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Natural Birth
punkrockabye
member
Another "please critique my birth plan" post
punkrockabye
member
I've been putting this off and I decided that I need to get the ball rolling. This is a conglomeration of points I have saved from across the internet over the course of the pregnancy, some of my own points, and points taken from the sample outline given to me by my doula (which was the awful "check which applies" type thing). Several weeks ago I mentioned a birth plan to one of the practitioners I see (I go to a hospital "clinic" and never see the attendings, but rather, there are MANY residents and students that I encounter) and they were very open to it; she mentioned that they work with them all the time so whenever I want to bring mine in is fine. It sounded promising.
I've also been told by many people--moms as well as our doula organization--that this hospital will give me a very good opportunity for the kind of birth I hope to have. My L&D tour experience reflected this. I do foresee some possible complications, though. I am high risk mainly due to preexisting high blood pressure, which has been perfect AND unmedicated so far during pregnancy, hypothyroidism, and GD. I've been treated as high risk since day one. I will be on the high risk L&D floor and I am almost certain that continuous monitoring will be "necessary."
Anyway, I am coming to you ladies because this bad boy is almost 2 full pages long, and many of you are much wiser than I and could probably give me pointers on how to condense it! I tried to maintain a very respectful tone throughout the whole thing, avoiding "refusal" language and such. I've heard nothing but great things about the L&D nurses at this hospital and I don't want to give off the wrong impression to them, nor do I feel as if they will work against me. My main concern is the fact that all I see now are residents and students, and I really want to avoid swarms of 10 people coming through the door in the blink of an eye. I don't have a relationship with any one doctor, at all.
The formatting looks horrible as I'm posting this but I'll be editing it immediately if this post makes it absolutely illegible. (EDIT: good lord that was bad. Hopefully I fixed it as much as possible by just taking it into HTML.)
Setting:
--I would like for my husband ((DH)) and our doula ((DOULA)) to be present at all times.
--I would like to play my own music during labor and delivery.
--Please keep practitioners to a minimum at all times; I do not wish to have groups of students present while I am laboring or delivering.
Labor:
--Unless absolutely medically necessary, I prefer to not be confined to bed. I would like the option to move about as I feel the need and to labor in whichever position I feel is best at the time.
--I would like to have access to a birth ball, squat bar, and birth stool, if available.
--I would prefer to have a saline lock placed instead of an IV.
--I would prefer intermittent monitoring. If continuous monitoring is necessary, I would prefer telemetry monitoring to allow me to move around while in labor.
-- If augmentation is necessary, I would like to try non-pharmacological methods first. If pitocin is required, I request that the it be administered following the low dose protocol and increased in intervals to allow my body to adjust to each dose increase.
--I would prefer Cervidil instead of Cytotec in the event that a ripening agent is needed.
Pain Management:
--I have prepared for a medication free birth. Please do not offer me any pain medication or ask me about any pain. I will ask for pain medication if I decide to do so, after a discussion with my birth partners. I have done my own research and I am aware of the options available to me.
--I would like to have access to the shower.
--I will allow myself to vocalize naturally during labor.
Delivery:
--I would like to push while assuming any position that feels right.
--Please direct my pushing only when the baby is crowning, in order to minimize tearing.
-- I do not wish to have an episiotomy and would prefer to tear naturally to aid in healing.
--In case of an emergency requiring assistance in the delivery of the baby, I prefer the use of a vacuum.
--((DH)) would like to help catch our baby and place her on my chest.
--Please allow the baby to be placed on my chest immediately.
--((DH)) would like to cut the umbilical cord. ((Am I correct in believing that GD eliminates my ability to delay this? I originally wanted to delay the cord clamping, but my limited research has told me that it's not the best option if diabetes is involved.))
--We will be taking my placenta home with us; we will bring the necessary materials to transport it properly and we will sign any wavers that this may require. ((I have not mentioned this to the doctors at all, but the doula who taught our birth class was extremely confident that I will not have any problems obtaining the placenta "nowadays" especially given the highly multicultural area we live in.))
Newborn Care:
--We would like our baby to room in with me at all times.
--Please delay all routine newborn care until after we have established breastfeeding and had 2 hours to bond.
--((DH)) and I will accompany our baby at all times during any procedures that take place in the nursery or elsewhere. If for any reason I am unable to go along, ((DH)) will still accompany the baby at all times.
--We will provide our own soap for bathing our baby.
--Please do not give our baby routine eye ointment. We will sign any forms that we need to at that time.
--Please delay the vitamin K for at least 2 hours after the birth.
--Please do not administer the hepatitis B vaccine; we will see our pediatrician for this at a later date. We will sign any forms that we need to at that time.
--We are confident that our baby is a girl; however, in the event of a surprise, we will not be circumcising our baby. ((Would this even be necessary? I am not sure. I'm not sure HOW this baby could be a a boy, but nothing's certain until the baby is born, and this issue would be very important to us if we had a son.))
--Our baby will be exclusively breastfed.
--Please do not provide any artificial nipples, pacifiers, or bottles of water, formula, or sugar water; please consult with us first if anything is necessary.
--I would like to see a lactation consultant as soon as possible.
C-Section:
We are planning and hoping for a vaginal birth. In the event of a c-section:
--If possible, please give us time alone with our doula to think about our options
--((DH)) is to be present at all times during the c-section.
--If ((DH)) has to leave the operating room with the baby, I would like our doula to take his place.
--I would like to remain conscious during the procedure.
--Please do not strap my arms down.
--I would like the baby to be shown to me immediately after it is born.
--I would like to have contact with the baby as soon as it is possible.
--I prefer a low transverse incision on my abdomen and uterus.
-- Please use double-layer sutures when repairing my uterus. If I have a second child, I hope to attempt a VBAC and understand this is a requirement for many doctors.
Recovery:
--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.
--((DH)) is 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.)
--Please discuss my post-operative pain medication options with me.
This discussion has been closed.
Re: Another "please critique my birth plan" post
haha thank you, I didn't even notice; it's a copy and paste from the form the doula gave me, which had a bunch of typos and I thought I caught them all!
blog! thescenery.net
I think you are on the right track, but I would definitely slim this down.
I would get rid of the 'Setting' piece all together, playing your own music shouldn't be a problem (I suggest headphones as it will drown out other noises) and unless you think they will ask your DH or doula to leave I think that part is unnecessary. I would just include under the labor piece something like, "Please only necessary medical staff, no students"
I would take out the first bullet under "Labor", you are just basically restating what you have in subsequent bullets.
Under "Pain Management" I would just say, "I am aware of what pain relief options are available. Please do not offer pain medication or ask me to report pain scales." Leave out the shower part, unless you think that will be a problem and leave off the vocalization part, they are used to seeing that and you certainly don't need to ask permission to make noise.
Under Delivery I would leave off the part about an episiotomy unless it's still routinely done at your hospital.
Newborn Care: I'm a little confused by the bath thing, are you asking to give the baby its first bath or just provide the soap? If it's the former then you need to be more specific. Just leave off the part about circumcision. There is a small chance it could be a boy, but even if it is they aren't going to wisk him away and circumcise him. Get rid of the part that says our baby will be EBF. You already established this by saying please don't offer formula, water, etc.
It's good you have a c-section part. You might consider making it a separate page and only presenting it if necessary. The only bullet I would remove from there is the part about remaining conscious. Now a days they only put women under in true emergencies, in which case I'm sure you would agree.
You've got a good foundation going here, just needs to be slimmed down a little. Hope this helps
Very good ideas, thank you! I am unsure yet about eating and drinking. I am going to ask at my appointment tomorrow what they like to do in terms of not having someone with GD go hours and hours without food, since that doesn't seem like it would work well. My own plan, which I don't think would look too good on paper, is to pack some things like honey straws and energy bars and if I feel like I need something, I'll have it. I mean, they're not going to kick me out. Chances are I won't have a craving for a footlong sub while I am in labor but I'm not too fond of the idea of not having anything if I want it. I'm thinking of taking some of those new Ensure Clear drinks, too.
I'm not actually sure about episiotomies at this hospital. It's something I'm pretty adamant about (unless, of course, we hit a life or death situation) so I'll ask about it tomorrow as well. I might feel like I need to leave it in unless I am literally told "we don't do them unless someone begs or someone's life depends on it."
From the L&D tour, I am under the impression that the baby's bath will be given with DH & I present, while the baby is in the nursery for procedures. It seems like they very much want moms and partners, or at least partners, to be present while the baby is in the nursery at this time. That's why I decided not to die on the "do everything in my room" hill, since my only reason for feeling that way was that I wanted to be present. As a standard practice they like to have the baby in the nursery for about 2 hours for very specific things, but they encourage the parents to be there the whole time, which I'm fine with. So we should be right there to bathe the baby, or to decide to stand and watch if we choose; I just want to provide the soap so I know what's in it!
I'll definitely keep the c/s part separate. Hopefully I can get the rest onto one page (it's VERY close now, after your suggestions) so the second page just addresses the c/s issue.
blog! thescenery.net
That-a-girl! If my hospital didn't allow me to eat, I would have eaten/drank anyway! That is honestly one of the most out-dated rules! I once read an article by an OB who compared it to telling people not eat/drink before they were planning to ride in a car, because what if they were in a serious accident and had to rushed into emergency surgery. Totally ridiculous!
Yep, that's my though exactly--my stomach is NEVER empty when I'm in the car, unless we're on the way to dinner!
I'm not going to blurt out "I'll do what I want" but I am going to see what their ideas are about having GD and needing some sort of nutrients while in labor, and I'll go from there. Nobody will scan my bags when I go to the hospital as if I am boarding a plane. If I happen to feel the need to put something in my stomach, I'll be doing just that. Of course I may not even want food. I'm pretty excited to try those Ensure drinks because they have a lot of vitamins and protein while still being a clear liquid. But man, if I want solid food, I'm going to have it.
blog! thescenery.net
In the actual document, I use his name; I just removed it from here in an odd moment of not wanting to use our real names!
blog! thescenery.net