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Discussion Starter · #1 ·
I have mulled over this over and over and I simply cannot think of how to word it, start it, finish it, etc..

What I'm making is a back up birth plan in case I go into preterm labor or something goes wrong. So, it has to include things like "if I have to have a c-section, this is the cut I want and I prefer spinal or an epidural" type things.

I'm also thinking of making a short one for my midwives. Not sure what'd I'd put on it though. They know I was planning an unassisted birth so they already know I don't want hands on stuff. Maybe just a short outline clarifying what I want so they don't have to ask and I don't have to be snippy during labor?

If any of you guys have one that I can see, I'd love to pull ideas from several.
 

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My birthplan is pretty long since I am having to deliver my twins in the hospital, and most likely in the OR. My OB's practice has 4 different doctors, therefore there is no guarantee that my doc will actually be helping deliver my babies, so I had to make it a bit more detailed than most.

Birthing Preferences Cover Sheet

Dear Dr....,

I have chosen you, our medical advisor, and you, our birthing facility staff, as the people I want to attend me when my babies are born. I have chosen the HypnoBirthing method of quiet, relaxed, natural birth. From all of our prior discussions, I truly believe that you will do your utmost to help me attain my wish for a joyous, memorable and most satisfying natural birth possible.

The information that follows is a copy of my birth preferences. I have given careful consideration to each specific request in the plan, and I feel that it represents my wishes at this time. I realize that as labor ensues, I may choose to change my thinking and wish to feel free to do so. I understand that these choices presume a normal pregnancy and birth. Should a situation arise that constitutes a medical emergency, please know that you will have my complete cooperation after I have had an opportunity for an explanation of the medical need and have had sufficient time to discuss the decision with my birthing companion. I wish to have clear explanations of all suggested procedures, of the progress of labor is it is assessed, and of any possible special circumstances if they occur. In the absence of special circumstances, I ask that the following requests be honored.

Please attach this to my prenatal record and make it available to all physicians/staff who may be attending the birth should you not be attending us.

Your support and understanding are very much appreciated.

Birthing Preferences

For Hospital Admission
I request:
The patience and understanding of caregivers to support my wish to refrain from having any practice or procedures that, in the absence of a medical emergency, could unnecessarily stand in the way of my having the most natural birth possible.
The opportunity to discuss my birth preferences with my assigned nurse
To self-hydrate and decline routine IV prep upon admission.
Natural means of inducement, moving to minimum doses of artificial induction only if medically urgent.
To have an LDR room with a shower, subdued lighting, music and quiet tones.
To have only intermittent monitoring of FHR after the mandatory twenty-minute strip at admission.
To have the following persons present during my labor:
-Doula
-Sister
-Parents
To have the following persons present during birthing:
-Doula
-Sister or mother
To have no telephone calls relayed - only messages
To respectfully decline to participate in the taking of pain scale information.

During First-Stage Labor
I request:
The patience and understanding of caregivers to support my wish to refrain from having any practice or procedures that, in the absence of a medical emergency, could unnecessarily stand in the way of my having the most natural birth possible.
To have only necessary hospital staff.
That staff refrain from references to "pain, hurt, etc…" and any offer of medication or labor-enhancing procedures unless requested.
To be free of blood-pressure cuff between readings.
Manual intermittent monitoring after pattern is established.
Internal monitoring only in the event of medical urgency.
Nutritional snacking if labor is prolonged.
Freedom to walk and move during labor.
To change positions and assume labor positions of choice.
Minimal number of vaginal exams - with permission - to avoid premature rupture of membranes.
That labor be allowed to take its natural course without references to "moving things along" or "augmenting labor".
To use natural oxytocin stimulation in the event of a slow or resting labor, and to be accorded the privacy to do so.
To be fully apprised and consulted before the introduction of any medical procedure - augmentation, amniotomy, membrane stripping, etc…
To enjoy the shower.
To forego epidural if both babies are head-down.
If special circumstances arise warranting epidural, to delay the insertion of the epidural catheter as long as possible and to keep the catheter un-medicated until necessary.

During and Following Birthing
I request:
The patience and understanding of caregivers to support my wish to refrain from having any practice or procedures that, in the absence of a medical emergency, could unnecessarily stand in the way of my having the most natural birth possible.
To birth in the LDR room absent a medical necessity requiring a transfer to the OR.
If transfer to the OR becomes necessary, to have an LDR bed available in the OR if at all possible.
That natural expulsive pulsations of the body be allowed to facilitate the gentle descent of the baby, with mother-directed Birth Breathing to crowning. Birth companion will offer prompts. No coaching.
Use of HypnoBirthing breathing techniques - not other methods.
To assume birthing position of choice that will least likely require an episiotomy.
Episiotomy only if necessary, and only after discussion.
That I or my birth companion receive the babies if at all possible.
Cords to be clamped and cut only after pulsation has ceased.
To be allowed the opportunity to immediately breastfeed Baby A upon his birth, while delivering Baby B.
To be allowed the opportunity to immediately breastfeed Baby B upon her birth to assist placenta delivery.
A wait for natural placenta delivery.
No cord traction, manual removal or use of pitocin for removal of placenta unless necessary.
That companion be allowed to remain with mom in the operating and recovery room in the event of a C-section.
That companion hold the babies after c-section birth and bring baby to mom for viewing and eye contact. In absence of urgency, companion continues to hold the babies.

For Babies
I request:
Babies to remain with mother and birth companion after delivery
Delay use of ointment in baby's eyes to allow optimal sight for bonding.
Do not circumcise baby boy.
Do not administer vitamin K absent a medical necessity. If vitamin K becomes necessary, discuss with myself and/ or birth companion first, then oral vitamin K to be used rather than an injection if available.
That babies stay with mother during recovery and throughout the hospital stay.
Breastfeeding several times during the first few hours of babies' lives.
Breastfeeding only. No bottles, formula, pacifier or artificial nipples.
If babies are delivered premature and a feeding tube is required, that babies only be given mother's breast milk.
If one or both babies require placement in the NICU, to keep both babies together and in one isolette/ crib if possible.
To be fully apprised and consulted before administering any medicine or tests to either baby.

I thank you in advance for your support and kind attention to my choices. I know you join me in looking forward to a beautiful birth and celebration of these new lives.
 

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I'm having a hospital birth. I had an unmedicated/natural hospital birth with dd, with a very supportive OB - so this is basically a reminder for her of my wishes. It's long, but pretty blunt.

Goal: Healthy mother & baby
It is our goal to have a natural, vaginal delivery without the use of medication for labor induction or pain management. If complications or medical emergencies occur, we understand that this plan may have to be diverted from to protect the health of baby and mother. We would like for all procedures to be discussed with us prior to being performed, including why it is necessary, risks, benefits, and what alternatives are available.

Labor & Delivery Preferences:
•Do not induce labor
•Do not rupture membranes
•Do Not offer meds - we are aware that they are available
•Intermittent External fetal monitoring only
•No IV or heplock
•Freedom to eat and drink as needed
•Freedom to use shower/tub as needed
•Freedom to use any position to deliver
•Touch baby's head as it crowns
•Prefer tearing - do Not perform an episiotomy

Post Birth:
•Wait for umbilical cord to stop pulsating before it is clamped and cut
•Place the baby on mother's belly immediately after birth, unless baby is in distress
•Perform all newborn procedures while the baby is on mother
•Wait two hours prior to giving eye ointment
•Deliver the placenta without use of Pitocin
•We would like to be released from the hospital as soon as possible.

Baby Care:
•Baby is to be breastfed only - do Not offer our baby artificial nipples at any point
•24-hour rooming-in with our baby.

In the event of a C-Section:
•Prefer to avoid general anesthesia
•Use multi-layered suturing
•Companion is to stay with Lauri during procedure
•Allow Lauri to have at least one unrestrained hand to touch the baby
•Baby is to stay with companion while Lauri is being attended to
 

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I think with a homebirth (am I correct in assuming it's a homebirth?) you don't need an written birthplan unless you don't trust your midwives...in which case of course you shouldn't be going to them.
For my homebirths I just discusssed all of the specifics with my midwife and she always remembered everything I wanted (more than I did!) during the births. I did write down my requests and requirements if for some reason I ended up in the hospital (I had preterm labor issues w/all of my pregnancies). I feel like it's one of those things that if you are prepared for it, it won't happen. If you're not prepared then of course it will.


As a doula I have helped a lot of women write out their birth plans. It's a good idea to have the language positive instead of negative because the negative ones do put the hospital staff on the defense and they're not as likely to accomodate you. Try to say what you would like instead of "NO ____" or "DON'T _______ ."

For example:

"I would like to keep my water intact until it breaks on it's own"

instead of

"Don't break my water."

or

"No ARM!"

It's also helpful to write it very clearly and stay away from being too wordy. It's ideal to divide it by:

Early Labor
Active Labor
Second Stage
Third Stage
Postpartum

It's easier for them to see what you want at what time.

It's also a good idea to write a brief introduction to kind of introduce yourself and make them have to see that you're truly a human having a life changing experience and not just another number, kwim?

Something simple like, "Hi, we're Jon and Mary and we are really looking forward to the birth of our child and are pleased to have your staff helping us out with it." But of course not quite that dorky.


Well, that's all I can think of for now. HTH When are you due?


Um, duh
, it's the October month club! Sorry. I'm an idiot. Is that okay for me to post here?


Since I'm already intruding I thought I'd add something else.
I did have all of my babies three weeks early and they were all good to go. Just thought you might like to hear that.
 

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Discussion Starter · #6 ·
MamaAllNatural, the only reason I need a birth plan is because it's triplets and the risk of really preterm labor is quite a bit higher than with singletons. I'm only meeting with my midwives twice before my due date so I'd kinda like a sheet of "this is what I want" so they don't have to try to remember it in just a few hours, kwim? I am planning a homebirth, but want the back up plan just in case. However, if I do go to the hospital, it will be an emergency so I don't know how much of the plan is going to matter.

I don't mind if you pop in on the DDC.
I miss seeing you around.
 

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IM on my way to bed and didnt notice if anyone has posted about it however i would recommend for csect especially for emergency that they hang the placenta like an iv ( and do not cut the cord)

this can save many babies from cerebral palsy

michele
 

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Quote:

Originally Posted by MamaAllNatural
It's a good idea to have the language positive instead of negative because the negative ones do put the hospital staff on the defense and they're not as likely to accomodate you. Try to say what you would like instead of "NO ____" or "DON'T _______ ."
Ok, I should probably rewrite mine, it is a little terse. I just hate feeling like I'm asking their permission. I was much nicer in my birthplan with dd, I just wanted to get to the point in this birthplan so the nurses wouldn't have to search for my wishes. Maybe I can find a happy medium.
 

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Discussion Starter · #9 ·
Quote:

Originally Posted by ArlyShellandKai
IM on my way to bed and didnt notice if anyone has posted about it however i would recommend for csect especially for emergency that they hang the placenta like an iv ( and do not cut the cord)

this can save many babies from cerebral palsy

michele
How would this work for the twin boys sharing a placenta? I can see how it would work for the girl since hers is seperate, but I don't see how it would really work for the boys.
 

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Funny that you shoudl bring this up

I did mine yesterday. I searched online for natural birht plans and found a really good one (that would be suitable for just about any birth)
I did mine up, it has pre made boxes you check. IN some places i did put DONT or NO cusae it was somethgin that I was not willign to compromise on. (Circ, vax, Vit k, etc) My feeling was that if i put "I would like" then they would skimp around it and try to do it their way rahter than respect what i want. (I've given birth 2 times at this same hospital and its very small and al teh same staff are still there. (And they all know what a B#[email protected] I can be if needed.) LOL SO i needed to be very clear in what i didnt' want versus what i woudl like. (I would liek to be ablew to eat and drink throughout labor if i choose VS Do not Circ my son)
 

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In my doula training, we got a looooong list of all possible events during a birth in any situation, with a scale from -10 to 0 to +10. the idea is that you put a mark on the scale how you feel about EACH possibility, with 0 being neutral, -10 being strongly doesnt want and +10 being strongly wants.
If you look at your birth plan in this way, then it can help you to see, like you may be really against any form of intervention, but if (for example) the labour goes on more than 48 hours, then maybe you shift your -10 to a -8 or even a +2...
There are always circumstances that can come up, the one in a million chance... and in that one in a million, it helps to be prepared. (though i'm sure you will birth unassisted just fine), its better to have a plan for if you do need an emergency C/sec, that you want you baby to be rooming in etc.
 

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Kathryn, congratulations X
!!!
That is so cool!

With my last pregnancy (my third) there was about a month where we thought I was likely carrying twins and I absolutely still would've had them at home. I know my midwife has done both twin and triplet homebirths as well. Good for you. That is just so awesome!


Quote:

Originally Posted by Kathryn
However, if I do go to the hospital, it will be an emergency so I don't know how much of the plan is going to matter.
Ah, good point. I guess it would still feel good to know that people have access to your wishes in general no matter what the circumstances are. Good to see you too.


Quote:

Originally Posted by texmama
Ok, I should probably rewrite mine, it is a little terse. I just hate feeling like I'm asking their permission. I was much nicer in my birthplan with dd, I just wanted to get to the point in this birthplan so the nurses wouldn't have to search for my wishes. Maybe I can find a happy medium
I can totally understand that. Unfortunately though, that tends to end up being the dynamic in a hospital birth setting no matter what. I think it helps to also word it as "Birth Wishes" and then maybe you can have a part that says:

My Birth Wishes are as follows:

Intact membranes throughout labor
To labor drugfree, without any offers of drugs from hospital staff
Cut cord *after* it's done pulsating

I think with certain things that are extremely important it's okay to write it seperately. Circ is something that, if I was in the hospital, I would not want to take any chances on. So I might write it at the top w/the intro as well as in the postpartum section. It also helps to thank them in the intro for their help with the birth and for respecting your wishes.

I think also, texmama, it's important to stay strong in the hospital setting and remember that even though it is set up for you to feel like you have to ask their permission for things and that they have some kind of control over you, they absolutely don't. As a doula, I have seen even the strongest, boldest women saying things like, "They won't let me get out of bed." "They said I have to stay on the monitor for ____ more minutes." etc. Or saying nothing when they take their baby away from them for no reason or do something they specifically requested not be done. Remember that *YOU* are the boss and it is YOUR body and YOUR baby and YOU will be the one making all of the decisions. The wording of the birth plan and the attitude toward hospital staff being respectful and positive is important for the relationship but what it comes down to is that they need to return that and you need to have the birth experience that will leave you feeling empowered instead of violated and controlled. Make sure whoever is helping you with the birth knows your wishes too and reminds you of them the moment it seems the hospital staff has forgotten.

Okay, I'll get off my soapbox now. Just trying to help.
 

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I was just talking about this yesterday with DH. We had a great birth experience with DS and our birth plan was very simple and straightforward and BRIEF. THere was no mention of anything hospital-related or emergency, etc. Now I am having DH read The Birth Partner (P. Simpkin) and they recommend having some details in the birth plan about what you'd like to do in an emergency. I don't want to include any of that in my plan (after all, that's NOT part of my plan
) but maybe it's not a bad idea to at least have one small section in there for the "just in case" scenereo. I don't know. It's a good question.
 
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