 PM
 
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I can not believe they risk you out this late. I think this is very unprofessional!

If your m/w can't come to the hospital, is there a chance to hire a Doula last minute. She could be the keeper of your birth plan.

What hospital are you going to? What are their intervention rates?

I have had 3 natural births in a small private hospital with a c-section rate of 50% (lots of rich elective sectioners), I gave the birth plan to my m/w who came to the hospital with me. I managed to do exactly what I wanted.

I am sorry you have so much stress so late!


Barbara, Mama to Isabel (06/2004), Jake (08/2006-03/2007), Noah (01/2008), and Matteo (07/2011) 
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Old 07-01-2011, 08:03 AM
 
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I'm so sorry.  I know how hard this must be for you.  I don't really have any suggestions for a birth plan, I'm working on one myself.  But I just wanted to offer my support and I hope you have the natural birth you want and deserve!  hug2.gif


 
 

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Old 07-01-2011, 04:02 PM - Thread Starter
 
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Thank you so much everyone for the support and advice. We really, really appreciate it!

Yes, our midwife will be able to come to the hospital with us. The down side of that is that this whole situation is squarely her fault so our relationship with her is pretty poor now. However the midwife practice would not let us switch to another midwife this late in the pregnancy as the other midwives all have full case loads. So we're stuck with her.

We do have a doula, and she is very sweet and nice, but she is inexperienced. So I'm concerned about relying on her too much. But we're going to get our birth plan ready using all of these suggestions and then DH and the doula will have to step up and make sure it gets followed in the event of something not going the way we want it to.

Still fighting for our natural, unmedicated, intervention free birth! Just in a different setting now!

Married to my wonderful DH 5/2010, Mom to DS1 Kayden 7-14-2011 wild.gif and DS2 Jakob 8-29-2013 babyf.gif


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