I am with a small practice (3 CNMs and 1 OB) that leans more towards the traditional midwifery model of care. They're probably slightly more medically oriented than the local CPMs, but not much. They're very hands off, trust your body, willing to be open minded, very supportive of VBACs and natural birth and know how to support natural births, etc. but I will be delivering in a (baby-friendly) hospital so they're bound by some hospital procedures (just things like they have to discourage eating during labor, wireless CFM is required for VBACs, no pushing in the tub because of the wireless CFM/VBAC, that kind of thing).
Anyway, I didn't have a very good experience last time (I was with a different practice, a very large OB practice) so this time I started out planning to have a specific written birth preferences list so that everyone was on the same page. However, since forming a relationship with my MWs and going over everything with them, the majority, if not all, of my preferences are standard practice for them. One of the MWs will be in the hospital with me the entire time (providing labor support, not just in the hospital managing my labor) so I'll be dealing directly with them rather than nurses at the hospital. So now I'm second guessing whether it's even necessary to write anything up because my MWs already know my preferences.
If you were in my situation would you still write up a list of birth preferences or is it unnecessary since my MWs and I are on the same page and they will be there with me? Would there still be a benefit to having a copy in my hospital file or something?
Re: Do I need a written birth plan/preferences?
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I would think it can't hurt to have it all articulated and organized, but if it means anything, I procrastinated on mine (i.e. never wrote it - thought I would have more time!) and went into the hospital with nothing but an understanding between my husband and me. Luckily, he understood how important staying med-free was to me, and was able to speak for me throughout if I couldn't answer questions through contractions. This was a semi-natural birth friendly hospital, but I would say NB is not the norm there. Several of the nurses in recovery said it's so rare for them to have a totally NB mom these days, which really surprised me.
I think whatever you do, it sounds like you already have a really great support system in place - wishing you a happy healthy delivery!!
I think having it written out is a useful tool for you to clarify in your mind what you envision for your birth--and it can't hurt to have it on hand for any nurses who may be involved.
I am really, really glad I wrote up a birth plan. I went to my 24-week appointment to go over it with my OB and there were some pretty major differences of opinion. As a result, I am switching to a CNM for the rest of my prenatal care. Talking things over is good, but having it in black and white is even better, IMO.
Over-40 parents...what we lack in vigor, we make up for with cunning.
I do not think a written birth plan is necessary if you trust your practitioners. I was comfortable with my MW practice and their low intervention practices for birth, so I felt writing something out was not needed.
I made sure to speak with them about my wishes, which I feel were pretty simple (no eye ointment, immediate skin to skin and delayed cord clamping), all of which were pretty standard with my MWs. I also made sure DH knew my wishes and was comfortable with them, so that in the event I could not speak up, he would be able to. I even told him, in the event of a c-section, please tell the doctor I want sutures and not staples - thankfully, that bit was unneeded.
My labor was very fast and the MW was in the room most of the time, so my wishes and preferences were upheld, but even so, the nurses I had were fabulous and supported me just the way I needed without any effort from me (our hospital is also baby friendly). So, no, I don't think a written birth plan is absolutely necessary.