STM- Birth plan question

momthatlifts · December 2013

When did you make your birth plan? Who would I talk to about it? (assuming my primary doctor) and who would I present it to? Just give me all the 411, pretty please! I'm so lost with this and I have so much I want to do with it.

sthomas1222 · December 2013

I started researching pretty early on. A LOT of info to digest and your views change as you get further along too. And some care providers flip-flop in their support too. A friend just switched providers at 39w b/c her doctor all of a sudden changed her tune about her VBAC!

I recommend to my doula clients to bring it up around 24w or so with their primary OB. Talk about how any/all partners in the practice will feel about it since they may be the ones on call. And I like to provider to sign it and put it in your record. If they won't do this then they're likely not going to be supportive and will change their tune.

momthatlifts · December 2013

My biggest fear is that who ever is delivering will NOT follow my birth plan. I have a few specific things I would like to do. Nothing drastic, but it is very important to me and I'm genuinely worried they wont follow through...

sthomas1222 · December 2013

Unfortunately there's nothing you can do. That's why I stress how important it is for people to research the hospital they're at too. It's all fine and dandy if your provider is on board but if you're at a big practice who knows who you'll have. The hospital I was at last time has the lowest c/s rate. It's a teaching hospital so HUGE on evidence-based practices which is all that I'm asking for. Labor is hard enough, I couldn't handle having to fight for every inch. It's why I didn't go with the midwife who is the most popular in our area. I know there's a good chance I'll risk out of the home birth and end up at a hospital. She requires you go to the doctor who backs her up, at the hospital with the 4th highest c/s rate in the state... He's amazing and they treat you differently as his patient but it scares the piss out of me! So, I interviewed another awesome MW and if I risk out before labor (damn GD) I'll get to go back to my old doctor.

Having the signed birth plan is a good step though. A physical copy of it signed is good as backup too. That way they can't play the "oh I don't see it in your file." Hiring a doula is definitely a good step. She'll know the practice you're with, the hospital you're with, etc... People talk, they share stories of the doctors, nurses, hospitals, everything. Even if she hasn't worked directly with your doctor she'll have heard stories or be able to ask around.

Junebug060609 · December 2013

My biggest advice as a STM when it comes to birth plans is to educate yourself. Know your preferences. Know your options. And know that what you write in that plan may not be able to be followed (pre-e, an induction and a maternal fever werent in mine, for example...and let me tell you labor and delivery wasnt what i envisioned because of them). Be ready to go with the flow.

momthatlifts · December 2013

sthomas1222 said:

Unfortunately there's nothing you can do. That's why I stress how important it is for people to research the hospital they're at too. It's all fine and dandy if your provider is on board but if you're at a big practice who knows who you'll have. The hospital I was at last time has the lowest c/s rate. It's a teaching hospital so HUGE on evidence-based practices which is all that I'm asking for. Labor is hard enough, I couldn't handle having to fight for every inch. It's why I didn't go with the midwife who is the most popular in our area. I know there's a good chance I'll risk out of the home birth and end up at a hospital. She requires you go to the doctor who backs her up, at the hospital with the 4th highest c/s rate in the state... He's amazing and they treat you differently as his patient but it scares the piss out of me! So, I interviewed another awesome MW and if I risk out before labor (damn GD) I'll get to go back to my old doctor.

Having the signed birth plan is a good step though. A physical copy of it signed is good as backup too. That way they can't play the "oh I don't see it in your file." Hiring a doula is definitely a good step. She'll know the practice you're with, the hospital you're with, etc... People talk, they share stories of the doctors, nurses, hospitals, everything. Even if she hasn't worked directly with your doctor she'll have heard stories or be able to ask around.

This was going to be another question that has been lingering in my mind. Where do I find information on my hospital with things such as c/s rates?? I saw someone else who did it and I want to find out what theirs is.

kalette · December 2013

I just showed up at the hospital and rolled with it.

sthomas1222 · December 2013

I live in VA and we can go to VHI.org and look up stats. They're a couple years old but still relevant. I don't know about other states

momthatlifts · December 2013

Junebug060609 said:

My biggest advice as a STM when it comes to birth plans is to educate yourself. Know your preferences. Know your options. And know that what you write in that plan may not be able to be followed (pre-e, an induction and a maternal fever werent in mine, for example...and let me tell you labor and delivery wasnt what i envisioned because of them). Be ready to go with the flow.

All I really want is to be handed my baby immediately after birth and my husband really wants to be the one to catch her. Those are very important to me! Of course I want to avoid being induced for as long as possible- I know it can't be done forever and could become very dangerous

sthomas1222 · December 2013

JKBMA2014 said:

Junebug060609 said:

My biggest advice as a STM when it comes to birth plans is to educate yourself. Know your preferences. Know your options. And know that what you write in that plan may not be able to be followed (pre-e, an induction and a maternal fever werent in mine, for example...and let me tell you labor and delivery wasnt what i envisioned because of them). Be ready to go with the flow.

All I really want is to be handed my baby immediately after birth and my husband really wants to be the one to catch her. Those are very important to me! Of course I want to avoid being induced for as long as possible- I know it can't be done forever and could become very dangerous

Completely relative to the situation. Just 25 years ago my MIL went to 44w b/c her baby (my SIL) was small and they wanted her to "cook" longer. Now your baby is small (not IUGR just small but still growing) they want to take them early... If I ever make to a due date it'll be a miracle (no one in my family does) but if it came down to it I'd ask for a BPP before agreeing to any induction just b/c I'm 42w+

momthatlifts · December 2013

sthomas1222 said:

JKBMA2014 said:

Junebug060609 said:

My biggest advice as a STM when it comes to birth plans is to educate yourself. Know your preferences. Know your options. And know that what you write in that plan may not be able to be followed (pre-e, an induction and a maternal fever werent in mine, for example...and let me tell you labor and delivery wasnt what i envisioned because of them). Be ready to go with the flow.

All I really want is to be handed my baby immediately after birth and my husband really wants to be the one to catch her. Those are very important to me! Of course I want to avoid being induced for as long as possible- I know it can't be done forever and could become very dangerous

Completely relative to the situation. Just 25 years ago my MIL went to 44w b/c her baby (my SIL) was small and they wanted her to "cook" longer. Now your baby is small (not IUGR just small but still growing) they want to take them early... If I ever make to a due date it'll be a miracle (no one in my family does) but if it came down to it I'd ask for a BPP before agreeing to any induction just b/c I'm 42w+

Exactly my idea too.. took the words out of my mouth

momthatlifts · December 2013

Thanks for your advice. I'm really mostly concerned about their c/s rate and when they choose to induce as well. I will talk to my ob or hospital about all the little extras

Allibob · December 2013

It's good to discuss your plans with your OB as you get into 3rd Tri. I think it's fine to have them put a copy in your chart, but for reals, nobody is going to read it. Don't be offended. Have two copies with you that you can review with your nurse & in case you misplace one. Other than having your OB ok with your desires, your nurse is the most important person that you will be spending the most time with. Your nurse can also be your advocate, assuming you don't have a crazy one.

Your husband catching the baby may be a long shot, but ask your OB. It's totally up to them (unless there's an overriding official hospital policy).

ABColeslaw · December 2013

I say talk to you OB. I know my OB is not pro section unless it is absolutely needed. I just talked to her and felt comfortable knowing she was of this mindset and that the other doctors in her practice were as well. Aside from that, I rolled with it. I feel like if you have a million requests they are likely to get ignored, but if you go in with one or two specific things that have been well discussed, then you should be good.

pandadair · December 2013

JKBMA2014 said:

sthomas1222 said:

Unfortunately there's nothing you can do. That's why I stress how important it is for people to research the hospital they're at too. It's all fine and dandy if your provider is on board but if you're at a big practice who knows who you'll have. The hospital I was at last time has the lowest c/s rate. It's a teaching hospital so HUGE on evidence-based practices which is all that I'm asking for. Labor is hard enough, I couldn't handle having to fight for every inch. It's why I didn't go with the midwife who is the most popular in our area. I know there's a good chance I'll risk out of the home birth and end up at a hospital. She requires you go to the doctor who backs her up, at the hospital with the 4th highest c/s rate in the state... He's amazing and they treat you differently as his patient but it scares the piss out of me! So, I interviewed another awesome MW and if I risk out before labor (damn GD) I'll get to go back to my old doctor.

Having the signed birth plan is a good step though. A physical copy of it signed is good as backup too. That way they can't play the "oh I don't see it in your file." Hiring a doula is definitely a good step. She'll know the practice you're with, the hospital you're with, etc... People talk, they share stories of the doctors, nurses, hospitals, everything. Even if she hasn't worked directly with your doctor she'll have heard stories or be able to ask around.

This was going to be another question that has been lingering in my mind. Where do I find information on my hospital with things such as c/s rates?? I saw someone else who did it and I want to find out what theirs is.

You can try looking on Healthgrades.com. For example, here is one of the hospitals in Houston area (not the one at which I'm delivering): https://www.healthgrades.com/hospital-directory/texas-tx-houston/cypress-fairbanks-medical-center-hgst0d3bc8b6450716#RatingsForMaternity?ratingCode=OB1

MissLadyTay · December 2013

The most important person to tell your preferences (re catching your baby) is the doctor on call WHEN you deliver. I would mention it when they come in to check on you throughout your labor. You will probably go through shift changes and nurse changes, so tell whoever is with you when you start pushing. No point telling anyone else - they won't be there to make it happen when it counts.

jjtyler · December 2013

Junebug060609 said:

My biggest advice as a STM when it comes to birth plans is to educate yourself. Know your preferences. Know your options. And know that what you write in that plan may not be able to be followed (pre-e, an induction and a maternal fever werent in mine, for example...and let me tell you labor and delivery wasnt what i envisioned because of them). Be ready to go with the flow.

100% agree with the above. Be ready for anything and I would advise women "DO NOT beat yourself up if things don't go the way you planned." I was never for a no meds birth, so one of my basic plans was get that epidural ASAP and avoid a C-section if I could.

I had a pre-e induction 3 weeks early with a fever as well...my little one went to the NICU as a precaution and honestly, if I didn't warn myself mentally beforehand, I probably would have over-reacted and freaked out (especially when I shared the room with a mom who tried to make me feel horrible by expressing her "horror" that I wouldn't be able to bond with the baby in the first 24 hours and that could set me up for disaster.....)

DaisyTortilla · December 2013

I read up about this not too long ago. I read mixed reviews. It says they are good to bring, but then some people say it kind of puts a wedge between you and the staff. What I'm doing is I'm writing out a birth plan, so I can know my preferences. I will show it to my OB and have him know what I prefer. But, when it comes to delivery time...i will Just tell them what I want. However, like most people said, there are sometimes when it is just not possible to get everything you wanted. At that point I think, more flexibility is important. On the other hand, know what is necessary and what isn't, with DD the staff was very pushy and us being FTM we got pushed around. They always threatened us with "to avoid fetal distress" but, there was no fetal distress at all. I think I wrote too much. Lol. Just know what you want, stick to it, but when it is medically necessary you might have to loosen the grip on the birth plan.

Empireceo · December 2013

During labor, it may be hard for you to communicate your preferences in the moment, so make sure your husband is totally on board and up to speed. You may think about at least interviewing a doula or two. Even if you decide you don't need one, they may be able to help you learn what questions to ask before and during labor.

momthatlifts · December 2013

I just got done reading. Thanks again . I think me and my husband are going to type some things up that we want to talk to my OB about. My only problem is that we will most likely not even be delivering at this hospital because we are moving but I would rather them and us be prepared!

momthatlifts · December 2013

JKBMA2014 said:

sthomas1222 said:

Unfortunately there's nothing you can do. That's why I stress how important it is for people to research the hospital they're at too. It's all fine and dandy if your provider is on board but if you're at a big practice who knows who you'll have. The hospital I was at last time has the lowest c/s rate. It's a teaching hospital so HUGE on evidence-based practices which is all that I'm asking for. Labor is hard enough, I couldn't handle having to fight for every inch. It's why I didn't go with the midwife who is the most popular in our area. I know there's a good chance I'll risk out of the home birth and end up at a hospital. She requires you go to the doctor who backs her up, at the hospital with the 4th highest c/s rate in the state... He's amazing and they treat you differently as his patient but it scares the piss out of me! So, I interviewed another awesome MW and if I risk out before labor (damn GD) I'll get to go back to my old doctor.

Having the signed birth plan is a good step though. A physical copy of it signed is good as backup too. That way they can't play the "oh I don't see it in your file." Hiring a doula is definitely a good step. She'll know the practice you're with, the hospital you're with, etc... People talk, they share stories of the doctors, nurses, hospitals, everything. Even if she hasn't worked directly with your doctor she'll have heard stories or be able to ask around.

This was going to be another question that has been lingering in my mind. Where do I find information on my hospital with things such as c/s rates?? I saw someone else who did it and I want to find out what theirs is.

You can try looking on Healthgrades.com. For example, here is one of the hospitals in Houston area (not the one at which I'm delivering): https://www.healthgrades.com/hospital-directory/texas-tx-houston/cypress-fairbanks-medical-center-hgst0d3bc8b6450716#RatingsForMaternity?ratingCode=OB1

Thank you!

MamaLlama14 · December 2013

My advice would be to do your research and then discuss the things you feel very strongly about with your OB, as well as any other doctors in the practice who might be on call to deliver or care for you PP. That being said, understand the need for flexibility, too- there will be a lot going on when you rush into LD and a lot of hospital staff involved in your care who are NOT your OB (nurses, sono techs, anesthesiologists, etc...). When I delivered my DS, it was literally a full moon and the entire LD ward was PACKED- and even preggo women in labor in triage rooms! There wasn't a lot of time for "let's sit and discuss this four page list of things I need". I felt strongly that no forceps or vacuums be used unless a medical emergency presented itself, and that I get skin to skin and breastfeeding with my newborn immediately. Because my list was short, I was able to make it clear- on many occasions- to the doctors.

sthomas1222 · December 2013

Can we just automatically assume when discussing birth plans/preferences that the person, unless otherwise proven to be bat shit crazy, has the information that "things don't go according to plan" and realize that all this implies that mom & baby is fine...? ETA: Birth plans/preferences should be no more than one page, preferably bulleted. Otherwise you may fall into the about mentioned bat shit crazy category.

sthomas1222 · December 2013

For the purpose of this site, unless someone is proven to be crazy (we all know who) or is asking for something crazy or not evidence based lets just say they're not being militant/rigid. A majority of responses are still "not everything goes to plan" "be flexible" etc etc. We get it.

Miles2Go · December 2013

sthomas1222 said:
For the purpose of this site, unless someone is proven to be crazy (we all know who) or is asking for something crazy or not evidence based lets just say they're not being militant/rigid. A majority of responses are still "not everything goes to plan" "be flexible" etc etc. We get it.

This is exactly why I can't participate in threads like this. Every disclaimer response makes my eye twitch.

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