Birth Plans

catem07 · February 2017

What's in yours? What aspects of it are you firmly committed to and what are nice-to-haves? Have you talked to your doctor/midwife about it? Did you have to negotiate around any of the pieces?

MWoodside · February 2017

I haven't talked to my provider about our birth plan during this pregnancy, but we used the same practice last time and they were fully supportive of the birth plan I presented. Mine is super long and specific. It's been respected both times so far by the staff that has attended our births.

Some of the things included are: dim lights, heplock instead of IV (I have been GBS+ both times, but don't want to be hooked up to an IV ongoing), heplock in wrist instead of crook of elbow, access to water/bath, don't ask my if I want pain meds, don't asked me to do cervical checks (if I want them I will request), don't break my bag of waters, no counting/coaching during pushing, no hep b shot after birth, no erythromycin on baby's eyes, baby to chest immediately after birth (unless emergent care is needed), wait to do stats until after I nurse initially, no family/guests in my room in L&D or for 1 hour after transfer to mom/baby unit, save my placenta (for encapsulation), don't pull on the cord to deliver placenta, no episiotomy unless I am asked and ok it (hasn't been necessary for me), counterpressure on the perenium while pushing to help prevent tears, no deep suction for baby post-birth, delayed first bath (we leave vernix on for the first day), allow cord to stop pulsing before DH cuts it, I don't want to deliver flat on my back (I tore a TON with DD1 b/c of this poor position)...

I am sure there is more, but it's at home.

KirstinH88 · February 2017

At my appt yesterday my OB gave me a handout on birth plans. I guess we will be discussing my desires next appt. I haven't looked at it yet, and literally told her "just get a healthy baby out of me."

akslevin · February 2017

I am hoping/praying to deliver at a birth center with a midwife, but we are currently prepping to move from Alaska to central Florida. We will arrive in Florida when I'm 35 weeks. I potentially have GD, but haven't been able to do the 3 hr test yet, because we are remodeling our home to be able to list it before we move. Insert all of the stressed emojis. All of that to say, thank you for this post! I have not been able to devote the time or energy to developing a birth plan, and it's been hanging over my head BIG TIME. If we're able to deliver at the birth center, I feel many of my desires will be their standard of care, but @mwoodside - I am totally copying your birth plan, as it puts into words many of my/our desires.

I'm a little nervous that we may be forced to deliver at a hospital, given that we don't know the area. I wondered if maybe I didn't need a birth plan, but in the case that we end up at hospital, it would be great to be able to clearly communicate our wishes.

Thanks again for this post!

schef070911 · February 2017

I've talked to our OB in a general sense about our wishes, but I get the sense that the birth plans are more for the nurses we interact with during labor as opposed to during actual delivery. I'm okay with that because from all my conversations with my OB our plans seem to be in line (don't induce until 42 weeks unless medically necessary to get baby out earlier, avoiding episiotomy, being able to walk around/change positions/use the tub if no epidural, etc.) Our hospital automatically does 1 hour of skin-to-skin immediately after birth unless the baby needs medical attention, so I'm happy about that.

Our hospital has a "birth plan" worksheet on their website so we will likely use that and make a few copies (at their suggestion during one of our classes) to give to nurses at assessment/triage and at labor and delivery. At this point, I want to attempt natural birth and have been preparing as though that is my goal, so a big part of my birth plan will be not asking them not to offer an epidural unless I specifically ask for it. @MWoodside some of the things you mentioned I had not thought about, so clearly I still have some work to do!

cafedisco · February 2017

Planning a homebirth so my hopes are pretty gauraunteed unless we have to transfer. I plan to document a plan similar to @MWoodside though just in case. The other thing I will add to mine, based on my first experience, is not to be told what time it is. Unless there is medical need to do so (such as waters broken for too long or baby in distress), I want labor to progress completely naturally, even without any "holistic" help such as specific manuvering, herbs, etc. Unless I request those things (which I likely won't. I hated all that last time).

akslevin · February 2017

@cafedisco - I love your mention of time. I hate to be rushed, and if things are progressing as they should, even slowly, I feel I would become stress/agitated if they're relaying the time to me. Great point.

HGRich · February 2017

Our childbirth class is tomorrow and I plan to talk with DH about all of that after. None of my doctors have brought it up, but I figured it was more for the birthing center nurses anyway. I do know there are things I'm definitely interested in seeing about. I actually don't know if they have labor tubs (will ask on our tour which is also tomorrow), and chest to chest will be really important to me. I also want to keep family out for at least an hour except for my mother who I hope will be able to be the second coach to relieve DH. The latter shouldn't be a problem though because both our families live hours away, so I guess their wait depends on when they arrive and they know I expect them to stay in a hotel and not at my house, so they can hang out there until then and I'm not going to feel guilty about it. But there's a lot I don't know to ask for so this thread will be helpful. I actually didn't even know what an episiotomy was until a couple of weeks ago when my mother told me.

Hahaha. I have so much still to learn.

Taylor72 · February 2017

@Mwoodside can I ask why you don't want the eye ointment? I have read that a lot of people are going this way(mainly here on TB in other BMB) but I'm unsure why

catem07 · February 2017

@taylor72 my understanding is that it's primarily to protect the baby from gonorrhea and chlamydia, so if you don't have either of those there's no need for the ointment. But it can also protect the baby from other issues like e coli.

One other thing you can do is delay the ointment until after the first feeding, to help baby see and latch.

mrsstuessy · February 2017

I find very little reason for a birth plan this time around. I am with midwives this time and they 100% support the kind of birth I want. I have talked about what I am hoping for with a couple of them and I have also worked as a doula with them before. I am not worried. The hospital is baby friendly as well, so they have to follow those guidelines. Also, the nurses who work with the midwives choose to do so, so it is pretty safe to assume they are fans of medication free, natural birth. I have joked that my birth plan is:
"I mostly want to be left along to do my thing as much as possible." They were totally cool with that.

But, I did end up writing down a few things just in case it is helpful for any of the nurses, and just as a small reminder. Protocol with the midwives is:
-cervical exams are kept to a minimum or when requested
-no episiotomies unless absolutely necessary, and with your permission
-no routine IV access
-delayed cord clamping
-immediate uninterrupted skin-to-skin
-intermittent feal monitoring when possible (except hospital protocol is a little dumb here and I have already talked to my midwives about declining even when it is protocol.)
-they will let you deliver in any position you want, including on the toilet and in the birthing tub (if you are in the special water birth rooms)
-won't break your water or do anything without your consent

So, since I don't have to mention any of those things. Here is my birth plan as it stands right now. I still might change it a bit.
Labor
-I would like an unmedicated birth. Please do not offer me medication.
-I would like the option of a water birth if one of the rooms is available.
-Intermittent fetal monitoring is strongly desired. I may decline continuous monitoring even if it is hospital policy.
-In the case of unexpected circumstances I would like to have all my options explained and then privacy to discuss them with my husband, alone.
-I would like to be left alone as much as possible.
After birth
-If there is a need for the baby to be taken away for any reason her father WILL go with her.
*With DD1 we had her rushed to the NICU right after birth. It was extremely traumatic for me. They wouldn't let DH go with her and I have had to deal with some horrible guilt around that. Since then I have learned they can't actually keep you from going anywhere with your child other than the OR. So, I will be left alone if I need to be and DH absolutely will NOT leave her side.*
-I plan on breastfeeding.
-Daddy wants to cut the cord.
-No eye ointment.
-No need for a hat when skin-to-skin.

Koukonei · February 2017

MWoodside said:

I haven't talked to my provider about our birth plan during this pregnancy, but we used the same practice last time and they were fully supportive of the birth plan I presented. Mine is super long and specific. It's been respected both times so far by the staff that has attended our births.
Some of the things included are: dim lights, heplock instead of IV (I have been GBS+ both times, but don't want to be hooked up to an IV ongoing), heplock in wrist instead of crook of elbow, access to water/bath, don't ask my if I want pain meds, don't asked me to do cervical checks (if I want them I will request), don't break my bag of waters, no counting/coaching during pushing, no hep b shot after birth, no erythromycin on baby's eyes, baby to chest immediately after birth (unless emergent care is needed), wait to do stats until after I nurse initially, no family/guests in my room in L&D or for 1 hour after transfer to mom/baby unit, save my placenta (for encapsulation), don't pull on the cord to deliver placenta, no episiotomy unless I am asked and ok it (hasn't been necessary for me), counterpressure on the perenium while pushing to help prevent tears, no deep suction for baby post-birth, delayed first bath (we leave vernix on for the first day), allow cord to stop pulsing before DH cuts it, I don't want to deliver flat on my back (I tore a TON with DD1 b/c of this poor position)...
I am sure there is more, but it's at home.

This was pretty much exactly mine with DS as well.

MWoodside · February 2017

Taylor72 said:

@Mwoodside can I ask why you don't want the eye ointment? I have read that a lot of people are going this way(mainly here on TB in other BMB) but I'm unsure why

I don't have an std. so it's not necessary.

Taylor72 · February 2017

I guess I didn't realize it was mainly for STDs. This little one won't be needing it either. I didn't actually know what it was called but now I can look it up

MWoodside · February 2017

@Taylor72, it also blurs their vision until it is absorbed. Baby can only see a short distance in front of their own face initially so I want her to be able to see me

HappyAnjel · February 2017

I didn't have a plan at all with my daughter. This time around my plan is pretty simple/basic. Im likely having a C-section but if I happen to go into labor naturally my doctor is allowing a "game day call." So if I am laboring and things are looking good I can go for a VBAC. I'm delaying cord clamping and I want a chance to breastfeed before anyone but DH is allowed in. That's pretty much it.

lovelongdog06 · February 2017

I'm planning a home birth so if I birth at home, I'm not concerned about my wants and needs being violated. I did write a birth plan though that speaks mostly to a hospital birth/c section. I've noted that I'm a hard stick but that an antecubital (crook of elbow) IV is unacceptable, that I refuse the catheter until after an epidural, that I don't want to be sedated during surgery (hated almost falling asleep on the table last time), that I'd like baby to remain on me and the possibility of nursing in the OR, and a list of things I want and don't want for baby.

twistsandturnsto2 · February 2017

I won't have an official birth plan, but I will be talking to the nurses and midwife about my previous delivery at that hospital and request some different positioning and such. they didn't break the bed down until they were about to do a vacuum assist with my first, and wouldn't you know, I pushed him right out once they did. (I had been pushing for 4 hours at that point to no avail).

Other than that, I'm pretty laid back and will go with the flow as I did the first time. We probably won't have any other family in the room this time- just DH and myself, so fx all goes well and we can do skin to skin (couldn't with DS since he went straight to the nursery) and recover post birth before family can come in.

Nolegirl1185 · February 2017

I'm in love with this thread, it's nice to see in writing what I am thinking, but can't articulate appropriately! I've googled birth plan templates etc and they don't come close to what I would like. How do these plans work..do you just type and print? Is it handwritten? Is their a birthing center/hospital form that is required? I'll be talking to my OB about my wishes, hopefully on Wednesday at my next appointment.

mrsstuessy · February 2017

@Nolegirl1185 I will probably type mine out and print it. With DD1 we had a binder. This time we should be good with a small folder. We will have insurance info in there, a contact list of people to update when the baby is born, my birth plan and some other paperwork we will need at the hospital. And then we will also have a place to put all the papers they give us. Most hospitals or doctors will have a form that you can use. But, you are definitely not required to have a birth plan or to use the one they give you. But it is a good idea to know what sort of info they are suggesting you write down. And definitely talk to your OB about what you are thinking to get their take on it.

Nolegirl1185 · February 2017

@mrsstuessy Thank you!

akslevin · February 2017

Any more naturally-inclined (for lack of better phrasing) mamas able to comment on a Plan B birth plan in the case of medical induction or required C-section? I want to leave some room in my brain for this contingency, given that I'm not easily able to roll with the punches Delayed cord clamping, no erythromycin eye treatment, immediate skin-to-skin, etc -- those would all still be relevant, but I'm thinking of other things that could come up prior to baby's arrival.

Is it irrational to still hope for a med-free birth with Pitocin? I've heard from many mamas that contractions on Pitocin (if I were to need a medical induction) are of a different variety than contractions without...any STM with experience in this arena?

MWoodside · February 2017

I haven't had an induction or pitocin, but several mama friends have been induced with it and not gotten pain mess or an epidural.

If i I need to be induced I'll request a foley bulb induction attempt if I'm dilated a bit. I'd prefer not to have pitocin to induce if at all possible.

belocin · February 2017

@akslevin Central Floridian here! What area will you be moving to?

Ekzerr · February 2017

I went into my first pregnancy with no real birthing plan other to go med free and I think it will be the same this time, with the exception of doing everything to avoid being induced again.

I didnt have a clue what to expect last time so my theory was that my body would know what to do and just go with the flow. Labour really was nothing like I expected but DH was able to coach me through and I look forward to having him there for support this time around as well, he did amazing

WkoutMomtoBe · February 2017

Taylor72 said:

@Mwoodside can I ask why you don't want the eye ointment? I have read that a lot of people are going this way(mainly here on TB in other BMB) but I'm unsure why

We were told (by our birth instructor) the ointment can impact abd interfere with bonding and breastefeeding.

The only reason it's done is bc it is routine and not single out people who may have those std/stis...so every baby gets ithe.

We plan to not get it.

WkoutMomtoBe · February 2017

My midwife asked what my birth plan was and provide a couple sheets with birth wishes and you just check off, they scan in and print out when you are in labor.

I'll do that but I plan to make a simple one that has labor, birth and postpartum with simple yes no columns.

This was advised by our Birth instructor explaining keep it simple and easy to read. Have extra copies, hang one on door, etc.

WkoutMomtoBe · February 2017

akslevin said:

Any more naturally-inclined (for lack of better phrasing) mamas able to comment on a Plan B birth plan in the case of medical induction or required C-section? I want to leave some room in my brain for this contingency, given that I'm not easily able to roll with the punches Delayed cord clamping, no erythromycin eye treatment, immediate skin-to-skin, etc -- those would all still be relevant, but I'm thinking of other things that could come up prior to baby's arrival.
Is it irrational to still hope for a med-free birth with Pitocin? I've heard from many mamas that contractions on Pitocin (if I were to need a medical induction) are of a different variety than contractions without...any STM with experience in this arena?

I plan to have alternative birth plans too...bc just never know.

Check out "gentle c section" and look at Mama Natural for her advice. Our Birth instructor showedd/told us they can use clear sheet if you ask so you can see being born (if they have it). But you may also request no shop talk, etc

mallyandryan · February 2017

Ekzerr said:

I went into my first pregnancy with no real birthing plan other to go med free and I think it will be the same this time, with the exception of doing everything to avoid being induced again.

I didnt have a clue what to expect last time so my theory was that my body would know what to do and just go with the flow. Labour really was nothing like I expected but DH was able to coach me through and I look forward to having him there for support this time around as well, he did amazing

This exactly...

Cook3133 · February 2017

After delivering 4 babies I found that a plan easily goes out the window! I have a few specific things, like no eye goop, delay clamping, skin to skin right away. Other than that we figure it out as we go.

smoochie041719 · February 2017

@cook3133 that sounds exactly like what I want... those few specifics you mentioned and a goal to do as much laboring as I can without pain meds, but I want to go in with a little bit of flexibility because I don't know what to expect and as you said things can change unexpectedly even with a plan.

Dannylion24 · February 2017

I think I've been naively fortunate through my last 4 births. With the exception of my first where I developed preeclampsia and needed magnesium sulfate and pitocin, I've always had very quick deliveries with a minimum of complications/interventions. My older son spent a few days in the NICU but the actual delivery was a dream. I guess for that reason I've never written a birth plan (who do you give it to?) I just know my options. After the first one my labors have only been 2-3 hours so not much time for repeated checks and monitoring and I've never torn and have always at least requested the epidural (only successful 50% of the time). I suppose having no interest in water birth or time for walking or a birthing ball helps. However, I applaud everyone for taking the time to do your research, consider your options, and put your decision and preferences down! Knowledge is definitely power.

akslevin · February 2017

Sorry for my belated reply - I can't bump on the weekends.

@belocin -- Heathrow! Do you know it? We're hoping to birth at Inspiration Birth Center in Winter Park.

@wkoutmomtobe -- thank you! I will start researching 'gentle c section.'

pammasu0909 · February 2017

A little late to the game, but here's my unofficial birth plan

Don't deliver in the car.
No pitocin unless I have to be induced due to GD
Episiotomy is fine, as long as they warn me ahead of time. I tore with #2 and the healing process was way worse than healing from the cut with #1... a straight line is way easier to sew than a jagged one
I want to have the room with a labor tub, since that's where I delivered my other two. I'd also like a nurse that isn't an idiot and the tub to be working.
Meds are cool with me.
I want my nipples covered during any photography.
No guests until after the baby's sugars have been tested at least once. DS was petrified because DD was screaming from hunger since I had to wait to have her sugars tested before she could nurse. Which brings me to another point - I will not wait for glucose levels to be tested this time. If the nurses can't get to my room within 10 minutes it can't be that critical.

KirstinH88 · February 2017

@pammasu0909 You're first bullet point made me LOL!

mrsstuessy · February 2017

@pammasu0909 I'm curious about your last bullet point. Is there a reason they wanted to test baby's blood? I have never heard of that. All my clients (as a birth doula) have nursed before any sort of test. Was there some sort of special situation going on?

SnarkasaurusRex · February 2017

@mrsstuessy Not sure if it's the same situation, but DS had to have his sugars tested pretty regularly because of his size and concerns that I'd had undiagnosed GD. Soooo many heel pricks.

SnarkasaurusRex · February 2017

I have two plans, one for my RCS and one in case she decides to come early and I get my VBAC.

VBAC Plan:

Prefer natural induction methods (no pitocin due to previous c-section)
Intermittent fetal monitoring
Ability to move during labor (either mobile IV or heplock)
Minimal internal exams
Dim lighting
Access to tub for labor (not birth)
No meds unless I request them - epidural is preferred to pain meds
Episiotomy is fine as long as I am asked first
Delay cord clamping
Immediate skin-to-skin and nursing before baby is cleaned
Routine checks occur after first nursing is complete

RCS Plan (Gentle C-Section):

I would like to be awake for the birth - refer epidural or spinal block - general anesthesia for emergencies only
No drugs for pain/relaxation
Skin-to-skin as soon as possible after birth (DH will hold if mother is unconscious/unable to)
Do not lower the drape when delivering the baby
Place baby on mothers chest for skin-to-skin and nursing while being sutured
Delay cord clamping
Routine checks occur after first nursing is complete

schef070911 · February 2017

FTM question: I just researched delayed cord clamping because I honestly didn't know it meant and what the benefits were. Is delayed cord clamping not a common practice at hospitals? Can you do skin-to-skin immediately after if you delay?

ETA words are hard

bww_0331 · February 2017

@schef070911 from what the nurse at our child birth prep class said, the "delay" is only around 45 seconds to a minute. So not much time. And then they do skin to skin.

HGRich · February 2017

@schef070911 I'm planning on doing it! And yes 30 seconds to a minute is what I was told too. I think that's worth it for the benefits.

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