Birth Plan - Anything I should add?

Annaeliz84 · February 2013

I just wrote my birth "wish list." I am posting it here so y'all can make sure I didn't forget anything!

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We understand that birth can be unpredictable but we hope to have a natural birth free from interventions. We are presenting this birth plan to create dialogue with the wonderful nurses and doctors at Paoli hospital who we know have the same goal we do ? healthy mommy and healthy baby!

Labor ?

- I would like a Heplock instead of an IV.

- I prefer to be able to move around during labor.

- I would like intermittent monitoring instead of continuous monitoring assuming the baby is handling labor well.

o During fetal monitoring I would prefer to be out of the bed if possible but within cords-reach of the machines.

- Please keep internal checks to a minimum.

- Please refrain from offering me pain medication. I know the option exists, and I also know that if I wait too long I might be out of luck if I change my mind! I am OK with taking that chance.

- We would prefer the lights to be kept dim, the curtain drawn, and the door closed at all times.

Labor Augmentation/Induction ? I do not wish to receive any induction medication unless other options have been exhausted.

- If it is necessary, I would like to try things like stripping the membranes and nipple stimulation first.

- I prefer Cervadil over Cytotec.

- If Pitocin must be administered please start with the lowest possible dosage and increase in small increments if necessary.

- I only want my bag of waters ruptured as a last resort.

Delivery ?

- I will choose a position for pushing that feels comfortable to me. That may or may not be on my back.

- I trust my doctor to make a good decision about an episiotomy but I prefer to tear naturally.

- I would like my doctor or nurses to use lubricant or compresses to help prevent tearing.

Immediately After Delivery ?

- I hope to have skin-to-skin contact with my baby as soon as he is born.

- Please clean and suction baby on my chest or abdomen.

- We would like to delay cord clamping for 3-5 minutes after delivery.

- Please delay other newborn procedures (eye ointments and shots) until after he has breast fed and we have spent some time with him.

- Please remember to numb the area before placing any stitches because I hopefully wont have had an epidural!

- Pitocin and other drugs can be administered to stop hemorrhaging or to help shrink the uterus.

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Our Preferences for In-Hospital Infant Care

I plan on rooming in with my baby after birth. I hope to not be separated from my baby unless it is required for health reasons.

I would like to meet with a lactation consultant.

Please do not give any bottles to my baby (including glucose water and plain water) without discussing the medical reasons with me first.

Please do not give my baby a pacifier.

We plan on circumcising our son.

aylafsu88 · February 2013

It looks good and I can not think of anything to add!

tokenhoser · February 2013

I had a line about mother-directed pushing, as I did not want anyone telling me how or how long to push (assuming I was unmedicated).

Looks pretty good. I don't think you need to remind them to numb you for stitches if needed; that's standard. Similarly, if post-delivery Pit is standard, you don't really need to mention it.

babyduejune · February 2013

tokenhoser:
I had a line about motherdirected pushing, as I did not want anyone telling me how or how long to push assuming I was unmedicated.Looks pretty good. I don't think you need to remind them to numb you for stitches if needed; that's standard. Similarly, if postdelivery Pit is standard, you don't really need to mention it.

My Dr sutured my two tears even while I was sitting there bawling telling her I had no epidural left could feel it, so yeah I'd leave the part in about the local anesthetic!

tokenhoser · February 2013

babyduejune:
tokenhoser:
I had a line about motherdirected pushing, as I did not want anyone telling me how or how long to push assuming I was unmedicated.Looks pretty good. I don't think you need to remind them to numb you for stitches if needed; that's standard. Similarly, if postdelivery Pit is standard, you don't really need to mention it.
My Dr sutured my two tears even while I was sitting there bawling telling her I had no epidural left could feel it, so yeah I'd leave the part in about the local anesthetic!

If your doctor is a sadistic as$hole, I'm not really thinking a line in the birth plan is what will help.

margeincharge3 · February 2013

That looks like a very reasonable birth plan.

babyduejune · February 2013

tokenhoser:
babyduejune:
tokenhoser:
I had a line about motherdirected pushing, as I did not want anyone telling me how or how long to push assuming I was unmedicated.Looks pretty good. I don't think you need to remind them to numb you for stitches if needed; that's standard. Similarly, if postdelivery Pit is standard, you don't really need to mention it.

My Dr sutured my two tears even while I was sitting there bawling telling her I had no epidural left could feel it, so yeah I'd leave the part in about the local anesthetic!
If your doctor is a sadistic as$hole, I'm not really thinking a line in the birth plan is what will help.

LOL true. However, I will say there are many OBs I spent 6 wks rotation working w/them so saw it many times who won't use or have prepared/readily available a local anesthetic when they know you have received an epidural. Even knowing this prior to my LD, you would think if a person was sitting there complaining of feeling it pain they would stop get it. Apparently my OB was in hurry that morning couldn't be bothered. Doubt it's the first time that's ever happened. I would specify you'd like local anesthetic regardless of whether you get an epidural so they have it ready to go. Studies have shown tissue healing is better with locals even when ppl are under general anesthesia. It SHOULD be standard of care, unfortunately it doesn't always happen.

babyduejune · February 2013

babyduejune:
tokenhoser:
babyduejune:
tokenhoser:
I had a line about motherdirected pushing, as I did not want anyone telling me how or how long to push assuming I was unmedicated.Looks pretty good. I don't think you need to remind them to numb you for stitches if needed; that's standard. Similarly, if postdelivery Pit is standard, you don't really need to mention it.

My Dr sutured my two tears even while I was sitting there bawling telling her I had no epidural left could feel it, so yeah I'd leave the part in about the local anesthetic!
If your doctor is a sadistic as$hole, I'm not really thinking a line in the birth plan is what will help.

LOL true. However, I will say there are many OBs I spent 6 wks rotation working w/them so saw it many times who won't use or have prepared/readily available a local anesthetic when they know you have received an epidural. Even knowing this prior to my LD, you would think if a person was sitting there complaining of feeling it pain they would stop get it. Apparently my OB was in hurry that morning couldn't be bothered. Doubt it's the first time that's ever happened. I would specify you'd like local anesthetic regardless of whether you get an epidural so they have it ready to go. Studies have shown tissue healing is better with locals even when ppl are under general anesthesia. It SHOULD be standard of care, unfortunately it doesn't always happen.

Sorry for formatting forgot my stupid phone won't show characters.

MrsBigTime · February 2013

I think this look like a nice birth plan. You may want to say something in regards to emergencies. We didn't write a birth plan, but I made sure DH knew that if an emergency C-section was required I wanted stitches instead of staples (personal preference because staples give me the heebie jeebies) and if the baby needed to go to the NICU I wanted my DH to go with the baby instead of staying with me.

My only other thought would be instead of saying "I would like a heplock instead of an IV" (which is what most birth plans I've seen say) I'd say "If placing an IV is required, I'd prefer to not have fluids running unless medically necessary."

I say this because I am a nurse and techincally an IV is the actual catheter they put into your body and IV fluids are what are coming into you via the cords/tubes. A "heplock" is an IV that is not in use, and it is "locked" (meaning positive pressure is helping to prevent the line from clotting off) with heparin (though most places now use Saline, making it a "Saline lock") and essentially the same thing. The fluids are the restricting part of the IV.

That's just my two cents but I'm probably being overly critical.

Thai527 · February 2013

babyduejune:
babyduejune:
tokenhoser:
babyduejune:
tokenhoser:
I had a line about motherdirected pushing, as I did not want anyone telling me how or how long to push assuming I was unmedicated.Looks pretty good. I don't think you need to remind them to numb you for stitches if needed; that's standard. Similarly, if postdelivery Pit is standard, you don't really need to mention it.
My Dr sutured my two tears even while I was sitting there bawling telling her I had no epidural left could feel it, so yeah I'd leave the part in about the local anesthetic!
If your doctor is a sadistic as$hole, I'm not really thinking a line in the birth plan is what will help.
LOL true. However, I will say there are many OBs I spent 6 wks rotation working w/them so saw it many times who won't use or have prepared/readily available a local anesthetic when they know you have received an epidural. Even knowing this prior to my LD, you would think if a person was sitting there complaining of feeling it pain they would stop get it. Apparently my OB was in hurry that morning couldn't be bothered. Doubt it's the first time that's ever happened. I would specify you'd like local anesthetic regardless of whether you get an epidural so they have it ready to go. Studies have shown tissue healing is better with locals even when ppl are under general anesthesia. It SHOULD be standard of care, unfortunately it doesn't always happen.
Sorry for formatting forgot my stupid phone won't show characters.

Agreed! My (female) doctor stitched me without anesthesia. I guess she figured it was 1 stitch and didnt need it. Wrong! Ouch! Especially after that area was already so traumatized!

memo9 · February 2013

How long is your birth plan on a regular page? I've heard it's best to keep it to one page....

It looks great though and I think you have kept a very positive tone throughout without seeming demanding.

tokenhoser · February 2013

I do wonder if epi moms were expecting no sensation? Even with the local freezing, I could feel the doctor stitching and it was uncomfortable. Not TERRIBLE PAIN, but it wasn't fun either.

sugar212 · February 2013

I would also add who you do and do not want in the delivery room. (example, interns, family, friends, etc). my hospital is very good about this! and also, when you are ok with visitors arriving after birth. I had my first LO and didn't want any visitors at all until we had a chance to bond with her for a little bit. She was 2 hours old before our parents even knew she was here. this time around I am making sure that big sister is the very first person to meet her little sister, of course besides my husband and myself.

A37licia · February 2013

Looks good, except I would try to make it less wordy. Bullet points are good, but not a lot of statements and explanation after the bullet points. . And remember, just keep holding that baby and a lot of the immediate post-birth issues shouldn't come up. Just don't let go. Stick out tongue

I agree about keeping it to one page - but don't make the font tiny just to make it fit lol. If you need to take things out, particular statements I think are ok removing are:

During fetal monitoring I would prefer to be out of the bed if possible but within cords-reach of the machines.

I know the option exists, and I also know that if I wait too long I might be out of luck if I change my mind! I am OK with taking that chance.

And, instead of

I trust my doctor to make a good decision about an episiotomy but I prefer to tear naturally.

-I would like my doctor or nurses to use lubricant or compresses to help prevent tearing.

you could just say "I prefer to tear naturally and request perineum support when baby is crowning"

Also, instead of

I hope to have skin-to-skin contact with my baby as soon as he is born

Please clean and suction baby on my chest or abdomen.

You could say "please place baby on my chest and leave him there do to newborn checks"

Remove statement about pitocin for PPH, and seeing an LC. You can just ask for that the next day.

Instead of I plan on rooming in with my baby after birth. I hope to not be separated from my baby unless it is required for health reasons.

you could just say "We wish to keep the baby with us during our stay" and when the nurse comes in the next day to say baby needs to go get newborn exam, simply ask it to be done in your room. Only reason he'd need to go out of the room is for his hearing test and DH can take him.

No need to mention that you'll circumcise since that's standard - only mention if if you're declining.

If you make some or all of those changes, it'll be more concise and it'll keep the main points of what your wishes are.

HTH.

SunnyMuffin · February 2013

Annaeliz84:
We plan on circumcising our son.

it seems like you have put a lot of thought and effort into preparing for the best birth possible, but do you want to give your son the best start possible? With circumcision, the more you know, the better you do.

https://birthwithoutfearblog.com/2011/11/27/the-circumcision-decision/

SunnyMuffin · February 2013

A37licia:
No need to mention that you'll circumcise since that's standard - only mention if if you're declining.

Good lord it is not a standard procedure, no wonder some women feel like they need to put onesies like this on their newborns while in the hospital

https://www.drmomma.org/2010/09/baby-circumcised-on-accident-in.html

darjeeling · February 2013

SunnyMuffin:
Annaeliz84:
We plan on circumcising our son.
it seems like you have put a lot of thought and effort into preparing for the best birth possible, but do you want to give your son the best start possible? With circumcision, the more you know, the better you do.

https://birthwithoutfearblog.com/2011/11/27/the-circumcision-decision/

I think your tone is a bit snide and condescending, which does your viewpoint a disservice. JMO, since we're all giving opinions here.

OP, except for the above interjection, I liked the concise wording suggestions. Hope everything goes well for you!

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