Birth Plans?

WolfBride87 · May 2014

Hello, ladies! I have just recently reached my 36 week mark with my first baby and my fiance and I are about to work on our birthing preferences. I do understand that I must consider that sometimes things do not go as planned and medical assistance is necessary, however, I prefer to go an all natural route if possible.

First off, I'd like to point out that upon my OBG/GYN visit last week I was informed by my doctor that a Water Birth (which was my ultimate goal) is a no go. His reasons made sense but I was still devastated since I hate hospitals and had wanted to make my experience the least "hospital-ly" as possible.

Yesterday I had to go to the ER for precautionary measures and my fiance and I had learned that my doctor is strictly by the book and won't allow me to walk around during labor and has a love for machine assisted labor and delivery....yuck

! I had hoped to be given the option to deliver in a position other than on my back if I chose to do so and I refuse to be restricted to my bed with a bunch of mechanics attached to me. I've tried finding a midwife but there are none in my area who accept straight medi-cal and I can't change doctors because there are none close enough who will take me as a patient due to my insurance and how far along I am. I'm extremely anxious and frustrated because I feel like I will be forced into having to do the opposite of everything I feel more comfortable with. I will still discuss my options at my next appointment but am not sure how to handle it if a compromise is not met.

Does anyone have any suggestions on how to deal with such a stubborn Doctor? I really want the best for my baby and to allow myself the most comfort possible to avoid another traumatic hospital experience. Thanks to all in advance.

sschwege · May 2014

I would suggest 2 things 1) it is not too late to find a doula, I would highly recommend one in your case 2) labor at home, I know that we always say that but this will make a world of difference for you. If you are questioning whether it is time to go most likely it is not time. Wait until you KNOW it is time. If you arrive ready to push or close to it, the odds are stacked in your favor that your birth will unfold how you want it to.

bluebird0521 · May 2014

The more time you spend at home, the less time you will spend fighting for the labor/birth that you want. Also, call the hospital and see what their policies are. Have you done a tour? Sometimes doctors are more strict and conservative than the hospitals they deliver at.

You should also draw up a birth plan and provide a copy to your doctor at one of your appointments, and also keep one on your to provide the nursing staff. Make is simple and easy to read, don't go into too much detail.

Make sure you and your fiance are on the same page because he will be your biggest advocate and can help you push for want you want. You have the right to call the shots about your care. Also I second PP about a doula.

GPeterson24 · May 2014

Ultimately your doctor can't "force" you to do anything, you are in charge although it doesn't always feel that way.

I would discuss with your OB your preferences ahead of time and come prepared with evidence to back them up. For example, confined to a bed and continuous fetal monitoring for a normal labour are not an evidence-based practices.

Will your doctor be the actual one there when you give birth? In my area the OBs aren't on call for their own patients, they have a set schedule with the hospital.

I definitely agree with labouring at home as long as possible or you feel comfortable. It's too bad you can't find a midwife. :-(

jmknox · May 2014

I agree with PP. I have no experience here but if I were in your shoes I would definitely try to hire an experienced doula and labor at home as long as possible. That way you can maybe arrive at the hospital so advanced that you can continue with the birth you would like to have despite being strapped down. Plus she could help be your advocate to help prevent unnecessary interventions. And maybe just try having a heart to heart with your doctor. It's a shame you can't switch to anyone else...

aylafsu88 · May 2014

sschwege said:

I would suggest 2 things 1) it is not too late to find a doula, I would highly recommend one in your case 2) labor at home, I know that we always say that but this will make a world of difference for you. If you are questioning whether it is time to go most likely it is not time. Wait until you KNOW it is time. If you arrive ready to push or close to it, the odds are stacked in your favor that your birth will unfold how you want it to.

I agree with both of these. They will help you avoid some of the interventions if you stay at home and have a doula to help you stay focused and positive. Some of the things you can quite honestly just do it labor and they cannot stop you. My OB probably wanted me to deliver on my back but it was not happening. When I started pushing it was in the tub and then I made my way to the bed. I flopped down and was mostly on my side with some intermittent hands and knees. The OB never said anything and honestly, I was not changing my position to flat on my back.
I also refused an Heplock. I was in transition and I was focused on contractions. The last thing I wanted to deal with was a needle. The nurse did not argue with me and because I had labored at home so long the OB did not have time to come in and question my decision. He came when I was pushing which was within @ 1.5 hours of arriving.
Remember they cannot force you to do anything, you have the right to refuse things. Be educated and informed on what you what and when certian interventions are needed.

jmknox · May 2014

Apparently each hospital has a patient's rights disclosure statement that by law they are required to provide you if you ask. May be a good idea to check into this too.

vvvvvfee · May 2014

excellent advice above. definitely stay at home as long as possible! you will know when it is time to go. wait until you can't talk during contractions.

your doctor will not be there for most of your labor. there is no real reason you can't get up and walk around. if you need to have an IV for GBS or something, you can ask for a hep lock so they can take the IV out when they are done administering. that way you can get up in between doses. you can also ask to be monitored intermittently-- have them get the baby's vitals, and then ask them to take the monitoring belt off.

you can rearrange yourself into other birthing positions, even if you're in a bed-- you can squat, get on all fours, or lie on your side.

my hypnobirthing instructor always reminded us that you can say "i do not consent," if you want to refuse any intervention. also helpful is the acronym BRAIN to consider any intervention (what are the Benefits? what are the Risks? what are the Alternatives? what do your Instincts say? and what happens if we do Nothing?). read up as much as possible in advance so you are educated (the complete illustrated birthing companion is a recent book that offers a great overview of the pros and cons of all types of births, plus info on interventions and alternatives).

jenn43 · June 2014

There is a lot of good advice here. As people have said, your doctor won't be there for most of labor. The part that will be difficult is you aren't really going to be in a position to argue with people (if needed) regarding your decisions. I think the idea of a doula is a great suggestion- she can run interference and go to bat for you so that you can focus on what's important.

Cryssteen · June 2014

My only experience is because I work in a hospital - ask for a tour of the L&D unit. They can schedule a tour for you, guided by a unit representative. You can pose your questions about what exactly they are capable of, and what they are not. For example, a water birth may be off the table simply because they don't have a tub on the unit. Perhaps no one is trained in that... Just ask, find out your options and heavily indicate that you prefer a natural birth to see how the rep responds.

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