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Discussion Starter #1
Okay, here's my birth plan. I'm bringing it in to the midwives to discuss within the next few weeks. They said if anyone at the hospital gives me a problem with something I can just tell them that its in my birthplan which was discussed and agreed upon by my MWs. Lets the hospital staff off the hook without requiring them to read through the entire birthplan...<br><br>
Tell me what you think, if I left anything out, etc.<br><br><div style="text-align:center;"><b>Natural Birth Plan for Cindy & Paul</b></div>
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We are very pleased to be sharing our birth experience with you and your staff. In preparation for a natural birth we have chosen to use the Bradley Method for labor and delivery and feel well prepared for when the time arrives.<br><br>
Unless medical problems arise, <i>in which case we expect both the problem and any procedural changes to be discussed with us</i>, we have certain requests as explained below. If our plans cannot be carried out because of specific policies/conditions we wish to be <i>informed ahead of time.</i> We are striving for as normal, safe and peaceful a birth as possible.<br><br><b>General</b><br>
·We expect to be part of the decision making team and to be consulted and fully informed of risks and alternative measures before any medical procedure even if it is “standard.”<br>
·We are requesting the Birthing Suite on the 4th floor.<br>
·We would prefer the birthing team kept to a minimum, which would <b>exclude any residents, trainees, students, and other non-essential personnel.</b><br>
·My support people are: the father, Paul, my best friend, Dawn, and my mother Nancy. Paul will be with me <span style="text-decoration:underline;">at all times of labor and delivery.</span> Dawn and Nancy are to be with me during labor, but will leave for delivery as it is to be a private moment between Paul, Cindy, and the birthing team.<br>
·<span style="text-decoration:underline;">I do not want to be offered pain medication or an epidural</span>. Instead, please make suggestions of non-medicated pain relief as you see fit!<br>
·<span style="text-decoration:underline;">No pitocin is to be administered!</span> We prefer natural methods to stimulate labor.<br><br><b>Labor</b><br>
·We understand that a fetal monitor will initially be used for approximately 20 minutes upon entry to the birthing room to get a baseline reading. Thereafter, we request freedom of movement with <span style="text-decoration:underline;">minimal, intermittent monitoring.</span><br>
·I plan on drinking water/juice to remain hydrated, therefore, <span style="text-decoration:underline;">I do not want an IV or heplock</span> unless I become dehydrated or a medical emergency arises as deemed by my midwives.<br>
·The initial blood test should include the Cord Blood Registry mother’s blood sample.<br>
·I wish to <span style="text-decoration:underline;">remain mobile throughout labor</span> and request the ability to change position at will. This includes standing, walking, squatting, use of the birth ball and tens unit I will be providing, shower/tub, etc.<br>
·I ask to be able to control the environment in which I labor as much as possible, including the use of low lighting, my own music, quiet if I want it at the time, use of massage techniques, warm compresses, etc.<br>
·Please, <span style="text-decoration:underline;">no amniotomy</span> used to expedite labor if waters not ruptured naturally.<br>
·There will be <span style="text-decoration:underline;">no episiotomy</span> without medical reason. We are preparing with Kegel exercises and perineal massage. The parents or midwives will apply warm, wet cloths or oil and perform perineal massage to the perineum prior to delivery. Perineum will be supported during delivery.<br>
·No forceps or vacuum extraction, unless they must be used to avoid a cesarean section.<br>
·Unless absolutely necessary, I would like to avoid a <b>cesarean section</b>. If a cesarean section is indicated I and the father, Paul, expect to be fully informed and to participate in the decision-making process. In the event of a cesarean section <i>I do not wish to be conscious in the operating room.</i><br><br><b>Delivery</b><br>
·If at all possible I would like to try a water birth.<br>
·I would like to be allowed to choose the position in which I give birth, including squatting, water birth, leaning, supported squat, all fours. I wish to avoid delivery in the prone or “stirrup” positions as they make no use of gravity.<br><br><b>Immediately After Delivery</b><br>
·We do not wish to cut the cord ourselves. We trust your staff to do it for us.<br>
·We are registered with Cord Blood Registry. Please follow the procedures necessary to ensure the safety and integrity of the cord blood.<br>
·Barring complications, the baby should be placed on my stomach/chest upon delivery.<br>
·We would like to breast feed as immediately as possible to help bond with the baby and naturally expel the placenta.<br>
·We will be <b>abstaining</b> from the antibiotic eye medication for the baby.<br><br><b>Postpartum</b><br><br><b>1. Nursing</b><br>
Our goal is to have a completely breastfed infant. To ensure this is the case we request the following:<br>
·Unless medically necessary as deemed by the midwives or our pediatrician, we do not wish to have any bottles/pacifiers given to the baby including glucose water, plain water, or “jaundice water.”<br>
·The baby is not to be taken to the nursery without medical reason. This includes being “sent up” ahead of me. The baby will instead remain with me in the birthing room until you have a room available for us.<br>
·I would like a private or semi-private room with no roommate if available.<br>
·I would like to have the baby “room in” and be with me at all times, 24 hours, including during visiting hours. I understand that this will mean that most of the baby care responsibility will be on me and look forward to it. I further understand that hospital policy dictates that should the baby need the nursery after being exposed to visiting hours that the baby would have to be isolated.<br>
·I would like to meet with a lactation consultant/la leche league rep if possible.<br><br><b>2. Other</b><br>
·Assuming everything is normal, we want to be released from the hospital as quickly as possible, preferably no later than 24 hours after delivery.
 

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If you're trying to avoid pitocin completely, you may want to include a statement about even after the baby's out. Otherwise, they may give you a shot to speed up delivery of the placenta and involution.<br><br>
If you really mean that you want general anesthesia in the event of a csec, you really should discuss this in advance with your providers. Many of them will not do general anesthesia without a medical reason (if you have a condition that would preclude epidural/spinal anesthesia being administered, then disregard), since it's more risky than an epidural or spinal. If you're concerned about being nervous or something like that, they can give you a sedative to make you kind of loopy. If you have general, you won't be able to see your baby for the first few hours, and there will be a delay in bfing. During which, a nurse may unwittingly give your child a bottle. Hopefully, you won't need a csec, but it's better to know how it would occur in advance than in the heat of the moment with all the stress.<br><br>
I feel that everyone should have a contigency plan in place for a csec. I think the worst thing about csecs (that are necessary) is not having planned for the possibility of one.<br><br>
Looks pretty good! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up">
 

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Discussion Starter #3
I know our midwives do not support the routine after birth pitocin, thank god. So we don't have to worry about that unless there really is a problem.<br><br>
I have very bad back problems and would rather not take the chance of having them put something in my spine. And also you're right, I'm a complete wuss when it comes to surgery. I've had a ton of biopsies, and the worst part was having to be awake during one...<br><br>
Yeah, I better not need a c-section! I guess the only saving grace is that if I do need one it will be in an emergency situation which at that point would probably preclude them having the time to give me an epidural as opposed to general.
 

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Looks good. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"><br><br>
One thing....I didn't newborn procedures (other than eye ointment) mentioned...<br><br>
Circumcision, Hep B, Vit. K, PKU etc.<br><br>
Might want to include your wishes regarding those choices! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Have you talked with your midwives about situations in which pitocin may actually be necessary and warranted? just curious...<br><br>
Re: the general anethesia... it's your choice, but seems like it's just as important to be aware and there for your baby after something like a surgical birth. Yes, it's hard and challenging, but your baby needs you and your attention at your birth, regardless of how it unfolds. You have obviously put a lot of effort, time, and thought into creating a birth plan and preparing for a gentle, natural birth. I sincerely hope that this is what follows for you. I was surprised to read that you wanted to be unconscious if a cesearean is necessary... almost sounds like that that point you "give up." Hang in there! Your baby is still coming and needs to meet its mama...
 

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If you can shorten your birth plan it will probably be more likely to get read.<br><br>
From your birth plan it sounds like you are OK with immediate cord cutting. Are you aware of the <a href="http://midwifeinfo.com/feature-cordclamping.php" target="_blank">risks of immediate cord clamping</a>?<br><br>
Regarding general anaesthesia during a possible c-section - are you aware that your baby will be exposed to the drugs as well? Are you comfortable with that? Also, it may hard on your baby if you cannot breastfeed and hold him/her fairly soon after the birth.
 

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Looks like you've gotten some good advice from the PPs! Lookin' good! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Having had a general anesthetic, a spinal and an epidural in the past few years, I would say that you may want to reconsider the choice not to be concious in case of a c-section. Seriously.<br>
I have scoliosis, as well as being on the, um, heavier side so i have really looked into this. The general does carry a lot more risks, both for you and babe plus you would be stuck in recovery (sans baby) for a lot longer than with a spinal block. Not to mention, the intubation hurts your throat and if you're anything like me, the puking is not fun (esp. after abdominal surgery)<br><br><br>
Other than that, it looks good!
 

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I'm another that is going to hop in about general v. epidural or spinal. I've had general and an epidural and will have a spinal to deliver our twins.<br><br>
Waking up from general is the most horrid thing you can imagine, and you certainly won't be seeing/holding your baby anytime soon. The passing of drugs from you to your child is too great a risk to take in my opinion. Especially when hoping to establish a good breastfeeding relationship at birth.<br><br>
I've had lifelong back issues, and was really scared about an epidural. We didn't want one, but after 27 hours of labor and broken water, our midwife had to transfer us to the hospital. It really wasn't bad, and the doctor was able to reassure me that the slight risks really outweighed the concerns with general. He was not willing to give me general unless there was true medical need. I did hate that the epidural took longer to wear off and I did not like that it was turned up and down.<br><br>
We opted for a spinal this time to get a one shot dosage and know the effects will be gone within 4 hours or so. I will be separated from the twins since they will need the NICU, so it was really important to me to be lucid and mobile ASAP so I could go see them, start pumping, and start recovering.
 

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Discussion Starter #10
Okay, I get the picture, general bad. However, unless they are going to sedate me enough where I won't be aware of the surgery and stitching <b>at all</b> I have no idea how I would get through it AGAIN. I am not "giving up" but preserving my mental state for the baby.<br><br>
Plus, my DH will NOT be in the room because he would definately faint. He can't even watch ER on tv even though it is fake. If its surgery he has made it clear that he doesn't want to be there.<br><br>
I have been though multiple outpatient surgeries (6 from ages 9 through 21), and been forced to do them awake, aware, and alone because in general circumstances family are not allowed in the or. I was terrified to move. I was terrified of the smells which I can recall like I'm still there. I was nauseaus for the entire stitching. After the surgeries I had nightmares for months. My depression became bad enough to need psychiatric help.<br><br>
While I appreciate the concern, (and I guess I did ask for it by posting the birth plan here, I just didn't remember that you guys don't know my history like my family do) I feel that making myself 100% emotionally after waking from a few hours of being unconscious, in the off-chance case of an absolute emergency, is much better than starting off my baby's life with mommy being depressed, having nightmares, and needing psychiatric help...<br><br>
Think of it this way, if you had to take medicine for asthma, or even depression after your baby is born, nobody would consider you a bad mom for taking care of yourself first so you can take care of baby better. For me, this is the same thing. If I am not aware of the surgery I won't have the emotional reoccurance which I strongly believe will effect the baby (and my marriage for that matter) more than the general.<br><br>
And again, the spinal/epidural is not advised with my back problems... Making these decisions is all about weighing risks vs. rewards...
 

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Discussion Starter #12
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<div>Originally Posted by <strong>Throkmorton</strong></div>
<div style="font-style:italic;">Fair enough, just thought i would give you a heads up</div>
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And I do really, sincerely appreciate it and all the other responses!<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/hug2.gif" style="border:0px solid;" title="Hug2"> I didn't mean to start anything. I just wanted to make sure that if general was your preference, you had gone over it with your providers. I didn't want them to refuse to do general at the last minute, because there wasn't a concrete reason. Frequently, there is plenty of time to do a spinal, even when an unplanned csec becomes necessary. I didn't want you to find out during the hectic stress of everything, that they weren't going to honor your request. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/hug2.gif" style="border:0px solid;" title="Hug2"><br><br>
FWIW- Not all necessary csecs are true emergency csecs. In my case with ds, I had been pushing for 6+ hours in every imaginable position, and he was stuck at +1. He was still doing ok, and I was still doing ok, so the providers were actually ok with me continuing to try for a vaginal birth, if I desired. But, at that point the odds of him coming out were close to zilch, and we didn't want it to turn into a true emergency. So, necessary- yes, true emergency- not yet.
 

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Hey Cindy...<br><br>
I had a C-section for the same reason as the pp...Adrock was just not moving after hours of labor and the vaccum...His head was just moving upi against my bone..<br><br>
I was very scared and didn't want to be awake either...I ended up going in with an epi. and they gave me some Nitrious Gas during the surgery so I wasn't aware of what was going on...I was able to see Adrock as soon as they pulled him out because they just took off the gas mask...They started it back up when they needed to staple...That might be something to look into to try and avoid the general...<br><br>
But hopefully Mama...none of this will be an issue for you and you will have a beatiful birth like you want..<br><br>
Here is some good vibes shooting your way!!!<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/dust.gif" style="border:0px solid;" title="dust">
 

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Sounds good, Cindy! As for me, I'm in the "you do what you have to do and make choices that aren't optimal when you have to" boat. So if the general is what you have to do, go for it. Naturally, this will be a moot point since your babe will come naturally! (I'm also big on positive thinking!)
 

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Discussion Starter #16
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<div>Originally Posted by <strong>*andiflipping*</strong></div>
<div style="font-style:italic;">and they gave me some Nitrious Gas during the surgery so I wasn't aware of what was going on...I was able to see Adrock as soon as they pulled him out because they just took off the gas mask...They started it back up when they needed to staple...That might be something to look into to try and avoid the general..</div>
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So you really weren't aware of what was going on? I've never had nitrious gas so I have no idea what that does for you. I just can't go through another freakin surgery awake and alone with a sense of hearing and sight and smell..... Did it just relax you or were you really unaware? Not something my bradley teacher mentioned either. Maybe that is a better choice. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Discussion Starter #17
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<div>Originally Posted by <strong>momma2emerson</strong></div>
<div style="font-style:italic;">FWIW- Not all necessary csecs are true emergency csecs. In my case with ds, I had been pushing for 6+ hours in every imaginable position, and he was stuck at +1. He was still doing ok, and I was still doing ok, so the providers were actually ok with me continuing to try for a vaginal birth, if I desired. But, at that point the odds of him coming out were close to zilch, and we didn't want it to turn into a true emergency. So, necessary- yes, true emergency- not yet.</div>
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Ouch! Yes, I guess you're right, they're not all "emergencies." I hope this one goes better for you as well!!! We all need some fairy dust next month!
 

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Discussion Starter #18
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<div>Originally Posted by <strong>mimid</strong></div>
<div style="font-style:italic;">Sounds good, Cindy! As for me, I'm in the "you do what you have to do and make choices that aren't optimal when you have to" boat. So if the general is what you have to do, go for it. Naturally, this will be a moot point since your babe will come naturally! (I'm also big on positive thinking!)</div>
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From your lips.... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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I had nitrus when my wisdom teeth were pulled and it was like you are aware but not part of it. I was just sort of there and felt very light and like I was in slow-motion. And when they take you off it, it goes away very fast.
 
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