Let's talk about - Birth Plans?

charmedlifex3 · May 2016

I think we are all heading into the point where doctors are asking us to fill this out in the next couple of weeks. Let's get a thread started to talk about questions we might run into as we do!

I admit some of the things on the template provided by my hospital I had no idea what they even were, much less know enough to form an opinion!

Also - can I say OMG. Didn't I just pee on that stick like last week?

jamiesc58 · May 2016

I made a really good plan for my very first child and I don't think I stuck to much of it at all. So for the next two kiddos and this one, there is no plan but to have dh by my side and have the baby.

Oh, and to try my hardest to make sure I can get an epidural. I am a sissy when it comes to pain.

SkiChic626 · May 2016

First of all, you were given a form from the hospital for you birth plan????? What the what???

Second.....I can't wait to read this thread

texasmama2014 · May 2016

I just want to go into labor without being induced. Preferably at a time that gets me out of something I didn't want to do in the first place, but I'm totally ready to read other plans!

charmedlifex3 · May 2016

@skichic626 It's four pages long and some parts are multiple choice. We went through it with our doula, and I am still overwhelmed, lol.

SkiChic626 · May 2016

Allisun85 WTF??? LOL When I mentioned a birth plan to my midwives last time they basically were like yeaaaaaaah.......and that was the extend of that. My only thing was that I didn't want to be induced because I hear nothing but horrible outcomes from inducement. And, of course, I was induced and 2 days later with no progress, because apparently I'm a stonewall against pitocin, I had my c-section.

Curls919 · May 2016

My plan is to get to the hospital in time to have a baby.

in all seriousness my plan is the same as it was with DS. Get to the hospital, listen to the OB and the nurses, hopefully get some pain meds when it starts getting unbearable, deliver a healthy baby. I'd love to delay clamping the cord for a minute or two but with DS he was early so the nicu team needed to check him out immediately so that didn't happen. My hospital does immediate skin to skin and nursing which I'm all for.

Oh and let family/select friends know when I'm in labor but not allow any of them to come to the hospital until we are ready (with DS I labored most of Sunday, he was born at night and we allowed visitors the next day).

JournoGrl23 · May 2016

I asked my OB about a birth plan and she just told me to take a birthing class, which I can't do because I work weekends. I told her I'd be more comfortable with a c-section due to my hiatal hernia and the fact that no one in my family has given birth naturally so I feel it'll lead to that anyway (although I could be completely wrong!). She said the plan is to try to give birth naturally and maybe have a c-section and that's that. So I have no idea what to expect to make a plan! And I prefer to have a plan. I look forward to reading some of yours so I can maybe have an idea.

Bookhousegirl · May 2016

My birth plan this time is much more about what we will be doing with DS1 once I go into labor (I.e. Who will come to us - we're about 45/50 minutes away from family - if it's the middle of the night). In terms of giving birth, I have some preferences but I know everything's so unpredictable that my only goal is getting to the hospital and DH getting there in time!

bearsandbeets7 · May 2016

@SkiChic626 I'm a stonewall against pitocin too! When we decided on the c section and they turned it off my contractions completely stopped. My body was not ready to have DD.

My advice for FTMs is to be informed of what's going on and to ultimately make decisions because it's what you feel is best not because a doctor is pushing you in a certain direction. Looking back I would've waited a little longer before going ahead with the induction and while in labor I would've waited a little longer to ok the c section.

Sekerambo · May 2016

Following whatever the doctor says is not always the best way of doing things. Educate yourselves so that you can make the necessary decisions when they come up. I know a lot of women that have ended up with forms of ptsd due to their birthing experiences. If I had done everything the doctor had told me I would have absolutely regretted my entire experience. Not only did I have a doctor that I didn't know, I had a doctor that felt he needed to push me into his idea of birth. I had to have my husband and the nurses run interference until the next doctor was on duty.

Also, a birth plan is the place to put your wishes when it comes to baby. Yes or no to vit k shot, vaccines, erythromycin for the eyes, breast feeding or not, skin to skin right away, baby staying in room, etc.

vsalazar411 · May 2016

HA!...plan...so far my plan is to get to the hospital and hopefully not be induced or go through an episiotomy or c-section, but I understand that if baby is in distress or I am , then things gotta happen. Hubby is in the military so his actually being there with me is still up in the air...yay...so there goes my support person.

So, plan is get to the hospital, go au natural for as long as I can tolerate and once baby comes out I'd like skin to skin , immediate breastfeeding and delayed cord clamping. As far as baby receiving standard medications such as Vitamin K (to help with blood clotting) and Erythromycin to the eyes (to prevent infection) I probably will allow that, but still reading up on it. I'll also have the choice on whether to start Hep B vaccination series immediately after birth, but still reading up on that. I'm def pro vaccination, I'm just unsure of the necessity for that RIGHT AFTER BIRTH. I'd love to hear what you all think about that.

In the end, I just want my baby and I to make it out alive lol That's priority numero uno.

cm716 · May 2016

My birth plan is to get to the hospital and not have the baby in the car.

Hopefully I also have time for the epidural. That didn't happen last time so i don't have high hopes.

bananers · May 2016

My birth plan is to get the baby here safely. I put my doctors' years of expertise above any desires for a particular "experience." My hospital does immediate skin-to-skin and supports breastfeeding and rooming in, which are the only things I would have been that opinionated about anyway.

The loose plan is to labor naturally as long as I can stand it, only because labor slowed for me once I got the epidural last time. But if the pain is anything like it was last time, I know I will definitely need the epi at some point.

I'm much more worried about plans for DS1 than the birth. My parents will stay at our house with him and our dogs, but they live an hour away, so I'm hoping we have lots of notice before we need to go to the hospital!

MamaKSquared · May 2016

I haven't started on mine, but there are some things I definitely want as long as baby comes out OK. Immediate skin to skin, delayed cord clamping, breastfeeding. I'm delivering at a birthing center, so as long as there's no emergency and I don't end up being transferred, I don't have to worry about any pressure to stray from our plans from a natural birth. There are still things I need to research and questions I need to ask at our birthing class before I know all my preferences for baby after birth.

MamaKSquared · May 2016

Allisun85 said:
Also - can I say OMG. Didn't I just pee on that stick like last week?

Yes! This! I'm 26 weeks today and I'm actually experiencing some sadness that my second trimester is almost over.

Curls919 · May 2016

And I know I should not just follow the OB blindly but I'll say my water broke with DS and I wasn't having contractions and my cervix was still long. So the doc said they were going to insert cervadil. They explained why and what it was and we did it. I didn't know about it before and didn't tell them to hold on while I googled to inform myself. Same with when my contractions were 4 in a row with 30 seconds off before the next set and they gave me something to slow contractions. I still can't tell you what they gave me but it was needed for DS to recover between contractions. So we can go in as informed as we think we need to be and still end up having things done that you never knew about.

bananers · May 2016

Curls919 said:

And I know I should not just follow the OB blindly but I'll say my water broke with DS and I wasn't having contractions and my cervix was still long. So the doc said they were going to insert cervadil. They explained why and what it was and we did it. I didn't know about it before and didn't tell them to hold on while I googled to inform myself. Same with when my contractions were 4 in a row with 30 seconds off before the next set and they gave me something to slow contractions. I still can't tell you what they gave me but it was needed for DS to recover between contractions. So we can go in as informed as we think we need to be and still end up having things done that you never knew about.

This! I always cringe a little when people preach about doing your own research. Yes, it's good to be informed, but no amount of googling is going to come close to the level of knowledge someone has after going though medical school, followed by years of daily practice. Hell, I get annoyed when people try to tell me how to do my job, and my job doesn't have life or death consequences.

I saw a meme online once that said "don't mistake your google search for my medical degree."

ballofmeat · May 2016

I agree that researching on Google is just a bad idea. I think this is why it is important to pick an OB you trust and respect for the start of your pregnancy.

Im not sure if I will do much of a birth plan or not. I work in a hospital lab as a medical laboratory scientist and have an extensive knowledge on lab tests and correlating them with disease states and complications. Because of that I feel like at this point in my pregnancy some ignorance can be bliss. I have refused a few of my prenatals and things I know I do not need based on my medical background and education.

What worries me the most by working in the hospital I will deliver in, is all the mistakes I have encountered on the birth floor. Very few of them are that serious, but when it comes to my birth plan, I already know I have such anxiety with things going not as planned. I think the major decisions for me will be most important, like medications, skin to skin contact, and nursing staff. As long as those things are honored to the best of capability, the details to me are better left to my OB whom I trust.

SkiChic626 · May 2016

@Lynnlove28 Pitocin didn't even give me contractions, and I was turned all the way up within about 3 hours of starting. DD wasn't ready but she was gigantic and my BP was high so she needed to come out.

JLyn821 · May 2016

My birth plan will be the same as it was for DS.

- Avoid induction as long as possible (2 weeks passed due date)
- Med free (don't even ask me if I want an epidural)
- DH is with me and/or baby at all times
- DH can make decisions on my behalf
- We're donating cord blood
- DH doesn't want to cut cord
- Skin to skin immediately
- All necessary shots and procedures are fine
- BFing within first 30 minutes

There was more to it than that, but this is the gist.

ETA: I also made sure to mention I wanted to be as mobile as possible and labor however I wanted.

Nikkoli98 · May 2016

Very interesting topic! While I think that having a super detailed birth plan isn't necessarily realistic, I do think there are some things it's good to have an opinion on. Overall I just want the baby to come out safely. If that means a C-section, that isn't my preference, but I don't want to go into with the idea that I'm against it if that is what will be required for a safe delivery.

Things I do have an opinion on: 1.) IF an episiotomy is required, a lateral has less complications than a mid-line one, yet the mid-line seems to be performed more often. 2.) There is a high dose and a regular dose pitocin protocol. My mom is an L+D nurse and a certified lactation consultant. She said at least on their unit the high dose tends to have a much higher failure rate, thus leading to more C-sections. 3.) Delayed cord clamping if possible. 4.) Immediate skin to skin contact and breast feeding in an uninterrupted first hour if the baby doesn't require medical intervention, with delaying the first bath. 5.) Erythromycin ointment only after the first (or maybe second alert period). This is in no way an emergency intervention. 6.) I am all for the vitamin K shot (even though some are of the opinion that the additives may be a large cause of neonatal jaundice) - to me the thought of risking neonatal bleeding is terrifying. 7.) I will decline the day 0 hepatitis B vaccine. I am not anti-vaccine, but this vaccine doesn't make sense if the mother is Hepatitis B negative or if your baby doesn't need surgery, dialysis, or a blood transfusion (I would at least consider the vaccine in these rare cases.) This is considered a "bonus" vaccine. It does not count towards the recommended series of 3 shots - they still need 3 at some point later on.

My big decision hanging in the balance at this point is whether to deliver at the small local hospital or at the tertiary care hospital with a NICU about an hour away from our home. Anybody else in this decision predicament???

ballofmeat · May 2016

Nikkoli98 said:

Very interesting topic! While I think that having a super detailed birth plan isn't necessarily realistic, I do think there are some things it's good to have an opinion on. Overall I just want the baby to come out safely. If that means a C-section, that isn't my preference, but I don't want to go into with the idea that I'm against it if that is what will be required for a safe delivery.

Things I do have an opinion on: 1.) IF an episiotomy is required, a lateral has less complications than a mid-line one, yet the mid-line seems to be performed more often. 2.) There is a high dose and a regular dose pitocin protocol. My mom is an L+D nurse and a certified lactation consultant. She said at least on their unit the high dose tends to have a much higher failure rate, thus leading to more C-sections. 3.) Delayed cord clamping if possible. 4.) Immediate skin to skin contact and breast feeding in an uninterrupted first hour if the baby doesn't require medical intervention, with delaying the first bath. 5.) Erythromycin ointment only after the first (or maybe second alert period). This is in no way an emergency intervention. 6.) I am all for the vitamin K shot (even though some are of the opinion that the additives may be a large cause of neonatal jaundice) - to me the thought of risking neonatal bleeding is terrifying. 7.) I will decline the day 0 hepatitis B vaccine. I am not anti-vaccine, but this vaccine doesn't make sense if the mother is Hepatitis B negative or if your baby doesn't need surgery, dialysis, or a blood transfusion (I would at least consider the vaccine in these rare cases.) This is considered a "bonus" vaccine. It does not count towards the recommended series of 3 shots - they still need 3 at some point later on.

My big decision hanging in the balance at this point is whether to deliver at the small local hospital or at the tertiary care hospital with a NICU about an hour away from our home. Anybody else in this decision predicament???

I couldn't agree more with all the above! It's like you read my mind! The only thing I think I might add is I will be declining all blood transfusions if my HGB is still above a 6.5 or 7. I have a weird blood type and I'd rather avoid complications in future in case I really need a blood transfusion for another emergency.

I wish I could deliver at our other hospital across town that has the NICU just because I am comforted by the idea of the experienced staff there.

The one I am delivering at has a lot of temp nurses which makes me nervous, not saying they aren't capable of great care, but there is something to be said about knowing the familiarities in policies where you work. Bummer that my midwife doesn't deliver at the NICU hospital

Sounds like a toss up decision since the NICU hospital for you is an hour away. How close is the other hospital?

Nikkoli98 · May 2016

@midwestbaby, the local hospital is about 13 minutes away, maybe 8-9 in an emergency...

I would feel more reassured with a midwife managing your labor if you are concerned about the nursing staff. My observation is that midwives tend to be more involved in the laboring process than OB's and hence more available to direct the nursing staff.

(Edited due to premature posting.)

ramoseecology · May 2016

When I went on my hospital tour I was given the welcome packet which included the birth plan worksheet. It made me realize we needed to get to work on thinking about the details (DH had a realization that he needs to think about cutting the cord, giving the first bath, etc). Haven't made all the decisions yet.

I was so happy to hear my hospital does immediate skin to skin for about an hour (before they want to give them the vit K shot, etc), which is really important to me assuming no complications. That was my biggest desire. I also want all the now probably standard options-- to be able to move around while laboring, etc. I'm also leaning towards delayed cord clamping.

TheBabyExperiment · May 2016

My plan is to have an elective c section. We've set the date at 40wks and if my water breaks earlier, I will request a c section when I arrive at the hospital. My choice has been documented in my patient record and my doctor approves. (Of course, if I am too far along in labor-which seems unlikely as the hospital is close and I'm a FTM-I will try for a vaginal birth with pain killers.) Special c section requests include: to have one arm free during the surgery and have the baby on my chest while they stitch me up. Everything else I will decide at the time depending on the situation.

Stephanie7693 · May 2016

With my first tw ok I made no attempt at a birth plan, which is probably good since I was only in the hospital for two hours before my kids were born. But with my second I knew what I didn't want and what we were in for, and explained it to the nurse. She listened to me and followed my requests even though they weren't really the norm. This time I'll do the same as far as labor and delivery, but I will put on paper for my husband that as long as baby is healthy I don't want him taken away from me for anything in the first hour. I want him put on my tummy and time to have skin to skin and nurse. And that I don't want his hands cleaned. Beyond that, I just want to get to the hospital and hopefully get an epidural

DDRRT1982 · May 2016

I am still up in the air with what I want to do. My situation is a bit different, though. I haven't decided if I want to be induced and they take my cerclage out then or if I want to have my cerclage taken out and wait for labor to start naturally. I contract a lot during my pregnancy and build a lot of scar tissue. The last time I got my cerclage out was the first time in my life I ever thought I was going to pass out. How are other ladies with cerclages going to do it? Cerclage out and wait for labor or cerclage out with epi?

I will do the hour of skin to skin, nursing, etc. This time I want DH to have skin to skin too. I want nobody at the hospital while I labor. I want very few visitors when the baby is born. I want my kids to be the first to meet him. I want delayed cord clamping, but all my kids have had a nuchal cord that were term and had to have it clamped and cut. I want an episiotomy vs tear.

Neesey · May 2016

I can't imagine not going in with some type of plan! There are so many option and things that should be discussed with your doctor prior to labor and I know that I was in no condition to listen to options while delivering DS. Here is some of my list:
If my water breaks before 36 weeks we are straight to l&d. Decision to induce or not will be made with input from MFM and OB. If later, I want to labor at home for up to 24 hours before heading in to the hospital or until contractions are consistent at 5 minutes apart.
I will have a room with a/c. Last time the heat was stuck on and I felt like I was suffocating.
No pitocun unless absolutely necessary.
Hep-lock preferred after complications from iv last delivery.
I prefer intermittent monitoring but if constant is required, I'd rather have the probe than the bands.
I want a birthing ball.
I won't be restricted to the bed unless I have an epidural.
If I choose to have an epidural, I want a pump rather than single dose.
If I don't have an epidural, I want to choose my pushing position and not be restricted to my back.
No counting during pushes as it increases my anxiety.
If I have to labor in my back, I need leg holders to be aware of my hip problems and previous surgery.
If I don't have pitocin for labor, I don't want it after birth.
If I need stitches, give me lots of meds!!!
My doula will take the placenta for encapsulation.
Hep B will be delayed, skin to skin ASAP if baby isn't in distress or needing intervention, no eye ointment, no bath until we say ok.
The hardest part with my son was not seeing him for 6+ hours after delivery. Even if DD is on the NICU, I want to be taken to see her ASAP.

Sekerambo · May 2016

midwestbaby said:

I agree that researching on Google is just a bad idea. I think this is why it is important to pick an OB you trust and respect for the start of your pregnancy.

I agree that researching on Google in the moment is a bad idea but there are plenty of great books that can be read ahead of time.

Also, every hospital is different and having the OB you respect and trust while in labor and delivery isn't always an option. I absolutely loved my ob but the hospital I delivered in was on a rotating schedule. After being sent to the hospital by my ob, I ended up getting a dr from another clinic. He was absolutely convinced I wasn't in labor at 5-6 cm with contractions 2-3 minutes apart. I was actually told I wasn't loud enough for my contractions to be that bad. So while doctors have gone to medical school, there are some doctors that have their own ideas on what labor is and how it should progress. I can't even imagine where I would have ended up had I followed his protocol and had gone on a high dose of pitocin not long after getting to the hospital.

nanner26 · May 2016

Neesey said:

I can't imagine not going in with some type of plan! There are so many option and things that should be discussed with your doctor prior to labor and I know that I was in no condition to listen to options while delivering DS. Here is some of my list:
If my water breaks before 36 weeks we are straight to l&d. Decision to induce or not will be made with input from MFM and OB. If later, I want to labor at home for up to 24 hours before heading in to the hospital or until contractions are consistent at 5 minutes apart.
I will have a room with a/c. Last time the heat was stuck on and I felt like I was suffocating.
No pitocun unless absolutely necessary.
Hep-lock preferred after complications from iv last delivery.
I prefer intermittent monitoring but if constant is required, I'd rather have the probe than the bands.
I want a birthing ball.
I won't be restricted to the bed unless I have an epidural.
If I choose to have an epidural, I want a pump rather than single dose.
If I don't have an epidural, I want to choose my pushing position and not be restricted to my back.
No counting during pushes as it increases my anxiety.
If I have to labor in my back, I need leg holders to be aware of my hip problems and previous surgery.
If I don't have pitocin for labor, I don't want it after birth.
If I need stitches, give me lots of meds!!!
My doula will take the placenta for encapsulation.
Hep B will be delayed, skin to skin ASAP if baby isn't in distress or needing intervention, no eye ointment, no bath until we say ok.
The hardest part with my son was not seeing him for 6+ hours after delivery. Even if DD is on the NICU, I want to be taken to see her ASAP.

Question, FTM here. Are the nurses in charge of making sure all of this happens? Do you remind them along the way?

SkiChic626 · May 2016

@TheBabyExperiment said:

My plan is to have an elective c section. We've set the date at 40wks and if my water breaks earlier, I will request a c section when I arrive at the hospital. My choice has been documented in my patient record and my doctor approves. (Of course, if I am too far along in labor-which seems unlikely as the hospital is close and I'm a FTM-I will try for a vaginal birth with pain killers.) Special c section requests include: to have one arm free during the surgery and have the baby on my chest while they stitch me up. Everything else I will decide at the time depending on the situation.

I had both arms free during my c-section, I just wasn't allowed to move them below my chest, and once they took all her vitals they brought her right over to me and put her on my chest while they were putting me back together :-)

Nikkoli98 · May 2016

@lgem4, there are a few ways to do the immunization schedule. In my case it would be an extra vaccine because I will likely defer the Hepatitis B vaccination series until later - thus creating too large of a gap. This vaccine was changed to the newborn schedule around 1996 simply due to the fact that adolescents don't have as many doctors appointments as infants and thus had difficulty completing the vaccination series.

That aside, many infants still get 4 doses of the Hepatitis B vaccine due to the widespread use of Pediarix (a combination vaccine DTaP, IPV, and HepB). If you / your pediatrician only use Pentacel (DTaP, IPV, and Hib) or the individual vaccines - then yes - only 3 are required, but that may prove difficult to accomplish given the 2015-2016 manufacturing delay that has caused a national shortage of Pentacel. Also, the CDC's Advisory Committee on Immunization Practices recommends sticking with the same vaccine product except in cases of shortage or if it is unknown what was used - so while you could do a combination of Pediarix and Pentacel (if available for the 4 month shot) to prevent the 4th Hep B dose - they don't recommend it.

Pediarix was introduced in 2002 and Pentacel didn't arrive until 2008 (the year I graduated from medical school). So, admittedly my interpretation of the "bonus" Hepatitis B vaccine was based on the fact that most infants at the time were getting the original Hepatitis B vaccine in the hospital and then the Pediarix series at 2, 4, and 6 months, and understandably so - who wants their child to have 3 or 4 injections per visit when 1 or 2 will do???

Nikkoli98 · May 2016

@lgem4, I hadn't heard of actual blind / deaf outcomes in transferring a neonate, but obviously there are risks including vibration of the ambulance. I think this is very good input, especially as it would be a long transport (i.e. an hour) and not just across town. I was already leaning towards the bigger hospital but my husband would rather be closer to home. Depending on how the baby is doing with the hydronephrosis issue - the decision may be made for us...

kristynmac · May 2016

My plan is to follow my Doctors lead, he is super blunt and we have a "give it to me straight" agreement. I want to stay unmediated for as long as possible, but I am not ashamed to give in when the pain is too much. I usually plan for EVERYTHING and have lists prepared ahead of time, but every time I consider writing out a birth plan I feel like my baby is in there laughing at my attempts.

Image: https://us.v-cdn.net/5020794/uploads/editor/di/3b3gb5n1gnig.jpg

Katm89 · May 2016

@Allisun85 There are a lot of responses here lol so I will skip reading some of them and reply to your OP. My Midwife gave me a template for a birth plan as well and we actually made ours at 12 weeks along and will be revising it quite a bit. My doula was explaining the birth plan is more for your nurses to understand your "preferences" because your doula and OB/ Midwife will already have had those chats with you. She also explained that some nurses get bitchy about a birth plan and write c-section on the top of them... as a joke with the other nurses. Hopefully our nurses are nicer. She mentioned to include wording that comes out as a request/ preference instead of a rigid demand because this will go over better with the nurses and they will want to help you achieve some of these goals. Obviously, a lot of the requests on your birth plan change if an emergency happens and to state in there that "if the situation allows, this is what we prefer". I have posted below a birth plan she made with previous clients that she wants me to kind of use as a jumping off point. As far as specific issues like delayed cord clamping and using a hemlock but not being attached to fluids or finding out if you can still have the option to walk around if you need pitocin... I can answer any questions you have... I have done a ton of research and am pretty unbiased... alot of the stuff I kind of tossed a coin and asked my husband what he thought... we also included a section on preferences for a c-section... like requesting our doula be present and that we can be handed the baby right away... and still do skin to skin even in its my husband doing it... its very involved... not to mention you have to include preferences for the baby after the birth...like delayed bathing... and such.... if that's important to you...

Vanessa and Jeff's Birth Preferences

Because we know you can’t “plan” how your labor and birth will go! All preferences are based on healthy mom and healthy baby through the labor and birth process. We may consent to interventions once we’ve discussed all risks, benefits, and alternatives with our birth team. We will have our doula, Lisa Falkner, present throughout the entire labor and birth.

Before Labor

• I request to go to 42 weeks without discussion of induction. I may consent to a Non Stress Test at 41 weeks.

• I decline to have vaginal exams during prenatal appointments unless requested.

Stage One Preferences

• Intermittent monitoring after initial assessment upon admittance.

• Heplock in place but no continuous IV fluids.

• Freedom to use various positions, walk halls, utilize shower.

• Minimal cervical examinations (no more than once per 3 hours).

• In case of stalled labor, use of nipple stimulation via breast pump, essential oils, acupressure are all to be utilized prior to resorting to artificial rupture of membranes or Pitocin.

• Please do not offer pain medication or an epidural unless I specifically ask for them.

• Eating/drinking at will.

Stage Two Preferences

• Freedom to push/birth the baby in whatever position feels most comfortable and effective.

• I prefer to push on my own accord and to stretch tissues slowly to minimize tearing but will look for guidance and reassurance that I’m pushing effectively.

• Tearing: I have read much research on the topic and request to tear naturally vs. an episiotomy.

Stage Three Preferences

• Passive management of the placenta. No routine use of Pitocin unless placenta is taking too long to deliver or excessive bleeding is occurring.

Baby Care Preferences

• Delayed cord clamping until the cord stops pulsing (at least 10 minutes).

• Uninterrupted first hour. I request that baby be placed on my chest immediately after birth and all assessment be done with her there. Weighing/measuring can happen after the first hour.

• We are declining eye ointment and hep b

• We prefer that the baby’s first bath happen at home and she will not be bathed while in the hospital.

• We plan to exclusively breastfeed and prefer that formula not be available to us to ensure a successful start. We would like to utilize a lactation consultant’s services.

• Rooming in. We prefer that the baby stay with all at all times and all procedures/tests be done in our room.

Cesarean

• In case of a non-emergency cesarean, I would like both my husband and doula to be present in OR pending anesthesiologist’s approval.

• “Family-centered cesarean” with delayed cord clamping (2-3min) if possible, skin to skin, and breastfeeding in the OR.

• In case of emergency cesarean, I understand that baby needs to be assessed quickly and will not come straight to my chest. But if baby’s apgar scores are good and she is found to be in good health, I prefer she come to my chest as quickly as possible and routine weighing, measuring, etc. wait until later.

Whitmore1027 · May 2016

I spoke to my doctor yesterday asking her about when we will talk about birth plans. She said "Honestly, don't do a birth plan, especially with your first". Why? Because no matter what, she will do what's best for baby and me, and she said it makes her so sad when a mother is SO caught up in her birth plan going exactly how she wants it, that the mother misses the joy and happiness of becoming a mother and just having the baby as safely as possible. I completely agree with her. I am going to trust her to do what's best. She said little things like immediate skin to skin contact, or me wanting to keep the baby with me and not the nursery are things can tell the staff the day of. She said take things as they go. Don't plan on medicating, or other things until it's time to make the decision. It will be less stressful the day of honestly because in your mind you just want that baby born healthy. So. That's my plan.

Katm89 · May 2016

@Whitmore1027 I spoke with my midwife and she recommended a birth plan so she can know my preferences ahead of time... but of course when writing one we need to also be willing to adjust and navigate other options when in the hospital. My doula did a birth with her a couple weeks ago and mom had to get pitocin which was against her birth plan. My midwife leaned over and said " don't worry, we can adjust the scenario so you can still have the birth you want" She made sure the hospital gave her the ability to move about the room and they used a water proof fetal monitor so she could still birth in the tub like she wanted. I thought that was amazing that since she knew her preferences before hand she was able to adjust the intervention to fit her as an individual. I think being rigid with your plan isn't good... but its a helpful communication tool.

Whitmore1027 · May 2016

@katm89 Oh, I definitely agree! I have done research on what kind of things to expect and I have preferences (like, I would prefer not to be induced, but if it's medically necessary I will. Same with C-section, soo scared to have one, but if it needs to be done I will not fight it. Basically preeclampsia runs and gestational diabetes runs in my family so I don't know how I'll be) I have a close friend who had a HUGE elaborate birth plan and fought and fought for certain things. Her labor was the most stressful thing because of that plan. Everything opposite happened that she wanted and end the end she had a C-section and was just SO upset about everything. A couple weeks later she came to me and told me she wish so much that she didn't fight it. That she should have trusted her doctor and done what they said to begin with because it wasn't worth the hurt of not getting her way. What was important was having a healthy baby. She said next time she will go along with the doctor.

Now my doctor and hospital encourages rooming in, immediate skin to skin, breastfeeding, and I know I want all those. So you can say I have a "plan" but I will be completely open to change if need be, and of course as long as the one with the medical degree explains everything to me.

Katm89 · May 2016

@Whitmore1027 I feel like the best thing is to choose a doctor/ MW that shares your beliefs so that you don't feel like you have to fight during labor for what you want. As far as I am concerned I have done alot of research on who to deliver with a where.. I hired a doula and have prepared as much as I can for the things I can control. I think sitting there and feeling like you have to fight during your labor is very stressful and can have an adverse effect on the process. I like knowing that if my Midwife turns to me and says "Honey we need to do a c-section" I'll know it wasn't a rushed and unnecessary decision, because I know her and she respects my preferences and there is a kind of beauty in being able to trust your doctor. That being said... I wouldn't just blindly trust just any doctor...that doesn't know me and I don't know them... I chose my midwife for a reason. I also like the fact that if I do have an emergency c-section my midwife will assist with the surgery and I won't be passed off to someone else. That really makes me feel a lot better. I would be so happy if things turn out exactly how I want... but I want to be realistic as well and prepared for other outcomes.

bananers · May 2016

Whitmore1027 said:

I spoke to my doctor yesterday asking her about when we will talk about birth plans. She said "Honestly, don't do a birth plan, especially with your first". Why? Because no matter what, she will do what's best for baby and me, and she said it makes her so sad when a mother is SO caught up in her birth plan going exactly how she wants it, that the mother misses the joy and happiness of becoming a mother and just having the baby as safely as possible. I completely agree with her. I am going to trust her to do what's best. She said little things like immediate skin to skin contact, or me wanting to keep the baby with me and not the nursery are things can tell the staff the day of. She said take things as they go. Don't plan on medicating, or other things until it's time to make the decision. It will be less stressful the day of honestly because in your mind you just want that baby born healthy. So. That's my plan.

Amen. The birth of my son was the greatest day of my life. It wasn't perfect but it's part of his story, so it's perfect in its own way. Birth is so unpredictable that it's almost never going to go how you imagine. The people who end up with PTSD are the ones who have it built in their heads down to every detail.

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