Post # 1
Here’s my birth plan, is there anything you suggest changing or that I missed?
- Able to walk around and change position.
- Vaginal exams to a minimum, no premature breaking of the membranes or scraping.
- No catheter.
- IV starter can be placed, but not hooked up unless necessary.
- External monitoring only
- No continuous fetal monitoring unless required by baby’s condition
- If deemed necessary, first methods used should be membrane sweep and/or breaking water. No premature rupture of the water or membranes.
- We would like to exhaust all methods of natural labor stimulation prior to any drugs being administered (nipple stimulation, ankle, etc.)
- In the case of any drugs being suggested, we would like to discuss the benefits vs risks.
- No episiotomy unless for baby’s safety; if episiotomy is needed, please do a pressure episiotomy
- Rather tear than cut
- Would like a local anesthesia if a tear occurs for stitches.
- Support the perineum during pushing/crowning and use a warm compress
- Free to move while pushing
- Push when the urge to push comes and push to comfort
- Baby’s shoulders should be birthed on their own, not pulled out
- Avoid forceps/vacuum if at all possible
- Only as an emergency last resort
- Participate in any discussions
- Low horizontal incision
- Baby will be breastfed ASAP
- We will be trying for a VBAC in the future, please take all measures to make the site as strong as possible
- Suture uterus in 2 layers
- If baby is placed in a nursery, father will accompany baby at all times
- Baby placed immediately on mother’s chest
- Wait until the cord stops pulsating to clamp
- Mother will expel the placenta on her own, please no tugging or pulling
- No Pitocin to remove placenta unless abnormal amount of bleeding requires it, must get permission to do so first
- We would like to delay the eye medication for one hour to better bond with baby
- No Hepatitis B shot, will get it done at a later date
- We prefer skin-to-skin contact over lamps and nursery
- No tests until after first feeding/golden hour
- Do not bath baby
- In case the need arises to separate baby from mother, father will accompany baby at all times
- NO circumcision
- Breastfeed exclusively, please no bottles, artificial nipples, sugar water, formula, etc.
- No separation from baby
Post # 3
Looks pretty comprehensive to me…only thing I would say is that while hopefully your birth goes exactly how you want it to be, if for some reason there is a need for an emergency c section, you’re probably not going to get a “discussion”. They’re going to be pulling cords, rushing around the room, etc.
They shoved a clipboard in my face while they were rushing me into the OR (baby’s heart rate was dropping dramatically, doctor said we couldn’t wait another minute).
Post # 4
“if for some reason there is a need for an emergency c section, you’re probably not going to get a “discussion”. They’re going to be pulling cords, rushing around the room, etc.”
We actually talked about this in my Bradley classes. My instructor said to watch the mannerisms of the people that are talking to you, if they are just nonchalantly saying “oh, maybe we can consider a c-section…”, it’s really NOT an emergecy. If they are rushing around like you said, then it probably is an emergency.
So the “would like to discuss” is an attempt to avoid an unneccesary c-section done for the doctor’s convenience because he/she wants to go home and not stay past their shift.
Post # 5
The only change I can see if is it is necessary for internal monitoring, you may want to keep that as an option. I know we had to go that route because the contractions and hb were not showing on a regular basis.
Post # 6
Looks like a well thought out and informed birth plan. Just out of curiosity (please feel free to not answer if you don’t want to), I’m wondering what your thoughts are about declining the oxytocin to remove the placenta?
Post # 7
I think it looks very well thought out. The only thing I can think of clarifying is the C-section part… it sounds like you’re of the “only if absolutely medically necessary for the health and safety of mom and baby” camp and so maybe something about that should be included so that that is clear in the birth plan? It might be better than saying you want to be a part of any conversations about it (although you could certainly keep that in there).
Post # 8
I think it looks good! Stay home as long as possible & know the reasons/research behind what you’re requesting… Including Darling Husband because you’ll be kinda busy. 😉
Post # 9
I would also add “no pacifiers.” A nurse gave my nephew one without asking his mom!! He was only a day old and she was breast-feeding.
Post # 10
Just commenting on this post so I can reference it later:)
Post # 11
I think this birth plan will make it harder for your doctor and nurses to do what is in their best judgment. As someone who has delivered many babies, seeing a birth plan like this makes us think high-maintenance and that you don’t trust the team working for you, even if those aren’t true. While it may not be right, I have seen countless times where providers or nurses spend less time with patients who have these requests and more time with patients they consider “nicer” and “more appreciative.”
Time spent writing a birth plan is better spent choosing the best physician, and then trusting his or her judgment. If you don’t trust their judgment, why are you going to them?
Post # 12
@guitargirl: With the exception of her preferences about augmentation and management of the third stage, all of the issues that she lists are actaully best practices based on solid evidence. So….I would imagine that (hopefully?) most care providers would already be adhering to most of this as a part of their “best judgement”.
And, perhaps more importantly, just because a woman thinks about her wishes, informs herself of the options and their risks and benefits, and is a PROACTIVE consumer of health care, doesn’t make her “high maintenance” or “less nice” or “less appreciative”. It also doesn’t mean she doesn’t “trust” her care providers. What it does mean is that she’s her own best self advocate for what she wants given the appropriate clinical scenario.
Also, lest we not forget (and I work in the industry so I do know) that not all doctors or nurses always do what’s in their “best judgement”….sometimes, they do what’s in their “best interest”. Like putting a healthy, unmedicated, uncomplicated woman on EFM just because it’s easier to monitor centrally than to actually spend enough time to do intermittant ausculation.
Post # 13
And less attentive nurses is not always > more attentive nurses.
Post # 14
Thanks everyone! I took it in last week to my doctor visit, there were a few things we dicussed and he said “we can do this unless xyz happens”, but I understand and expected that, I know our plan is an ideal and that things may come up where there need to be exceptions. My doctor very much supportive of my plan though! He did say to remind him of some stuff when it came up, such as the delayed cord clamping, because he may not remember, but that’s fine, we’re also going to have a doula, so she can help watch out and convay our wishes too. As cdncinnamongirl said, I discovered much of it is actually routine practice for the hospital I’m delivering at.
@guitargirl – It’s unfortunate you feel that way. Maybe instead of labeling women who have researched specific things they would like for their care, you should be more open-minded to them. I know you probably aren’t trying to come across this way, but your comments come across like “patients are stupid and should just blindly do whatever the nurses say”.
And I, like many women, don’t just have 1 doctor. There are 8 doctors at the practice I go to, any one of them could be the one who attends my delivery. And I don’t expect a doctor to remember everything we discussed when the delivery day comes, a doctor has many patients to take care of.
Post # 15
@abbyful: oh my god how do you KNOW all this stuff?? I’m 29 weeks exactly, i think from my baby bump thread stalking that i’m only a few days behind you (yaaay) and I dont know about half this stuff!! I think I want what you want though! (Although this may be a case of last minute copying someone else’s homework ha ha) Did you read books to decide what you wanted from you birth, or talk to people?