Had a great 37 week appt, went over whole birth plan ETA added birth plan

AngieandTony

I was so relieved because i was really nervous i was going to get resistance on some of the things i requested.  She went over it line by line and the only thing she had an issue with (which I have known since day 1) was the continuous external fetal monitoring.  The hospital policy is 20 minutes out of every hour. She told me, however, that she prefers with her VBAC patients that it be truly "constant". 

 

I told her I felt very strongly that I wanted not to be tied to the bed and wanted to labor on the ball, in the shower, walk around etc and this was imperative since I was trying for a med free birth. She agreed that if the initial monitoring is fine, that she will be ok with me going with the hospital policy of 20/60 min of being on the monitor 

 

i felt really good for advocating for myself and I already feel 10 times more confident that I ever did with my first.  She complimented me on my birth plan (its only one page) and assured me she'd fax it ahead of time to L&D.  We also went over my preferences in case I have a RCS and she agreed to all my "terms" as well.    We also talked about what if I go past due date.  She indicated that she would "let me" go about 10 days so long as baby was ok (NSTs etc) and that she would be willing to try some induction techniques before going for the RCS. 

I forgot how empowering it was just to speak up for yourself! 

MsMom1

That is awesome. I would love to read your birth plan.

LiluBee

Sounds great!  I'm guessing your hospital doesn't have telemetry?  At least you are allowed off of it for awhile to move around and get in the shower!

AngieandTony

There is apparently one portable monitor on the unit which conveniently can't ever be found. It's a myth lol. I'm prepared to deal with it when the time comes though and I'm not gonna let myself stress over it. I'd love to share my birth plan. I can try to post it later from my Laptop (on iPod now)

iris427

That's great, Angie.  I bet you feel so much better.  Good for you for advocating for what you want!  I would also like to see your birth plan if you get a chance to post it.

rena5498

Thats great! also advice my midwife gave me she said she notices the monitors never seem to stay in place when patients move around and when they dont then they would make me stay in bed but she said she had a patient who had a postpardum support belt that she brought with her and wrapped it around her waist over the monitor and it stayed put. So she was able to move around and use the birthing ball. Just some advice to pass along! I already brought one for myself as i know those monitors do act funny when you move and I refuse to sit still. GL!

AngieandTony

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BIRTH PLAN

AngieandTony

Due Date: 05/13/2011
Patient of Garden State OBGYN
Scheduled to deliver at Virtua Voorhees

Thank you very much for being a part of my labor and delivery team. My goal forthis birth is to have a safe and healthy delivery with as little interventionsas possible. I appreciate your cooperation and I look forward to this being apositive experience for everyone.

Sincerely,
AngieandTony

Labor

• I would like to be free to walk around during labor.
• I would like to be able to have fluids by mouth throughout the first stage of labor and I would prefer the use of IV only if I become dehydrated.
• I would prefer to keep the number of vaginal exams to a minimum.

Monitoring

• I do not want an internal monitor unless the baby has shown some sign of distress.
• I would like the opportunity to take breaks from CEFM to get in the shower or to walk around.

Labor Augmentation/Induction

• I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.
• I would prefer to be allowed to try changing position and other natural methods (walking, nipple stimulation) before Pitocin is administered.
• I prefer that my amniotic membranes are not ruptured without my express permission and consent

Anesthesia/Pain Medication

• I realize that many pain medications exist. I'll ask for them if I need them.
• Before considering an epidural, and if the situation warrants, I would like to try an injection of narcotic pain relief (Nubain, Demerol, Stadol or similar).

Cesarean

• Unless absolutely necessary, I would like to avoid a Cesarean.
• I would like Tony, my husband present at all times if the baby requires a Cesarean delivery.
• I would prefer the use of  stitches that dissolve to seal the incision instead of staples
• I would like the incision to be made so that a future vaginal birth could be possible.
• So I can view the birth, I would like the screen lowered just before delivery of the baby.
• I do not want my arms tied down at any time during the surgery
• I want the baby brought to me in the recovery room, and I want to attempt to breastfeed the baby in recovery

Episiotomy

• I would prefer not to have an episiotomy unless absolutely required for the baby's safety. 
• If possible, I would like to use perineal massage to help avoid the need for an episiotomy.

Delivery

• I would like to be allowed to choose the position in which I give birth, including all fours
• If  labor stalls, I want cervical scar tissue digitally massaged away before other induction methods are used
• Even if I am fully dilated, and assuming the baby is not in distress, I would like to try to wait until I feel the urge to push before beginning the pushing phase.
• I would like to have the baby placed on my stomach/chest immediately after delivery.

Immediately After Delivery

• I would like to have Tony, my husband cut the cord.
• We would like to not have the cord cut right away; we would like it to pulse for at least 2 minutes.

 Breastfeeding

• I plan to breastfeed the baby and would like to begin nursing very shortly after birth.
• Unless medically necessary, I do not wish to have any bottles given to the baby (including glucose water or plain water).
• I do not want the baby to be given a pacifier.
• I would like to meet with a lactation consultant.

Other

• I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.

AngieandTony

rena5498:

Thats great! also advice my midwife gave me she said she notices the monitors never seem to stay in place when patients move around and when they dont then they would make me stay in bed but she said she had a patient who had a postpardum support belt that she brought with her and wrapped it around her waist over the monitor and it stayed put. So she was able to move around and use the birthing ball. Just some advice to pass along! I already brought one for myself as i know those monitors do act funny when you move and I refuse to sit still. GL!

 

this is excellent advice, Thank you!  I think I may have a hand me down belt somewhere in my closet so I will hunt that down and throw it in my hospital bag.  

disbride061103

Can I ask why you don't want students, interns or residents to even observe? I know it's a personal decision but I wondered what your view point was? I had students and residents observe and participate in my VBAC attempt. My doctors and hospital did so much to avoid my c/s and were so caring and wonderful when it came time to discuss c/s. I remember thinking at one point that I was glad that the residents (and students in particular) were there seeing everything that was being done and how I was treated. I really was hoping that those experiences would then help them treat a VBAC patient well in the future.

AngieandTony

disbride061103:

Can I ask why you don't want students, interns or residents to even observe? I know it's a personal decision but I wondered what your view point was? I had students and residents observe and participate in my VBAC attempt. My doctors and hospital did so much to avoid my c/s and were so caring and wonderful when it came time to discuss c/s. I remember thinking at one point that I was glad that the residents (and students in particular) were there seeing everything that was being done and how I was treated. I really was hoping that those experiences would then help them treat a VBAC patient well in the future.

My hospital has one of highest rates of c/s in NJ and I really want my OB's focus to be on me and what my wishes are during the delivery. I think if they are in "teacher" mode or if other medical professionals/students are in the room it might change the decisions that my OB makes or how they present information to me. If things go well this time and I have a positive experience then I will consider it if we deliver there again.

cchill01

Sounds like you're all ready.  Thanks for posting your short birth plan - I think the 4 page questionnaire from the Bump makes L&D teams look the other way.

disbride061103

AngieandTony:

disbride061103:

Can I ask why you don't want students, interns or residents to even observe? I know it's a personal decision but I wondered what your view point was? I had students and residents observe and participate in my VBAC attempt. My doctors and hospital did so much to avoid my c/s and were so caring and wonderful when it came time to discuss c/s. I remember thinking at one point that I was glad that the residents (and students in particular) were there seeing everything that was being done and how I was treated. I really was hoping that those experiences would then help them treat a VBAC patient well in the future.

My hospital has one of highest rates of c/s in NJ and I really want my OB's focus to be on me and what my wishes are during the delivery. I think if they are in "teacher" mode or if other medical professionals/students are in the room it might change the decisions that my OB makes or how they present information to me. If things go well this time and I have a positive experience then I will consider it if we deliver there again.

Thanks! It's always great to hear a different perspective.

MsMom1

Thanks for sharing your birth plan! I loved reading it. Best wishes!