Birth Plan needed with a midwife?

TheHauntedHauswife

I am curious from STMs (or any L&D Nurses!) who delivered with midwifes if you found having a birth plan was actually necessary.

My hospital is geared towards more of a holistic approach as is and most of the crunchier things are sort of assumed, such as no epidural, skin to skin, breast feeding, etc.

I was planning on writing out this birth plan but then read something about how if you already have the providers and situation you are comfortable with, its not really necessary. They went on to talk about how birth plans are often not even really read or really closely followed anyway by hospital staff, and that birth plans are more for people who lack confidence in their providers than those of us who have providers and hospitals whose philosophies we are in alignment with.

Im not sure if this was just one persons opinion, or more the true reality of the situation. Also, I did a holistic birth class that provided a 1 page check list where you basically just check boxes off, and I am thinking maybe that's all i need instead of a whole thing written out. She said she thought the check boxes were a lot easier for nurses to quickly reference, but she did not explicitly mention what i wrote above.

Thoughts? 

MeganF08

FTM mom so no experience here but I felt the same way about writing a birth plan- I really trust my doctor and after all, he is the medical professional so why would I tell him how to do his job. My doula really encouraged me to create one though and I'm glad I did. It helped me to think about things I had never considered. With that being said, mine is labeled as Birth Goals instead of Birth Plan and I have a short blurb on the top that says that the items below are my preferences but my doctor and nursing team are the professionals and ultimately I defer to their expertise.

adiaz132003

I say write out some bullets and discuss with then to just double check everyone is on the same page. If you are then you can toss it in your hospital bag as a reference if needed. But if you're happy with the way they do it then don't stress about it too much.

Bear14+

I didn't write one. My plan was for a healthy baby! Plus, I expect nurses & ob to discuss with me before any decisions are made. I'll be doing the same again. I trust the level of care at my hospital. 

Emztron500

I think a simple checklist is definitely all that is needed. If you need to express more detailed wishes and preferences, you can do so while you're there in labour and go with the flow. It's not like you're just a piece of meat being thrown around. You'll have plenty of input the whole way.

For my first I was really in the same boat as you - I felt like my midwife was on the same page as me and so I didn't really worry about it. She asked me some specifics at prenatal appointments - would I like oxytocin after birth, did I want to give the baby vitamin K, did I want the baby to get antibiotic eye drops. Stuff she would have to have supplies ready for, I guess (I was planning an out-of-hospital birth). But I did not prepare any kind of birth plan.

This time I have more ideas. I was really annoyed, for instance, that my midwife last time kept hoisting homeopathic remedies on me during labour. I do not believe in homeopathy at all (I think it's just useless) and having alcohol-based solutions sprayed in my mouth was gross and annoying, but I was in too much pain to deal with the situation tactfully.

Later on, my midwife had to transfer me to the care of an obstetrician. For me this meant whole new setting, nurses, etc because I hadn't been at the hospital prior. They did ask me when I got there for my birth plan, and I just had to rattle off everything I had discussed with my midwife off the top of my head. Kind of wished I could've just handed over a checklist. Some preferences went out the window because of complications, some were fought due to bizarre hospital policy (seriously, why would they have a problem with delayed cord clamping??) and a few involved paperwork and release forms (like keeping my placenta and skipping the eye drops for baby). So I probably could've been better prepared.

CopperLane

I'm seeing a group of midwives that provide a birth plan form. I'll be using that as my birth plan with them. It really can't hurt to bring something along. Unless you end up rubbing it in everyone's faces and annoy them with it. 

marriedtoadutchman

I had a birth plan for my first and for my last two I didn't have one but had gone over what I wanted. 

TheHauntedHauswife

I am thinking i am just going to stick with that checklist she gave me. I may write a slightly more detailed version just encase i find i need it for something, but i think ill just give the hospital that check list. I think it will be more than sufficient. My midwife has worked with the doula who ran the class that gave me the checklist and she said she uses it for all her births so i imagine that my midwife will even be familiar with this exact checklist. I think thats going to be more than enough!

Thanks everyone! Your replies were super helpful!

Diesel615

I'm a FTM, but I kinda mostly want to go with the flow. My midwife gave me a checklist birth plan, and it was helpful to see my "options" while in the delivery room and it opened up conversation between my H and me about what I need and want in the delivery room. 

xc1148

I didn't write one down, my hospital had a checklist which was nice.

One activity in my Bradley class that was super-helpful was a set of pre-printed index cards with all of the possibilities/options that you then stacked in order of importance to you. That sort of analysis was really beneficial to me, but is really what I think a birth plan should be all about. Everyone wants a healthy baby but if the doctor asks you, A, B or C? It's helpful to have thought about it/discussed it with your husband ahead of time/while not in labor. Not every dilemma is life or death, and often the medical team will ask what you prefer.

thycapa

FTM. We have a big presence of Nurse Midwives at my hospital as well as OBs and its up in the air who delivers you based on availability, but I'm not writing a birth plan. I may not plan on an epidural, but if I'm laboring for 40 hours may give in, don't necessarily  want a CS, but if it's what the baby needs I wouldn't object, etc. I'm assuming before decisions are made or ruled out they will be discussed with me first and if I think that isn't happening I can be pretty strong willed with my questions and suggestions so that I feel I have a say if I feel I'm not being heard or decisions are being made on my behalf and not discussed. This may not be the best approach, but I have no idea what to expect and am just going to do everything in my power to get him out safely.

Soverthis

I am a FTM seeing a midwife. She wants to talk about my birth plan at my next appt. I also have a doula. We have a mtg with our doula next week then again in 2 weeks. I know the doula writes up a one page plan with us so I plan to give the midwife that. I know things don't go as planned but its nice for me to have a list of things I want/don't want so I can focus on other things.  

BlueJuice

I think it's valuable for you to use a birth plan form or checklist to figure out your preferences and priorities, if you haven't had the opportunity to do this yet. Often I find people think of things they haven't really had a chance to research yet, and it can be useful that way. I do believe very strongly in the mother and any birth partners knowing what interventions they prefer, if there's anything they want to decline, and having a chance to talk this over in detail with their midwife or OB beforehand.

As far as literally bringing a piece of paper with you to the birth, I would say it depends a lot on the birth team and the facility's norms. You're right in believing that if the facility's standard procedures are in alignment with your preferences, there's no need to reiterate all that in excruciating detail in a lengthy essay. Printed birth plans are great for situations where you have preferences that are different from standard, and where there will be caregivers cycling through whom you might not have had a chance to meet and discuss with in advance: for example, hospital nurses. In a different scenario where you have the same caregivers the whole time, that can be less of an issue and a paper birth plan might not be as valuable. I do tend to shove one in my hospital bag anyway, in case someone asks my husband what we prefer about something, because he's forgetful and I might not be mentally present enough to remember or articulate either at that particular moment.

huskypuppy14

I'm planning to write up a quick birth plan but my hospital has a form and you go over it with your doctor at your 36 week appointment. 

My doctor might not be on call when I deliver so it goes as a part of your file that any of the doctors or nurses can reference. It's also good for your support person to have a copy so they know what you want if you can't advocate for yourself.  I think the birth plans that get side eyes from the medical professionals are the ones where there is no flexibility. Or they are so ridiculous.

Essentially the the things I care the most about are already available at my hospital. An epidural is my only real want and possibly delayed cord clamping but I can be flexible if that can't happen. I'd prefer not to have forceps or an episiotomy( which is not routine at my hospital anyway). 

TheHauntedHauswife

Yeah i feel even more secure about the ''check list'' one. But also agree with figuring out on our own that is most important where that stuff is concerned, and maybe going over it with my husband. I am also thinking maybe using a highlighter and highlighting the very most important ones.