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Discussion Starter · #1 ·
I've birthed all three of my kids at home. I have no experience with current hospital birthing protocol.<br><br>
I'm currently doing unassisted pregnancy - I have no insurance and money's mega tight right now so I'm not seeing a midwife. I still have not decided about the birth itself - my choices are UC or medicaid funded (whenever they get around finishing my paperwork) hospital birth.<br><br>
If anything were to come up that necessitated a hospital visit - what kinds of things should I put in an emergency birth plan? I am a childbirth educator and have read a million pregnancy/birth books, but I have no idea how current or up to date some of the info on hospitals is. Do they still do vit k shots? Eye goop? Surely they don't do shaves/enemas anymore, right? Obviously I don't desire anything like that - but I don't want to add dorky out of date stuff to my birth plan that will just make the docs shake their head.<br><br>
Thanks in advance for any advice!
 

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it all depend on the hosptial -- and to some extent the provider <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> sorry<br><br><span style="color:#FF0000;">it is tough to make blanket statements.</span><br><br>
yes most do vit k and eye stuff -- but i had no problem option out, signed a form, as did both of my sisters at 2 differnt hosptials in 2 differnt states. however some pople stillpost tht they caught grief over a refusal.<br><br>
some hospitals give Hep B at birth, again 2 sisters refuised and our Ped doesn't do it till 2 month visit so i didn't even have to sign a form -- but another mom at eh same hoptial did have it done and she was not educated enough to know it was gonna happen.....<br><br>
no shaving or emmas -- at least not that i have currently heard from anyone....<br><br>
here is my current "in work" BP --<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Packard Birth Plan Nov 2007 -- 2nd birth<br><br>
General<br>
My support people are Scott Packard (Husband) and -------------(Doula) they will be with me at all times.<br>
Our son Theodore will visit the labor room as we, the parents, see fit.<br>
I would like time to discuss any interventions (monitions, labor augmentation, medications, etc) with my husband and Doula privately.<br><br>
Labor<br>
I would like to be totally mobile during labor, free to walk or change positions at will.<br>
I would like to shower or soak in a tub to aid in relaxation.<br>
I would like to be able to have food and drink by mouth throughout labor.<br>
I would prefer to keep the number of vaginal exams to a minimum.<br><br>
Monitoring<br>
We will not have continuous fetal monitoring unless it is required by the baby’s condition.<br>
We will not have an internal monitor unless the baby has shown some definite, repeated, or unchanging signs of distress.<br><br>
Labor Augmentation/Induction<br>
We do not wish to augment labor and delivery or alter the natural process in anyway.<br>
We prefer natural methods of encouraging labor.<br>
We do not wish to have the amniotic membrane ruptured artificially.<br>
We prefer to strip (sweep) the membrane and try other non-drug interventions in place of medication.<br>
We refuse Cytotec.<br>
We would like to give labor a good opportunity to re-start if stalled before Pit is administered.<br><br>
Anesthesia/Pain Medication<br>
We realize that many pain medications exist — We’ll ask for them if I need them.<br>
We strongly prefer not to have any phamicutal pain management suggested.<br><br>
Cesarean<br>
Unless absolutely necessary we would like to avoid a Cesarean.<br>
We would like to attempt forceps, again, before a surgical birth.<br>
If a Cesarean delivery is indicated, I will be fully informed and to participate in the decision-making process.<br>
I would like Scott and -------- present at all times if a Cesarean delivery is necessary.<br>
I wish to have an epidural for anesthesia.<br>
I will not have my hands restrained in any way.<br>
So I can view the birth, please lower the screen just before delivery.<br>
Baby should be given to Scott immediately after birth and not removed from the mother’s sight.<br>
I will nurse Our Baby as soon as possible; within 30 minutes of birth, even after a C-section.<br><br>
Episiotomy<br>
I prefer not to have an episiotomy; I prefer to tear naturally.<br><br>
Delivery<br>
I would like to be allowed total freedom to choose the position in which to give birth.<br>
I prefer to push only spontialus and as hard or for as long as I feel the need (avoiding purple pushing).<br><br>
Immediately After Delivery<br>
Scott will cut the cord.<br>
The cord should be allowed to pulse until it naturally stops before being clamped and cut.<br>
I would like to hold the baby while I deliver the placenta and any tissue repairs are made.<br>
ALL evaluations of the baby are to be done on my abdomen, not the warming table.<br><br>
Postpartum<br>
Unless required for the health of the baby, the baby is not to be removed from the mother for any reason. The baby will stay in my room -- all tests and exams will be done there.<br>
If the baby must be removed from the mother, the father or another adult designated by us will be with and in physical contact with the baby at all times.<br><br>
Baby Care<br>
We refuse the eye ointment.<br>
We refuse a routine Vit K shot.<br>
The baby does not need to be bathed immediately.<br>
We prefer to hold the baby – mother or father – skin to skin rather than have the baby artificially warmed.<br>
We do not want our baby admitted to a special nursery merely for observation,<br>
The baby is to receive NO vaccination at the hospital.<br>
The baby is to receive NO medication or tests without prior written consent of the parents.<br><br>
Breastfeeding<br>
I will exclusively breastfeed Our Baby and will begin nursing immediately after birth.<br>
Our baby is not to receive a bottle for any reason.<br>
If our baby is unable to nurse she/he should receive only mother’s milk (or medication) via a nasogastric tube.<br>
We do not want Our Baby to be given a pacifier, other any other artificial soother.<br><br>
Circumcision<br>
We do not want Our Baby circumcised.<br><br>
After the Birth<br><br>
•We may choose to leave at the 24 hours mark, rather than the 48 depending on recovery of the mother and time of day, so to avoid unnecessary time away from our older child.<br>
•Our 24 month old son, Theodore will visit as soon as reasonable to see his new sibling, likely as soon as medical personnel have left the birth room and the bed is remade.<br>
•Theodore will stay with us as we feel best for the family as a whole, including possible spending the night with his mother and new sibling.</td>
</tr></table></div>
it is tooooooo long<br><br>
and most of it doesn't apply to you and an emergcy tranfer -- but it will show you what is current <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> it is my plan from 2005 and Theo modified<br><br>
let me know if there are other things<br>
A
 

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Discussion Starter · #3 ·
Thank you, Aimee, for sharing yours! That was so helpful and addressed things I would not have thought about.
 

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Here's my birth plan from my first pregnancy. The best advice I got was to keep it to one page.<br><br>
Birth Plan of Christine and Darius<br><br>
We are very excited that God has blessed us with a child and are looking forward to welcoming our first baby into the world. We are pleased with our choice of *midwife name* and *hospital name*. We have heard wonderful things about the midwives and the hospital and look forward to giving birth in a loving, peaceful, natural atmosphere. Because your assistance is so vital to our goal of having a natural, unmediated, vaginal birth, please review our birth plan. We have done everything we can to stay healthy and low risk during this pregnancy. We are very well prepared, educated and motivated to have a wonderful birth experience. We completely understand that this birth plan is contingent upon normal delivery, and, if complications arise, other medical procedures will be considered.<br><br>
PLEASE DIRECT ALL QUESTIONS, SUGGSTIONS, COMMENTS TO DARIUS<br><br>
BIRTH TEAM:Darius (husband/coach)<br><br>
Labor<br><br>
•Freedom to walk, use shower/bathroom, change positions<br>
•No loud noises, lights dimmed please<br>
•Limited exams please (Please do not tell Christine what the dilation is, but let Darius know if he wants)<br>
•We prefer to allow labor to progress at its own pace without augmentation, unless necessary<br>
•We prefer to avoid any IV’s, unless necessary (Christine has tested negative for Group B Strep)<br><br>
Baby Care<br><br>
•No fluids other than breast milk<br>
•Please delay initial vital signs and baby examination for at least one hour to allow bonding time<br>
•If baby needs to be moved, Darius to accompany him<br>
•Pediatric examination by *ped's name* in our room – PKU to be done at pediatrician’s office<br>
•Please, NO EYE OINTMENT, NO CIRCUMCISION, NO VACCINATIONS<br>
•Please avoid Vitamin K injection unless the baby is sick and needs immediate surgical procedures<br>
•Delay bathing baby to avoid decrease in body temperature and to allow the vernix to moisturize the skin.<br><br>
Premature/Sick Baby<br><br>
•Please give full explanation of procedures, medications, options and risk/benefits to Darius<br>
•Christine and Darius to travel with transport team if transfer is necessary<br>
•Christine and Darius involved in the care of the baby – diapering, breast feeding etc…<br>
•Baby to only receive expressed breast milk (no formula or supplements)<br>
•Christine allowed to breast feed when baby is able<br><br>
Cesarean Section<br><br>
In the event a C-Section is medically necessary, we still want to do everything to make the birth as gentle and loving as possible.<br><br>
•Surgery after spontaneous labor begins (no induction or scheduled surgery)<br>
•Full explanation of procedures/reasons to be given to Darius, and Darius present when possible<br>
•Spinal/epidural medication<br>
•Following the birth, please honor our requests under Baby Care<br>
•Sutures only (no staples)
 

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I guess it's possible, but I would be shocked if any hospital did enemas or shaving anymore.<br><br>
The routine things that you would be likely to encounter are pitocin, fetal monitoring, episiotomy, and nursery care of the infant (all kinds of stuff there--yes, vitamin K; yes, eye goop; also bath, bottles, and pacifiers are routine). If circumcision is not something you want, make sure someone knows that. They do need your consent, but there have been cases of babies circumcised without parental consent.<br><br>
It is common for the nurses to take the baby into the nursery for a long time--many of my friends have said it was anywhere from 1 to 3 hours. I would put in your birth plan that you want to hold and nurse the baby immediately after birth and want all care done in the room with you as long as the baby is OK, or have your DP in the nurseryf while it's being done. Sometimes they get busy and can't accommodate that, but it doesn't hurt to try.
 

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<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/notes2.gif" style="border:0px solid;" title="notes right-handed">: Great info!
 

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also i am not sure how much of our BP -- written planning to have a hosptial birth -- is differnt from a possible emergency tranfer... you know?<br><br>
let us know what you decide.<br><br>
our baby never left our room.....<br><br>
remember -- soooooooooooooooooooo much depends on the actual hospital....all have different sop..... you know<br><br>
aimee
 

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I delivered Titus at a hospital and actually had a REALLY good experience. Like Aimee said though, it depends a lot on the provider and staff.<br><br>
I only had a rough sketch of the BP that didn't make it to the hospital with me, but DH knew well enough wha I wanted that I wasn't worried. As they wheeled me into my "birthing suite" The nurse asked me if I would be having an epidural, I said "No, I'm going to deliver him naturally. I don't want any intervention." She even added "Great, your doctor is known for not doing episiotomies too."<br><br>
I did have an external monitor, but If I felt like walking around, it came off. I don't rememer at what point I told them no circ, but basically everyone around was like "Oh good, it's just so unnecessary!"<br><br>
After delivery, he was weighed and measured all in the room and never left me until the next day to be weighed for about 3 minutes. We were actually there for two days due to "ecogenic debris" in his liver which turned out to be nothing but it could have been something- anyhow, on the way out the door to be discharged, they realized there were all these things on their checklist, tests and measurements and such that never were done because he was with me the whole time.<br><br>
Oh, and I loved this... They all had a sign IN my room and on the door and on his bassinet and a special wristband that said "We're learning to breastfeed. NO formula!"
 

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Awesome birth plans! Thanks for sharing, ladies! I will be taking notes...I'm planning a HB, but it's good to have a back-up plan!
 

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don't ever ever let that baby out of the sight of either you or DH or someone you really really trust (who has NO issues with confrontation/ authority) that is the best advice I can give,<br><br>
the above plans all have great info in them..unfortunately (as reported by about a dozen OB nurses I know personally) they don't read them or care much.. but write it and bring it and give it so it is a legal doc if they try to go against wishes.. ie they can't claim "we didn't know" it is also great to write it all out to crystalize it in your mind and so that everyone is on the same page (literally)<br><br>
One great thing I have heard it to write in sharpie on fluorescent index cards and tape them to door or bassinette with "NO CIRCUMCISION" "NO VACCINATION" "NO INJECTIONS" "NO PACIFIERS" "NO FORMULA/ GLUCOSE WATER" "NO EYE OINTMENT" or whatever you don't want so they are visible and eye catching.. much more visible than a printed birth plan but hav ethat too... good luck with UC (I really want one but DH is a freakazoid..) hugs mom
 

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i think, again, it is all hosptial and provider<br><br>
at our son's birth the nurses -- who all had worked withour CNM before -- ASKED to see our birth plan when they first came in the room -- and asked a lot of questions about why, and this or that alternative ... they both (we had 2 L&D nurses we were there so only in lkabor) said they wanted to aks now while things were calm.<br><br>
however i also knwo that the nurses that generally want to work with the CNM (or the OB we have this time) are more intrested in NCB than others might be. our L&D nurse had given brith naturall and medication free to twins less than 2 years ago 9she worked 2 days a week) -- and was very supportive and understanding.<br><br>
we did post signs like discussed above -- and DS left my room ONCE with DH to get his heel prick done. other than that DH or i were in physically contact with him at all time (and DH was whne he went for his heel prick).......we were vocal about our wants and not-wants .... but really didn't have to "fight or argue" for anything.......but i knw other moms int eh same hos with differnt births 9but main cuz they didn't care and got the medical birth they expected and even wanted) -- so i feel safe going back the the same place again this time. you have to be ready and aware -- but so much comes down to luck of the draw with nurseing, the SOP of the hosptial, and the provider and how much THEY support you -- i think sicne we had a CNM we didn't even hear a lot of what some moms with an OB might hear... yk?<br><br>
about a BP is good for you, dh, and whoever else -- in addition to the nurse -- or even instead of the nurses so everyone esle cn be vocval and keep track.................dh need the cheat sheet for himself.<br><br>
Aimee
 

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Like the pp said, I think it really depends on the hospital. I would (if you haven't already) find out which hospitals you can transfer to and then start asking around about their rep-c/s rates, AP friendly, etc. We ended up transferring without a birth plan (not that I recommend that we just forgot it at home) and had a great hospital experience. We knew ahead of time about the hospital and how friendly they were to natural childbirth, etc. They acutally had dh write out a quick birthplan for them.<br><br>
On the other hand, there is a hospital here that has a reputation for not really paying attention to birth plans, very high epidural and c-sec rate.
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">On the other hand, there is a hospital here that has a reputation for not really paying attention to birth plans, very high epidural and c-sec rate.</td>
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really talk to people<br><br>
the "nicest hosptial" in the area my sis lives is know for being opposed to natraul birth, hostial to transfers,a dn has a c-rate over 60 %......but it is the nice new one that is pretty and has nice rooms. the one she has birthed at twice is in a less great part of town (not really bad, but not the new nice area) and is older and the rooms are smaller and so on .....but she has had 2 GREAT expereinces, the nurses are supportive and the over all intervention rate is low comapred to the national average and very low compared with the local ageraves..........<br><br>
tours mean nothing -- talk to people.<br><br>
Aimee
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>Aimee21972</strong> <a href="/community/forum/post/8201304"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">really talk to people<br><br>
the "nicest hosptial" in the area my sis lives is know for being opposed to natraul birth, hostial to transfers,a dn has a c-rate over 60 %......but it is the nice new one that is pretty and has nice rooms. the one she has birthed at twice is in a less great part of town (not really bad, but not the new nice area) and is older and the rooms are smaller and so on .....but she has had 2 GREAT expereinces, the nurses are supportive and the over all intervention rate is low comapred to the national average and very low compared with the local ageraves..........<br><br>
tours mean nothing -- talk to people.<br><br>
Aimee</div>
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So true! The one I had such a good experience at is older, not at all fancy- the tubs are lacking (you can order in a labor tub if you are planning to birth there) and isn't really "popular". The nice new one with the fancy rooms is the one that seems to get a lot of births and is the one that doesn't have the greatest rep-at least among the natural childbirth community here.
 

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Discussion Starter · #16 ·
Wow, thanks for all the responses!!!<br><br>
What I think I'm going to do is establish a relationship with an OB that was recommended to me by a friend - decide from there what to do. The hospital that she is affiliated with has been voted the best place to have a baby in Fort Worth. Don't know what that really means - but we'll see. I think it would be better if I decided to have a UC and needed to transfer - it would be smoother if I already had a client relationship with someone and not just on mercy of whoever is there on shift.<br><br>
So, I'm going to include everything in my birth plan, as if I plan to birth there all along. Really it's a mental struggle right now...I'm so used to being at home, I keep reading horror stories of women's births being mismanaged and whatever...but then the majority of people I know who deliver in hospitals were perfectly happy with their births. I'm not ultra set on a UC yet. I'm not sure but I just have this strange feeling about this birth that I can't put my finger on. I have never had a problem during my births; complication free - and never had this feeling. Just want to be prepared!!
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>marisa</strong> <a href="/community/forum/post/8203892"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">The hospital that she is affiliated with has been voted the best place to have a baby in Fort Worth. Don't know what that really means - but we'll see. I think it would be better if I decided to have a UC and needed to transfer - it would be smoother if I already had a client relationship with someone and not just on mercy of whoever is there on shift.</div>
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The hospital that is supposedly "Baltimore's Best" for having a baby has a 40% c/s rate (yes, you read that right! 40%!) So it's worth investigating. A lot of us here on MDC have pretty different ideas from most mainstream mamas about what a "good" birth is...but I do agree that it would be worth it to establish a relationship b/f a potential transfer since that would likely make the whole process smoother.
 

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Are you visiting the UC forum here at MDC to get support and information too?<br><br>
If you do transfer to the hospital, expect some passive aggressiveness (or worse, full aggression) because you were trying to UC. Just expect it and handle it head on.<br><br>
When at the hospital, if it's an actual emergency transport, I would keep a separate birth plan (many copies) of that, and one that's longer for a transfer that's not an outright emergency.<br><br>
Reason is, in an emergency, they're going to get the baby out befpre looking at the plan, so have it for you from the second the baby hits the air. Make sure you're partner is ready to stay with the baby and fight for it.<br><br>
I hate painting a gloomy picture, but at my last birth, they seemed like a good hospital and responsive staff and they PROMISED they understood and would follow our simple requests and they lied. Outright lied.<br><br>
They "stole" the baby from us, saying they were taking him to weigh him and he would be right back. They then put him in the nursery and told my husband he could stand there but not hold him for hours while my son cried under a warmer instead of being with us. There was NO medical reason.<br><br>
Had my hubby known, he could have insisted and taken the baby out of there, but he was scared, having been told stories about social services coming, etc.. We didn't have a reason to worry, but he didn't know that.<br><br>
I am sure everything will go fine though, but keep doing soul searching to tell if it's intuition or anxiety. It's hard to tell sometimes! I do hope you get a peaceful birth at home!!
 

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Also, if you're not there under dire emergency that necessitates a c-section, they cannot MAKE you have one unless they call the jugde and get an order. Some DO that, but if you play your cards right, and you're transfering for a reason other than emergency, you should be okay refusing anything other than a natural, vaginal birth.<br><br>
I am convinced sometimes if you don't go in looking for a fight and you're assertive but not aggressive, you might get more cooperation than if you go in with your fists up. *sigh* Too bad we have to worry about this stuff!
 
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