Birth Plans

Nicbert1214

So a couple of months ago, I printed out the birth plan that The Bump offers. I do admit it is quite lengthy, but I believe some of the questions on there are very important to have answers for, especially for my DH to be able to speak up if I am unable to during/after labor.

Anyway, I am already a couple days past my due date, and because today was my last appointment with my OB, DH and I decided to go over it together and give my OB a copy of it today. 

Well, this freakin lady, not even his nurse, in fact, I've never seen her before today, maybe she was his medical biller or office manager- calls me up to the desk when I was leaving and asks me "where did you get this? I've never seen it before." I thought she was asking because she liked it- so I told her, from The Bump app. She goes on to tell me that nobody at the hospital will read it and most of the questions on there will ultimately be up to the doctor. I proceeded to tell her that I knew it was lengthy and I wouldn't expect the hospital staff to sit down and read the entire thing, but that a few of the questions on there are important to me and I feel they should be documented. She repeated herself again, totally disregarding what I had said. So I repeated myself again and stressed that there were some important questions on there and that my DH would have a copy as well so he can answer for me if I am unable to. She pretty much blew me off, and I had to pee really bad, so I walked away. 

Has anyone else filled out a birth plan? Have you been met with resistance from your doctor or his staff? For those of you who are STMs or have already given birth, did you use a birth plan and did you find it helpful?

I really feel as though questions such as waiting until the cord stops pulsating prior to it being cut is important. I feel that asking if I want my LO bathed by hospital staff is important, whether or not I want my LO staying with me in the room overnight and whether or not I want him to be given formula- are all important questions that should be documented. I was very upset when I left the office today and didn't appreciate that witch totally disregarding my wishes!

araecasey

Birth preferences are definitely important! It's imperative that you and your care provider are on the same page about your preferences. I do agree with this gal that the birth plans from The Bump and similar are way too long. I keep mine short and sweet, kind of like a resume. If it can't be read in under 30 seconds, then it won't get read. 

proudparent2b

My hospital provides a birth plan packet to fill out, in which there are around ten questions with multiple choice answers, so you just select your preferences.  I was required to bring it to an OB appointment around 32 weeks to have the doctor review and sign off. I then brought it to my hospital intake meeting around 34-35 weeks.

My OB already knew my preferences ahead of time, so there were no big shockers. She mentioned her only concern that I might have to get an IV due to dehydration if I cannot keep myself properly hydrated throughout labor (I don't want an IV).

To be honest, I think you should have gone over your preferences directly with your OB way before your final appointment. However, given that DH knows your preferences now, he can act as a voice for you and ensure that your wishes are observed.

Bellodomani

Same as what the first person said, my doula advised me with my first baby that I should keep it to 3-5 bullet points of the most important info. I discussed my preferences verbally with my OB prior to my birth, but knowing she may not be the person who actually delivered me, I also brought the printout into the hospital with me when I went into labor. However, I didn't even end up needing to show it to anyone because between me, my husband, and my doula, we were able to verbally communicate the important stuff. Also, even at my not-at-all-crunchy hospital they seemed to get that a lot of this stuff tends to go hand in hand- no epidural, mobile fetal monitoring, delayed bath/ measuring in favor of immediate skin to skin, no formula, etc. Short of you having to go under general anesthesia for an emergency c-section, you should be fine just handling decisions with your care team as they come up. 

lalala2004

I agree with @araecasey that it's like a resume. I went over ours with my doctor and she responded well. We also shared it with the L&D staff, but didn't give them a copy. I was very glad to have a doula, as there was talk of breaking my water and I was pretty out of it, and my DH was a bit overwhelmed. If you can get a doula, they are worth their weight in gold in helping make sure you know what's going on and make the decisions you really want to make.

Nicbert1214

Thanks for your opinions/suggestions ladies, I really appreciate it. I wound up not having enough time to do a hospital tour, so I wasn't given their birth plan- which was probably a lot shorter. When I first saw the one the Bump provided, I almost fell off my chair because it was so long. I don't think I have any outlandish requests- and for many of the questions I simply wrote "as medically necessary" or "as per doctor" and some questions I actually crossed out. I guess just knowing that my DH is aware of certain things, I feel more comfortable with him being able to speak up for me just in case I can't. You guys are also right about me sitting down with my doctor beforehand to have gone over this stuff- I guess I am the type to try and avoid being a burden and he always seems like he is in a rush, so I never wanted to bother him with this stuff, even though it's super important LOL! As for getting a doula, I don't think I have the time to get one at this point- I'm already 3 days past due. 

Dasha420

During my hospital tour, we asked about the birth plan documents and the people on staff there said that document is the very least of their concerns during the labor. They said of course you can have it and fill it out and you can give it to us but make sure that it is short and concise however do not expect It to be followed. It is the last resort in any case and will be the last page in the chart. 

I figured there's no point of even doing one because I know myself and whatever is needed I'll have to put trust into the hospital staff and my family. I will speak to the OB and the nurses before and hope all goes well. 

littlebb22

Agree with all PP. Thought I'd share what I did for my birth plan- I tried to break it up according stages of labor and tried to stick to the big stuff in order to keep it from getting too long. Hope it is helpful!

BIRTH PLAN

In the Room:

My husband, Chad, and my mother, Charene, only.

First Stage Labor:

-I prefer minimal vaginal exams.

-I prefer to be allowed to labor for as long as necessary, without intervention, as long as my baby and I are not at risk.

-I would like minimal interruptions and for the atmosphere to be calm and quiet.

-I prefer intermittent fetal monitoring, to allow for as much mobility as possible.

-I plan to be mobile and to use tools such as the birthing ball, shower, and tub.

-I will be utilizing hypnobirthing relaxation techniques.

-I do not wish to use any form of pain-relieving medications.

-I would like the opportunity to discuss thoroughly any medical interventions the medical team deem necessary.

Second Stage Labor:

-I prefer to practice spontaneous pushing.

-As long as the baby and I are healthy, I prefer to have no time limits on pushing.

-I do not want an episiotomy performed, unless I am having a medical emergency.

-I am open to the use of warm compresses and/or perineal massage.

-I would like to practice immediate skin to skin contact with my baby when he is born and to initiate breastfeeding within the first few minutes of his birth.

-I would like for the room to be quiet, calm and dim upon my baby’s birth, in order to ensure a smooth transition for him.

Third Stage Labor:

-Please allow my husband to cut the umbilical cord.

-We wish to practice delayed cord clamping, and for the cord to be done pulsating before it is cut.

-I would prefer the placenta to be born spontaneously without the use of Pitocin, and/or controlled traction on the umbilical cord.

 

THANK YOU!

Eta: After I posted I noticed it looks kind of long in this format but when I printed it ended up being less than a page...

folamij

I "took notes" off of the bump birth plan of things I wanted and then typed them up separately to a format I liked, and kept it to one page. My dr. is very on board with me having a birth plan but there was a couple things on there that when we sat down and she read over it that she said couldn't happen. I also wanted to wait until the cord stopped pulsating but she said she would allow a delay in clamping but wouldn't wait until it stopped pulsating because baby may get too many red blood cells and that's not good.

Overall, I was slightly disappointed that a few of my choices had to be axed due to hospital policy but knowing that my Dr. took the time to actually read through it with me and give advice (and explain why some things were axed that went beyond my research!) since I'm a FTM makes up for it. A copy is already in my file and she said to bring a copy when I go in labor just in case the hospital doesn't have it printed out in time.

Hope everything works out for you and you get someone nicer!

Lusitano8

Don't let some grumpy old lady tell you what to do! You and your DH have a right to have the birth you want. You are paying your OB and the hospital, you are not a prisoner. I believe a big plus for the birth plan is for the nurses coming in and out to know your preferences and not presume what type of birth you want. Many will actually read it! I know the culture is different at every hospital but many will skim it and get an idea of what you want and go off the birth plan. Like if you want minimal internal checks or no continuous monitoring, they will see that and remember not to ask you every hour! 
 
I agree with PP's that you should condense it down to a one page of your wishes so that they can skim it easily. I shared mine with my OB and she said thank you for keeping it to a page it will be helpful. The one above looks like a great example.

Pascal86

My hospital will add birth plan notes to your chart anytime you bring it in during an appointment before you deliver, and at delivery have a place right by your bed where they hang it up for everyone to check. I guess I should take advantage of that, but it seems like their standard procedures follow most of what you guys are saying you'd request anyway, and it all sounds good to me!

proudparent2b

@Nicbert1214 I totally feel you on not wanting to burden your busy doctor. It took me quite a number of appointments, watching my OB run in and out in 5 min., before I worked up the courage to interrupt her as she stood up to leave to start asking questions.

Honestly I probably would have been much more hesitant to have even created a birth plan if it hadn't been a requirement for my hospital.  I give you props for your initiative.

sillyfox

For the delayed cord clamping, I asked about it with my first and my OB said that it is more beneficial if the baby is premie, but that it has been shown to cause jaundice since the baby often gets too many red blood cells. I don't have a medical degree so I trust his judgement on that one. Not trying to change anyone's mind, just sharing what I was told.

gemini2005

sillyfox said:

For the delayed cord clamping, I asked about it with my first and my OB said that it is more beneficial if the baby is premie, but that it has been shown to cause jaundice since the baby often gets too many red blood cells. I don't have a medical degree so I trust his judgement on that one. Not trying to change anyone's mind, just sharing what I was told.

My OB said the same thing: there's no benefit to delayed cord clamping with a full-term baby.  I was surprised about the risk of jaundice too. I think we will do some skin-to-skin as soon as she's born and let the cord pulse for a few minutes but not the full 20 minutes.  

littlebb22

Re: delayed cord clamping. That is very interesting- I wonder why it is touted as so beneficial? I'll definitely have to talk to my midwife about it next visit.

dandyleah

My perspective as a soon to be 3tm, I didn't use a birth plan with my 1st 2 deliveries and when I brought up the subject of a birth plan with my ob for dd3, (different dr this time),  his exact words were, "the longer the birth plan, the greater the chance of a cs." I also spoke with a nurse in l&d at the hospital and she reiterated that it is not necessary and they do not provide an outline for one. Their top priority is healthy mom, healthy baby. There are a few things that are important to me such as skin to skin, breastfeeding ASAP, epidural ASAP,  and limited visitors, and saving the placenta (for encapsulation). Dh and dr are aware of these and when I get to the hospital, I will make the nurses aware. If you are having a "standard" hospital birth, the nurses will do most of the leg work anyway. Until the dr arrives to "catch the baby" so to speak, they will be the middle man, communicating between you and your dr so make sure they are fully aware of all your preferences when you arrive and are admitted so there is no confusion, especially if the woman in your dr office didn't take yours seriously. 

vinerie

I do not have a birth plan, although I'm wondering if I should. In general, though, I think these things go over much better at midwiferies than at a medical practice with physicians. At least that's my sense, although different OBGYN practices might be more open to them. 

araecasey

@littlebb22 Delayed cord clamping is important because all of the blood left in the placenta is your baby's blood! Immediate clamping and cutting means that a good portion of your baby's blood is removed from his or her little body. Breastfed babies especially need as much of their blood as possible in order to be nice and alert after birth (you'd be super sleepy too if you had a massive blood loss) and because breastfed babies need as much of their iron stores as possible since breastmilk is very low in iron and baby won't be getting dietary iron until around the 6-9 month mark.

littlebb22

araecasey said:

@littlebb22 Delayed cord clamping is important because all of the blood left in the placenta is your baby's blood! Immediate clamping and cutting means that a good portion of your baby's blood is removed from his or her little body. Breastfed babies especially need as much of their blood as possible in order to be nice and alert after birth (you'd be super sleepy too if you had a massive blood loss) and because breastfed babies need as much of their iron stores as possible since breastmilk is very low in iron and baby won't be getting dietary iron until around the 6-9 month mark.

That is exactly what I have read but PP mentioned that their doctors told them that it is only beneficial to preemies and can cause jaundice in full term babies, which I have never heard before!

folamij

Also, I should add: know what the standard procedures are for the place you are giving birth at. Most of my wishes like immediate skin to skin and delayed bath are standard practice at my hospital so they are not on my birth plan. It makes it so much easier to add other things that you would like ( or don't want) without taking too much space. I also had at the bottom of mine my requests in case an emergency c section was needed.

lalala2004

sillyfox said:

For the delayed cord clamping, I asked about it with my first and my OB said that it is more beneficial if the baby is premie, but that it has been shown to cause jaundice since the baby often gets too many red blood cells. I don't have a medical degree so I trust his judgement on that one. Not trying to change anyone's mind, just sharing what I was told.

I find that very hard to believe. Whoever said it was 20 minutes, though, its really only 1 1/2 to 2 minutes as opposed to immediate cutting. My baby with an APGAR score of 9 and bilirubin levels that are barely on the chart because they were so low obviously didn't experience this, although I know this is only one example. 

Nicbert1214

I probably should have done a bit more research about the hospital I am delivering at in regards to their common practices- but I've been so busy with everything else, I just didn't get around to it. All I do know about the hospital is that they have one of the lowest c-section rates in the state and will only perform one if LO is in distress or 10 pounds +. I mean I could totally understand that due to its lengthiness, it can be a bit off putting, but if they weren't useful, why would they even make them? I am totally realistic in regards to the fact that not all of my wishes will be able to be honored- but if it's something that I am completely against, and it would not be putting myself or LO at risk, I would want that documented you know? 

blaisdew

We have hired doulas and they have been extremely helpful with helping us with our birth preferences. It depends on the hospital you will Labour at, but a lot of what women will write in their preferences is unnecessary. For example, "we would like baby to be placed immediately on mom for skin-to-skin contact" is not necessary because that's their routine anyways. The same goes for wanting to use the tub, exercise ball, etc. and be active during labour. Apparently that is all encouraged. 

Then in there are things like wanting to delay the baby's bath.. Apparently do they not only wait 24 hours to give the bath anyways (unless you ask) but in our hospital anything that happens after the delivery of the placenta is actually the responsibility of a different unit (Mother and Baby) and therefore should not be part of your birth preferences. 

We went from having a pretty long birth plan to an extremely simple one once we educated ourselves about the routines practices at our hospital. I was pretty impressed and put at ease, too, since I thought we were pretty granola-y! 

Long story short-- the advice we were given was to have a plan that was simple, short, less than one page in a large font, and didn't tell hospital staff to do things that they do routinely, or not to do things that they wouldn't outside of an emergency.