Is two pages too long for a birth plan?

KScheibe12 · November 2011

I've had a really hard time paring it down. The hospital has some really great pro-natural policies already so I didn't have to include things like immediate skin to skin contact and delaying newborn procedures. However, it's still really long and I can't identify anything else that can be cut at this point. Any suggestions? Is two pages really not a big deal? I just don't want the nurses to see it and decide the two minutes it would take to read is not worth it...

Anyway, this is our birth plan:

Our Primary goal is a healthy mother and baby.
We strongly believe in labor and delivery as a natural process. We therefore desire a non-medicated labor and delivery, limiting the use of medical interventions to those necessary for the health of the mother and/or baby and/or for treatment of an abnormality or complication. We understand that complications can arise unexpectedly and are grateful for the technology and assistance available to us in that event. However, assuming no complications, we need your help in supporting us in our wishes for a natural, un-medicated birth.

?    Assuming no complication, we prefer to labor without the assistance of labor stimulants or pain medications. Please do not offer pain medications; we will ask for them if/when needed.

?    Please allow the membranes to rupture naturally (i.e. no stripping of the membranes during vaginal exam, or artificial rupture before or after labor begins). If the medical team feels either of these procedures is necessary, please be willing to discuss the medical indications beforehand.

?    I prefer to have a hep-lock/saline lock unless IV fluids are necessary for treatment of an abnormality.

?    In the absence of medical complications, I prefer intermittent electronic fetal monitoring to allow for as much mobility as possible.

?    Please limit vaginal exams to: upon admittance, during the pushing stage, and for specific medical indications only.

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

?    I would like to be encouraged to try the following different positions for labor: Classic semi-recline, side lying, and/or squatting.

?    During delivery, assuming no overriding complication, please do not perform a routine episiotomy. I prefer the risk of a tear to this surgical procedure. To help prevent tearing, please apply: hot compresses, perineal massage, and slow delivery of the head.

?    Upon delivery, assuming no complication, please delay cord-clamping and cutting until the cord has stopped pulsating.

?    If a C-Section is not an emergency, please give us time alone to think about it before asking for our written consent.
o    My spouse is to be present at all times during the C-section.
o    Ideally, I would like to remain conscious during the procedure.
o    I would like the baby to be shown to me immediately after she's born.
o    I would like to have contact with the baby as soon as possible in the delivery room.
o    I prefer to have a hand free to touch the baby.
o    If possible, please discuss anesthesia options with me (including morphine options).
o    Recovery:
?    If my baby is healthy, I would like to hold my baby and nurse her immediately in recovery.
?    I would like to sign any waivers necessary to permit me to be with my baby in recovery.
?    As long as my baby is healthy, I would like my spouse to be the baby's constant source of attention until I am free to bond with her (i.e., holding, skin-to-skin contact, etc.).

NEWBORN PROCEDURES:

?    If the baby has any problems, I would like my spouse to be present with the baby at all times, if possible.
?    Immunizations:
o    Immunize the baby according to normal procedures.
?    Feedings:
o    My baby is to be exclusively breastfed.
o    I would like to see a lactation consultant as soon as possible for further recommendations and guidance.
?    Please do not offer my baby the following without my consent:
o    Formula.
o    Pacifiers.
o    Any artificial nipples.
o    Sugar water.
?    If my baby's health is in jeopardy, I would like:
o    To be transported with my baby if possible.
o    My spouse to go with the baby.
o    To breastfeed or express my milk for my baby.

We thank the nursing and medical staff of {Hospital Name} and {OB Practice Name} in supporting us and sharing with us in this most precious day!

Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

MrsMincks · November 2011

It looks pretty reasonable too me. I don't think it's too picky or overly controlling or anything, it's just specific. Which I think is a good way to be so that you don't have to be mulling over options while you're in the heat of labor.

nosoup4u · November 2011

I don't think you need the details. And you could keep the c-section requests separate, and only get them out if needed. You could also just list that you don't want to be offered pain meds, and that no procedures be done without discussion first. I'd do the same for newborn procedures, just make sure the nurses know you don't want anything done until they inform you.

Brevity really is a good idea, it makes it easier to remember what you want also, in case you don't have your plan w you. I wrote one for both my births, and ended up not having it w me either time!

flyer23 · November 2011

I would take out the parts on: time limits on pushing, episiotomy, and cord clamping. Those are things that will be decided by your OB, not your nurses. So, talk over your preferences with your OB, if you haven't already. If you feel that your OB will need to be reminded of them... you can give him/her a longer copy of your birth plan for your records, that includes those things. But they don't need to be on the copy you give the nurses.

Stripping membranes does not mean membrane rupture. (At least, rupture is not the primary goal.) So I'd rephrase that point. Maybe even move the stripping-membranes stuff into the point on vaginal exams. Also, all the stuff on rupture is another one that is much more likely to be controlled by your OB than the nurses, so it's probably better to discuss with your OB and either remove entirely or leave on an OB-only plan.

Do you know if a hep lock (vs. continuous IV) is standard at your hospital? I know it was at the one where I originally planned to deliver DS, so I left that out. I would leave it in if they usually do continuous IV, though.

I'd remove the point on positions you want to try during labor. That's more the domain of your husband/doula/other support person, vs. the nurses.

I'd limit the newborn procedure stuff to the "if my baby's health is in jeopardy" point. Put everything else on a separate page. It's likely that the nurse you have for L&D will not be the same one you have on the maternity ward, so no sense in including your preferences for both on the same sheet. (Unless you specifically know that is NOT the case at your hospital.)

You can also remove the point on immunizations. In the absence of direction from you, they will do EVERYTHING according to normal procedures Smile

That should pare it down pretty nicely, but if you still need to cut more, I like the pp's suggestion of putting the c-section stuff on a separate page.

honkytonk_kid · November 2011

Yeah, that's way too long. A good tip when writing a birth plan is to consider your audience. You don't need to say "we don't want to induce, we don't want an episiotomy, no time limits on pushing, etc" because the nurses don't have the power to do those things on their own, kwim? Talk to your OB/MW about that. Your birth plan (the copy you take to the hospital) should address the nurses and hospital policies. Consider what THEY have control/influence over. You should definitely take this copy to an appointment though and talk it over with your provider though so they are on the same page as you. Also, look into standard hospital policies where you will deliver. Many of the things included are (IMO) unnecessary because are they ARE standard, or, are things that you could just ask for- ie no one will give you general anesthesia unless it is an emergency, so you don't really need to state a preference for being conscious, and unless it is an emergency, your anesthesia options WILL be discussed with you. Just ask to see the LC. If you need a c/s just tell them not to strap your arms down. Kwim? A long, detailed birth plan does not replace communication with your nurse, it hinders it. Make sure your H knows what the game plan is, and make sure your OB is on the same page as you, then include just the basics on your birth plan.

Take to the hospital something like:

Please do not offer pain medications. I know what is available and will ask if I want them.

I would prefer a hep lock unless fluids become necessary. I would like to eat and drink during labor, as discussed with (provider's name).

I would prefer intermittent monitoring.

I would prefer to limit the number of vaginal exams.

I would appreciate your help and encouragement in suggesting positions for laboring and pushing. Please do not "coach" my pushing unless I request it.

In the event a cesarean becomes necessary, please make it possible for me to see and touch baby as soon as possible. As soon as baby is assessed, my husband will hold baby until I am able to in recovery.

Baby is not to be separated from us unless there is an emergency. In the event that further care becomes necessary, we would prefer my husband accompany baby.

I plan on breastfeeding. Please do not offer baby pacifiers, formula, or sugar water without discussing with us.

That's probably barely half a page, but it gives the nurses some direction for what you expect. Everything else needs to be addressed either with your OB, or as the situation calls for it.

KateLouise · November 2011

I think you can eliminate some of the wordiness by taking out the resptitions on phrases, "unless medically necessary" "unless necessary for mother or baby's health" etc at the beginning of several requests.

Your opening paragraph states that you understand that there is sometimes medical necessity and that the following requests are following the assumption of a complication free birth.

So therefore I remove those statements and just stick to, what it is that you want.

LaurelBee · November 2011

Just butting in to share that my nurse broke my water w/o my or my OBs consent. Afterwards I went from 8cm to 10 w/ one (horribly awful) contraction- my OB was already in an emergency CS, so they had me wait until the on call OB got there. I would keep the membrane breaking part in if it's important to you.

cecilyandgautam · November 2011

Just a thought but you could break this down into 2 birth plans: 1) all is relatively normal 2) c-section becomes necessary. Only pull out birth plan #2 if it's needed.

We're planning a birth center birth so we have the birth plan for that. We have another version for hospital transfer when only drugs are needed and a third for hospital transfer when a c-section is needed. Might sound like a bit much but it keeps all of the them pretty short & sweet.

KScheibe12 · November 2011

cecilyandgautam:
Just a thought but you could break this down into 2 birth plans: 1) all is relatively normal 2) c-section becomes necessary. Only pull out birth plan #2 if it's needed.
We're planning a birth center birth so we have the birth plan for that. We have another version for hospital transfer when only drugs are needed and a third for hospital transfer when a c-section is needed. Might sound like a bit much but it keeps all of the them pretty short & sweet.

That's a good idea. I'll have to break this down into three separate birth plans. I hadn't really thought about that as a possibility.

dosafyre · November 2011

I think it's good too (just wordy)...and your intro paragraph sets a great tone. Cut things down to simpler bullet points after that...the nurses are very familiar with all of this, they just need to know your preferences at a glance. Yes

(ie: heplock placement is okay, perfer to tear/no episiotomy)

Try to keep it all on one page...my nurses took mine at the beginning and got familiar with it, and let the doc know what I wanted (I wasn't delivered by my OB, and you may not be in a place to chat with a new doc during active labor)

Want a personalized experience?

Is two pages too long for a birth plan?

Re: Is two pages too long for a birth plan?

Choose Another Board

Search Boards