Birth Plan with a c-section

sunnyplaces · October 2013

I have known from the start that I'll have a c-section. As a result, I've kind of tuned out of discussions regarding labor. That said, I have started to wonder if I should continue to tune out the "birth plan" conversation. For those of you who had a planned c-section or have one on the way, did/do you have a birth plan and what did/does it include?

TIA for your thoughts!

michellersayer · October 2013

This is my second c section (in 2 weeks).. I don't think there's much to plan..

[Deleted User] · October 2013

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youleen · October 2013

That's a great plan, thanks for sharing!

EmR22 · October 2013

I did a very brief request letter that I gave to the nurses and the doctor at the hospital. I showed it to my OB ahead of time and she okayed it. The nurses were very nice about it. I'm actually really glad I did because otherwise they would have done the bath and footprints without me, and I think it sped up me getting to breastfeed because they actually broke hospital rules and brought DD to me in recovery to nurse. Everything actually went exactly according to the requests so I was very happy. There is so much you can't control with a c-section. This helped me feel a little more involved. We were team green by the way that's why the he/she.

This was mine:

Requests for C-Section Delivery/Recovery

Please allow my husband to remain with the baby at all times.

I would like to breastfeed as soon as possible after delivery.

Please do not give the baby any formula, sugar water, etc… unless medically necessary.

Please delay any visitors from having contact with the baby until after I’ve been able to breastfeed – otherwise the baby may starve before he/she gets to eat for the first time. 

Please delay any procedures that aren’t immediately necessary until I can be there. I would really like to be there for the baby’s first bath, footprints, etc… if at all possible. I don’t want to miss any more than I absolutely have to…
Thank you!

I didn't have a plan with my 3 c sections but I like the things mentioned in this one. I have to say my hospital did these things automatically -- my DH had baby the whole time, they came to recovery with me, I could breast feed right away in recovery and once we were moved to another room they asked if they should do the bath in the room or back at the nursery.

You don't really have a say in how the c section goes but like this post mentions you may have a say in the "after" stuff. So ask how your hospital typically does these things and see if you that is what you want.

sunnyplaces · October 2013

Thank you so much for your feedback and suggestions, this is so helpful.

spinsoffresonance · November 2013

Mine was pretty short:

-DH stays with baby at all times

- I want to do skin to skin with baby in the OR as soon as possible ( cleared it with Ob ahead of time)

- try to breastfeed as soon as possible

- no formula, sugar water, pacifier unless medically necessary

- baby sleeps in room with us not nursery

I had also asked my Ob about delaying cutting the cord and administering the antibiotic eye ointment but they couldn't do it.

kristen.rimer · November 2013

I also had a birth plan that included all of these items. I delivered at a teaching hospital so I requested limiting the number of professionals in the OR to only those necessary and no student observers. This was important bc they will ask you on the spot otherwise and the resident was able to say no for us. I didn't want a lot of ppl in and out during the procedure. I also requested that my Dr, not the resident, complete the stitches. This allowed for a dialogue about the stitching process, and ultimately I decided to allow the resident, since she does it more frequently and is actually probably better at it than the dr. I asked that my husband be there during the spinal, but they couldn't do that due to protocol and OR set up. I also requested that the anesthesiologist give us the play by play during the surgery, so we would know exactly what was going on below the curtain. We had a pretty good experience and I think the BP was a big help in opening lines of communication.

zbeesma86 · November 2013

We had very few things-
DH was to be with her the whole time.
I wanted skin to skin as soon as I was out of recovery.
Wanted to try and breastfeed before she was given formula (she was born at 36 weeks and my milk came in late).
She slept in our room with us- no nursery.
We didn't do Hep shot at birth. We waited until her first pedi apt.

[Deleted User] · November 2013

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[Deleted User] · November 2013

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EmR22 · November 2013

@JandACoffee I don't think your starting crap at all.

@andertrr One of my good friends had numerous tumors removed from her uterus so when she actually became pregnant (which was a miracle) she had to have a c section because of all the previous incisions (she sadly had to have a hysterectomy at the same time). She knew that before she even got pregnant.

This woman owes you no explanation as to why she is having one. Whether it's medical or not it's her body her choice. You sound very bitter about having a c section. I'm glad your LO is doing good despite a less than ideal birth. In her case she knows it's a c section so she is just trying to control as much as she can, obviously you can't blame her since it sounds like you wish you could have controlled more.

sunnyplaces · November 2013

JandACoffee EmR22 for backing me up and supporting me, I really appreciate that I don't have to explain myself -it gets really exhausting.

andertrr I'm sorry that you had an unplanned C-Section followed by having your b-plan disregarded by the hospital. That totally sucks! Despite that, it sounds like you ended up with a healthy baby and if that's the little critter on your siggy, he's adorable.

Again, thanks to those who provided feedback about the b-plan.

spinsoffresonance · November 2013

Totally agree with @JandACoffee. There are lots of medical reasons why you would know ahead of time you're having a csection. I knew before I even conceived DD I would be having a csection because I had prior surgery to my uterus. This is how I know I will be having a csection again with this baby, and in fact this time I need to have a hysterectomy. Sure I would have loved to experience labor, attempt a vaginal delivery and have the option of having more kids in the future, but that's just not in the cards for me.
I think it's great that OP is thinking about a birth plan even though she is having a csection. A birth plan is a great starting point to talk to your Ob and have them walk you through what will happen on delivery day so you don't feel lost and too overwhelmed. Maybe some things on your birth plan are standard practice at your hospital, but you won't know until you ask.

jknigh8 · November 2013

JandACoffee said:
I did a very brief request letter that I gave to the nurses and the doctor at the hospital. I showed it to my OB ahead of time and she okayed it. The nurses were very nice about it. I'm actually really glad I did because otherwise they would have done the bath and footprints without me, and I think it sped up me getting to breastfeed because they actually broke hospital rules and brought DD to me in recovery to nurse. Everything actually went exactly according to the requests so I was very happy. There is so much you can't control with a c-section. This helped me feel a little more involved. We were team green by the way that's why the he/she.

This was mine:

Requests for C-Section Delivery/Recovery

Please allow my husband to remain with the baby at all times.

I would like to breastfeed as soon as possible after delivery.

Please do not give the baby any formula, sugar water, etc…
unless medically necessary.

Please delay any visitors from having contact with the baby until
after I’ve been able to breastfeed – otherwise the baby may
starve before he/she gets to eat for the first time. 

Please delay any procedures that aren’t immediately necessary
until I can be there. I would really like to be there for the baby’s
first bath, footprints, etc… if at all possible. I don’t want to
miss any more than I absolutely have to…
Thank you!

Mine is very similar but I also added I want sutures instead of staples

BootsOrHearts · November 2013

During Surgery

Please ensure all medications are suitable for breastfeeding
No sedatives please and no anit-nauseant unless it’s non-drowsy
I would like catheter to be inserted after spinal is administered
I would like IV and monitoring to be done in my non-dominant (left) arm and for neither arm to be strapped down.
Please make new incision as close as possible to existing scar
Please lower curtain at the appropriate time so we can see Baby being born
In case of hemorrhage, please make every effort to preserve my uterus for future childbearing
Request double layer suturing of uterus and that uterus not be removed from abdominal cavity unless necessary to minimize air pockets
Father will be present during surgery and would like to take pictures if permissible

Baby

If possible allow the cord to continue pulsing after the birth so Baby may start breathing on hia own while still attached to the placenta
Cord blood will be donated, see instructions with collection kit
Please allow for skin-to-skin contact immediately after delivery and evaluate Baby on my chest, (If this is not possible – then father would like to have skin-to-skin contact)
Please allow Father to cut cord if possible
No Eye Gel please
No Hep. B vaccine. I will sign the waiver ahead of time and agree to be tested for Hep B prior.
Request oral dosages of Vitamin K rather than an injection

Recovery

We would like to keep Baby with us at all times. If Baby must go to the NICU due to medical reasons, father will go with him.
Delay Baby’s bath until the evening after Baby is born rather than bathing Baby right after birth.
I would like to meet with a lactation consultant as soon after the birth as feasible and begin breast-feeding immediately
Please no formula or other supplements unless previously approved by us
Please no percoset, oxycodone, vicodin, or anything similar as they make me nauseated, please discuss other pain management options with me before administering

spinsoffresonance · November 2013

@BootsOrHearts, I'm curious have you already cleared this birth plan with your Ob? You have some stuff on there that I had asked my Ob about but they couldn't accommodate 11 months ago so I was wondering if they're doing it now? Mainly curious about delaying cutting the cord ( I think you and I discussed this a while back).
BTW I had my arms strapped and once the anesthesia hit me it actually felt really good to be tied down. They unstrapped my dominant hand once DD was skin to skin on my chest so I could hold her while they finished up the surgery. Also they went right over my myomectomy scar so I only have a single scar.

BootsOrHearts · November 2013

@lica001

I am going through it with the OB next week so we'll see. But my hospital is very family-friendly so they're hip to a lot of these things - i.e. skin to skin contact. I didn't even have to ask for rooming in with baby, that's standard. So I'm hopeful!

Which ones did they object to besides the delayed cord clamping? Just curious.

Oh that's good to know that they unstrapped you and let you have the skin to skin contact!

spinsoffresonance · November 2013

BootsOrHearts said:

@lica001

I am going through it with the OB next week so we'll see. But my hospital is very family-friendly so they're hip to a lot of these things - i.e. skin to skin contact. I didn't even have to ask for rooming in with baby, that's standard. So I'm hopeful!

Which ones did they object to besides the delayed cord clamping? Just curious.

Oh that's good to know that they unstrapped you and let you have the skin to skin contact!

I was really happy we got to do skin to skin right in the OR. They had to take DD to get checked out by the neonatal pedi first, but that only took 3-4min, was done in the corner of the OR and DH was there with DD the entire time. Then they got her on my chest and she stayed there until we left the OR, maybe 30min. Of course she came with us to recovery and we got her right back on my chest and then DH's the whole time in recovery. I got to breastfeed then as well.
The other ones we couldn't do were father cutting the cord and no eye ointment. For the cord cutting they said they can cut it long so that the father can cut it down but they can't have the father actually cut it for real because the surgical area needs to remain sterile. Turns out DH wasn't interested in cutting it anyways. I don't remember why they wouldn't delay the eye ointment.

homediva · November 2013

I would add if you are Team Green, you can say you want DH to call out the sex! That was a really special moment for us and I plan to have that again at my RCS!

MIT721 · December 2013

Hi all! Late to this thread but have a couple Qs:

Why delay the eye ointment?

Why decline/wait the Hep B vaccine?

I am just curious as to why you would request both of these. Also, I will be cobbling together my own birthplan/ questions from this thread. So many things I never even thought about!

Thanks!

Ardmhs83 · December 2013

I will be attempting a natural VBAC next time, but if for some reason things end in another c/s I will def. have a "natural" c/s birth plan. Not that the section itself will be natural, but I want a totally different environment next time. Things like skin to skin right away if no problems, no bath, delayed cord clamping, relaxing music playing, breastfeeding right away. I want it very family-centered.

sunnyplaces · December 2013

Ardmhs83 said:

I will be attempting a natural VBAC next time, but if for some reason things end in another c/s I will def. have a "natural" c/s birth plan. Not that the section itself will be natural, but I want a totally different environment next time. Things like skin to skin right away if no problems, no bath, delayed cord clamping, relaxing music playing, breastfeeding right away. I want it very family-centered.

Ardmhs83 do you anticipate any resistance from hospital staff about your requests? I have asked to breast feed right away and the doc basically said that as soon as she's completed stitching me and I'm in the recovery room, I'll be able to hold and feed the baby. This description sounds like it will take a while. Because this is a surgery I think I'm having a harder time knowing what I can advocate for and what is protocol that cannot be amended... Curious to hear people's thoughts, thanks!

Ardmhs83 · December 2013

It is just too long to wait to breastfed, IMO. The surgery takes like an hour, but only about 10 minutes to get the baby out. The rest of the time you are laying there, by yourself getting stitched up. They didn't even let me breastfed my son in the recovery room last time. It was two hours before I got to nurse him. That is way to long to wait...especially since their were no problems. You can advocate for pretty much anything...you have to consent to it all. If they tell you no about something, ask questions and then research their response online to see if it can be done. Unfortunately, some doctors do things for the "speed" factor. If your requests slow them down, they don't like it. Question, question, question...

I hope I don't have to do any of this at all since I'll be attempting a VBAC, but if this does happen I just want to be more prepared and more outspoken this time. I'm not really sure if the hospital will show me resistance, but I'm going to push their limits to have a better experience than last time.

Edited for spelling error.

CDMay2006 · December 2013

lica001 said:
Mine was pretty short:

-DH stays with baby at all times

- I want to do skin to skin with baby in the OR as soon as possible ( cleared it with Ob ahead of time)

- try to breastfeed as soon as possible

- no formula, sugar water, pacifier unless medically necessary

- baby sleeps in room with us not nursery

I had also asked my Ob about delaying cutting the cord and administering the antibiotic eye ointment but they couldn't do it.

This was mine, almost exactly. We also noted vaccine and antibiotic ointment preferences, and that if i wasn't able to have immediate skin to skin contact that dh would.

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