Birth Plans and Hospital Plans

IkesHawaiian06 · August 2011

I'm starting to put together my birth plan and plan for the hospital. I'm going to schedule a c-section, so obviously my plan will be different. Here are some things I'm working on putting together:

C-Section:

No catheter until Spinal has been administered
I would like the baby to be placed directly on my chest (my OB says this is a possibility!)
I would like nobody allowed into recovery or my mom-baby room without permission with the exception of DH, DD and my parents.
I would like to breastfeed as soon as possible after surgery.
I would like baby to stay with me during my entire stay at the hospital.
I would like all evaluations done in my presence.
I would like to eat solid food as soon as possible (mostly because when I had Em, I didn't get to eat for about 24 hours)
I do not consent to the use of pacifiers, sugar water or formula.
My husband would like to help with the first bath

Plan for the Hospital Stay:

C-Section and Recovery - Just DH and I

DH will call my parents first, then his. *A photo of the baby and his stats will be posted to FB before calling his parents (since we all know that MIL will likely disregard our request for keeping things quiet until we are able to post ourselves)

First Visitor - Em ~ At least one hour just Em, Baby, DH and I

Visitors After - My parents - DH can call and let his parents know that they are okay to visit after my parents arrive.

All other visitors must check in before entering the room.

*~*~*~*~*~*~*~*~*~*

For those of you that had a c-section, is there anything else that I should consider having written down so I can go over it with my OB? Anything from delivery in general or the hospital stay that I should add?

skenyon · August 2011

I've never had a c-section so I don't have any specific advice, but everything looks reasonable IMO.

Seattle_JiLLn · August 2011

all of that was pretty standard when I had c-sections. Except my kids were not put right on my chest. But mine were born 4 and 6 weeks early, so everyone was more concerned about their health and breathing and all... They did bring the baby to me (both times) really quickly but there was no where to have them on my chest.. they were right next to my face while DH held them. And then Cooper had to go to the NICU so pretty much the rest of the things were out of my control.

The only other things I can think of you might want to talk about are the eye drops and the Hep B shot at the hospital.

Oh and if you want to see the baby through the drape/window deal as he's being born and if you want a mirror to watch the c-section (no thank you!).. .but some people want to.

I also had a drug with my first c-section that made me pretty much forget a lot of that first day. So I talked to the anaesthesiologist about that the second time and he looked back at my chart to see what Imight have over reacted to and they didn't give me that the second time and I felt like a completely different person that time. I also didn't have pre-eclampsia so that might have helped?

MrsH_08 · August 2011

Looks like a good list. I was not given the chance to have James placed right on me, either, even though I asked. But he was born in distress, so that's part of it. I also didn't get to see him over the drape, since he was handed right to NICU, in the room with me. I did have him with me every single second I was in the hospital, as specified in my birth plan. They said they could take him and do the bath and measuring separately and bring him back to me in recovery. I said 'no way.' So, they did the basics in the OR, while I was being closed up. And then bathed him later that evening. All measuring, bathing, testing, etc was done with me in a room, which was great.

Jill mentioned the one thing I was thinking you may want to add: your preferences for the HepB injection. From what I've read, many hospitals will do it automatically, if you don't specify.

Oh, also, my OB told me I had a choice between spinal and epidural. He told me the pros and cons of each, as well as his preference. I agreed that the spinal would be best for me. So, I put spinal on my birth plan, just to be sure.

ETA: You may want to bring 2 copies of your birth plan. I ended up giving one to the nurses at check-in in triage, and they kept it. So, I gave a second copy to the nurses on my floor, when they said they hadn't seen it. Because I'm anal, I even had a 3rd copy that I kept in my bag. :-)

ckmommy · August 2011

I echo the Hep B shot, I specified that I wanted that delayed otherwise they would have done it. I don't know how your hospital operates but you might want to also specify if you are having your son circd. We did not and had to reiterate it multiple times because they would have done it there. I can't believe you are so close!

doublem · August 2011

What about cord clamping/cutting - do you want it done right away, wait a while, donate cord blood, and/or have DH cut it?

If you want to hold/breastfeed that baby right away, you might want to be really specific that they give him to you before doing all the weighing, bathing, etc.

Also, some people like to wait for the baby to be bathed so that the natural moisturizers can soak in more. I don't know how much of a difference it makes, but my midwife suggested it, so we did it.

Kathzoo · August 2011

Ask for a spinal with no narcotics if you want to be awake/alert. Other things that might make you feel more comfortable/like a participant: Any music you want playing, do you want the team to introduce themselves or minimize nonessential conversation during the birth, do you want them to explain what they are doing, do you want to take photos, do you want to do anything special to set the tone such as pray together before you start. Be sure to tell your preferences to the anesthesiologist when you meet him/her and have your DH advocate for you. Have a great birth!

Seattle_JiLLn · August 2011

doublem:
What about cord clamping/cutting - do you want it done right away, wait a while, donate cord blood, and/or have DH cut it?
If you want to hold/breastfeed that baby right away, you might want to be really specific that they give him to you before doing all the weighing, bathing, etc.
Also, some people like to wait for the baby to be bathed so that the natural moisturizers can soak in more. I don't know how much of a difference it makes, but my midwife suggested it, so we did it.

I don't think you can BF while they're still putting you back together, so they might as well weigh the baby first and clean him up. I have never heard of anyone BF'ing in the OR before you go back to your room. I can't even imagine how you could orchestrate that flat on your back with your arms out to the side and the BP cuff and IV and all...

kaskade · August 2011

That looks reasonable to me; Although - can they put a catheter in before a spinal?? That would suck.

I got to snuggle K immediately after birth, but not hold her as I had my IV in and really didn't have use of my arms the way I was positioned. We got some good face to face time and family time, and then they took her, did vitals and wrapped her up. We tried breastfeeding as soon as we were settled in our room. Your DH should be able to do the first bath all by himself too - no reason he would even need help I'm sure!

As far as the solid food, I don't remember about that one. I can't remember eating right away, or even wanting to eat. I know as soon as I said I was ready I had a tray there pretty quick - I think it was under 24 hours from the birth.

You're so close!!!

Seattle_JiLLn · August 2011

The solid food thing is a safety issue... they do give it to you as soon as it's safe. YOur intestines have to sort of start working again after the anaesthesia... I feel like you had to pee a certain amount and maybe poop too? Or pass gas? Something to show that your system was working... I can't remember now.

IkesHawaiian06 · August 2011

Seattle_JiLLn:
doublem:
What about cord clamping/cutting - do you want it done right away, wait a while, donate cord blood, and/or have DH cut it?
If you want to hold/breastfeed that baby right away, you might want to be really specific that they give him to you before doing all the weighing, bathing, etc.
Also, some people like to wait for the baby to be bathed so that the natural moisturizers can soak in more. I don't know how much of a difference it makes, but my midwife suggested it, so we did it.

I don't think you can BF while they're still putting you back together, so they might as well weigh the baby first and clean him up. I have never heard of anyone BF'ing in the OR before you go back to your room. I can't even imagine how you could orchestrate that flat on your back with your arms out to the side and the BP cuff and IV and all...

I think that this time, my arms get to be free! My OB said that they have been practicing keeping moms arms free so that as long as baby is okay when they pull him/her out, they get to be placed on mom's chest.

I don't think I'll get to BF until the recovery room. Nathan is the only person allowed in recovery per hospital rules. Only one support person is allowed in recovery and I'm okay with that :-)

Thanks for the cord ideas, Nathan is pretty grossed out by the whole cutting the cord thing. He's a weirdo :-)

For the HepB shot, when do you guys think they should do it? I can't remember what they did with Emma.

As for circumcision, I think we may have it done at the hospital. From what I've heard from friends, they preferred it over having it done outside of the hospital here. I should call our pedi and find out what she says...

You girls are the best! I am loving all of the new ideas, suggestions and even confirmation that I'm not being a total whacko with my hopes for this c-section!

ckmommy · August 2011

I think your hopes for the c section are fine as long as it doesn't end up an emergency situation. Even in an emergency though, at least with my exoerience, they do the very best they can to accomodate your wishes. For the Hep B, we had it done at his two week check up. Had we gotten C circd,we would have had it done at the hospital.

ckmommy · August 2011

I just re read that and realized it sounded awful, so not the point I was trying to make. Blarg. Your plan sounds awesome and completely reasonable. You are not whacko with what your hopes are.

Seattle_JiLLn · August 2011

on the Hep B issue... I waited on it. There's no reason that anyone has ever provided to me for them to get the Hep B that early. It's a sexually transmitted disease. They have to have blood or other fluid contact with an infected person to get it. All I can think is if they're worried they get it from infected mothers? But seriously it just seems weird to me so I don't get it til later. I think you need 4 or 5 of them though so starting early isn't a bad idea so you're not having to get extra shots for your 5 year old (like I am). But I just feel like their poor little selves have just gotten here and to throw something else at them that they don't need yet is unecessary. Let their little immune systems settle in first.

MrsH_08 · August 2011

We did the HepB at about one week. And my arms were totally free for my c/s, though of course, I had the IV in one. I BF'd the first time in recovery. Oh, and I had them wait a few hours to bathe him. They do a basic wiping off, in the meantime though, which was ok with me. I just wanted to be able to watch the first bath. They came to my room, that evening, to bathe him.

I was on magnesium for 24 hrs after the birth b/c of pre-eclampsia. So, no getting up, catheter stays in, very limited liquids and no solid food for about a day and a half. I kept asking for cheeseburgers, so I chose a burger for my last 2 dinners there. :-)

The circ will probably depend on your OB, Ped and/or hospital (if you want it done, that is). My OB doesn't do them and our Ped doesn't go to hospitals or do circs. They referred us to a circ specialist at Evergreen. We couldn't get it done til he was 3 weeks because of his weight.

ETA: You are a brave and thoughtful woman allowing family to visit you that day (minus DH and DD, of course). I said no visitors at all on the day of the c/s, which was just as well once I had to be on magnesium.

MrsH_08 · August 2011

Seattle_JiLLn:
The solid food thing is a safety issue... they do give it to you as soon as it's safe. YOur intestines have to sort of start working again after the anaesthesia... I feel like you had to pee a certain amount and maybe poop too? Or pass gas? Something to show that your system was working... I can't remember now.

I have never experienced being asked if I'd passed any gas, yet, like after the c/s. :-) It was kind of funny (and kind of painful b/c I hadn't). The nurses would check vitals and ask if I passed gas.

JillyJ · August 2011

I attempted a VBAC but did a c-section birth plan just in case the VBAC didn't happen (and it didn't... so I had another c-section). I made it very plain that I did not want the surgeons having small talk during the operation (this happened during my first c-section and I was really annoyed about that after the fact - it seemed disrespectful to me, although I was so out of it during the operation that it didn't occur to me until after the fact). I also wanted my arms free and wanted myself and the baby to be shielded from the bright lights by blankets after he was born and given to me. I wanted to hold the baby immediately after he was weighed. All of this happened and despite the fact that I was very upset about having another c-section, it was a very good experience for me. My doula and midwife, in addition to DH, of course, were there and my midwife massaged my temples during the surgery and spoke softly to me, telling me what was happening, while my doula took photos of the operation.

Here is the c-section portion of my birth plan that I wrote:

During Surgery

We kindly request respectful silence during surgery, unless a discussion about the surgery itself is necessary. Please avoid casual, unnecessary conversation.
I would like to watch the delivery of the baby by lowering the screen so that I can see the baby emerging.
I prefer that baby not be extracted using a vacuum.
I prefer that the umbilical cord stop pulsating before it is cut.
If possible, please do not have the uterus exteriorized for the repair (in hopes of avoiding nausea).
Please use double layered suturing to allow for a future VBAC.

Immediately After Birth

Once it has been determined that the baby is in stable condition, please give him to DJ (husband) immediately.
I would like to hold the baby during the surgical repair of incisions if I feel up to it.
While holding the baby, please keep us warm and shield us from overhead lighting with blankets.
Please allow DJ to accompany baby for initial exam.
If medical concerns require the baby to be moved out of the operating room, DJ will accompany the baby at all times.

Preferences for Postpartum Care

If the baby goes elsewhere for care, DJ prefers to go with the baby.
We decline erythromycin ointment or eye drops as Jill is STD-free and has had no sexual partners but DJ (and vice versa) for over ten years.
We decline the Hepatitis B vaccine at this time.
We decline circumcision.
I will be exclusively breastfeeding our baby and request that no bottles, pacifiers, or artificial nipples be given to our baby.
We would prefer to bathe the baby.

jcyahne · August 2011

I think that you have considered most everything. Hayden was a planned c section, but when I went in we found out I had HELLP so I ended up on Magnesium after delivery (that sucked). If I were to do a 3rd c section, I might opt for a epidural rather than a spinal because I had a very bad experience with the spinal. As far as solids, I was definitely not ready for them for a while after delivery. I don't know if it was the mag or the anesthesia, but I didn't keep solids down for a while. And really after both deliveries it took a while for my appetite to come back.

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