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3rd Trimester
Birth Plan Ques. Please help?
Sorry if these seem like "obvious" answers...but I would appreciate some help...thank you in advice...
Ques. 1; I'd like fetal monitoring to be:
A.) Continuous
B.) Intermittent
C.) Internal
D.) External
E.) Performed only by Doppler
F.) Performed only if the baby is in distress
I figured it should be at least Intermittent, but if I'm aiming for a natural waterbirth should they only perform it w/ a doppler or if baby is in distress? I would think "F" would be a dumb idea either way you look at it. And WTF does it mean by Internal and External? External by doppler? Someone shoving something up there Internal? Uh, can I pass on that? lol.
Ques. 2: I'd like labor augmentation:
A.) Performed only if baby is in distress
B.) First attempted by natural methods such as nipple stimulation
C.) Performed by membrane stripping
D.) Performed with prostaglandin gel
E.) Performed with Pitocin
F.) Performed by rupture of the membrane
G.) Performed by stripping of the membrane
H.) Never to include an artificial rupture of the membrane
I marked "performed only if baby is in distress" because I have NOOO clue what an augmentation is...?!
Ques. 3: I would like an episiotomy:
A.) Used only after perineal massage; warm compresses and positioning.
B.) Rather than risk a tear
C.) Not performed, even if it means risking a tear
D.) Performed only as a last result
E.) Performed as my doctor deems necessary
F.) Performed with local anesthesia
G.) Performed by pressure, without local anesthesia
H.) Followed by local anesthesia for the repair
Again, I don't know what an episiotomy is...or maybe I do and I just don't recognize it. Lol.
I think that's it...help would be great....pleaseee?! 
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This discussion has been closed.
Re: Birth Plan Ques. Please help?
Question #2: If you need medical intervention to get your labor going.
Question #3: If they need to surgically cut in order for the baby to fit through (instead of a tear).
for Question #1: I would just put a "see as I go" stance.
An episiotomy is where they cut a slit in your vag so theres more room for the baby to come out. It will require stitches after.
Q 1. They DO shove something up there for internal. I opted for external only.
Q 2. The options make it sound like inducing labor. But I'm not sure
1. If you are in the water they'll be using a doppler most likely. If they have you come back to the bed request B - intermittent. You don't want internal monitoring if you are trying to remain mobile.
2. Augmentation is speeding up labor. Honestly this one just depends. If you aren't worried, then go with A....and discuss options as the need arises.
3. This is cutting the area so the baby can come out, should be done only as a last resort IMO.
Obviously I am doing "research" by coming on here and asking experienced women. I would rather ask and look :dumb: then just pick an answer and it be not what I wanted. Always someone that needs to insert foot in mouth. And please don't blame hormones, it just gets tiresome.
this. i do NOT mean that to be snarky, either. there are books that talk about L&D and all the choices you may face. Many go into detail about the rationale behind each intervention as well as the pros and cons of each. Many have a bias (leaning towards more intervention, or less) so be careful which you choose. If you are going natural, or are inclined towards less intervention, a book that is biased towards heavy med. intervention may be off putting (same for the other way around). Good luck. These choices are so personal and us Bumpies are smart, but we can't give you all the info.
Are you signed up yet for a birthing class? I think it would be really helpful in making your decisions. One website I also like for good basic answers is www.childbirth.org
Yes, but they don't start till the 29th of March.
DD1 born 5/24/10.
Missed M/C at 14 wks Feb 2012.
DD2 born 5/14/13.
Missed M/C at 9 wks July 2015.
I understand. But with the answers so far it does make me understand more. I will do more research before I fill out the rest of the paperwork!
Thank you everyone for your answers.
I'm going to be honest. Don't take this the wrong way, but I don't think you are prepared to do a birth plan yet. You need to research more. You shouldn't just pick and choose from these options--frankly, that isn't the way it should work with several of these questions anyways.
E.g.:
1. Fetal Monitoring. At our hospital, they require it. But they do it intermittently if you are cool with that (15 minutes/hour). However, this answer will change based on what happens during labor. If you decide to be given Pit, then you need to be monitored 24/7 instead of just 15 minutes/hour, etc. because Pit could make the contractions incredibly strong and cause problems. You do NOT want them to do it continuously instead, generally, because it will increase the chances of you being induced/c-sectioned.
As for internal vs. external, you would want external unless medically necessary to do internal. Internal is where they have this little tube that goes through your vag, and there is a little clip that sticks into the baby's scalp. Basically they push something through the first layer of your baby's scalp.
2. Augmentation presumably means getting labor started quicker. Again, I don't think you're prepared to answer this, because your answer should change depending on what happens during labor. IF your water breaks, for example, and your body doesn't naturally start labor on its own, after about 24 hours, you need to SERIOUSLY consider being put on Pit, because you are at a huge risk of infection if they keep doing internal exams on you. But you shouldn't just select "when in fetal distress" without knowing what this means--because the Dr.'s version of "fetal distress" may be very different from what really IS fetal distress. Also, you would want to select both "only in distress" and "natural methods/nipple stimulation, etc." because really if labor doesn't start right away, you are going to want to go to natural methods, then if that doesn't work, have them put you on Pit when you truly need it. But from everything I've read, as long as they dont' do excessive internal exams after your water breaks, there is no reason for them to induce labor immediately (24 hours is sort of the breaking point here, it seems like).
3. Many hospitals don't routinely do episiotomies (where they cut open your skin to get the baby through) anymore. They generally only do them if they HAVE to to get the baby out. They do not heal as well as natural tears.
I strongly suggest reading this book to educate yourself:
https://www.amazon.com/Thinking-Womans-Guide-Better-Birth/dp/0399525173/ref=sr_1_1?ie=UTF8&s=books&qid=1268669516&sr=8-1
I'm def. not prepared to do a birth plan in the sense of certain questions, I admit that! lol. And this is why I am doing it so early. I can gather as much information as possible before making bigger decisions.
And honestly...this "Birth Plan" came FROM thebump.com and it's the best one found so far....
Thank you for all the information given.
)
Intermittent is usually best, say 20 minutes on...40 minutes off.
Labor Augmentation is if your labor stalls do you want them to use pitocin to start it again, break your water if it's not broken, would you like to try natural techniques such as sexual intercourse, nipple stimulation...etc
Episiotomy is when they cut your perineum instead of allowing it to tear if that is the case
Question 1:
If you want a water birth, you may want to ask for intermittent monitoring. If they see something troubling, they can switch to continuous or internal monitoring. Some people want no monitoring at all because of concerns that monitoring can cause unnecessary interventions. Others want continuous monitoring because they are worried about something going wrong and it not being caught quickly. If you end up deciding to have an epi or pitocin, you may have to get continuous monitoring. Talk to your doctor or midwife to see if your hospital has a policy. My hospital has a policy of continuous monitoring, but I discussed it with my doctor first and she gave the okay for intermittent monitoring as long as there are no obvious problems.
Question 2:
You really should try to read about each of these things as much as possible to see how you feel about each of them. Option H sounds really unrealistic, because sometimes people have problems with the baby dropping until the water is broken and it might be necessary to keep things moving.
Question 3:
Many doctors have a policy of doing it only if it is necessary to get the baby out. The current consesus seems to be that a tear heals better, so many doctors will not do one unless the baby needs to come out quickly or a tear has started and looks like it is going to move in a way that is damaging. In that case, they may create a new cut to guide the tear the correct way. I talked to my doctor about it and went with E, because I know she is anti-episiotomy. Again, try to read about the procedure and why it is done to see what you are most comfortable with, but definitely discuss with your doctor or midwife.
No worries. I wasn't prepared at all to answer these questions at 27 weeks. It's been in the last month that I've done my research and tried to figure out how I want things to go if this or that happens...Its just that it would be best for you to research using books (with actual statistics, explanations, pros/cons, rather than on here where you are going to get very different opinions, because these are very personal choices that go really to whether you want a birth with medical interventions, or one with as few as possible. Even my responses were biased towards no medical intervention. E.g.: some wouldn't see a problem in starting labor up right away with Pit. I don't want to because of the risks involved. But that is a personal decision.
Also, these questions require really in-depth answers, as you can maybe start to get a sense of from some of our answers. My answers, for example, were far from complete. To be fully informed and make a good decision, you need more than you are going to get just from a post on here.
I would def. do some reading about these procedures and all the options before even trying to do a birth plan. I just read this great post by an L&D nurse about writing a birth plan, and she said that when women come in with a "check the box" birth plan from a website, and they don't really understand what they checked off, it is not that helpful. I would also try to find out what is standard procedure at your hospital - for instance, I don't need to write about any of these things, because their standard is to do intermittent monitoring w/ a wireless monitor unless things come up where they determine that you need continuous monitoring (like if I get an epidural, they might do continuous monitoring, if you get pitocin you may have to get continuous monitoring, etc.), no routine episiotomies (natural tearing instead unless an absolute emergency), etc. but not all hospitals are like this. My sister's hospital did do routine episiotomies (so yes, places that do them still exist even though it is not really standard practice anymore).
If you want a waterbirth, that tells me that maybe you are more interested in having fewer rather than more interventions? I am not sure if that is strictly true for you, but you should definitely do some more reading. More natural perspective books (i.e. fewer interventions) are books by Ina May Gaskin, Henci Goer, William Sears, although I think that books like What to Expect When You're Expecting do a decent job of covering L&D situations. You basically want to know two things- what is intervention X, and under what circumstances do I think that X is appropriate? Your ideas of when X is appropriate may not be the same as your hospital's, and when it isn't, that is when it is most important to communicate that in your birth plan.