Birth plan

ridedatide · July 2017

Has anyone created a birth plan yet? Have you discussed it with your doctor? For STM did you create one for the first time? Did you find it useful? How did the Hospital and nurses take your birth plan? Also has anyone visited their hospital yet?

alysapuggles · July 2017

I have not created one and probably won't. I didn't with DS either, and with him my water ended up breaking at 36w so we were pretty much in "go with the flow" mode at that point. I think many people like having one, but you just can't get too hung up on things going a certain way. There is so much unexpected that can happen! Of course it never hurts to discuss important points/preferences with your doctor though.

MJDsquared · July 2017

@alysapuggles You just made me feel so much better. I didn't know having a birth plan was such a thing (I mean I'd heard of it, but I thought most people didn't, then these boards made me think otherwise). I didn't really plan on having one but after hearing all the talk about it I thought I had to or something. That's a relief!

The hospital I'll deliver at is attached to the building my OB's office is in. I'm due at the end of December so I'm pretty far behind (ETA: I mean I'm far behind others on this board so I have some more time to prepare), but I'm guessing we'll try to make it so we can tour the hospital after/before one of my OB appointments if possible. I should probably start figuring that out!

sjis · July 2017

I'll be using the same birth plan with DD. I kept it fairly simple on one page. Doctors and nurses like a simple plan. Here's mine:

Edit: birth went according to my plan with the exception of manually breaking my water to speed things up

ilikestars089 · July 2017

+1 to not creating one this time around. I made one with my first pregnancy and the nurses seemed respectful of it and it gave me a kind of peace knowing that my wishes had been "heard". However, birth is unpredictable and I ended up needing almost every intervention I'd been afraid of having because of my sons positioning and dropping heart rate during contractions.

Overall writing the birth plan was helpful for me before labor in terms of preparing and soothing anxiety; having my mind set on what I wanted and in writing was a way to worry about it all a little less. But I'm not sure that it was super helpful to the hospital staff because ultimately they will do whatever it takes to make sure you and your baby are safe.

mrsorigami · July 2017

MJDsquared said:

@alysapuggles You just made me feel so much better. I didn't know having a birth plan was such a thing (I mean I'd heard of it, but I thought most people didn't, then these boards made me think otherwise). I didn't really plan on having one but after hearing all the talk about it I thought I had to or something. That's a relief!

The hospital I'll deliver at is attached to the building my OB's office is in. I'm due at the end of December so I'm pretty far behind, but I'm guessing we'll try to make it so we can tour the hospital after/before on of my OB appointments if possible. I should probably start figuring that out!

it's not far behind to go tour the hospital now. if your hospital is like mine, hopefully they have a list of all of their birthing/parenting classes and the hospital tours, with dates and times listed so you can register if needed or instructions if you just need to show up. or you can always just call them and see how they do the maternity ward/birthing center tours. you have plenty of time to go check out the hospital but i would try to get that crossed off the list soon just so you don't have it in the back of your mind.

rainbowdashh · July 2017

My birth plan is get the baby out.

I've never had one and never felt one was necessary. No one pushed anything on me that I didn't want and anything they wanted to do was thoroughly explained and my consent was given.

birth is unpredictable and for me personally, having a plan and then that plan not working out would have been really upsetting.

Tennis11785 · July 2017

I haven't thought about my birth plan, but I plan on doing some research and creating one. Although mine will be more of a one-pager of how I'd like things to go under ideal conditions and some intentions. I'm not as opposed to a c-section as others (I wouldn't schedule one, but I'm ok if it happens), so it might have some "if it comes to this intervention or going for a c-section, let's just go to the c-section". But I want to be realistic that plans can go out the window in a heartbeat, because the ultimate goal is to get the baby out in a way that is safest for baby and momma. As long as that happens, it's a successful delivery.

alysapuggles · July 2017

@MJDsquared Yeah, no need to worry about it. If there are specific things you have a concern about, definitely discuss with your doctor ahead of time. That might help put you at ease as well. Plus, I found at my hospital, when I checked in, they went over a lot of stuff with me at that point anyway (pain management, breastfeeding vs bottle, etc.) to find out what my preferences were.

I forgot to answer the hospital tour part. They have tours on certain Saturdays every month, so I planned on doing one of those maybe in October since this will be a different facility than I had DS in.

missphil · July 2017

Yes I think it's important to have one. The nurses took it right away. You have to pick your battles. I had one side for natural birth with things like "I prefer not to be in supine position when pushing" and no eye ointment, no hep B shot. The Csection side had things like "double sutures to help with a vbac next time" and "skin to skin with dad if not possible with mom right away"
i think it's important to educate yourself and not let every single decision be made by the staff if not medically necessary.

ridedatide · July 2017

I feel like I'm in a completely different position. I've always wanted a natural tub birth. I found out with my first before I miscarried that my insurance will not cover a midwife or a birthing center. Nor will the hospital work with them. So I feel like I've already had to change my mindset. Now I feel like I have to adapt my mind around having a birth in a hospital that in my opinion does not feel "natural birth" friendly. (It's the only one in the area.) So it's not like I have other options.
Luckily my SO is on board with what I want. He is also a nurse at the hospital (different location). So I've been able to listen to and discuss different things with him. I know with birth a lot of things can happen and you might have to adjust thinking and actions and yes I want myself and baby to be ok.
I feel that birth can also be a wonderful experience and feel a lot of times doctor's and hospitals will rush this process along leading to more problems.
I've starting working on a birth plan and my doctor knows that we came from wanting a tub birth and having to settle for a hospital setting.
(Don't worry most people in my family thought I was crazy when I told them my wishes years before I was even pregnant.)

failuretofly · July 2017

I think the benefit of a birth plan isn't so much around 'this is how things MUST go' it's more about a structured way to go through ALL of the potential options/interventions and deciding ahead of time your *preferences* not demands.

For example, I've started keeping a mental list of things I will ensure are on my birth plan:
-ABSOLUTELY no homeopathics (this was pushed on DS and I with my first birth, and I regret it because I don't believe they have any benefit and have risk of harm)
-If forceps are ever on the table as an option, I want a c-section.
-no episiotomy unless it is a medical emergency - even then I'd prefer to risk tearing
-delayed cord clamping until it has stopped pulsating - initial medical interventions for baby can be done on my chest if needed.
-keeping the placenta for encapsulation
-expectant 3rd stage
-no induction until 41+3, try 'natural' stuff earlier, and avoid pitocin if possible.
-I want to eat and drink throughout labour and even into pushing.
-I WILL NOT hold my breath and bear down to push, I will allow my body to push naturally (unless medical emergency)

and preferences:
at home, in my tub, with only DH and the midwife team present. Maybe a doula if I decide on one. Maybe DS if the circumstances allow, but he will guide us as to how he is with it. There is a chance the ILs will be staying with us at the time, so they will not be allowed in once I'm in the tub, or for at least 60 minutes after the baby is born.

The benefit of having a midwife over an OB is they WANT a birth plan. Their goal is to give you your perfect birth, within reason, if they can. So even though I had no intention of having one with DS, my midwife made me do one and I am glad she did.

kyrwyn · July 2017

I have not created a birth plan, but DH and I have talked about a few key issues in preparation for discussing them with my OB. We'd like to delay cord clamping, even if just 30s is all we can manage due to c-section or other complications. I would like to hold the baby immediately after birth, and if I cannot then DH would like to. We would like to delay any measurements that cannot be made while the baby is held until 1 hr after birth, where reasonable, and first bath until several hours after (if not on a later day).

All of these are post-birth. The process of getting him from the inside to the outside we feel much more play-it-by-ear about. I'd prefer not to have an episiotomy. I'm fine with a c-section, if it's medically necessary. I know my pain tolerance: I will probably want drugs, but I'll ask for them when I'm ready. Keep all visitors but DH out (preferably out of the building).

There will also be a very necessary note that DH faints when he sees needles, or lots of blood, so maybe they should just keep him pointed away from the downstairs action and not ask if he wants to see anything medically cool but practically messy.

MJDsquared · July 2017

As I'm reading this, some of these things I know for sure that I want. And if I have to write them down to make sure they happen, I'm all for it! (i.e. Only DH/staff in the room, no episiotomy unless absolutely necessary, DH gets skin to skin if I can't, etc.) Otherwise, I'm pretty sure I want an epidural, but I'll just ask for that at the time.

ab920 · July 2017

For our first, we made a one-page document with our birth plan, printed out like 10 copies, laminated one and hung it next to our room entrance, and attached the rest to baskets of goodies (fruit, granola bars, snack packs, etc) for the nurses/staff. We realized we seemed a bit...much....so we ordered donuts in the morning and pizzas at night for them. The nurses loved it.

We're going to do the same thing this time.

Also, I reviewed the entire thing with my OB prior and he "signed off" on it. The only suggestion he made was to include, when you were planning to do it unmedicated, if you wanted to be offered medication.

Edited to Include birth plan:

XXX and XXX’s Birth Plan
Room _______

Mom’s name: XXX                                                                                            Dad’s name: XXX
Due date: XXX
Doctor’s name: Dr. XXX                                                                                    Pediatrician’s name: XXX
My delivery is planned as UNMEDICATED VAGINAL (Bradley). Please do not offer pain medication.

I am: GBS positive, RH negative, O negative

During labor, I’d like:

-               GBS Antibiotics via forearm Hep Lock          -               Lights dimmed, room quiet
-               XXX present the entire time                              -               Eat and drink as approved
-               Intermittent, mobile fetal monitoring              -               Avoid intervention unless emergency
-               No visitors without parental consent

During delivery, I’d like to:

                -               Be in any position I find most comfortable   -               Push as my body indicates
                -               Use a mirror to see the baby crown                  -               Avoid intervention unless emergency
                -               Avoid episiotomy unless last resort (if episiotomy, follow with local anesthesia for repair)

Immediately after delivery, I’d like:

- XXX to cut the cord after delayed clamping
- Immediate skin-to-skin contact with baby

If Pitocin becomes necessary, I’d like

- Minimum dosage to start - Gradual increase in minimum increments
- Cessation of Pitocin once body activates sufficient contractions

If a cesarean becomes necessary, I’d like:

- XXX to be present the entire time - Stay conscious during surgery
- Skin-to-skin contact as soon as possible - Repair with subsequent VBAC in mind

Newborn Procedures

-               Initiate breastfeeding on demand as soon as possible
-               Baby’s medical exam, medication (including eye ointment), and bath given only after bonding
-               No separation from baby unless medically necessary
-               Baby to be exclusively breastfeed; no artificial nipples or formula without parental consent
-               Visitors may visit after one hour of bonding between baby and parents

Thank you for helping us welcome our baby girl into this world!

Enjoy the treats!

casace · July 2017

I am a STM. One piece of advice that I got is even though you want to have the baby naturally (vaginally) have it in at least the back of your mind that there is a possibility of a c-section. The friend who gave me the advice was traumatized because she wasn't prepared for one. Luckily she gave me this little piece of advice so I was okay (not happy, but okay) with going ahead with the c-section. This is just a small piece of advice for those with strict birth plans, you never know how it will turn out and you at least want to be partially mentally prepared when it doesn't go your way.

lavashiner · July 2017

Ours was one page. I'll likely do the same one this time. Like @ilikestars089 and @kvacmak this was mostly for me and helped me navigate labor preparations and preferences in an organized way. I found the nurses respected it but the midwife read the first half and couldn't be bothered with the rest. ha! I should add that at my hospital you don't know who will deliver your baby until it comes time to push...

Two things: the cord was cut right away, alas. I think my husband just forgot and it wasn't a priority for him, so they gave hime the clamp and he was so excited and just did it! No big deal. Everything else went according to the plan.

@ridedatide you may want to investigate having a doula there. My doula really helped make sure my needs were met and she talked us through stuff. For instance, I was open to any intervention if medically necessary, but the doula would explain what we needed either in private if time allowed or just give her opinion if time didn't allow. I did actually hemorrhage after labor and needed drugs. The midwife asked if she could administer them and I was so set on a natural birth that I looked to my doula a little crestfallen and she just said, "baby's born, now you need those drugs!" I wasn't in a state of mind to fully comprehend what I needed. haha.

I didn't include stuff that my hospital already does as standard protocol: immediate skin to skin, etc. Also, the hospital has a formal birth plan that I submitted separately and that included stuff like, please do a c-section if/when needed.

@kvacmak I also wanted to eat during labor, but at my hospital they don't allow it since you may need surgery (c-section). I smuggled some snacks in, but didn't really want to eat. I had sips of water and smoothies occasionally. Afterwards my sister brought me Mexican food, I think. I was ravenous!

I also agree with @casace to be prepared and open to anything! The last thing you want is to feel disappointed or let down after this miraculous event. The miracle is the same whether it is without medical intervention, or with all the pain meds in the world! It is no small feat bringing a baby into the world, and really the goal is a healthy baby and mom. I think the birth plan allowed me to feel empowered to know that I would try my best to do a natural birth even if it might culminate in intervention or surgery.

I attached the birth plan in case anyone is interested.

disneyfan0511 · July 2017

I had a very simple birth plan with DD1 - nothing went according to plan although my OB tried his absolute best to make my requests happen. I ended up with a c-section after 24 hours of labor - which was hard for me to mentally accept. Things happen, so just be aware that sometimes things don't go as planned. But I think if there are things you want to try for, you should write them down and let your OB, MW, nurses know - it's a great step to feel prepared.

I had a RCS with DD2 and my only request was skin to skin right away and nurse ASAP and both requests were met by my OB without hesitation. It was a really great birth experience, even if it was major surgery.

This time, I am asking for the same as before and hoping all goes as smoothly as DD2.

splsmama2016 · July 2017

All that was on my birth plan for DD was to delay pain meds until requested, and to delay pitocin until necessary; be mobile during labor; only DH was allowed during actual delivery, followed by my sister/photographer for those first moment photos; delayed cord clamping/cutting.

However!! We know that childbirth doesn't follow any plan, so when I went to L&D triage and learned my water had broken (and I didn't know), I was admitted and put on pitocin almost immediately to speed up delivery, which then had me requesting an epidural shortly after. I don't think the new nurse read my chart where I wanted to delay cord clamping until it stopped pulsating, but I can't change it now.

I dont think ill do another birth plan, but if I do, it won't be any different.

Marley629 · July 2017

STM here. I didn't have much of a birth plan with DS and honestly given what ultimately happened it wouldn't have mattered anyway. With this one, I don't get the opportunity to have a birth plan because it will be a repeat c-section. I will ask for immediate skin to skin if it's possible though. I didn't get that opportunity with DS and I was really sad for how my birth went with him for a long time after. That being said, I'm really interested in the various birth plans discussed here. I find it fascinating!

cait5413 · July 2017

I filled one out mostly to get preferences clear in my mind, but I don't think I even gave it to anyone--just kept it for my reference. Things did not go as I expected, really (failed induction followed by c-section) but it was ok. I'll have a repeat c'section this time so I probably won't write one up.

Piccola1988 · July 2017

My birth plan is to get my kid out safely, whatever that means. I'm a type A planner so that's a tough stance for me to take, but I'd rather not fixate on the details.

My mom is an L&D nurse and she jokes that when patients come in with an extensive birth plan they just go right ahead and prep the section room because by Murphy's Law there's a damn good chance they'll need it!

jlemons-2 · July 2017

I didn't have a birth plan with the first and won't this time either. I have a few requests that I will just talk about at the time. For instance, I won't be allowing anyone to break my water this time unless I am far along the process and I will have delayed cord clamping, no bathing for a day, and skin to skin for as long as I freaking want.

Kirss · July 2017

I'm having a RCS, I just want to be able to hold him right away this time, and I'm leaving everything else up to the professionals. In my other BM Group, a lady posted a picture of her 26 page birth plan. Twenty Six Pages.

elev2017 · July 2017

I'm planning to request a C-section since I'm having twins and there's a high likelihood I'll need one for one or both. I'd rather have it planned than need an emergency one and have to be knocked out during the birth. I do plan to ask for collection of the cord blood (since we plan to bank it) and immediate skin-to-skin/bonding.

blueskies17 · July 2017

I'm a FTM and still working through what I want. Ideally I'd like to go as natural as possible, but it seems like the odds may go against me in hospital setting. We don't live in an ideal world, so I am going into it with an open mind. Our hospital provides a birth plan template which covers a majority of my preferences, so I'll probably use that. I plan to get a doula if I can find one that we like, so my plan to use the template may change, depending on her advice.

ETA I haven't visited the hospital yet, but will be will be attending their information session for expectant parents soon.

bbylifelove · July 2017

Being informed and open minded is how me and DH are looking at it. I won't be creating a formal document for my birth plan, but I'll be taking a private prenatal class so that I understand what all of the options are - so I can be better prepared and educated about what's going on. Overall, I'd prefer vaginal birth, but will be asking for epidural right away regardless. I've gone through so many painful issues (and surgery) for endometriosis/fertility, that I'm not putting myself through more pain if I don't need to! Many of my family and friends have had c-sections, so I know that's a big possibility. We ultimately want what's best and safest for baby, whatever that ends up being.

TigerCakes · July 2017

@Kirss That's my exact birth plan too. I didn't get to hold my DS for 4 days after he was born so I really want to hold this baby ASAP! Is anyone else who is having a RCS worried at all? I'm terrified even though everything with the surgery itself was fine the first time. The experience overall was so scary, but most of the fear went with not knowing what was wrong with my son and not knowing if he was going to make it. Everyone I know who had a RCS has said the second was so much easier, but I just don't know how to shake this fear!

Kirss · July 2017

@TigerCakes 4 Days, that had to be the longest 4 days ever

. My first go around wasn't bad, I just describe it as the crazy scene in ET, just so bright and sterile, and holding still while they did the spinal was the worst.
A friend of mine had a vaginal delivery the first time, and for her second opted for CS, said if she has a 3rd she'd go RCS all the way! That made me choice on trying for a VBAC or RCS so easy.

skc040512 · July 2017

My suggestion would be to wait until you have toured the hospital (if you're planning to) before making a birth plan. The hospital I delivered at has one of the lowest C Section rates in the country, encourages kangaroo care immediately after birth, and will provide anlactation consultant within 6 hours of delivery for any woman who indicates she is planning to try breastfeeding. Literally the only thing I had to tell my nurses was that no one besides DH was allowed in during deliver and DH would cut the cord after delayed cord clamping (Which was also encouraged and standard at the hospital). If the hospital you are delivering at is pushing to become "breast friendly" or a hospital with more natural options, the majority of the things that you need on a birth plan will be a part of your intake forms.

Also, all my prenatal nurse friends say they hate patients with detailed birth plans because you're just asking to be dissatisfied with your delivery.

TigerCakes · July 2017

@kirss yes it was the longest 4 days ever. I know everyone says a RCS is not that bad, I'm just not sure how to get over this fear. I have the option to try for a VBAC, but that scares me too! I think given what happened with my son I'm going to be scared until I'm holding a baby in my arms and that's just the way it is.

disneyfan0511 · July 2017

@TigerCakes I will be having my third c/s and I would be lying if I said I wasn't nervous. My second c/s was much easier than my first, but I know that isn't always the case. I think it's normal to be nervous about childbirth in general. I wasn't a good vbac candidate but even if I was I would have still picked a RCS. My first birth was very traumatic and I knew I was going for a RCS because I had PTSD from it. My daughter was in the NICU for 15 days and was full term so I can relate to your fears. In the end, you will know what you are most comfortable with and that is the best decision for you!

Edited bc bc replied to wrong person - darn pregnancy brain!

clovelyone · July 2017

@bbylifelove I also have endometriosis and I will surely have an epidural. I can't imagine having adhesions and contractions being fun. Id like to talk to my doctor in more detail about C Sections. I'm having twins and I'd hate to deliver one vaginally and need an emergency C Section for the other. That sounds like a nightmare. That private class sounds great. I would like to know all of the possibilities beforehand.

I probably will not make a birth plan, but I want an epidural, I do not want an episiotomy unless a medical emergency, delayed cord clamping, no bath the first day and immediate skin to skin for DH and I.

sjis · July 2017

Question for stm: was your milk coming in delayed post birth after extended use of the epidural? Mine was a week late coming in and gave me so much anxiety. I found out only later that it was due to using the epidural too early on.

TigerCakes · July 2017

@disneyfan0511 Thank you for your reply. My son's birth way also very traumatic and he ended up in the NICU for 2 weeks as well. It's been almost 2 years now and I still think about it on a daily basis. My doctor said I'm a good candidate for a VBAC. The idea of waiting to see if I go into labor and worrying that the same thing is going to happen to this baby that happened to my son doesn't sound appealing either. They also told me this week that I'm at risk for placenta acreta because of where my placenta is in relation to my scar from my firstborn CS. Sorry for the rambling, but At least I'm not alone in my fears!

thatlauragirl · July 2017

@sjis, I had an epidural in for about 12 hrs before we had to do an emergency c-section and didn't have delay issues. I'm not sure if that would be considered extended, though?

We're having an RCS so I don't need a birth plan per se, but I am going to discuss in advance some requests I do have. My first birth was pretty traumatic and I had a hard time dealing with it but I was listening to a podcast about "natural c-sections" recently and I do think there are some reasonable things I can request for a better experience.

disneyfan0511 · July 2017

@TigerCakes sounds like we have very similar experiences. I hope that this baby comes easily and it helps you forget the trauma of your first delivery - that helped me tremendously! I remember having DD2 in our room and crying tears of joy that she was healthy and able to room in. While I can't help with VBAC questions, I'm happy to answer any RCS you have.

darkfyre · July 2017

@sjis do you mean your milk took a week to come in? If so that isn't really a week late. Milk typically takes 2-5 days to come in. And 7 days is not unheard of. I know having an epi can delay it But I'm not sure if the epi's duration is a factor.

TigerCakes · July 2017

@disneyfan0511 Thank you for your support! Can I ask how long after your RCS were you able to lift your older daughter? My DS is very attached to me and I'm worried about not being able to pick him up. Literally, the only reason I have even considered trying for a VBAC is because I think that it would be easier on him.

disneyfan0511 · July 2017

@TigerCakes It took me about a month, and it was hard. We moved DD1 to a toddler bed though, she had just turned 2, and that made it easier. I would make time to cuddle with her when DD2 was sleeping, play crafts, and make time for just her and I. It was hard because her life had completely changed and I was recovering from surgery, but the cuddles made up for it and eventually it was a thing of the past!

cait5413 · July 2017

Thanks for the info, @disneyfan0511! The thing about RCS I am most concerned with is my DD who will be 16.5 months. it is going to kill me not to pick her up.

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