A different kind of birth plan question

catsinawindow

I plan on delivering at a free-standing birth center, with CNMs.  At my last appointment, I asked about whether they recommend birth plans, both for birthing at the center and in the case of a hospital transfer.  My MW told me that for births at the center, they like to look at birth plans as a list of "helpful suggestions" because their standard practices are already so low-intervention.  Regarding a hospital transfer birth plan, she said that I could write one if I wanted, but in most hospital transfer cases, not all of mom's wishes will be able to met due to the situation leading to transfer.

With this in mind, I'm struggling about how optimistic to be with my hospital birth plan, and how to word an opening paragraph explaining that this is not a planned hospital birth.  If anyone in this situation has any tips or examples, I would love to see them.  Also, if anyone has suggestions for writing a good birth center birth plan, I'd love to hear them to get a feel for what it could look like.  I have a birth plan from DS's hospital birth, but I am finding that I will need to change it up a lot! 

catsinawindow

lbs2012 said:

Yeah this is tough. I'm leaning more towards focusing on newborn care/procedures. Did the CNM give examples of non-emergency reasons for transfer? Obviously in an emergency the hospital staff is going to act fast. A non-emergency situation might allow for a more typical birth plan. Also might be good to know the hospital standards. Our hospital already followed a lot of our birth plan items as standard. The only thing different from normal was declining 3rd stage pitocin unless warranted and declining a couple newborn procedures.

Some non-emergency situations might be maternal exhaustion, high BP, or going to 42 weeks (or before 37 weeks). It's situations like these that I'm mostly planning to write the hospital birth plan for. Obviously in a true emergency, a birth plan will be the last thing on my mind, lol!

Also, from what I hear, the hospitals around here are not natural birth friendly, so my wish-list IS going to differ substantially from standard hospital procedures. Which obviously makes things more difficult.

CLLDLL

I had a NB in a hospital with an OB. To write my birth plan, I started by researching what procedures were standard at that hospital and deciding which I wanted to decline.  Then I wrote a bullet point list of things I wanted/didn't want and discussed with my OB at my 34 week appointment.  She really helped give me clarity on what was going to be easy to get "my way" on and what I was going to have to fight for.  

After my talk with my OB it was easier to write my birth plan. I kept the stuff I knew I could get easily short and sweet and at the bottom.  I completely left out anything that was already standard procedure - like allowing clear liquids during labor.  

I started with an intro sentence thanking the nurses in advance for their help during the special time for our family.  I then stated that our overall goal was a healthy mom & baby with as little medical intervention as possible.  I underlined the sentence stating that I wanted all procedures done on me or baby to be explained to my husband and/or I before they were done, provided it wasn't an emergency.  I felt like this sort of set the tone, that we were willing to listen to the staff but that we wanted the ultimate say in what was done to LO and I. 

FWIW I really struggled with writing the c-section part of my plan.  I really didn't want one.  But in the end I put myself in the frame of mind that if I were to agree to a c-section it would be because baby or I were in grave danger.  At that point, I'd want what would keep us safe first.  But I'd still want the same request - everything explained to us first so we could make an informed decision.

I'd recommend you think about it in those terms.  If something happens beyond your control, how would you feel? How would you want to be treated?  Just because you don't get the perfect birth you have in your head doesn't mean you can't have a birth with the same "spirit" that you envision when you think of your perfect birth.  

Good luck to you! 

margaritachikita

Do you have a doula? It is very difficult to predict what circumstances might land you in the hospital, and hard to plan for every situation. If you have a doula, you can go over your preferences with her before the birth, and then she would be with you during the transfer to advocate for you and your baby. She will remind you what your wishes were and if she sees something happening that you may not be okay with she can speak up and let you know what is going on and check to make sure you are okay with it. A birth plan may get completely over looked if there is an urgent situation, but a doula is someone who is physically present with you and ensuring your wishes are being met. I would strongly recommend hiring one!

Best of luck to you!!!

catsinawindow

Thank you everyone for the advice!

@margaritachikita - I've thought about having a doula, I think it would have improved my birth experience with my first, but it would be very difficult to swing the cost.  I'm thinking about looking into student doulas in the area.

@joules235 - in my mind, the most likely reason I'll be at the hospital is high BP (I had PreE with my son, so I'm at increased risk of developing BP issues again).  In this case, I know I'll need extra monitoring and my movement might be restricted, but I'd still like to attempt a pain-med free birth.  This is why I am hoping for this to be more than an "emergency plan".  Also, to answer your question, I'm preparing for this NCB by taking a birthing refresher course offered by my birth center and doing weekly yoga (I found mindful/relaxation breathing very effective during my labor with DS, so I use yoga to practice those techniques).