[dayiscoming2006]

Quote:

Birth Plan and Baby Care My name: Danielle V... We expect to be asked for consent before anything of any kind is done to our baby or to me. We reserve the right to make the final decisions regarding our care. We do not hold the hospital responsible for any personal decisions we make regarding our care. Normal Childbirth (vaginal delivery) •Maintain mobility •I prefer no restrictions (Eat & drink to my comfort) •I do not want an IV, please give me water if I am dehydrated. •I would like to choose my positions for pushing and giving birth •I would not like to be touched by anyone without my consent •I need my husband to be with me and our baby at all times because I do not speak Romanian and I will not be OK without him being there. •private birthing room •Please, no students or residents •No vaginal exams •I would appreciate having the room as quiet as possible when the baby is born. •I would like to push when I feel the urge to push. I do not need to be instructed on how or when to push. •In case of hemorrhage I have brought an herbal remedy called hemhalt that could be given according to label specifications. I would prefer this be tried first before typical methods. •Please allow me to vocalize as desired during labor and birth without comment or criticism. Episiotomy •Prefer to Tear •Do NOT give me an epsiotomy Monitoring: •I do not wish to have continuous fetal monitoring In the event that I require or have chosen fetal monitoring, my preference is: •Fetoscope Pain Relief Preference: •I plan to give birth naturally without medication. Placenta: •I do not want an injection of pitocin after the delivery to aid in expelling the placenta. •I prefer to wait for spontaneous delivery of the placenta •I would like to see the placenta after it is delivered. •I would like the placenta destroyed. Induction: •I do not wish to have the amniotic membrane ruptured artificially unless there are proven signs of fetal distress. •I do not wish to be induced. Complications & Cesareans: •Unless absolutely necessary, I would like to avoid a Cesarean Baby Care: •Umbilical Cord: My husband would like to cut the cord if possible and only after it has finished pulsating. •Eye care: None. I do not have a STD so the baby has no need for special eye care. •Feeding Baby: Breast feeding only (no pacifiers or bottles) •I would like the baby's blood type tested to see if they are Rh positive or negative. I am Rh negative and will need a Rhogam shot within 72 hours of the birth if the baby is Rh positive. I do not want to receive Rhogam if the baby is Rh negative because it is not necessary. •Do not give or do anything to my child without mine or my husband's consent. •Separation: No separation. I would like my baby in the room with me. Circumcision: -None -Do not retract the foreskin Vaccines: -I do not vaccinate and do not want my child receiving any vaccinations. We do not hold the hospital responsible for any personal decisions we make regarding our care.

It will be translated into Romanian by my husband when I'm finished. I tried to keep it as short as possible but all these things included I believe are important.

 

[dayiscoming2006]

Another thing I wanted to add is that they said I would have to sign a form there if I do not consent to vaccines for the baby. I put that in my birth plan though and I will sign that, do you suppose this would serve as a replacement to the form? I don't want to sign anything that could "incriminate" me.

 

[AutumnAir]

It looks pretty comprehensive to me.

I doubt you need to worry about the circumcision issue - it's not commonly done in Europe, and I would imagine Romania is the same. Of course it's always worth checking.

It may also be worthwhile quoting the law which was ratified recently in Europe explicitly stating that informed consent to medical procedures is a basic human right. I can't find my reference now, but google the above terms and you'll come across it.

I hope it all works out for you

 

[dayiscoming2006]

Quote:

Originally Posted by lisabeeprague It looks pretty comprehensive to me. I doubt you need to worry about the circumcision issue - it's not commonly done in Europe, and I would imagine Romania is the same. Of course it's always worth checking. It may also be worthwhile quoting the law which was ratified recently in Europe explicitly stating that informed consent to medical procedures is a basic human right. I can't find my reference now, but google the above terms and you'll come across it. I hope it all works out for you

Thanks for your reply. My hubby said they don't do circumcision here unless you ask for it so I got that out of the birth plan to make it shorter. I plan to bring a copy of the law with me. It won't be in the actual birth plan but we will have it to reference to.

 

[ebbybaby]

I dont want a debate on vacs here so I edited my post.

 

[Rivka5]

It's hard to really comment given cross-cultural issues - I don't know what would be considered to be normal care in a Romanian hospital - but a few things jump out at me.

- Hemorrage: I can't imagine any hospital being willing to administer an herbal remedy that you brought with you from outside, and that the doctor knows nothing about, for what they will view as a medical emergency. If they give it to you, even if you supplied it, they are legally and ethically responsible for any negative effects it might have - it's completely different from you deciding to take an herbal remedy on your own.

- "Unless absolutely necessary, I would like to avoid a Cesarean." I don't think any doctor walks into an L&D room thinking, "I want to give this woman an unnecessary Cesarean." *They* think it's necessary, even if objective evidence disagrees. It might be more productive to say something like "I am not willing to consider a C-section for 'failure to progress' or 'suspected large baby' " (or anything else you are particularly concerned about), or to say "Before a C-section is considered I would like to try ___" (changes in labor position, etc.)

- You might want to state, in the pain medication section, that you do not want anyone to suggest or offer pain meds.

- Rh factor: You don't need to spell out that you need Rhogam if the baby is Rh+ and don't need Rhogam if the baby is Rh-, because they know that already. If the hospital's normal protocol is to give Rhogam to all Rh- mothers without testing (which seems odd to me), it should be sufficient to say something like "Delay administration of Rhogam until baby's blood type has been determined" or "No routine Rhogam unless baby tests Rh+."

- Do you need to say "I wish to have the placenta destroyed?" What else would they do with it?

 

[LilacMama]

I think this is a good list for you to start with. So that YOU and your husband know the things that are important to you. So, I think it's great that you thought about it and wrote it all down. I would pare it down before presenting it to the hospital though, simply because it is long and much of it is not needed. I fear that you would get a negative response from the staff with this birth plan as is.

Like the above poster, I really don't know about birth in Romanian hospitals, so take what I say with a grain of salt and use your knowledge of the culture and their normal policies/procedures.

A birth plan is not a legal document. So, using legal jargon in it and saying that you need informed consent before any procedures is not legally binding and it may come across as offensive to them since that is what they are supposed to be doing anyway. I would consider removing that.

I agree with everything the previous poster wrote.

Also, there are MANY things on this list that are very doctor specific. Have you discussed your birth plan with your doctor? Things like "I do not wish to be induced" are things that you sort out before a birth. Things like "I do not want an IV" would be good to discuss before showing up at the hospital.

Without knowing the culture of birth in Romanian hospitals, I may be totally out of line when I say this....but the plan, as it is worded, seems to be very defensive and negative towards your care providers. If you feel the need to remind them not to touch you without consent, criticize you, or ban your husband from the room then you have some serious (accurate or not) concerns about this hospital.

 

[dayiscoming2006]

Quote:

Originally Posted by Rivka5 It's hard to really comment given cross-cultural issues - I don't know what would be considered to be normal care in a Romanian hospital - but a few things jump out at me.

Quote:

- Hemorrage: I can't imagine any hospital being willing to administer an herbal remedy that you brought with you from outside, and that the doctor knows nothing about, for what they will view as a medical emergency. If they give it to you, even if you supplied it, they are legally and ethically responsible for any negative effects it might have - it's completely different from you deciding to take an herbal remedy on your own.

I actually spoke with the head of the L & D section and he said I could bring my herbal remedy. Maybe it's different here? I don't know.

Quote:

- "Unless absolutely necessary, I would like to avoid a Cesarean." I don't think any doctor walks into an L&D room thinking, "I want to give this woman an unnecessary Cesarean." *They* think it's necessary, even if objective evidence disagrees. It might be more productive to say something like "I am not willing to consider a C-section for 'failure to progress' or 'suspected large baby' " (or anything else you are particularly concerned about), or to say "Before a C-section is considered I would like to try ___" (changes in labor position, etc.)

Yeah, I probably could have worded that better. I already have my birth plan put out there though. Ultimately I should have to agree to the C-section unless it is a serious emergency so I won't worry about it too much.

Quote:

- You might want to state, in the pain medication section, that you do not want anyone to suggest or offer pain meds.

I don't know if they do a whole lot of offering of pain meds here? I do know that they can offer it all they want and I will not be interested because I don't consider the pain medicine to be 100% safe for baby or myself and would rather go through pain than take unnecessary risks (in my opinion.)

Quote:

- Rh factor: You don't need to spell out that you need Rhogam if the baby is Rh+ and don't need Rhogam if the baby is Rh-, because they know that already. If the hospital's normal protocol is to give Rhogam to all Rh- mothers without testing (which seems odd to me), it should be sufficient to say something like "Delay administration of Rhogam until baby's blood type has been determined" or "No routine Rhogam unless baby tests Rh+."

I worded that poorly too, but hubby already printed the stuff today and I don't have a printer. I think they will get the point anyway. I didn't know if they did routine Rhogam on Rh- moms though. I actually have heard that some hospitals do this because they don't wait to see what the baby's blood type is or something.

Quote:

- Do you need to say "I wish to have the placenta destroyed?" What else would they do with it?

Actually, I have heard plenty about hospitals selling the placenta for research and stuff.

 

[dayiscoming2006]

Quote:

Originally Posted by LilacMama I think this is a good list for you to start with. So that YOU and your husband know the things that are important to you. So, I think it's great that you thought about it and wrote it all down. I would pare it down before presenting it to the hospital though, simply because it is long and much of it is not needed. I fear that you would get a negative response from the staff with this birth plan as is. Like the above poster, I really don't know about birth in Romanian hospitals, so take what I say with a grain of salt and use your knowledge of the culture and their normal policies/procedures. A birth plan is not a legal document. So, using legal jargon in it and saying that you need informed consent before any procedures is not legally binding and it may come across as offensive to them since that is what they are supposed to be doing anyway. I would consider removing that. I agree with everything the previous poster wrote. Also, there are MANY things on this list that are very doctor specific. Have you discussed your birth plan with your doctor? Things like "I do not wish to be induced" are things that you sort out before a birth. Things like "I do not want an IV" would be good to discuss before showing up at the hospital. Without knowing the culture of birth in Romanian hospitals, I may be totally out of line when I say this....but the plan, as it is worded, seems to be very defensive and negative towards your care providers. If you feel the need to remind them not to touch you without consent, criticize you, or ban your husband from the room then you have some serious (accurate or not) concerns about this hospital.

Honestly, I hate hospitals and do not trust doctors so I tried my best to word things as well as I could. I honestly felt the need to remind them about informed consent because of my experience with my son's birth. I was done things to and given things without informed consent. I realize the birth plan is not legally binding but I put everything I want down in it anyway.

The other issue here is I do not have a specific doctor here and there is no way that I will have one before the baby is born so it is a bit difficult to discuss these things with them ahead of time. I did my best by discussing these things with the head of the L & D department. I actually had to get special permission to have my husband be at the birth. It is not normal practice in Romania for the husband to be allowed at the birth. I also have read articles about the Romanian way to handle births and the nurses and doctors tell women to suck it up and deal with the pain. I was told to relax when I was in labor with my son in the US too. The nurse seemed upset when I felt the need to make any noise. Oh yeah, and the touching thing is because I do not want vaginal exams or an episiotomy. Episiotomies are still routine in Romania. I talked to the head of the L&D department about not wanted an episiotomy and he said that it would be fine and that I would not get one. The head of the L & D department told me to make a plan detailing all that I was hoping for.

If I were in the US I would be having a home birth. The problem is that home births are illegal in Romania. Thanks for giving your opinion on my plan. I do appreciate it.

 

[LilacMama]

I'm sorry you had such a bad experience before. I didn't realize Romania was so um, backwards in its birthing practices. I wish you all the best with your birth! Let us know how it goes, please!

 

[mommietime]

I just have to post that the hospitals in Romania (while much less fancy) are MORE accomodating to laboring women's requests than American hospitals.

Just try refusing monitoring , internals, and IVs in the US and see how it goes!

It is perfectly possible to have a regular OB doc as well, I am not sure why you haven't?

I do think the comprehensive birth plan is a good idea. A simple translation can be done that will include those requests and not sound negative.

 

[dayiscoming2006]

Quote:

Originally Posted by mommietime I just have to post that the hospitals in Romania (while much less fancy) are MORE accomodating to laboring women's requests than American hospitals. Just try refusing monitoring , internals, and IVs in the US and see how it goes! It is perfectly possible to have a regular OB doc as well, I am not sure why you haven't? I do think the comprehensive birth plan is a good idea. A simple translation can be done that will include those requests and not sound negative.

That's very good to know. I noticed that they seemed a bit nicer when responding to my requests than the OB I had in the US with my first child.
I already have my stuff printed out so not sure how I can change the birth plan now. I could go into labor any moment/day etc.
I didn't want an OB. I wanted to UC (unassisted birth) this child in the US but when we moved that became impossible. I am a UPer(unassisted pregnancy) so an OB was unnessary for me as I haven't had any health problems.

 

[dayiscoming2006]

I'm in the process of editing my birth plan to make it sound more positive. My hubby said he would be fine translating it again. Thanks for your suggestions.

 

[mommietime]

Make sure your DH adds lots of "multumesc frumos" in there.

I was suggesting you have an OB since then you can discuss your plan and know the person who is at the business end in the hospital already has agreed to your wishes. Makes it a lot easier. I had an OB in Romania (a friend who happens to be an OB doc) who I would trust with these things far beyond any American doctor.

You will find that while the conditions / accomodations are below what an American would expect, the people in medicine there are generally more respectful in Romania. The docs/nurses here are so condescending. In Romania, birth is still considered a natural occurence, even though it is assisted by Obs.

I am curious about the law there. I will ask my friend, but when I was in the village, almost 8mos along, there was no way we could have gotten to a hospital or clinic. We would have had a homebirth with DH and probably the Wife from the farm next door as a helper. So much of the nation is still rural, I am confused how it can possibly be unlawful to give birth at home. Surely this is where the village women are giving birth.

 

[dayiscoming2006]

Quote:

Originally Posted by mommietime Make sure your DH adds lots of "multumesc frumos" in there. I was suggesting you have an OB since then you can discuss your plan and know the person who is at the business end in the hospital already has agreed to your wishes. Makes it a lot easier. I had an OB in Romania (a friend who happens to be an OB doc) who I would trust with these things far beyond any American doctor. You will find that while the conditions / accomodations are below what an American would expect, the people in medicine there are generally more respectful in Romania. The docs/nurses here are so condescending. In Romania, birth is still considered a natural occurence, even though it is assisted by Obs. I am curious about the law there. I will ask my friend, but when I was in the village, almost 8mos along, there was no way we could have gotten to a hospital or clinic. We would have had a homebirth with DH and probably the Wife from the farm next door as a helper. So much of the nation is still rural, I am confused how it can possibly be unlawful to give birth at home. Surely this is where the village women are giving birth.

As far as homebirth. I just know what the official law is and that is that home birth is not allowed from what I read. But, I'm sure they can't really enforce that when it comes to people who can't actually reach the hospital in time. I may have tried for an "oops" birth if it wasn't for the fact I am currently staying with my inlaws who would have a heart attack if I tried to do that in their home.

And we did speak with the head of the maternity ward when I was about 35 weeks along about how we were hoping things could go and he seemed open to a lot and willing to cooperate.

 

[mommietime]

It's too late for the info, but my OB friend in Romania says there is no law against homebirthing UC style, only against a medical assisted homebirth. So homebirth midwives aren't allowed, but UC is totally legal. If you call the ambuance during UC, they are required to take you to hospital rather than try to help you homebirth, but if you can UC, you are free to do so.

I am not sure where you got the initial info, but it's not right. I know my friend is on top of it, she is a practicing OB, and I have visisted her in Romania when I was pregnant.

 

[annekh23]

Try and make it more specific to the hospital you are birthing at, as currently your plan reads from a very American perspective. If you gave that to someone in a British hospital, it would be meaningless, for example circumsion is very rare and when it is done, is not done at birth, so a statement about circumcision isn't necessary. Same with many other things, the norms are just different from the US. If you can't get specific details then try and state things more generally, so don't say don't use pitocin for the 3rd stage, but don't use drugs, for example.

 

[dayiscoming2006]

Quote:

Originally Posted by annekh23 Try and make it more specific to the hospital you are birthing at, as currently your plan reads from a very American perspective. If you gave that to someone in a British hospital, it would be meaningless, for example circumsion is very rare and when it is done, is not done at birth, so a statement about circumcision isn't necessary. Same with many other things, the norms are just different from the US. If you can't get specific details then try and state things more generally, so don't say don't use pitocin for the 3rd stage, but don't use drugs, for example.

Too late. But thanks for your advice. I had my baby already. It seems the hospital I was at has never seen a birth plan before. One doctor I had paid attention to it but she didn't deliver me and no one else ended up paying attention to it mostly. They gave my baby formula and vaccines even though I didn't give consent to vaccine and had written against it in my plan and did not sign the consent for vaccine in the hospital consent forms. Technically I guess we could sue them since the consent was not given but we don't have the money nor the time and what is done is done.

 

[dayiscoming2006]

Quote:

Originally Posted by mommietime It's too late for the info, but my OB friend in Romania says there is no law against homebirthing UC style, only against a medical assisted homebirth. So homebirth midwives aren't allowed, but UC is totally legal. If you call the ambuance during UC, they are required to take you to hospital rather than try to help you homebirth, but if you can UC, you are free to do so. I am not sure where you got the initial info, but it's not right. I know my friend is on top of it, she is a practicing OB, and I have visisted her in Romania when I was pregnant.

I guess I assumed UC was illegal since I saw homebirth was illegal in the stuff I was reading, I didn't notice the difference between medical assisted and unassisted, my mistake. Thanks for this info and I hope someone looking back in the archives finds it useful. I still wouldn't have been able to UC because I'm staying with my inlaws and they would have certainly called an ambulance even if I asked them not to.

 

[AutumnAir]

I'm so sorry you had a bad experience at the hospital. I've been following this thread and hoping that you would have a good birth even if you couldn't have a UC this time. I know how awful it is to be powerless to prevent 'medical authorities' from doing harmful things to me and my baby. I had an horrific birth at a Czech hospital - unnecessary forceps delivery, and couldn't do anything to stop them from suctioning DD and giving her vax and formula too. It was the anniversary today - aka DD's birthday - and I'm still healing.
Again, I'm so sorry that you didn't have the birth you wanted and that you and your baby weren't respected as you deserve to be. Feel free to PM me if you want to talk.

(P.S.- I used to be known as lisabeeprague)