UO Thursday

jessilee15 · August 2017

after 4.5 years on the bump...I still don't know how to make a GIF

Aeml1985 · August 2017

Birth plans; the only plan that is worth making imo is a healthy baby and mom. It's good to be informed about your options, but at the end of the day you will never know better than your care provider (you know, med school and all that) and if you don't trust that they have you and babies best interest at heart time to find a new one.

the_other_mother · August 2017

Aeml1985 said:

Birth plans; the only plan that is worth making imo is a healthy baby and mom. It's good to be informed about your options, but at the end of the day you will never know better than your care provider (you know, med school and all that) and if you don't trust that they have you and babies best interest at heart time to find a new one.

I think this seems like a pretty popular opinion here. I have to disagree though. I can't stand when someone asks about making a birth plan and they get 50 responses that say, don't bother. I think it's important for people to know that you do have choices and that you should be in control of how you want things for yourself and your baby. Ultimately the most important thing is to bring your baby into the world in the safest way for baby and mom. Sometimes there is a medical necessity to deviate from your plans, but that doesn't mean that you have to let your birth be something that happens TO you. It's important to be informed and know what you have choices about and what you need to leave up to the medical professionals. I had a birth plan, and did everything go exactly as planned? No, but it was important to me for my providers to know how I was going to do things with MY child. It's much easier to have everyone attending know the information beforehand than to argue or try to buck the system immediately after pushing a baby out/being cut open and sewn back up.

rainafire77 · August 2017

Aeml1985 said:

Birth plans; the only plan that is worth making imo is a healthy baby and mom. It's good to be informed about your options, but at the end of the day you will never know better than your care provider (you know, med school and all that) and if you don't trust that they have you and babies best interest at heart time to find a new one.

Thank you! My doctor, while willing to allow me to have a VBAC, is not comfortable with it. For one, I'm over an hour and a half away from him and the hospital. Two, he said I have a lot of scar tissue from my first c-section 15 years ago & he's genuinely concerned for complications if I go into labor. He did say if I wanted a VBAC that he would recommend that we stay in the city where the hospital is from 36 weeks on to be safe. Can't financially do that. So he, myself and my husband all agreed to a planned c-section. Now does this mean we won't be able to change our plan if, say, I go into preterm labor? Of course not. But we have that birth plan in place because we want the safest plan in place for me and the baby.

TattoosandLace · August 2017

I love seeing everyone's back to school photos.

TattoosandLace · August 2017

Aeml1985 said:

Birth plans; the only plan that is worth making imo is a healthy baby and mom. It's good to be informed about your options, but at the end of the day you will never know better than your care provider (you know, med school and all that) and if you don't trust that they have you and babies best interest at heart time to find a new one.

I disagree. Thinking about what you're okay with in the labor and delivery process can be extremely helpful to FTMs.

winnie1122 · August 2017

Birth plans are great for the sake of being prepared and doing research, but also can be a problem if you can't handle deviation from it. I think in most cases yes, the care providers should and do have your best interests and well being in mind, but there are also so many horror stories of births that ended up being traumatic to a new mom because everything went totally against her wishes and out of her control because of a care provider who was in a rush or just for whatever reason didn't care what she wanted or needed. Especially if you have unusual medical needs it's important to have that made VERY clear to all involved in your birth because the staff changes a lot through that time period (I had four different nurses since I was in labor over 30 hours, and two different doctors) and they have lots of patients. They don't know anything about you other than your chart which isn't always very comprehensive and easily breezed through. I was fine not having a birth plan per se, but I know some people who really did benefit from having something written up. My best friend had her severe allergies typed up on red paper, the people who should be talked to before any treatment was changed, etc and posted it by her head during labor. She said the nurses appreciated it because it was something that made a huge difference in her care and they hadn't encountered her specific issues before. So agree and disagree on the usefulness of a birth plan. It has its place, but I agree that sometimes it can cause more problems for new moms rather than help.

eggplantface · August 2017

Aeml1985 said:

Birth plans; the only plan that is worth making imo is a healthy baby and mom. It's good to be informed about your options, but at the end of the day you will never know better than your care provider (you know, med school and all that) and if you don't trust that they have you and babies best interest at heart time to find a new one.

But birth plans are fairly far-reaching, from the big details that I think you're referring to here (VBAC vs. RCS, e.g.) to small (cut the cord right away or wait a minute, e.g.). So I agree with this when when it comes to the big details that could mean the difference between life or death, but when it comes to the small stuff, I'll make those choices myself. Overall when it comes to birth plans, it seems the best idea is to have one so your providers know what you want in an ideal scenario, but be flexible because you never know what could happen.

SunflowerMama428 · August 2017

...

eta: I don't know why this posted

ash0625 · August 2017

TattoosandLace said:

I love seeing everyone's back to school photos.

Yes!

Image: https://media.giphy.com/media/3o85xspHMaZxVGbzY4/200.gif

lainikins · August 2017

I have mixed feeling on birth plans. I did not really have one with my first. The hospital just asked me as we went along. I am a very rigid person, so if I made a plan and things did not go according to plan, I would have a ton of anxiety. Instead my plan was to go with the flow and make choices as I went along. If you are not going to stressed or worried if things do not go to plan, then letting the hospital staff know your preferences before hand might lead to less questions along the way. I liked being asked as I went along. It made me feel more involved, more in control of what was happening, and I did not have to worry about correcting people if they forgot something on my list.

I also feel that the people who are planners and like thing to go to plan (myself) are the people that tend to write birth plans. These are the people that get disappointed, anxious, not really sure the best word to use here, if things do not go to plan. That is why my plan was to go with the flow. It was not because I am laid back. I can assure you I am not.

I completely understand the need if you have medical limitations or allergies. Those can't be deviated from safely in many cases.

SarahFoley725 · August 2017

I absolutely hate those mini shopping cart at the grocery store. I feel like so many people use them as an excuse to not have to deal with their kids and they ruin it for all the well behaved children. There's nothing cute about being rammed by a three-year-old or watching them knock shit off the shelves.

meatballs37 · August 2017

My OB gave us a small two page questionnaire for a birth plan that I found SUPER helpful. It wasn't anything overly detailed, but it talked about delayed cord clamping and the vitamin k shot for baby. I think with anything in life there is a happy medium. It's important to be informed about what decisions ARE up to you ultimately.

And as a medical professional myself, I have seen plenty of doctors make the wrong or uninformed decision. So I am definitely team know your rights and options.

meatballs37 · August 2017

I also wanted to add that while I trust my current OB. When I delivered DD, she was on vacation, so I had someone I had never met deliver my first baby. So it is still a good idea to know your options in every scenario.

eggplantface · August 2017

meatballs37 said:

My OB gave us a small two page questionnaire for a birth plan that I found SUPER helpful. It wasn't anything overly detailed, but it talked about delayed cord clamping and the vitamin k shot for baby. I think with anything in life there is a happy medium. It's important to be informed about what decisions ARE up to you ultimately.

Oooooo I hope my OB does this.

SarahFoley725 · August 2017

On the birth plan topic, I think it depends on what your goal is. If your goal is to try to control every single aspect you may very well end up disappointed. If your goal is "don't give me and epidural even if I ask for it" that's different. I think it's good for your partner to have a hard copy of your wishes so they don't get overwhelmed in the moment. With DD I had a scheduled c section so there wasn't a ton for me to plan for. If I go VBAC this time there will be some things I want the doctor/DH to know in case things get crazy.

rainafire77 · August 2017

@SarahFoley725 I think that's exactly what these plans are for. A baseline for what you do and do not want (epidural, delayed cord clamping, music, etc) However I've read about so many women, especially with their first, who basically minute by minute schedule out how they want the birth to go and freak out if there is the slightest deviation. That's where I think birth plans go haywire.

TattoosandLace · August 2017

SarahFoley725 said:

I absolutely hate those mini shopping cart at the grocery store. I feel like so many people use them as an excuse to not have to deal with their kids and they ruin it for all the well behaved children. There's nothing cute about being rammed by a three-year-old or watching them knock shit off the shelves.

I fucking hate those mini shopping carts because my daughter acts like she HAS to use one and it makes shopping 638:92646389x longer because I'm constantly making sure she isn't that asshole kid that's bumping into everyone.

TattoosandLace · August 2017

Re: birth plans

With DD2, upon checking into the hospital the nurse that was doing the admitting asked me a series of questions that essentially gave a bullet point birth plan. That made me feel good that all our wishes were out in the open and "in" my chart.

jessilee15 · August 2017

I'm with the people who largely thinks birth plans are silly. If I were going to have an appendectomy, I wouldn't put preferences on how they did it either. But I can see that having a checklist for little things (like epidural) could be handy so you don't get asked 40 times what you want

the_other_mother · August 2017

jessilee15 said:

I'm with the people who largely thinks birth plans are silly. If I were going to have an appendectomy, I wouldn't put preferences on how they did it either. But I can see that having a checklist for little things (like epidural) could be handy so you don't get asked 40 times what you want

I think that the fact that people look at childbirth the same way as a medical emergency is part of the problem. Giving birth is not an illness.

hudson202 · August 2017

^yes, but a lot of things can go wrong.

SarahFoley725 · August 2017

rainafire77 said:

@SarahFoley725 I think that's exactly what these plans are for. A baseline for what you do and do not want (epidural, delayed cord clamping, music, etc) However I've read about so many women, especially with their first, who basically minute by minute schedule out how they want the birth to go and freak out if there is the slightest deviation. That's where I think birth plans go haywire.

People here can be crazy. That's why I said it depends on your goals. It always makes me think of Elizabeth Banks on What to Expect When You're Expecting. "I want to push, I have a birth plan, I typed it"

mamajenna_cnm · August 2017

Aeml1985 said:

Birth plans; the only plan that is worth making imo is a healthy baby and mom. It's good to be informed about your options, but at the end of the day you will never know better than your care provider (you know, med school and all that) and if you don't trust that they have you and babies best interest at heart time to find a new one.

I just can't with this. Seriously. Just a little FYI....the US has the higheest morbidity abd mortality rates among mothers and newborns BC of the convenient over use of interventions during labor and birth. I'm sorry to break it to you ladies, but many obgyns want to get home in time for dinner every night. Your labor and birth experience is NOT their concern. The problem in this country is that pregnancy, labor, and birth is treated like an illness instead of a normal physiological process. If you're ok with taking the back road and letting someone make medical decisions for you, then good for you. But do not criticize those women who have chosen to be active in one of the most intimate moments of their lives by being informed, prepared, and demanding options. Know your options, know your rights, educate yourselves. Your birth experience can be so much more if you want it to be. Improvingbirth.org, evidencebasedbirth.com, and birthtools.org are great resources with evidence based statistics and information on pregnancy labor and birth

mamajenna_cnm · August 2017

@jessilee15 no....labor and birth cannot be even remotely related to an appendectomy. Sorry.

soulcupcake · August 2017

Birth plans aren't novel or new things. They exist for a reason, and for many, with the best intentions and goal for an uncomplicated labor. Sometimes, a lot of times, that includes far less interventions than what is considered routine practice. That could mean opting for a hep or saline lock instead of an IV. If quick access to a vein is needed, the latter two are fine alternatives. There is no evidence to suggest that laboring women *need* IV fluids. And there's plenty of evidence (via cochrane database) that doesn't suggest restricting fluids and food during labor. There's also plenty of evidence to support IFM vs. CFM. There's evidence that shows AROM increases the risks of infection, and the same for repeat VEs, especially after ROM. Not only does AROM increase the risk of infection, it can also lead to stalled labor like "failure to progress" and arrest of descent due to fetal malpositioning. It's much easier for the babies to move into ideal/preferred positions (LOA and OA) when membranes are intact because the aquatic environment better facilitates movement. Intact membranes also cushion the cervix and can lessen the pain of contractions. Ambulation helps with fetal descent and progression of labor. Trying out different positions during the second stage can reduce pushing time. Gravity helps. Just common sense stuff.

Opting out of certain interventions is supported by evidence-based medicine and practice. Most people who advocate for choice/options aren't blind to reality that sometimes interventions are warranted and necessary. If I'm planning an OOHB and we notice a high temp and tachycardia, that's something to be concerned about and address quickly by transferring to the hospital. My homebirth midwife with #4 had a client just barely in active labor that presented with nonreassuring heart tones. She observed the pattern of decels over a short period of time before deciding to call L&D and explain the situation and possible emergency c-section. Her client was transported, monitored in triage and taken in for an ECS. The caregivers suspected a cord compression.

I planned three homebirths because its core philosophy is low intervention, a model of care that I trust for low-risk pregnancy. I also had complete trust in my caregivers. They were phenomenal. For the first time, I'm no longer low-risk, and I accept that. I understand my situation with this pregnancy increases my risks of complications and for those reasons, it is best that I birth in a hospital. My planning a hospital birth doesn't change my overall birth plans. I'll still request a heplock, no AROM, IFM, limited VEs, ambulation, low dose of pitocin to jump start labor and discontinue once in an active labor pattern, trying different positions in the second stage if I'm up to it, delayed cord clamping, etc. All of that is assuming I even make it to the hospital or "labor" much to begin with. If I throw a clot, I'm not going to be like "Nah. Don't give me blood thinners." or if my BP skyrockets even more, and I'm spilling protein, I know I'll need mag sulfate. I'm not dense. I understand when a situation can turn serious (BTDT) and the necessary response.

meatballs37 · August 2017

I find it discouraging to those of you who are writing off birth plans as silly up front. That's really misleading to those who are FTM's. I understand that expectations need to be in check for what you deem as your ideal plan. Because every birth and situation is different.

But as far as important decisions regarding your body/baby, I still think you should ask your OB/midwife on what their general practice for birth is. I already pointed out delayed cord clamping. But what about episiotomies? Or the use of forceps? My midwife discussed all of these with me and most importantly "why" she does or does not practice certain things. The birth plan questionnaire she gave me was a great conversational piece to go over at my appointment. It also gave me a better understanding of what to expect.

SarahFoley725 · August 2017

meatballs37 said:

But as far as important decisions regarding your body/baby, I still think you should ask your OB/midwife on what their general practice for birth is. I already pointed out delayed cord clamping. But what about episiotomies? Or the use of forceps? My midwife discussed all of these with me and most importantly "why" she does or does not practice certain things. The birth plan questionnaire she gave me was a great conversational piece to go over at my appointment. It also gave me a better understanding of what to expect.

I love my OB practice for this. It stresses me out to think about any mom (espeically FTMs) going into something like blind! We don't have a little questionnaire like yours does, but they ask me questions about everything.

mamajenna_cnm · August 2017

soulcupcake said:

Birth plans aren't novel or new things. They exist for a reason, and for many, with the best intentions and goal for an uncomplicated labor. Sometimes, a lot of times, that includes far less interventions than what is considered routine practice. That could mean opting for a hep or saline lock instead of an IV. If quick access to a vein is needed, the latter two are fine alternatives. There is no evidence to suggest that laboring women *need* IV fluids. And there's plenty of evidence (via cochrane database) that doesn't suggest restricting fluids and food during labor. There's also plenty of evidence to support IFM vs. CFM. There's evidence that shows AROM increases the risks of infection, and the same for repeat VEs, especially after ROM. Not only does AROM increase the risk of infection, it can also lead to stalled labor like "failure to progress" and arrest of descent due to fetal malpositioning. It's much easier for the babies to move into ideal/preferred positions (LOA and OA) when membranes are intact because the aquatic environment better facilitates movement. Intact membranes also cushion the cervix and can lessen the pain of contractions. Ambulation helps with fetal descent and progression of labor. Trying out different positions during the second stage can reduce pushing time. Gravity helps. Just common sense stuff.

Opting out of certain interventions is supported by evidence-based medicine and practice. Most people who advocate for choice/options aren't blind to reality that sometimes interventions are warranted and necessary. If I'm planning an OOHB and we notice a high temp and tachycardia, that's something to be concerned about and address quickly by transferring to the hospital. My homebirth midwife with #4 had a client just barely in active labor that presented with nonreassuring heart tones. She observed the pattern of decels over a short period of time before deciding to call L&D and explain the situation and possible emergency c-section. Her client was transported, monitored in triage and taken in for an ECS. The caregivers suspected a cord compression.

I planned three homebirths because its core philosophy is low intervention, a model of care that I trust for low-risk pregnancy. I also had complete trust in my caregivers. They were phenomenal. For the first time, I'm no longer low-risk, and I accept that. I understand my situation with this pregnancy increases my risks of complications and for those reasons, it is best that I birth in a hospital. My planning a hospital birth doesn't change my overall birth plans. I'll still request a heplock, no AROM, IFM, limited VEs, ambulation, low dose of pitocin to jump start labor and discontinue once in an active labor pattern, trying different positions in the second stage if I'm up to it, delayed cord clamping, etc. All of that is assuming I even make it to the hospital or "labor" much to begin with. If I throw a clot, I'm not going to be like "Nah. Don't give me blood thinners." or if my BP skyrockets even more, and I'm spilling protein, I know I'll need mag sulfate. I'm not dense. I understand when a situation can turn serious (BTDT) and the necessary response.

Yaaaaaaaasssss!

meatballs37 · August 2017

mamajenna_cnm said:

@jessilee15 no....labor and birth cannot be even remotely related to an appendectomy. Sorry.

Right? When they tell me that they start taking out appendices without any drugs, then I might find them a little more comparable.

mbirdie · August 2017

I think my main takeaway with birth plans is to keep them simple and stick to what is truly important to you. I had a scheduled c-section and had a short half a page birth plan. I was already a little sad about the c-section and having a birth plan made me feel like a had some control. My plan however did not include medical choices that didn't feel educated enough to make (because I really know very little) or things that I felt were not important in the long run (like the temperature of the room). My plan did include things like "please don't tell me what is happening during the operation except when the baby is being pulled out" and "If possible I would like the baby to be placed on me for skin to skin and nursing right away". My OB was grateful to be able to provide me with a c-section that still gave me a wonderful and personal birth experience and I was so grateful.

SunflowerMama428 · August 2017

I just love that people are finally being opinionated one way or the other. Either way you look at this topic, FTMs have just gained a lot to now think about.

I was extremely low risk and had an extremely healthy pregnancy and then everything went to shit. They let me labor for 19 hours with only medication that would help me, i.e. My blood pressure sky rocketed and I needed medicine but it kept me in bed but I said I didn't want Pitocin so they left me alone. 19hrs later we decided that I should have a c section but if I wanted to continue in labor they would have let me.

Not all Obgyn's want to be home in time for dinner. That comment is a little extreme. I didn't even have a birth plan. I just researched everything and when it came time to make decisions I made them to what I thought was best with my doctor. The whole point is women need to be informed.

Also in countries like Brazil, women can have c sections as a choice which for some countries is what keeps the mortality rate low since these women are having less complications from not going into active labor. There are always two sides to statistics.

SarahFoley725 · August 2017

Not all Obgyn's want to be home in time for dinner. That comment is a little extreme.

Agree! And if your doctor has that as a priority, you need a new one! With DD, my doctor let me know ahead of time I needed to know a c-section was a possibility. I did get a second opinion and was told the same thing. My OB could tell I was nervous about it and she said "you know lots of people say we want you to have c sections to accommodate our schedule or because we make more money, but no good doctor WANTS you to have major surgery. Plus, it's extra paperwork." The last part made me giggle, but I did feel much more comfortable.

rainafire77 · August 2017

I'm not coming out anti all birth plans or anti being active in your medical choices. I'm saying having your labor planned out (as I have seen with some women) to the minute with no back up plan or allowance for something to go wrong and freaking out because their labor didn't follow the exact schedule (I was only supposed to push during the classical section of the playlist!...not even kidding, heard this from in a mom group I was in on Facebook) is a bit ridiculous.

However, things like "I don't want to labor on my back. I want to walk as long as possible. I want zero medical interventions unless it becomes medically necessary for myself or the baby" are important. You also have to be vocal with your doctor up front and the day of. If you can't then someone should be with you in the delivery room who you authorize to go to bat for you. Whether this is your spouse, partner, sister, doula, father, whoever. Have them make sure that your wishes are followed except in the case of a medical emergency. Because if your vitals are good and the baby's are good there is zero reason why they can't follow your requests. And saying "hospital policy" is a cop out. Hospital policy says you can't leave with your baby in anything other than an approved car seat but I seriously doubt it says "leave laboring woman on her back in stirrups for hours on end".

EDIT because autocorrect does not recognize doula.

SarahFoley725 · August 2017

@rainafire77 that's exactly my viewpoint too. I've heard and read some over the top things.

mrsgunsta · August 2017

My birth plan= labor, epi, baby, Chinese takeout. Worked the first time around...

SarahFoley725 · August 2017

I really hate cucumbers.

the_other_mother · August 2017

I hate avocados. Blech.

SarahFoley725 · August 2017

the_other_mother said:

I hate avocados. Blech.

*insert gif of me being appalled here*

BUT GUACAMOLE

SunflowerMama428 · August 2017

Sorry I had to

misspricklepants · August 2017

@the_other_mother Yep, can't stand avocado or guac! The texture, smell, taste- everything about it.

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