If you manage to find a halfway decent OB, or family or general practioner, who's willing to actually talk with you here's a terrific alternative to a birth plan. Have them write what you want on your chart as doctor's orders. I was talking to my mother tonight about her vbac with my little brother and it turns out that her doctor actually put that "there is no standard operating procedure with this infant, all procedures must be approved by one of the parents" and that "this infant will be with one of the parents or the big sister at all times." Also, because she knew from 3 days of back labor with me that posterior babies got stuck in her, she wanted a c-section right away if she started having back labor with my little brother. So they had the operating room set up next to the birthing room with an OB waiting (her doctor was an FP), on her chart was "the OB will not be allowed into the birthing room unless the decision to do a c-section has been made."
So anyway, if at all possible, talk to your OB and get them to write it on the chart. They won't have to say things like "if at all possible" to make it palatable to the nurses, they can just write stuff in as orders. That could also make things easier on your doula, she could say "have you checked my client's chart? what does the doctor say about that?"
Turns out my mom's fp was pretty non-interventionist. His comment was "I discovered I get paid just as much if I just sit back and drink orange juice as I do if I try doing a 'traditional' delivery."
Well, it does require a decent care provider. It's also only really useful for stuff the staff might do, not so helpful for stuff the doctor might do. E.g. it's good to help keep people from continually offering epidurals, but not so hot for avoiding an episiotomy.
Funny, I thought that was SOP for birth plans. I took mine in to the OB at around seven months, and she signed it and put it right in my chart, telling me that made it official Doctor's Orders. It was there waiting at the hospital when I got there.
And for the record here, the only point the nurses "broke" was the one where I said "Please do not offer pain relief." While she didn't actually *offer* it, she did step in to tell me the anesthesologist was getting ready to leave for the night, so if I thought I might be considering an epidural, now was better than later. DH caved
Yeah--I doula'd a friend's birth, and she had a quality fam. practice MD. The nurse had to call/check w/ him before any "standard" proceudres, like IV, vag exams, toco-on-the-belly nonsense, etc. That helped make the experience easy, because it wasn't the patient fussing; it was just following the hospital chain of command, where RN must follow MD orders.
Thanks for posting this, s-chan....even though I was there, I didn't think about the universality of having an OB write his/her rules for patient X in the chart. Interesting.
The really cool thing is it was actually her doctor's idea to put the stuff on the chart. She had just been planning to go in and discuss things with him and he was like "this is all reasonable, I'll add it to your chart."