Birth Plan Critique

abbyful

Here's my birth plan, is there anything you suggest changing or that I missed?

Thanks!

 

 Labor:

Able to walk around and change position.Vaginal exams to a minimum, no premature breaking of the membranes or scraping.No catheter.IV starter can be placed, but not hooked up unless necessary.
Monitoring:
External monitoring onlyNo continuous fetal monitoring unless required by baby's condition
Augmentation/Induction:
If deemed necessary, first methods used should be membrane sweep and/or breaking water. No premature rupture of the water or membranes.We would like to exhaust all methods of natural labor stimulation prior to any drugs being administered (nipple stimulation, ankle, etc.)In the case of any drugs being suggested, we would like to discuss the benefits vs risks.
Episiotomy:
No episiotomy unless for baby's safety; if episiotomy is needed, please do a pressure episiotomy Rather tear than cutWould like a local anesthesia if a tear occurs for stitches.Support the perineum during pushing/crowning and use a warm compress
Delivery:
Free to move while pushingPush when the urge to push comes and push to comfortBaby's shoulders should be birthed on their own, not pulled outAvoid forceps/vacuum if at all possible



Caesarean:
Only as an emergency last resortParticipate in any discussionsLow horizontal incisionBaby will be breastfed ASAPWe will be trying for a VBAC in the future, please take all measures to make the site as strong as possibleSuture uterus in 2 layersIf baby is placed in a nursery, father will accompany baby at all times
Post Delivery:
Baby placed immediately on mother's chestWait until the cord stops pulsating to clampMother will expel the placenta on her own, please no tugging or pullingNo Pitocin to remove placenta unless abnormal amount of bleeding requires it, must get permission to do so firstWe would like to delay the eye medication for one hour to better bond with babyNo Hepatitis B shot, will get it done at a later dateWe prefer skin-to-skin contact over lamps and nurseryNo tests until after first feeding/golden hourDo not bath babyIn case the need arises to separate baby from mother, father will accompany baby at all times
Post Partum:
NO circumcisionBreastfeed exclusively, please no bottles, artificial nipples, sugar water, formula, etc.No separation from baby

tokenhoser

I think this is okay to use as an outline to discuss with  your doctor, but you may want to clean it up (shorten it up) for use at the hospital.

You may want to ask about food/drink during labour.

Some things are kind of pointless. They're going to tell you a c-section or episiotomy is necessary if they're doing it. They don't do them for fun. I would hope anesthesia is normal for stitches - I sure didn't have to ask for it, it was standard.  The induction section is good to discuss with your doctor, but not needed for the copy you give to the hospital. They won't sneak up and induce you (although asking what's happening can be important if you don't want your waters broken, but you addressed that elsewhere).

I guess I'm saying it's long and repetitive. Say things once. 

RockyMtnMama

I think it covers most everything, but I agree with the pp that this is more for your doctor and labor team (DH, doula, etc.) to know and less for the hospital.  A quick 2 paragraph statement might be more appropriate for the hospital...something like this could be in your file and on your door or in your room even. 

"I am working on a natural, med-free, vaginal delivery for our son with few to no interventions and procedures.  Prior to any interventions or medicine, please consult with both my DH and I and we will weigh the pros and cons prior to approval.  Thanks for being supportive.

After delivery, I would like to postpone or delay all newborn shots, vaccines, procedures until after skin-to-skin bonding if at all and will be focusing on breastfeeding without the introduction of pacifiers or bottles.  Again, please consult DH or I prior to any interventions or administering medicine."

katcarls

I would put the c/s part on a separate page to shorten things up a bit.  You probably won't need it but if you do you can just pull out that page.

Some things are redundant like PPs said.  For example, you say you'd rather tear than be cut and you also say no episiotomy unless needed.  One of those would be sufficient, there's no need for both.  You could also combine that section with the part about delivery and title it "second stage of labor" or "pushing."  I would also consider combining the Labor, Monitoring, and Augmentation sections.

You can probably eliminate some of the details after talking with your provider about what standard procedures are.  For example, my hospital delivers all babies onto the mom unless there are complications so I didn't include that in my birth plan.

stever

ShkagoBride:

I am happy to email or send you mine as well- here are some things to think about...

Using more positive wording- we prefer/request as opposed to "No"

We mentioned only having intermittent checks by our own midwife,OB, and on-call nurse- our hospital is a teaching hospital and we made mention of this in the BP (I personally don't want students checking me).

Also- you mention sweeping membranes and breaking water, but then say not to do it. This seems a bit confusing. Could you mention wanting to naturally progress but if need be, then those interventions are okay?

 I like your C-Section instructions!

Overall great job on this!

 

 

 

The bolded confused me as well. I also agree that it needs to be made shorter and the language needs to be changed from "no" to "opposed to" or "would prefer."

Manderlin923

I think you need to shorten it. I have heard it's best if it's under 1 page in length. Keep it to your top/most important preferences with bullet points. I'd do a c-section birth plan (another short one) on a separate page as well.

BLuvsE

I usually post on Dec 2012, but wanted to put my two cents in here -

for several of these, instead of (or in addition to) having it in your birth plan, my MW suggested making sweet little signs to hang in the room. For example, above my bed will be a sign that says "I'll ask for pain meds if I want them. Please don't offer." and then we'll have a sign in the bassinet that says "If I'm hungry take me to my mom!" and on our door will be a sign that says "Shy Mama...please knock! Thanks!"

We'll also have a birth plan but I won't be the only mom delivering when it's time and I want to make it easy and cheerful for them to remember. We're also planning on bringing some kind of treat (fruit tray probably) for the nurses that help us.

judahsmommy1

RockyMtnMama:

I think it covers most everything, but I agree with the pp that this is more for your doctor and labor team (DH, doula, etc.) to know and less for the hospital.  A quick 2 paragraph statement might be more appropriate for the hospital...something like this could be in your file and on your door or in your room even. 

"I am working on a natural, med-free, vaginal delivery for our son with few to no interventions and procedures.  Prior to any interventions or medicine, please consult with both my DH and I and we will weigh the pros and cons prior to approval.  Thanks for being supportive.

After delivery, I would like to postpone or delay all newborn shots, vaccines, procedures until after skin-to-skin bonding if at all and will be focusing on breastfeeding without the introduction of pacifiers or bottles.  Again, please consult DH or I prior to any interventions or administering medicine."

I really like this! I agree that how you address the AROM procedure is confusing. Also, are you familiar with your hospital's procedures yet? Some of this might be completely unnecessary. For example, at the hospital I will be delivering at, a nursery is not available for healthy babies unless the mother is busy with a medical procedure. (C-section etc...) It is assumed that healthy babies will room in with the mother and will not be taken away.

Just keep in mind that if you set yourself up to be an adversary to the nurses, you could be denying yourself some wonderful support. That doesn't mean that you have to always agree with the nurses, but communicating that you are interested in being an active part of your medical care is likely to gain you more respect than stiff arming any medical procedures that you have pre-emptively determined to be unnecessary. (Am I making sense here?) I would encourage you to go through your BP and look to see how you can incorporate that concept. I think that's why I like the quoted PP so much!

brookemarie1025

Lurking......

Can I just say its awesome you are anti circumcision  

momkam

I think it's a great birth plan!  I do like the idea from a PP about putting friendly reminders around the room/door/bassinet.  Especially for NO circumcision (Good for you, btw!)  If you are in a high circ area, I would be really, really careful with this one.  Make it very clear that your son is not to be circumcised and I, personally, would not let him out of my sight.  I would also make it clear that his foreskin should not be retracted.  I was a pediatric nurse and learned you were supposed to retract  Even my mother/baby nurse friend who made me question circumcision thought you should retract.  We now know this should never be done, but many, many medical professionals are completely uninformed.   If he has to go to the nursery, I would send your husband.      

 Best of luck to you!!