Post # 1
I was hoping to get some feedback on the rough draft of my birth plan (parts of which were blatantly stolen from other bees–sorry Shimmer and abbyful, and thanks!) It’s one page in Word, with a second page specifically for a c-sec that we thought we could pull out if needed.
Is it clear and concise? Do I repeat myself anywhere? Miss anything big? Any feedback is appreciated. I’m still undecided if I want my mother and/or SIL with me, so that’s something I might need to add?
I should add that hep-locks are standard/required at my hospital, and the hospital prefers to allow women to tear naturally rather than giving episiotomies.
We have created this birth plan in order to outline some of our preferences for birth. We understand that the following are preferences and understand the need to be flexible as many of these are contingent on the health of me and the baby and the normal, steady progression of labor. We do not want to replace the medical personnel, but instead wish to be informed of any procedures in advance, and to be allowed the chance to give informed consent. In the event that I am unable to give informed consent, my husband David McK (from here on referred to as the Father) will act as my proxy. Please keep him informed and allow him to read over and sign any consent forms if I am unable.
Please feel free to ask if you have any questions or comments. Thank you!
- I understand that Penn State Hershey is a teaching hospital, and am comfortable with medical students observing my progress and treatments, but not with their active participation.
- I would prefer that the Father be allowed to remain in the room for all exams and procedures.
- Please do not offer an epidural. I will request one if needed.
- Please do, however, inform me if there is a “last chance” to receive an epidural.
- Please allow me to labor in different positions (walking, birthing ball, etc).
- Baby’s health permitting, I would prefer that fetal monitoring be performed intermittently with an external monitor.
- Please keep vaginal exams to a minimum.
- Please avoid induction (Pitocin or membrane scraping or rupturing) unless deemed medically necessary.
- If necessary, first methods used should be a membrane sweep and/or breaking of the waters.
- If Pitocin is required, I would prefer to start and stay at the lowest effective dose.
- Unless medically necessary, please avoid the use of forceps or a vacuum.
- If epidural has not been administered, please allow me the freedom to push from a position I find natural (squatting, on my knees, etc).
- To help my perineum stretch, please help guide my pushing efforts by letting me know when to start and when to stop.
- Please allow the Father to announce the baby’s gender.
- Please place the baby on my stomach or chest immediately after delivery.
- I would prefer that the umbilical cord be allowed to cease pulsating before clamping and cutting.
- The Father does not wish to cut the umbilical cord.
- If possible, please allow newborn exams to be performed with baby on my chest.
- Please refrain from administering the Vitamin K shot and eye drops until after the baby has been nursed and has had at least an hour of skin to skin contact.
- Unless it is medically necessary to be separated, I would like to hold the baby for at least the first hour following the birth.
- If the baby must go to the nursery or NICU for evaluation or medical treatment, the Father will accompany the baby.
- I plan to breastfeed and wish to nurse immediately after birth.
- Please do not give the baby supplements, including formula, glucose or plain water without my or the Father’s consent.
- Please do not give the baby a bottle or pacifier.
- If the baby is a boy, we are not planning on circumcising.
- Please do not administer general anesthesia without my consent.
- Please allow the Father (and another Support Person if desired) to be present as early during delivery and surgery as possible.
- Please do not strap my arms to the table unless medically necessary.
- I would prefer a low traverse incision.
- Please do not perform a hysterectomy without the informed consent of me or the Father.
Post # 3
Sounds like you covered everything.
Post # 4
This seems very thorough.
Post # 5
@Mrs Sarah McK: sounds good. They need to be TOLD to not perform a hysterectomy?! I would think they’d ask you for consent either way, but I guess its good to be clear.
Post # 6
@TurtleDoves: I assume they’d ask for consent too…but I saw it on someone else’s plan and figured I should cover all my bases, just in case.
Post # 7
Looks like you put a lot of thought into your birth plan!
Just for coversation sake, I wonder how many ladies come in with a birthing plan and how the nurses feel about following it? Any nurses willing to chime in? If you don’t mind, OP.
Post # 8
@tcanne: I don’t mind at all! Our childbirth instructor (who’s a L&D nurse at our hospital) actually encouraged us to write one. She said they can’t always followed exactly, but when it’s possible they will adhere to the parents’ wishes.
Post # 9
@tcanne: I have never made one for eiter one of my pregnancys, but I have always known my doctor would be the one delivering so I didn’t feel it necesary. As a nurse (not L & d), from my friends who are say they usually go out the window. The hospitla has policies that I see would effect almost all of the plans on here,so I hope people aren’t upset if theing can’t go the way they would prefer. ex- Some places have to have the arms strapped during surgery as a safety issue, if there is an emergency with baby there might not be room for them to work efficiently and have Dad there. And then there are some things that are common practice- not using forceps unless necesay, obtaining consent for anesthesia (unless it is an emergency).
@Mrs Sarah McK: I think one of the most important htings you said in this entire document was the very first bullet about a teaching hospital, alot of peole forget about this:)
Post # 10
You know, it makes total sense if you’re not sure if you’ll end up with your doctor or not. I didn’t even think about that. I didn’t do one, my doctor said she would be on call until her leave a few weeks after my due date. I had discussed with her what exactly I wanted before hand. To be honest though, I wasn’t very detailed. Just anxious to have baby come out the safest way possible.
Post # 11
I didn’t do a birth plan for either of my pregnancies. I know women who have been utterly distraught that their birth did not go the way that it was planned. And I didn’t want to fall into that trap.
I did have an idea where I stood on certain issues such as that I wanted my partner with me at all times, that I did not want an epidural and that I did want the injection after the birth so that I didn’t have continued labour with the placenta.
But other than that I really went with the flow. If they needed a decision or had a concern the staff talked to both of us about it as it occured. One example is with my first born she wasn’t breech, but she was backwards. So her spine was against my spine when it shouldnt of been. So they gave me options on techniques to use to encourage her to spin the right way.
I feel like I made informed deicions as I needed to, and then didn’t fill me head with details which in the end weren’t important. And there is no way that anything would be done to either the baby or myself without my express consent, or if I was unable to give it, my partners consent. Our local hospitals triple check and explain everything before proceeding.
Post # 12
@tcanne: I know I won’t have my doctor, since I flip between seeing a midwife and a CRNP, and neither aren’t allowed to deliver babies at my hospital. Even if we’d seen an OB at our office, unless I had a planned induction the chances of us getting our OB when I deliver would be 1/27. If I’d seen all of the OBs from my satellite clinic during my pregnancy the chances would still only be 3/27. We decided we were okay with not knowing who would catch our baby because we love our midwife and CRNP, and we’re very happy with the 9 months worth of care and attention we’ve received from them.
Post # 13
I’m not an L&D nurse but when I worked as a mother/baby nurse the ones that had a birth plan, usually wasn’t really followed. All the stuff you have about not doing things without a consent….they cannot do without your consent anyways. As for performing newborn exams on your chest….that isn’t very realistic tbh. To get a better look at the baby and be able to fully assess baby…it would be easier(and much quicker) to let them be able to lay baby on a flat surface. Also, if baby has to go to the nursery or NICU many hospitals will not let Dad come with baby right away. Many have windows to where Dad can watch baby and I’m sure they will gladly let him come in once they get baby settled in. Understand when a baby comes into the nursery/NICU the nurses have things they have to do right away to assess baby and make sure he/she is breathing ok, etc, etc. And sometimes family, while we know they mean well and are certainly concerned, get in our way of initially trying to help baby.
Also, if your baby has to spend time in the NICU (let’s hope this isn’t the case) you still don’t want him/her to have a pacifier? Pacifiers really are not evil and actually are of great comfort to a newborn, esp in a NICU setting. I understand your concerns about nipple confustion and all…but I’ve cared for many babies that were able to breastfeed just fine and still took a pacifier.
And for circumcising….many hospitals don’t do them inpatient anymore. It is an insurance thing…you usually do it outpatient after you and baby go home so you likely don’t have to worry about that.
Post # 14
@nursemel: Thank you for your feedback, those are definitely some things to consider.
Post # 15
@Mrs Sarah McK: No problem. I think it is great that you have taken into consideration the things important to you and your husband for the delivery of your baby. And most hospitals today really do try to respect their patient’s wishes. If they are unable to it isn’t cause they just don’t want to honor your birth plan. Just please be prepared that things may not go by the birth plan. Let it be a guide to how you want things(and yours looks like you have considered that).
I remember one…the parents would not allow us to give vit k or ointment to the baby’s eyes and wouldn’t let us check baby’s blood sugar. They said each poke was a risk for infection. They also wanted us to rub in the vernix and not bathe baby. They didn’t want baby’s first bath to be given for a couple days(I’m sorry…but that is just disgusting).
Post # 16
@nursemel: We know this is more of a wish list than anything. Ideally, with a perfect labor and delivery, most of these will be doable, but we’re well aware that things rarely go exactly according to plan. I told our childbirth instructor that we have “a birth preference list” rather than a “birth plan”, and we’re definitely prepared to need to be flexible on just about everything (minus DH not cutting the cord–he really has zero interest in doing that 🙂 On my first draft I had “unless deemed medically necessary” on pretty much every line but I decided it was too repetitive.
ETA: I also haven’t had a chance to ask about circumcision procedure at our hospital, or talk to a pediatrician yet, so I figured it was better to have it somewhere on paper.