Birth Plans

lzablocki · April 2016

looking for advice from STMs about birth plan choices they made and the positives/negatives of those choices. Not sure if there is already a discussion on this topic but I didn't see one when I searched. TIA!

xaudreyx2011 · April 2016

My only plan is to have a healthy baby. This is my 3rd and I've definitely learned that a lot of the "birth plan" is established by the baby. It's good to familiarize yourself with all the "what ifs" and have an idea on how you would like it to go. I hated that I "regreted" the way my first was born (emergency csection). With my second I was more aware that my opinions were 2nd to the health of my baby and myself. Soooo...hope for a wonderful birth that is everything you imagined, but plan for all the things that could change.

lzablocki · April 2016

xaudreyx2011 said:

My only plan is to have a healthy baby. This is my 3rd and I've definitely learned that a lot of the "birth plan" is established by the baby. It's good to familiarize yourself with all the "what ifs" and have an idea on how you would like it to go. I hated that I "regreted" the way my first was born (emergency csection). With my second I was more aware that my opinions were 2nd to the health of my baby and myself. Soooo...hope for a wonderful birth that is everything you imagined, but plan for all the things that could change.

I was wondering more about things like pain meds. for mommy (have a friend that got really nauseous with pethidine during labor and read that it can make baby drowsy for days and more difficult to breast feed), birthing positions, postpartum care for baby (eye drops, vitamin k, hep. B, etc.) and labor in general. Obviously baby's health comes first but I know there are some things I definitely want such as immediate skin to skin for 1 hour, delayed cord cutting etc. but just looking for some first hand experience of what mommies loved and weren't too fond of looking back.

NLewis1 · April 2016

lzablocki said:

xaudreyx2011 said:

My only plan is to have a healthy baby. This is my 3rd and I've definitely learned that a lot of the "birth plan" is established by the baby. It's good to familiarize yourself with all the "what ifs" and have an idea on how you would like it to go. I hated that I "regreted" the way my first was born (emergency csection). With my second I was more aware that my opinions were 2nd to the health of my baby and myself. Soooo...hope for a wonderful birth that is everything you imagined, but plan for all the things that could change.

I was wondering more about things like pain meds. for mommy (have a friend that got really nauseous with pethidine during labor and read that it can make baby drowsy for days and more difficult to breast feed), birthing positions, postpartum care for baby (eye drops, vitamin k, hep. B, etc.) and labor in general. Obviously baby's health comes first but I know there are some things I definitely want such as immediate skin to skin for 1 hour, delayed cord cutting etc. but just looking for some first hand experience of what mommies loved and weren't too fond of looking back.

it's completely fine to want these things (I also want immediate skin to skin and wanted it my first go around as well) but just know that in the event baby struggles a bit upon birth, you may not get them. My son was born blue and was over bagged which collapsed both lungs - needless to say I didn't get any of what I wanted during my birth experience. I'm not telling you this to freak you out - I just wish I had thought about all of that and prepared for it before my son was born. I mourned my birth experience for a while because it didn't go how I wanted it to (and really was very traumatic for all of us). This time around I'm more like X, y, z would be lovely, but as long as baby is healthy I don't really care how it goes down.

etr152517 · April 2016

Good point @NLewis1
Sometimes what you want isn't what baby needs. I was adamant about having skin to skin immediately but as soon as we laid him on me, DS started screaming and wouldn't stop. We finally realized that he felt more secure being swaddled so we kept him wrapped up and snuggled and loved on him that way.

lzablocki · April 2016

Thanks, ladies! Definitely keeping an open mind and realize that it may not go "as planned". Just trying to write up a general birth plan for my wants and preferences if possible.

AmberLiz99 · April 2016

Best advice: be flexible!

It's good to know what you want, but it's so important to be able to adjust your plan without feeling regret.

For me my birth plan is basically
-go into labor on my own (if my body allows it)
-go as long as I can without pain medicine or an epidural, but get it if I feel my body stray to fight against the contractions (I've had one epidural and one med free birth)
-skin to skin if baby is healthy
-listen to my body and my midwife

vulpini · April 2016

An hour of skin to skin and delayed cord cutting may not happen if you or baby have an complications. My son was born just shy of 35 weeks and I got to hold him for about 15 minutes before he was taken to the NICU. The cord was cut immediately because there was concern over an infection that may have triggered the early labor. They later determined my placenta was infected but my son wasn't.

This time around, I still marked the delayed cord cutting and skin to skin on my birth plan form (they are both standard at Kaiser now anyway), but I know to be prepared to not get either.

I plan on an epidural. Last time, I didn't dilate at all for over 15 hours until I got one and then dilated fully within 3 or 4 hours after getting it. I likely would have ended up with a C-section without it, since my OB wasn't going to let me labor over 20-24 hours due to him being early. The epidural limits my birthing position to on my back, but if I don't get it right away and they don't need me to be hooked up to so many monitors this time, I put that I want to be able to walk around.

I plan on getting all medically recommended newborn care for my son. I want the doctors to do whatever the need to to get us both through the labor and delivery alive and healthy. I prefer to tear naturally rather than get cut. My husband will cut the cord. I don't want a circumcision for baby. That about sums it up for me.

BlueJuice · April 2016

I honestly think all these things are important to think about in advance, and each possibility could seriously fill its own discussion thread. Overall I don't disagree with the ladies who say that you can't plan out everything, because circumstances or your body or your baby's temperament can change what becomes 'best' at any given time. However, I also think it's tremendously empowering to have a firm understanding of what you prefer (knowing it may not happen), and why, because it allows you to make better decisions in the moment and adjust your plan on the fly.

An example: I prefer to labor and deliver with no pain medications. The reasons for this in my case include my VBAC status (there is evidence suggesting that in the small chance of a uterine rupture, the outcomes are much better in unmedicated labors, probably because they are detected earlier), my preference to be able to self-direct my pushing, and my desire to avoid unwanted side effects in myself and the baby. Someone else might reach the same preference but mostly be worried about potential side effects, but also be worried about their pain management abilities or what happens if their labor is prolonged. While I probably wouldn't change my plan unless we were shifting to a c-section (at which point, yeah, give me pain meds!), this other person could very reasonably plan to go med-free as long as she was comfortable, but potentially ask for them later on in labor if she wanted to. Neither of these 'plans' are crazy or unreasonable, it's just a question of knowing your own situation and priorities and being able to best support your goals and priorities within the framework of how your labor actually goes down.

None of us can literally plan when exactly we will go into labor, how long it will take, how long we will push, whether there will be any complications, etc. We all know that much of this process is out of our hands. I see the birth planning process as less a statement of will ("this birth will happen in exactly THIS way, because I say so!") and more a statement of prioritization and self-awareness.

alitria · April 2016

I just want to add that having a conversation with your birth support people about your wishes and talking to them about advocating for you/baby is also important. I had an emergency birth with my first, was basically alone for all but the last few minutes of transition/delivery and was so out of it that I tried to speak up but an emergency plus being distracted by pain meant I had very little control over or even any real idea of what was going on. I'd hired a doula but she wasn't there for the birth. However, she came a few hours later when I called her after being stabilized and she was able to make sure I did get at least some of the stuff I wanted, got me started pumping (which had me in tears because I'd be handed a pump and told they'd be back in an hour) and fought for me to have the opportunity to hold my baby for the first time. I just remember being SO GRATEFUL that someone else was there and had the energy and confidence to do the fighting for me and had no fears about being considered pushy or b**chy. Obviously it doesn't have to be a doula but having someone else who is aware of your desires and totally in your corner who is willing to be the person who will fight for you when you just can't is priceless and makes a huge difference in what you get, IMO.

adiaz132003 · April 2016

Make a list of what your ideal birth would look like to you and make that plan A. You don't have to "plan" for pan B, just don't be hard on yourself if it doesn't work the way you want. For things like the eye drops, shots, pain meds ect, I made a list of pros and cons and made my choices from there. It was easy for me to say what I wanted cause all my choices were bases on the fact that I wanted as little medical intervention as possible but I still stayed very educated on what can happen so that way I have no surprises that would deter my plans. For example God forbid I need to transfer to a hospital for a c-sec, I can still request that my husband be skin to skin with the baby while I get stoched up and still request they don't leave my side for tests they have to do.

xc1148 · April 2016

xaudreyx2011 said:

My only plan is to have a healthy baby. This is my 3rd and I've definitely learned that a lot of the "birth plan" is established by the baby. It's good to familiarize yourself with all the "what ifs" and have an idea on how you would like it to go. I hated that I "regreted" the way my first was born (emergency csection). With my second I was more aware that my opinions were 2nd to the health of my baby and myself. Soooo...hope for a wonderful birth that is everything you imagined, but plan for all the things that could change.

I think that is sort of the plan here. Everyone's goal is to have a healthy baby; do some people get caught up in the plan and become distraught when it doesn't work out perfectly? yes. It sounds like you had something related to that. More often people ignore it completely and end up with the "No one ever told me/I had no idea about..." which can also be tough. But I think it makes sense to learn all of the options/possibilities and have a plan, because in a non-emergency, your doctor might ask what your preference is.

OP- My goal was to go as long as possible without meds, which I did. Same thing this time. My friends that did it naturally had very fast labors. Just think about what you're comfortable with; I think choice of hospital/doctor can be more important. My hospital is very 'baby friendly' so they do immediate skin to skin, encourage BF etc.

@bluejuice makes great points- research all of the possibilities, focus on your baby, know that most of it is out of your control but you can absolutely control your reaction to scenarios.

BlueJuice · April 2016

I find that feeling like you had a 'good experience' often comes from understanding why the things happened that happened, and that your wishes were respected whenever possible. Even if you have to deviate from your original plan, it makes such a big difference when your doctor says to you, 'So this is happening, the risks of it are X and Y, and I would like to do intervention Z in order to mitigate the risks.' Having the opportunity to give educated consent to your care, and to have your questions answered, is huge. Occasionally in a L&D setting there are true emergencies when things need to happen instantly, but in the vast majority of cases, even when there is a need for a change in plan, there is time to speak to the mother and make sure she is on board with the new plan.

Another example: When my second was born, I had wanted to have immediate skin-to-skin afterward. As it turned out, there was meconium in the fluid, so the hospital policy was to have a NICU team there in the room to do an immediate evaluation. I discussed it with my OB, consented, and she was indeed whisked away to the warmer for about two minutes right after delivery (after which point she was brought right back to me, still naked, because she was completely fine). Even though it didn't go quite the way I would have preferred, I felt respected and very positive overall, especially because the nursing staff that I had did an incredible job of honoring requests on my birth plan that I wouldn't even have remembered in the moment. (One of them brought a mirror over so I could watch the baby crown, which I had asked for but totally forgotten because PUSHING.)

alileecam · April 2016

I didn't have a birth plan the first time, and don't really plan to write anything up other than, "I am the decision maker." My husband tried to freak out when the doctor had to use forceps and it basically just got me rattled and delayed the process. I was looking at hospitals near me, and they had this checklist of sorts (it's called a 'wish list') to help you organize your birth preferences (as I prefer to think of it). I think the best way to go in is open-minded and educated, but don't be disappointed if your ideal plan gets thrown out due to circumstances beyond your control, like if the baby is distressed or needs extra medical attention at birth. Here's the link to the pdf: https://www.wakemed.org/documents/Women/birthday_wishlist_2015.pdf

lzablocki · April 2016

BlueJuice said:

I find that feeling like you had a 'good experience' often comes from understanding why the things happened that happened, and that your wishes were respected whenever possible. Even if you have to deviate from your original plan, it makes such a big difference when your doctor says to you, 'So this is happening, the risks of it are X and Y, and I would like to do intervention Z in order to mitigate the risks.' Having the opportunity to give educated consent to your care, and to have your questions answered, is huge. Occasionally in a L&D setting there are true emergencies when things need to happen instantly, but in the vast majority of cases, even when there is a need for a change in plan, there is time to speak to the mother and make sure she is on board with the new plan.

Another example: When my second was born, I had wanted to have immediate skin-to-skin afterward. As it turned out, there was meconium in the fluid, so the hospital policy was to have a NICU team there in the room to do an immediate evaluation. I discussed it with my OB, consented, and she was indeed whisked away to the warmer for about two minutes right after delivery (after which point she was brought right back to me, still naked, because she was completely fine). Even though it didn't go quite the way I would have preferred, I felt respected and very positive overall, especially because the nursing staff that I had did an incredible job of honoring requests on my birth plan that I wouldn't even have remembered in the moment. (One of them brought a mirror over so I could watch the baby crown, which I had asked for but totally forgotten because PUSHING.)

"Even though it didn't go quite the way I would have preferred, I felt respected and very positive overall, especially because the nursing staff that I had did an incredible job of honoring requests on my birth plan that I wouldn't even have remembered in the moment."

^^THIS^^ Exactly why I am writing up a birth plan. Great advice! Thank you thank you.

blackgirlmagic · April 2016

vulpini When do you fill out this form? I am a FTM and I also have Kaiser as my insurance.

vulpini · April 2016

BeachTigress said:

vulpini When do you fill out this form? I am a FTM and I also have Kaiser as my insurance.

They handed it to me at the 24 or 28 week appointment. It was a checklist where I just marked the items I wanted and had some space in the end to fill in any "other" things not listed. They took one copy and gave me one to keep and said to bring it to the hospital. If you didn't get one yet, it may be coming at a later appointment in your area. Or just ask them next time you go in.

jennk0118 · April 2016

I'm not having a birth plan except to go in to have a baby. I read up on everything with my son and had preferences.. And absolutely nothing went the way I had hoped. The only thing that I'm hoping for is to have skin to skin right away in a VBAC or family friendly c-section, where basically same thing.. She goes on my chest. Everything else can wait. Oh and I'll be put on medication for PPD right away.

laurendiaz02 · April 2016

Kaiser gave me a form to fill out for my birth plan and honestly it's still pretty empty. I told my doctor my plan is to get this baby out as quickly and safely as possible! I'm going in with an open mind so I won't be disappointed.

SMLmom · April 2016

Last time, I was really hoping I could do yoga, avoid an epidural etc. (my friend had bombarded me with "natural childbirth" info and I was feeling guilty about even considering an epidural). In the end, the epidural was just amazing in that it allowed me to relax, spend some lovely moments with my family, dilate quickly etc. and I would be ridiculous to second-guess it.
This time, I'm with the ladies who want to just get the baby out quickly and safely- that's really all I care about. Being flexible is key and I really do trust the medical professionals at my hospital. It's not their first rodeo.

blackgirlmagic · April 2016

@vulpini thank you! I will ask them about it at my appointment tomorrow.

arteduc8 · April 2016

STMs, Thoughts on wanting the mirror so you can see when you are pushing? Did you ask for one? Did it help or hinder? Not so sure I'm wanting it, but I really don't know any pros or cons about it. Thoughts?

alitria · April 2016

@arteduc8 I think my preferences are probably on the crunchier end of the normal scale but it has never once occurred to me to ask for a mirror and now that the option has been presented my thoughts are "no" followed by "definitely h*ll no." I think my ability to give birth is really helped by the fact that I can't see what is happening very well and you just can't un-see certain things. I pushed one kid out sunny side up while the dr watched, and as much money as I'm paying, they can be in charge of watching again.

I am curious though about the reasoning behind it helping? Is it just so you can see progress? I figure if standing on your head is a tutu is what a woman thinks will help her get through labor more easily, then someone should hand her a tutu and wish her good luck, even if that's not what will help me.

arteduc8 · April 2016

I frankly didn't even know it was a thing until it was mentioned at the child birth class I took at my hospital and when she pointed one out in the room on the tour. My first reaction was also "hell no!" So I'm curious if perhaps I'm missing something? Sounded like some woman like to see the progress. My DH cringed at it too. He's afraid he's going to pass out.

AmberLiz99 · April 2016

No mirror for me! I'd rather not see it, I dint even like seeing birth videos at all. I can Fuchs much better without that particular visual. The pain from giving birth has always been sufficient motivation for me to push baby out as hard as I could

BlueJuice · April 2016

@arteduc8 As I mentioned somewhere upthread, this was a thing I had asked for during my previous delivery (I guess because I thought it would help, or be interesting? I don't honestly remember.) In practice by the time I was ready to push I didn't even remember that I had wanted it, and although my nurse was great and brought me one, I didn't use it at all. I was just too focused on what my body was doing and sort of tuned inward at that point. I also delivered kneeling upright against the back of the hospital bed (like, the head of the bed was raised and I was kneeling on the lower part of the bed), so I couldn't see the mirror anyway even if I had wanted to. I think my husband used it to notice that the baby was starting to crown, which was lucky, because I had a kind of fast pushing stage and my OB was nowhere to be found at the moment and had to kind of do the running slide into the room at the last minute.

TL:DR - I didn't find I cared about having a mirror, or that it helped (or hindered) me in any way. I probably wouldn't ask for it again. YMMV.

Birth Plans

Re: Birth Plans

Mrs. H

Crohn's Dx: August 2008

Endometriosis Dx: May 2010

Married: 05/19/2012

TTC #1: June 2013

BFP: December 2013

DS: Born 08/29/2014

TTC #2: July 2015

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