Natural Birth

Birth Plan..I think its pretty reasonable and fair

First of all thanks for all the helpful advice about my last topic regarding inductions and my FORMER (yay) OB. I did find a new one. And from the discussions we've had seems very open to letting me do what I want. I still made a birth plan though because from what I've been reading its usually the L&D nurses that give the most problems. So what do you think?

L & D:

1.I do not consent to ?unnatural? induction methods. Membrane sweeping is fine. But  no Pitocin, I have enough heart issues I don?t want anything supercharging it.

 

 2. I do not consent to CONTINUIOUS fetal monitoring or constant interference, I need to be able to be as calm as I can and labor in peace for me to be effective.

 

 3. No epidural

 

 4. We consent to the hep loc but not an IV, as I need to have full movement in order to be able to labor effectively

 

5. The only people besides the OB and nurse that I want in the room is my husband and my doula 

After birth:

 1.Delayed cord clamping is a must, I would like the baby to get the full benefits of the properties if the cord blood.

 

 2. We WILL do the eye drops because although they are not needed in our case. I don?t see any downside to having them.

 

 3. We WILL do the Vitamin K shot.

 

 4. We do not consent to the Hep B shot.

 

 5. Please do not rub all the vernix off of the baby, because it has anti-bacterial properties and is good for their skin. We will do the first bath ourselves

 

 6.  Baby must be in room at all times, which I am sure will not be an issue since this is already stated as protocol in your ?Having a Baby? brochure/packet

 

7. We are choosing not to circumcise

8. If all is well with mother and baby we request an early discharge

 

*fyi. Nothing to do with the above but if any one is looking for a Britax travel system. I just scored one for 20% off on diapers.com, not sure if its a temporary sale or what just figured I'd pass it along*

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Re: Birth Plan..I think its pretty reasonable and fair

  • Sorry for the jumbled format, not sure why it came out like that.
  • I think the wording in your plan comes off as really defensive and if you reworded it you might have a better response to it. I think all of the things you are perferring are resonable and in a lot of cases standard.
  • The only things that I can think that you might want to add are:

    If you plan to breastfeed, maybe put something in there about that, skin to skin contact immediately after baby is born, no bottles or pacifiers if you don't want them used.

    Maybe something about them not asking you if you want medication, that if you decide you want it you will ask for it.

    Some of the stuff you listed that you do want is standard. I used my birth plan to put things in that are not typically standard.

    You might want to change the tone of it as well.

  • How should I re-word it?

    When I first wrote it, I had put "we would like to request" instead of "we will/we won't" but I was afraid that it sounded to much like I was asking their permission. I don't want to sound mean or defensive and I also don't want to seem like I am asking their permission to do something that I've made up my mind on. So any suggestions for a happy medium would be helpful.

    Oh and I though they don't give babies formula in the hospitals anymore? I didnt know I had to add it. But I will just in case

  • image NoeK:

    How should I re-word it?

    When I first wrote it, I had put "we would like to request" instead of "we will/we won't" but I was afraid that it sounded to much like I was asking their permission. I don't want to sound mean or defensive and I also don't want to seem like I am asking their permission to do something that I've made up my mind on. So any suggestions for a happy medium would be helpful.

    Oh and I though they don't give babies formula in the hospitals anymore? I didnt know I had to add it. But I will just in case

    I agree with PP-I would try to word it bit differently. 
    I started mine out with sentences like "We would prefer" " or " I would like". 
    I get what you're are saying about seeming like you are asking for their permission but starting the sentences off like this just comes off as less defensive to the nurses, who you will be relying on.  (in my head I am soooo defensive but I am going to try so hard not to let that out at the hospital unless its called for)
    I also read that you should leave out any practices that are already standard at your hospital. 
    But-its short, to the point and makes sense to me!  :) 
    GL!

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  • It seems really negative. I would rephrase in a what you DO want, rather than what you don't. like:

    -I would like to avoid pitocin. Sweeping membranes is acceptable, but please ask me first.

    -I prefer intermittent fetal monitoring with a doppler and would like to avoid continuous monitoring.

    -I will ask for pain meds if I want them. Please do not offer.

    -I consent to a hep lock rather than an IV. I would like to avoid IV fluids if possible.

    - The only people besides the OB and nurse that I want in the room is my husband and my doula

     

    etc. Generally, no, you aren't asking permission, but you aren't running the show either. Coming in with a list of "no" makes you look combative and uncooperative.

  • On my plan I worded things like this:

    We DO NOT want IV fluids unless [name] becomes dehydrated. [name] plans to stay hydrated through drinking fluids.

    We ask that non-chemical induction methods be tried first: walking, breast stimulation, etc

    We plan to handle pain with relaxation, counter pressure, massage and water (tub)

    We realize that many pain medications exist. Please don?t offer, we will ask for them if [name] needs them.

    Sorry for the huge font, I copy and pasted from my birth plan and something went screwy with the format.

    EDT: Think I fixed the formatting.

  • ok how's this?

    L & D:

    1. Membrane sweeping is fine. But I would like to avoid Pitocin, I have had heart issues in the past I don?t want anything to cause any additional issues.

     

     2. I would prefer intermittent monitoring and minimal interference, I need to be able to be as calm as I can and labor in peace for me to be effective.

     

     3. I would prefer pain medication not be offered to me.

     

     4. We would like the hep loc instead of the IV, as I need to have full movement in order to be able to labor effectively

     

    5. The only people besides the OB and nurse that I want in the room is my husband and my doula

     

    After birth:

     1.Delayed cord clamping is a must, I would like the baby to get the full benefits of the properties of the cord blood.

     

     2. We will not be giving baby the Hep B shot

     

     3.  Please do not rub all the vernix off of the baby, because it has anti-bacterial properties and is good for their skin. We will do the first bath ourselves

     

     4. Please make sure no formula is given, as I will be attempting to breastfeeding right away.

     

     5. Baby must be in room at all times, which I am sure will not be an issue since this is already stated as protocol in your ?Having a Baby? brochure/packet

     

     6. We are choosing not to circumcise.

     

    7. If all is well with mother and baby we request an early discharge.

  • image krdietzel:
    I think the wording in your plan comes off as really defensive and if you reworded it you might have a better response to it. I think all of the things you are perferring are resonable and in a lot of cases standard.

    This.  I think that if you don't want to be met with a lot of attitude and resistance that you should reword these as wishes.  You can find templates online with that type of wording.

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  •  These are my suggestions for you.  Keep it short and sweet.  They don't need to know your reasons (or would already be aware of the benefits of them.) so there isn't a reason to add them.

     

    L & D:

    1. We prefer to try non chemical methods of labor augmentation. Membrane sweeping is fine but we'd like to avoid Pitocin if possible.

     

     2. I would prefer intermittent monitoring and minimal interference of my freedom to change positions for comfort during labor.

     

     3. I am aware that there are pain medications available to me if needed.  I will ask for them if I feel it is necessary but would prefer that it not be offered until then.

     

     4. I would like a hep lock instead of a standard IV to allow for freedom of movement.

     

    5. My husband and doula will be the only non medical team people in the room during labor and delivery.

     

    After birth:

     1.Unless there is an emergency that requires immediate clamping and cutting of the cord, I would like the cord to stop pulsing before it is clamped and cut..

     

     2. We will decline the Hep B shot.

     

     3.  Please do not rub the vernix off of the baby.  We will do baby's first bath ourselves.

     

     4. I will be breastfeeding my baby.  Please do not offer formula or pacifiers.

     

     5. Baby must be in room at all times, which I am sure will not be an issue since this is already stated as protocol in your ?Having a Baby? brochure/packet  (if this is already protocol - delete it entirely)

     

     6. We are choosing not to circumcise. (does this need to be in your birth plan?  They would ask you this separately I presume)

     

    7. If all is well with mother and baby we request an early discharge.


  • Thank you wittyschaffy!

    I included #5 because even though thats what the booklet said, when i was talking to the Ob about it he said"that's weird, I dont think they do that". Maybe I'll take that part out and asked them about it verbally instead?

    Thanks for all the input ladiesSmile

  • I think it's fine but remember to be open to things not going your way. With my daughter I had a very specific plan in my head and actually planned a home birth but had to transfer after 24ish hours of labor. At the hospital I was faced with getting an epidural so that I could rest (I threw up the entire time and was VERY exhausted) and a little pitocin or having a c-section. I opted for the epi and pit and from that point on things went very well and I delivered a healthy baby girl vaginally. 
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  • I like the second draft much better. I went to the hospital with DS all ready to defend my choices and my nurse ended up being someone who had had three natural births herself and was a lot like a doula to me. I think the newest draft of your birth plan you could give to a nurse like that, or a worst case scenario nurse and get what you want without ruffling too many feathers.
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  • image NoeK:
    ok how's this?

    L & D:

    1. Membrane sweeping is fine. But I would like to avoid Pitocin, I have had heart issues in the past I don?t want anything to cause any additional issues.

     

     2. I would prefer intermittent monitoring and minimal interference, I need to be able to be as calm as I can and labor in peace for me to be effective.

     

     3. I would prefer pain medication not be offered to me.

     

     4. We would like the hep loc instead of the IV, as I need to have full movement in order to be able to labor effectively

     

    5. The only people besides the OB and nurse that I want in the room is my husband and my doula

     

    After birth:

     1.Delayed cord clamping is a must, I would like the baby to get the full benefits of the properties of the cord blood.

     

     2. We will not be giving baby the Hep B shot

     

     3.  Please do not rub all the vernix off of the baby, because it has anti-bacterial properties and is good for their skin. We will do the first bath ourselves

     

     4. Please make sure no formula is given, as I will be attempting to breastfeeding right away.

     

     5. Baby must be in room at all times, which I am sure will not be an issue since this is already stated as protocol in your ?Having a Baby? brochure/packet

     

     6. We are choosing not to circumcise.

     

    7. If all is well with mother and baby we request an early discharge.

    Definately feels more positive and like you are going to stick to guns. 

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  • I think your rewrite is much more positive and on the right track.  

    You might also consider shortening your plan if possible.  For example I would just leave out the part about consenting to eye drops and vitamin K.  That is normal hospital procedure, so no need to write about it.  I think you could also leave off the part about baby rooming in, since it's part of hospital policy and also number 8.  That is something you can easily discuss later with the pedi and your OB.  To me a birth plan is a tool used for when you may be unable to speak for yourself, like while you are in labor.  Those final bullets will be easy to address afterward.

    Also have you thought about a c-section birth plan?  I know it's not something we want to think about, but I wrote one this time just in case.    

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  • wow.. I haven't thought about a c section birth plan. I mean I do realize that things may not go the way I want them to this time around and the possibility may arise that I need one. But I have no idea what specific aspects of it I should or should not consent to....I'll have to research that one.
  • image NoeK:
    wow.. I haven't thought about a c section birth plan. I mean I do realize that things may not go the way I want them to this time around and the possibility may arise that I need one. But I have no idea what specific aspects of it I should or should not consent to....I'll have to research that one.

    Mine is pretty brief I think it's only three bullets:

     I asked them to use a double suture, which is supposed to make a VBAC more favorable (we plan to have one more baby).

    Husband to announce the sex of the baby

    One arm free after baby is presented to me so I can touch the baby

     

    Here's a link that I found helpful:
    http://momotics.com/c-section-birth-plan-by-dou-la-la/ ;

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  • image NoeK:
    ok how's this?

    L & D:

    1. Membrane sweeping is fine. But I would like to avoid Pitocin, I have had heart issues in the past I don?t want anything to cause any additional issues.

     

     2. I would prefer intermittent monitoring and minimal interference, I need to be able to be as calm as I can and labor in peace for me to be effective.

     

     3. I would prefer pain medication not be offered to me.

     

     4. We would like the hep loc instead of the IV, as I need to have full movement in order to be able to labor effectively

     

    5. The only people besides the OB and nurse that I want in the room is my husband and my doula

     

    After birth:

     1.Delayed cord clamping is a must, I would like the baby to get the full benefits of the properties of the cord blood.

     

     2. We will not be giving baby the Hep B shot

     

     3.  Please do not rub all the vernix off of the baby, because it has anti-bacterial properties and is good for their skin. We will do the first bath ourselves

     

     4. Please make sure no formula is given, as I will be attempting to breastfeeding right away.

     

     5. Baby must be in room at all times, which I am sure will not be an issue since this is already stated as protocol in your ?Having a Baby? brochure/packet

     

     6. We are choosing not to circumcise.

     

    7. If all is well with mother and baby we request an early discharge.

    I agree with pp's the first one was kinda defensive. I think this is much better!

    As a side note, I requested intermittent fetal monitoring and the OB was like "well what do you think we're not going to monitor the baby? We have to hook you up to the monitor." So I was like whatever, can I at least use the wireless one if you have it? And they let me do that.  I guess intermittent with a doppler was out of the question but it probably depends on your hospital policy.

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  • This was on the back-side of our birth plan.  As it turned out, I ended up with a c-section after a long labor.  The staff did an excellent job of following my birth plan (minus the one nurse who tried to give DS sugar water because he was a "big baby".  Dh stopped her).

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    Cesarean Preferences

     

    Should a cesarean become necessary we hope to maintain as many aspects of our original birth plan as possible.  Events permitting we also ask for a cesarean that will give us the best chance of a VBAC in the future, including the use of double layer repairs and a low transverse incision.

     

    General Preferences:

    ?       If time allows we would like to request a second opinion

    ?       Request a doctor who performs double layer repairs

    ?       Prefer a low transverse incision if possible

    ?       I would like my husband to be with me during the procedure

    ?       Would like for doctor to communicate with us as events occur

    ?       After the birth I would like my husband to be with the baby at all times

    ?       No sugar water, formula or pacifer for baby

     

    Anesthesia:

    ?       If not an emergency, I would prefer to remain awake and aware

    ?       Please do not use Versed or other memory blocks

    ?       Please place catheter after anesthesia takes effect

    ?       Please do not start procedure if there are areas of sensation

    ?       Prefer to be alert and comfortable after surgery to facilitate bonding and breastfeeding

     

    Ill Baby Preferences

     

    If our baby?s health is in jeopardy, we would like the following:

     

    ?       For mother to be transported with baby, if possible

    ?       For father to remain with baby whenever possible

    ?       To breastfeed/express milk for baby

    ?       To utilize ?kangeroo care? for baby when possible

     

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  • sorry for the horrible formatting.

     

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  • This is really good, if you do not mind I will use alot of these points
  • I like the re-write better, too.

    On the floor I work/deliver on, separate consents are obtained for any medicinal induction (cervidil/Pitocin/cytotec) and for HepB for the baby.  You might not need those points at all if your hospital is similar.  On the other side, VitK and erythromycin are standard procedure, so if you're okaying them, I wouldn't think you would need those, either.

    The discharge thing would be up to your OB/Ped, so I wouldn't even put that in there.  The L&D RN will have nothing to do with that.  I'd bring it up with the OB after delivery.

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  • I have no personal (no kids yet) experience with the eye drops so not sure if they have changed since I was born, but my parents are upset to this day that they were given to me without their approval.  My mom said that I looked at her with the clearest eyes when I was born then they weighed and measured me and put the drops in my eyes and my mom said it took a few weeks before my eyes were clear again.  Not sure if I just had a bad reaction to it or not but since I know we don't have any STD's to be concerned about I will be opting out of the eye drops. 
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  • image pumabrew:
    I have no personal (no kids yet) experience with the eye drops so not sure if they have changed since I was born, but my parents are upset to this day that they were given to me without their approval.  My mom said that I looked at her with the clearest eyes when I was born then they weighed and measured me and put the drops in my eyes and my mom said it took a few weeks before my eyes were clear again.  Not sure if I just had a bad reaction to it or not but since I know we don't have any STD's to be concerned about I will be opting out of the eye drops. 

    You were probably given silver nitrate, which can be irritating.  Now most hospitals use erythomycin, which is gentler.  I actually had to use it when I had an eye infection and was BFing and it didn't bother my eyes at all, just blurred my vision for a few minutes (of course that is just my own experience).  You can also ask them to delay the eye ointment until an hour or two after birth, so you can better bond.  

    Please understand, I am not trying to persuade you to do the eye drops, just offering another side for any readers out there :) 

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  • I would leave out the "why" on a lot of these. Asking for delayed clamping is one thing. Telling why just sets you up for arguments with people who disagree on some of these issues that the NB community sees differently than medical-model birth.
  • THIS IS IMPORTANT:  doctors and nurses will challenge "unconventional" requests sometimes the best way to approach them is to say they are part of your culture or religion by regulation they cant really argue there unless there really is something wrong.  Dont worry about being defensive stand your ground!  More importantly make sure your doula and husband stand behind you on everything and communicate all of these needs. 

    I also reccomend writing out a cesarean birth plan just in case.  Although most times doctors only want to do them for their benefit there are a few cases they are necessary.  So if you are in that very small group I would include keeping your breasts out of the sterile area so that you can still do imediate skin to skin and only using an epidural to manage pain.

  • I am actually going ot advise against rewording to sound less pushy.  Pushiness is necessary.  A lot of doctors will push to get what they want rather than what you want.  Doctors more often than not dont like natural births so to get what you want you need to be firm and specific.

  • Yep, better. Although, I am finding the explanations for some your requests to be a little redundant and unnecessary.

     EX: "I would prefer intermittent monitoring and minimal interference, I need to be able to be as calm as I can and labor in peace for me to be effective." They are L&D nurses, so I would expect that they already know why you are making this very common request. Same for the vernix request and the Hep Loc.

    To be fair, I tend toward a very business-like tone when dealing with medical preferences, so I err on the side of "Please, this is what I want" with minimal or no explanation unless specifically asked....which, like I said, these are all common requests, so clarification shouldn't be needed.

    That's my thought anyway. I could be wrong.

  • I agree with PP's that your initial plan is too blunt and may be a turn off for nurses who may see you as high needs and not be as willing to assit you in having the birth you want. Your rewrite is MUCH better. I also agree having a c section plan isn't a bad idea "just in case"

    Not sure if this will be helpful to you but this is the list of preferences I have put together.

    Birth Preferences  

    We are looking forward to sharing our birth experience with you. We are hoping for a medicine free and intervention free birthing experience much like that of a birthing center.  We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goal to make this labor and birth a great experience.

    Important to Note:

    ?   My blood type is Rh negative. I received a RhoGAM shot during the 28th week

    ?   GBS +

    ?   This will be a VBAC. Had Emergency C-Section 11.22.09 here at MVH due to low blood pressure after epidural

    ?   I had a post-partum hemorrhage with last delivery 11.22.09

    Labor

    ?  I expect that doctors and hospital staff will discuss all procedures with me before they are performed.

    ?   I prefer to wear my own clothes, rather than a hospital gown.

    ?   Would prefer a HepLock other than when receiving antibiotic treatment for GBS

    ?   Intermittent monitoring is preferred where possible, otherwise a portable monitor so I can labor without limitations

    ?   Would like option to labor in bath tub or blow up tub

    ?   Strong preference to avoid pain medications, mainly for benefit to baby and labor progress. I will consider accepting medications for difficult or long labor

    Delivery

    ?   I would like to push without time limits and in the position of my choosing

    ?   I would rather tear than have an episiotomy

    ?   I would like to have a mirror available and adjusted so I can see head crowning.

    ?   I appreciate assistance, but would prefer to push when I feel the urge (no counting)

    Cesarean Section Delivery

    ?   If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making and possibly get a second opinion if time allows.

    ?   Please explain the surgery to me and allow me to view as it happens (no sheet between us) creating as much of a ?Natural? Cesarean as possible.

    ?   I would like baby to be placed on me skin to skin as it would be in a vaginal birth

    ?   I would like my husband to be present during the surgery if he feels comfortable

    Newborn Care

    ?   I would like baby to be held by myself or husband at all times including during APGAR and other assessments.

    ?   No erythromycin eye treatment

    ?   No Hepatitis B Vaccine

    ?   No circumcision

    Breastfeeding

    ?   I plan to breastfeed and want to nurse immediately following the birth.

    ?   Please do not give supplements or pacifier (including formula, glucose, or plain water) without my consent.

    ?   I would like to meet with the staff lactation consultant.

    Visitors

    ?   I do not mind if medical students, residents, or interns are present for the birth, however I reserve the right to change my mind.

    ?   I would like to hold off family and visitors until after I have had a chance to breastfeed the baby.

    ?   My husband will be responsible for giving the okay for when and if visitors are allowed in the room during labor/delivery and after delivery

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  • For what it's worth, that plan is really more for your husband and doula. Your doctor and nurses won't even read it. 

    I wasn't in so much pain that I couldn't advocate for myself, ( in fact, even when I was pushing the doctor wanted me on my back and I told him NO, and birthed on my side. He made some smart ass comment about how someone needed to support my top leg then ( which my doula did, I believe)). The nurses told me later they've never seen anyone stand up to him like that hah.  

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