Birth Plans

R0824H · September 2016

OK so I did a search a couple times and didn't see a discussion that was dedicated to this topic..unless I missed it as a discussion in a Random or Stupid Question Sunday thing so if I did miss this I'm sorry

Is anyone planning on creating a birth plan? STMs, did you have one and found they were useful? I've been looking at them on Pinterest and while I've heard of people having them I've never really gave it a second thought because I'm guessing in most cases plans need to be modified when the big event actually happens.

I'd love to hear your thoughts on this

SmashJam · September 2016

I had a birth plan that my midwives asked me to turn in last time (no mention this time...weird.) and what was nice is that my midwife new I really wanted to avoid a csection (just surgery fear, no other reason) because of that plan, and framed all decisions I had to make, like whether or not I gave in or took drugs, in that light. For example, I asked for the drugs, but DS was in a weird position and she was like, "if you take them, then you won't be able to do these exercises to turn him, and this might result in a csection. So lets try this first, ok?" So that was a plus for me. Otherwise I thought not a bit about it during labor, but thats just me.

LinziLoo09 · September 2016

We had "birth wishes" that we gave our provider leading up to the date. They didn't really work out haha, but it was a nice thought. Essentially I've told my midwives this go around that my birth plan is to "get this thing out of me through any means necessary". The plan is to start with low levels or no intervention and then increase as needed. Sleep deprivation and front and back labor can be game changers when it comes to withstanding contractions for 22+ hours. I don't want to feel guilted if the plans change, so we just don't have plans.

mattanda2011 · September 2016

I have never written a formal birth plan, but both my doctor and the nurses at L&D ask me the most pertinent information right as we get to know each other. My dr starts talking about them around 36 weeks and the nurses asked as we were getting checked in. Things they asked -

Are you planning for an epidural?
Do you want a mirror to see when you are pushing?
Are you doing delayed cord clamping?
Who do you want in the room/is there anyone we need to keep out?

Those were the main ones, and really the main things that were important to me - once they knew what those goals were I felt like the nurses and doctor know pretty well how to steer things as best they can.

R0824H · September 2016

I like the idea of the Birth Wishes, I definitely want to make sure the OB and L&D nurses know what I would like as far as pain management options go. I'm undecided on an epidural, I want one..but the thought of getting one scares the heck out of me.

mrsmerc2015 · September 2016

I had no formal birth plan with DS and it didn't work out at all like I'd wanted in my head (see birth stories post

). Since Bodhi will be a scheduled c-section, and my hospital does family centered c-sections, they sent me a form to complete that outlined my wishes - no curtain, DH cuts cord, immediately putting baby on my chest, allowing us to breastfeed in the operating room, not washing him up right away...I basically took them up on everything they offer

. We'll see how it goes.

If you do put together a birth plan, I'd make it 'birth wishes' and/or be ready to let go of some things. I think it is good to be educated and aware of what you want, but it is also important to be flexible with what happens because the birthing process isn't always as straight forward as the books and videos make it seem!

tinattt23 · September 2016

Aiming for a med free birth. My birth class has one session where we write our birth plans. My doula also writes a birth plan with us at one of our sessions. Not sure if I'll give the physical sheet of paper to my OB, but we'll definitely discuss it. And I'm hoping my doula will help with reminding the nurses as they come and go. But obviously things will go how they go and the world/me may decide to shred that plan once the reality kicks in

leksiL · September 2016

My Bradley class also has a session to write out our birth plans in a few weeks. My doula will also help me with it. We are aiming for a med free birth.

My provider encourages us to do a birth plan also. They have a handy sheet here: https://middlesexhospital.org/files/dmfile/PregnancyAndBirthCenterPlan1.pdf

We have discussed some of the options in our Bradley class already. For instance the constant fetal monitoring will make it so you can't move around (if you have an epidural you can't move around anyway so it might not be as big of a deal). Also, I'm going to ask the provider not to announce the level of dilation unless I ask for it, so I don't get frustrated or too hopeful with progress.

Toller · September 2016

We did "Birth Preferences" with our Doula (so she could help advocate for us if/when needed). I brought a copy to share with hospital staff, but we didn't have time. I wanted the birth preferences for us, because your brain can get a little foggy through all that labor, and it's nice to have the reminder of what you originally wanted! Particularly if you start getting pressured to do certain things from docs/nurses.

We had preferences for quite a few scenarios (med free, complications, c-section, etc)

allicat89 · September 2016

I don't have a birth plan going in, mostly because I don't have very strong opinions about how the birth goes, other than what everyone else wants: to have their child arrive healthy and safe. I have a lot of respect for my nurse and OBGYN team, so I plan to trust their recommendations throughout the process. I assume I'll get an epidural, though I would like to labor without one until the pain becomes unmanageable. And just in case the epidural doesn't take or labor comes too quickly, I've studied up on some med-free pain relief techniques and positions that can hopefully get me through.

I'm not really afraid of epidurals or c-sections, since both DH and I were emergency c-sections, and my dad is an anesthesiologist who does epidurals every day. But if you have strong opinions about going med-free, avoiding a c-section, or any other aspect of birth, I think it is probably better to make a birth plan and share it with your doctors and nurses. Then, even if the plan goes awry, you'll know that you did everything in your power to have the birth experience that you wanted.

slartybartfast · September 2016

You know, I was gonna but then I just looked at ours from last time and they are really kind of all givens at this point. The document we made really was an exercise for US not our providers now that I'm looking back. I feel less overwhelmed by all the aspects of labor and delivery and less like I'll forget something this time so I probably won't have one written up for L+D. However, I think it's a great thing to do to go through with your partner.

acreight13 · September 2016

@LinziLoo09 I totally agree. The first time I was planning all sorts of things for my labor and none of them happened. I like the idea of Birth Wishes. At the end of the day after over 31 hours I did whatever it took to get my DS out safely- and luckily was able to avoid a c-section by the skin of my teeth. Healthy baby, healthy Mama. That's what is comes down to for me. The rest is fluid depending on what happens.

Pgh_Kel · September 2016

I have a very general idea of how I'd like things to go but I'm pretty flexible as long as the end result is a healthy baby. I've discussed my thoughts with my ob and my BF so we're all on the same page, that's probably as far as I'll go with it. I'd like to see how things progress without an epidural, but am open to getting one if I feel it's necessary at some point. I'd prefer not to have a c-section, but realize that it will probably be out of my control if it has to happen, so I'll roll with it.

As a FTM I'm just trying to soak in all the information that my doctor and all of you have been providing and go from there. My main goal is to avoid setting expectations to high (or too specific) and being disappointed in the end.

princesslockness · September 2016

I personally find that if you know what things you can insist on/fight for and what you need to let go of, you are generally able to be happy and content at the end. Example would be delayed/dad cutting the cord- something you can insist on-unless NICU is involved. Where as baby heart decelerations are not really anything to mess around with.

SarahF8611 · September 2016

I did not have a birth plan with my first and I will not with this little gal either. My husband and mother (she was in the room) both knew what I wanted and I was very easily able to advocate for myself (with a little help from them) in a respectful manner to the hospital staff. I also talked about my wishes with my OB ahead of time, just to make sure I wouldn't get any guff from any staff members and they were all in the "normal" realm of what to expect at the hospital at which I was delivering.

Having a doula that will be with you, or a midwife is one thing totally different then walking into a hospital and giving a stranger nurse a birth plan, IMO. Like a PP said, my nurses asked me a ton of questions while I was in early labor, made notes in my chart, made notes on the baby's future bassinet (no pacifers/formula/don't take to nursery at anytime) and all of my wishes were heard and implemented. I think that's the best way to go!

karmba · September 2016

I don't have a birth plan really, just some ideas - I like the idea of birth wishes. I'd really like to labor in water and hopefully go med-free. If neither of those pan out, I'm hoping to avoid a c section. But if I end up with a c section, it's not the end of the world. I don't want to go in with a strict "plan" and risk being really upset if nothing goes how I wanted it to.

Kbchavez23 · September 2016

My birth plan is to get the baby out healthy and well. That's it.

dmontgo · September 2016

I found a picture of my plan!

But in all seriousness, my plan has changed so much since I found out about being pregnant. I originally really, really wanted a homebirth...couldn't get that so I opted for a med-free vaginal birth at the hospital...doesn't look like the med-free part is going to happen (although I still would like to...just not realistic now) so now I'm preparing for either an induction or CS. I'm sticking to the things I know I can control, like delayed cord clamping, skin to skin, etc. I'm going to have some Birth Wishes that I will discuss with the doctor, but yeah...Overall it's been a rude awakening for me how crazy and quickly things change.

Lisa3379 · September 2016

I feel like I need so much more education regarding this stuff. I figure the class we've signed up for will help us sort out all these options, but I also feel like what will be, will be. My hope is to be able to do it without drugs, but I'm not ruling it out. I definitely want my boyfriend in the room with me, and maybe my mom if she can/wants to. No mirror, yikes - the best part of this whole thing happening to me is I don't have to look at the carnage. I'd prefer to avoid a c-section, but if I need one, then whatever. I'm gonna try to not stress about it, but then maybe I'm being too nonchalant? Meh.

kbduke · September 2016

My "birth plan" is to try to avoid a c section in any way possible. If it happens, it happens but I'm going to try to do everything I can to not be in that situation. I'm a murphy's law person when it comes to medical procedures and I have a very high fear of any surgery after previous experiences.

fauxpa-2 · September 2016

My only plan is to get the baby out as safely as possible for both of us. I really like the "birth wishes" idea. I'm hoping to go med free, but am not ruling anything out since I've never done this before. I hate the idea of an epidural while I'm not in extreme pain, but I can imagine not giving a flying fig about it in the moment.

I just want to learn all the med free techniques I can so I feel like I have options to try and give it an honest shot. If I can cool... If not.. Oh well, I tried. Just keep me and the baby safe!

Shima42 · September 2016

I'm writing a kind of 'birth tree' rather than a birth plan. There are several main branches that are possible (for example: premie, induced due to complications, emergency c-section) and several branches that apply to each of those (like med-free, nitrous and narcotics, epidural, general anesthesia). Some things, like fetal monitoring, will be allowed in certain circumstances but not in others. I'll be making a sort of poster out of my tree and hanging it in my room as a reference for my husband, friend, nurses, and midwives to use should I become incapacitated. Given all I've read about the way women can be victimized in the delivery room, I think it's important to make our choices clear to our healthcare providers. Many women's birth plans include music selections, lighting, or strict rules about one path to childbirth - and for that reason, 'birth plans' are often ridiculed as unrealistic. I think that this is unfortunate, because if we want to avoid things like sideways episiotomies and 'husband' stitches, it is up to us to take our rights as patients into our own hands. The fact is that doctors have been inculcated to believe that they have the right to make decisions for the mother, and we shouldn't have to sacrifice a hospital birth to avoid illegal and nonconsensual procedures. A birth tree is a clear record that these decisions were carefully thought-out ahead of time, and should give any healthcare practitioner reason to pause before violating one's wishes.

ashleaf2018 · September 2016

I've been trying to ask my OB more questions about hospital policy so I know what I have to let go of and what choices I may be able to make regarding the birth. For example, I wasn't sure if I wanted to do delayed cord clamping or cord blood banking, but in talking to my OB found out that I may not be able to do delayed clamping anyway, but if I have the kit then they will do the collection/banking for us. Especially with us having a planned c section there's not a lot about the actual birthing process I'll be able to change, but there are certain things for after birth that I want in our "birth wishes," such as no formula supplementing, no pacifier, no circumcision, etc. And of course all of that will be subject to change; if he needs formula then I'm not going to starve him, I just would prefer to breastfeed and not supplement if I don't have to. I think a lot of it is being open to the unknowns that could happen and focusing on what you do have a say in.

bakerstreetboys · September 2016

I'm not making one. I've had three babies and three very different births. Kai will be born at the same hospital as the first three, so I know their policies and how my OB's practice goes about things. For me, the biggest thing is just allowing myself to have a voice and make to make my own decisions as it progresses. I'd like to go med free again, but I'm not married to it. Safe delivery by any means necessary is all I truly want!

Austenista · September 2016

After some consideration I think I'm just going to go the "wishes" route. I feel like I'm going to be more at peace walking into it expecting to go with the flow rather that expecting things to be my way or the highway. I don't know what labor is going to feel like for me and so I'm just going to see where that takes me.

I started out really diehard med free and honestly the idea of having to fight for that was not only giving me anxiety because I was contending with those things that were not in my control and etc. Also, I realized the kinder thing for me was to not put any parameters around what I might need to decide to do. I feel like that's only going to induce guilt for me or make me feel like I failed at something. I'd love for a smooth unmedicated birth, but I might decide I'm happier with a medicated birth in the end. Or it might be intense and scary and preparing for that mentally, I think is going to do a lot to ease my nerves. Accepting the things that I can't control and all that jazz.

Like @ashleaf2018 and others have said, I'm just going to make a simple wishes list (is there any way I can be allowed to move around & use shower or tub?, no circumcision, please leave him in the room with us, skin to skin, breastfeeding, etc.) and leave it at that. I want Eaton and myself to have the least traumatic birth we can have, and I think staying calm and being willing to ride out the storm however the wind blows is what is going to be the best choice for me.

hecklet · September 2016

We had one last time around, but labor went so quickly (he was born less than an hour after getting to the hospital) that I don't think it was ever looked at. Not sure if I will actually write one up this time or not. It's not my first rodeo and I'd like to think that I know what I want but every pregnancy, labor and birth can be so different!

yellingbanana · September 2016

With my first DD, I had a well thought out birth plan. I'm glad I did because in it I wrote that if I wanted an epidural that I would tell them, please don't ask or pressure me to get one. Especially because I didn't really get much of a break between contractions and couldn't talk through the contractions. My whole idea was to have as natural a birth as possible, I was terrified of a c-section (I'd never had a surgery before).
My plan went to the dogs. You can look up my birth story on the birth stories thread. DD and I did not do well during our 26 hour labor, and not a day goes by that I'm not eternally greatful for modern medicine, and some great doctors, for saving my daughter and me.
So while I support the birth plan, like many others said before me, 'preferences' and 'wishes' are more accurate. Because 'plans' are intended for situations that are under your control. Be flexible, and know that a healthy baby and mama are the most important things.

Unless you ask my 5 yr old, she says the most important thing is to watch out for predators. Yup.

jptrumptone · September 2016

I don't think I'll have a full plan per se, but my hospital has a very thorough preferences worksheet (here) that we think we will probably fill out together because it will help us determine where we really have preferences. As a FTM, I'm super happy my hospital offers such a great sheet!

zubenescamali · September 2016

we had no plan for our first. we wrote a plan for our second. some of it like the labor tub we were denied up front and we didn't get delayed cord clamping or immediate skin to skin. i am glad we wrote one though because when we checked in the nurses asked for a copy of our birth plan which actually surprised me. I've copied it below for anyone who is interested (pretty sure i copied this from the Bradley template)

Thank you for your assistance in the birth of our second daughter. We have taken natural birth preparation classes in order to achieve our goal of a gentle, intervention-free VBAC. We appreciate your support in this endeavor, and have outlined our preferences for your convenience. We understand complications may arise. In the event that certain interventions become necessary, we appreciate full disclosure regarding the benefits, risks, and alternatives, as well as the respect to provide consent to such procedures. Thank you.

Labor and Delivery

DH and birth attendant doula will be present

Prefer to hydrate orally, IV fluids only when absolutely necessary

Freedom to move around and change positions to maximize comfort

Labor tub

Minimal internal exams/cervical checks

Respect to deliver in position of choice

Please no “counting” during pushing, will be pushing to comfort

No routine episiotomy

Please delay cord clamping and allow DH the opportunity to cut the cord

Allow spontaneous delivery of placenta. We would like to keep the placenta for post-partum consumption, please do not place in any preservative or chemical; a cooler will be provided

Baby to be placed on mother’s chest immediately after birth for skin-to-skin contact, breastfeeding and bonding

If Surgery becomes necessary

Please narrate the procedure

Please lower the screen if possible so that we may see the baby’s head emerge.

Baby to stay with mother during recovery

Please use a double-layer suture for uterine repair

If no placental pathology is observed, please set aside for us to take home as above, a cooler will be provided

Newborn care

No ophthalmic ointment

Please delay tests and procedures for 1-2 hours to allow for bonding

No bottles or formula, we will be breastfeeding. No pacifiers within the first 24 hrs.

We will be delaying the Hep B vaccine until office follow up with our pediatrician.

maamawaabangi · September 2016

I made birth plans for our 1st and 2nd but haven't since doing home births. Our midwives come for a home visit and we discuss all of our wishes. Everything from pain management to who will take photos or what I want to eat post birth and who will make it. It's nice to have a team who care about the little things.

Its my expectation to have a Med free birth to the extent that nothing else is needed... I view it as a progression of care...

Least invasive - I'm birthing on my own with minimal assistance from the midwives. I'm free to do what my body needs or tells me. I labor by walking, showering and in a tub. I feel free to eat or drink as desired. The midwives use a handheld Doppler occasionally, they check my cervix only once or twice to verify progress, help driver baby because I'd rather not be responsible for catching it myself and stimilate breathing, patch me up if needed, give me my needed shot of pitocin to minimize bleeding, do a post birth exam of the baby, generally just help out, make me food and take photos. This is a very standard experience for me.

Slightly more - midwives use techniques and tools they need to help me (suggest new positions, help position baby if needed, use oxygen if needed, use pressure to stop bleeding, etc...) ive experience some of this at home and it was nice to have experience midwives who knew what to do when needed.

Much more intervention- Consider or transfer to hospital care. Midwives call ahead and arrange for a low stress amiable transfer with OBs that are open to a spectrum of care. Midwives continue to care for me in a doula function in the hospital setting and needed interventions are used (epidural, pitocin, forceps, etc...) Thankfully never had to been moved during labor (sounds horrible to me) but it was discussed during my 3rd birth and it's a good option to have when things aren't going well.

Full intervention - A needed c-section is performed for either or both of our benefits. It's a miracle and such a good thing! One of my children is alive today because her birth mama was able to get a csection! I'm so thankful that it spared them both.

All that, I don't really consider anything but the least invasive as my "norm" because it's the standard of care I both expect and have most experience with. I think if I were to be transfered I'd probably adopt more of an attitude of "screw it" and be willing to accept things that aren't normally in my "ideal birth scenario".

1MommyRunner · September 2016

I didn't have a birth plan last time and I won't for this time either. However, I did learn last time that I will be refusing pain meds through my IV. I will have to have an IV to get antibiotics for group strep B since I tested positive for that early on. No biggie, but the narcotic they gave me last time knocked me out for most of the day. It also made me feel extremely sick and dizzy when I was awake which was no fun at all. I'll be waiting for my pain to increase and then be getting an epidural, which really wasn't bad at all!
Our hospital is mother/baby focused. The baby will come straight to me and we will have skin to skin for at least an hour before they do anything with her. I LOVE that! They don't even have a newborn nursery in our hospital anymore. She will be with us from start to finish unless she needs extra NICU support.

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