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Critique my birth plans!

405 Views 8 Replies 7 Participants Last post by  mamacatsbaby
I have 2: one for the birth center (planned) and one for the hospital (in case of transfer). The hospital one is very long (2 pages), but most of it would probably be moot--we would likely only transfer in case of an emergency, at which point we'd be beyond many of the stages listed. We divided it into sections for this reason--i.e., so the hospital could skip whatever did not apply. In any event, let me know what you think.

Birth Plan for NYCVeg and PapaVeg (at birth center)
We are extremely grateful to the midwives and staff at [Birth Center] for their support!

First stage labor
We wish to:
·be offered the option to labor in water when labor is well established

We wish to avoid:
·AROM or other medical methods of induction; please suggest alternatives
·vaginal exams
·visitors or phone calls until after the birth

Second stage labor
Perineal support: Although I (obviously) do not wish to tear, I would like to avoid touching or manipulation of the perineal area/vulva as much as possible. I do not wish to have a "vulvar sweep" or any hands/fingers inside my vagina to massage the perineum. I believe I will stay more relaxed if my skin is simply allowed to stretch slowly and naturally, without interference, and that I will have greater freedom to choose a comfortable pushing position if I am not worried about providing "access" to this area. It is possible I may want a warm compress, oil, or counter-pressure on the outside of my perineum (ideally, PapaVeg would provide these); please suggest it if you feel it would be helpful, but do not apply either without my consent.

NYCVeg would like to:
·wait to push until she feels the urge and avoid "coached" pushing (e.g., counting)
·allow PapaVeg to catch the baby.

Birth and Post-Partum
We would like to:
·delay cord cutting/clamping until cord has stopped pulsating and/or placenta has delivered; PapaVeg would like to cut the cord
·allow placenta to expel naturally (no pulling on cord, pressing uterus, etc.)
·rub vernix into baby's skin after birth; avoid bathing
·breastfeed as soon as possible after birth
·test baby's cord blood for ABO incompatibility (I'm O+) and c-reactive protein
·If stitches are needed for a tear, please use local anesthetic.

We would like to avoid:
·antibiotic eye ointment
·vitamin K shot, except in the case of a very long pushing stage or obvious birth trauma; please discuss this with us after the birth
--In the event we choose to receive vitamin K, we would like baby to receive 0.5 mg (the lowest recommended dose), rather than 1mg

Please see other side for transfer instructions; separate hospital birth plan attached.

In case of transfer to Inova Alexandria Hospital
·We wish to remain together at all times
·We do NOT give consent for students or other unneccessary personnel to be present
·No procedures/medications are to be administered without explicit consent
·If baby is transferred to nursery or NICU due to emergency, Mike will stay with her at all times and for all procedures
·We wish to breastfeed exclusively and as soon as possible

Please see separate hospital birth plan

* * * * *

Birth Plan for NYCVeg and PapaVeg (at XXXX Hospital)
·Our birth assistants are XX and XX. We request that they, and/or a midwife from XX Birth Center, remain with us at all times.
·Please do not perform any procedures, including routine procedures, on NYCVeg or baby with first receiving informed consent from NYCVeg or PapaVeg. This includes the administration of any medications. We thank you in advance.

NYCVeg would like:
·to remain with PapaVeg at all times
·to be consulted before any procedures (including routine procedures such as IV and EFM) are done; PapaVeg will provide/deny consent if NYCVeg is unable to
·freedom of movement throughout labor, including walking and changing positions
·to birth in whatever position is most comfortable (squatting, hands and knees, etc.)
·low lights, quiet, minimum disruption during labor (no students or visitors please)
·to eat and drink, as desired, during labor

We would like to avoid:
·Pitocin: we will try natural methods of labor stimulation
·continuous external fetal monitoring and/or any internal monitoring; we prefer that monitoring of baby's heart rate be done with fetoscope or doppler
·pain medications: please do not offer any; if we ask for medication and/or it becomes medically necessary, we prefer epidural anesthesia and wish to avoid narcotics
·artificial rupture or stripping of membranes
·any vaginal exams
·IV fluids; if IV prep is necessary, we prefer a heparin lock to allow movement
·other medications, except in case of medical emergency/necessity, and then only with express consent; under NO circumstances is NYCVeg to be given Cytotec
·unnecessary visitors: please, no students or unnecessary personnel at any time

NYCVeg would like:
·to push only when/as she has the urge…no counted or coached pushing please
·to slow pushing during crowning to allow the perineum to stretch naturally
·delayed cutting/clamping of cord; we do not wish to clamp or cut the umbilical cord until it has stopped pulsating; PapaVeg would like to cut the cord
·to deliver the placenta naturally, encouraged by breastfeeding

NYCVeg would like to avoid:
·episiotomy: do NOT perform except in case of medical emergency and then only with express consent
·forceps or vaccum delivery
·assisted delivery of the placenta (e.g., by pulling of cord, pressing uterus, etc.)
·routine administration of Pitocin after birth; please use Pitocin only in case of hemmorhage, and then only with express consent of NYCVeg or PapaVeg

After Birth
NYCVeg would like:
·baby placed on chest (skin-to-skin contact) immediately after birth
·to breastfeed as soon as possible, ideally within ½ hour of birth
·to stay with baby at all times

We would like to avoid:
·any separation of baby and parents; we do not wish for our baby to be removed to the nursery or to a warmer
·any artificial nipples or baby food; please, NO formula, pacifiers, bottles, or sugar water; our baby will be exclusively breastfed (if baby must be taken to NICU for any reason, I would like to provide pumped milk)
·bathing of baby after birth; please gently towel off baby and rub vernix into skin

We respectfully DECLINE:
·Hepatitis B vaccine
·antibiotic eye ointment
·PKU testing (this will be done by baby's pediatrician)
·routine administration of vitamin K shot, except in case of obvious birth trauma or prolonged pushing stage, and then only with express consent

In the event of a cesarean section
·NYCVeg gets very claustrophobic/panicky when face-covering oxygen masks are used; she would strongly prefer tubes that fit in the nostrils to deliver oxygen
·Please sew incision with a double row, rather than a single row of stitches
·One parent is to remain with baby at all times and for any procedures; please do not perform any procedures (including administration of vaccines and eye ointment, PKU testing, etc.) without express parental consent
·NYCVeg would like to hold the baby as soon as possible and to breastfeed as soon as possible
·NYCVeg would like to room-in with baby
·In the event that the baby must go to the NICU due to medical emergency, PapaVeg will remain with baby at all times and for any procedures

Many thanks for your cooperation with the following. We sincerely appreciate your assistance and support in the birth of our baby.
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Looks good to me! I had to giggle when I saw the parts referring to perineum support/massage/etc in your plan, that's a good discussion!
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I had combined my birth center plans with my 'transfer' hospital plans and had them all color coded...but I think I like the seperatness of yours...I think I'll be redoing mine now! Thanks for the idea
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You may want to add something to your hospital plan that says "In case our dd turns out to be a ds, we do NOT wish to have him circed." Even if you decided to do a bris, you wouldn't want him circed in the hospital. Otherwise, it looks really good!

Originally Posted by momma2emerson
You may want to add something to your hospital plan that says "In case our dd turns out to be a ds, we do NOT wish to have him circed." Even if you decided to do a bris, you wouldn't want him circed in the hospital. Otherwise, it looks really good!
Would they ever circ w/o consent?!? DH would go ballastic (he's more in favor of religious circ than I am, but violently opposed to hospital circ--go figure).
wow, you should see MY plans, they include mostly abou tafter labor and birth. Lol, I think I didn't think to put all that in because I have VERY quick labors and think things will go pretty quick anyways!

Also , keep in the back of your mind , if labor doesn't go as planned.
With my 1st, my labor was LONG and all the plans were great!
My 2nd....I wanted MEDs as soon as I could get them and was devistated to learn when i got to the hospital i was too far progressed to receive any.
I was YELLING at the doctors...."I want MEDs"!!!
They kept asking, do you feel pressure or pain? (they must have asked a million times) and I yelled at them....I Feel BOTH!!!!!
They checked me and I was complete!! Things started flying around the room and people were freaking (it was a teaching hospital so there was alot of people). I kept insisting I wanted medication and then in one fall swoop............I gotta PUSH!!!!!!!!!!!
3 pushes and he was OUT!!

So, keep yourself flexable. Course arguing with the doctor about meds DID help keep my mind off the pain, lol!

As you see, I am not totaly against pain meds, I think they have thier place, but I am sure I won't be getting any and I will be lucky to just get to the hospital!

you're very organized!
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Originally Posted by NYCVeg
Would they ever circ w/o consent?!? DH would go ballastic (he's more in favor of religious circ than I am, but violently opposed to hospital circ--go figure).
I don't know that they would, but if you talk to enough people online, you hear stories, where babies have been violated. I guess, in some places it might be considered routine still, much like eye ointment and vit. K.

Ds's birthplan specifically said "no circ," because we had a bris planned, and dd's says just in case the 6 u/s have been wrong "no circ." I figure, it can't hurt to add it.

I'm crazy opposed to hospital circs too, so I can sort of see where your dh is coming from. Odds are that you're having a girl, and it won't be an issue, but you never know.

Really though, your plan is very thorough and well thought out. I don't know how you have time for everything you're doing right now. I would put a smilie here, but they're disabled right now. I'm very impressed.
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Looks good! Hmmm, the more I read about perineal massage, the more I'm thinking I wouldn't like it either.
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