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April 2019 Moms
irshdancr5500
member
Birth Plan Thoughts
irshdancr5500
member
I know this probably seems early, but at my appointment Wednesday, my midwife wanted to know whether I wanted to give birth in the traditional hospital setting or the natural birth part of the hospital. With my first, I was in a normal hospital, but we didn't have any natural birth options where we lived at the time, or I probably would have done that. I did have an epidural with my first, which wouldn't be an option in the natural birth setting, but I didn't get it until my labor was augmented with pitocin, which I don't think would have happened in the natural birth center. I definitely want less interventions than occurred in my first birth, but I'm just not sure if I'm brave enough to plan on no epidural.
Anyone else starting to think about birth plans? Any moms that have delivered both with and without epidurals?
Anyone else starting to think about birth plans? Any moms that have delivered both with and without epidurals?
Re: Birth Plan Thoughts
I’m not comfortable in a clinical setting so hospitals are not my first choice. I also tolerate medications poorly (I always have side effects etc.) and I’m willing to do things that would make other people very uncomfortable; I have no shame.
But a good friend of mine wouldn’t feel safe at home or in a birth center and a hospital is right for her...
It’s highly individual. I recommend the book ‘Birthing from within’ for those who want to discover how they really feel and what will make them most comfortable. It’s important to be educated about possible interventions that can help and and be an important part of your birth experience, at the same time it is valuable to learn and master natural pain management techniques like breath awareness etc. For instance, you might plan an epidural but baby may come too fast for you to get one (natural pain management would be so important). Conversely you may plan an unmedicated birth and have a difficult positioned baby, painful back labor or a stalled labor and an epidural would give you the pain relief you need to rest, gather your strength and allow a stalled labor to continue or prevent suffering with back labor etc. Do the benefits out weigh the risks? What’s right for you?
I’ve only delivered without an epidural, because DD came 14 weeks early and fetal/uterine monitoring didn’t show contractions so they weren’t convinced I was in labor for most of it. I did get medicated when my placenta tore and they had to manually remove it...like dr’s wrist through my cervix to scrape it off the walls of my uterus with her fingers. I didn’t notice any difference between when they did that unmedicated and medicated so I basically assume all medicine is fairly ineffective.
my general birth plan is to know what my options are and know when I’ll choose certain interventions.
For me with my first, I took a birth "plan," in to my doctor at the time and he was a condescending jerk about it. I get that some women have very set ideas in their head and aren't willing to bend, but as it happened with my labor and delivery, I did everything the doctors suggested so we could have a healthy baby even when it was "against," my birth plan. So his reaction was rude and uncalled for and one of the reasons I'm going to a different hospital with this baby, but anyway.
My birth wishes for my first had been no pain medication, labor in multiple positions so I could be comfortable and delayed cord clamping. That changed when my blood pressure spiked and they hooked me up to the monitor and I was stuck on the bed. Long story short, I ended up with an epidural, episiotomy, forceps vaginal delivery, and he came out blue so they cut the cord immediately to put him on oxygen.
I'm going into this delivery with the hopes of not getting an epidural (which I believe contributed to the need for the episiotomy and forceps since I couldn't feel to push), but whatever happens, happens. The important thing is safety and the health of the baby and mother.
Research different styles of pain management techniques, read about c-sections and recovery on the chance it might happen, find a doctor or midwife you're comfortable with, and go with the flow. At the same time, don't be afraid to stand up for yourself either. I'm hiring a doula this time to help be an advocate, since the first go around I wasn't as educated about my options and, quite frankly, I was terrified and just did what everyone told me to do. There's nothing wrong with having birth wishes, just know that it may not go according to plan! Babies have a mind of their own, even from the womb
I'm aiming for a med free birth and a labor where I can move around as much as possible. I'm also hoping to use the tub, but the hospital only has one so I can't rely on that plan too heavily. Just aiming for what I feel would be my best birth but also ready to handle things that don't go ideally for me. My first was an induction and the pain was so severe that I was very grateful for access to meds.
I also can accept that I have no idea what's going to happen and what will be will be. A plan is great, but sometimes the universe has her own plans.
@saraleigh2 I'll definitely be looking out for that book!
Anyway, I’d ask the birthing center their transfer methods. Would it cost a $3000 ambulance ride if there was a need to transfer? How far are they from the nearest l&d department.
Having asthma and having had had an asthma attack while pushing that nobody noticed until after... I think I’ll stick with hospital personally. (We also live 35minutes from the hospital)
DD born: 3/31/19
I actually just wrote in the UO thread last week that I’m against birth plans - I do think “wishes” is a good way to think about it as you do want to have an idea of your preferences, but you’d be doing yourself a disservice going into the birth dead set on a plan. These babes have a mind of their own.
A friend of mine gave birth 6 weeks before me and she planned on an unmedicated birth with as few interventions as possible. I, on the other hand, just wanted an epidural and a hospital birth, and otherwise was prepared with the same plan as @sheknows6 - whatever gets me home with a healthy baby. Needless to say, my friend got an epidural at 4cm and had to have her baby vacuumed out, while I didn’t even have time to get my epidural. It seems to work out that way pretty damn often. FWIW, I want the drugs this time!
The birth "plan" or birth "wishes" will likely be the first time you eat crow as a mother. Right now, it's easy to say "I don't want an epidural but you know what? Birth freaking hurts. Yes, I got an epidural. But not until I had been laboring for over 24 hours and then had two hours of one minute contractions, one minute break. And guess what? The epidural finally helped me relax and got me from 1cm to 8cm in 2 hours.
I say all this to go in with what you WANT but have an open mind to what you might NEED.
DS1 is 7. DD is 1. DS2 is coming in late April.
prevously helloblueeyes
Me:32 DH:33 Married:04/2012 DD:07/2014
BFP 8/14/2018 #2 due 4/18/2019
it was not ideal and this time we are going right for a csection bc doc things we have a good chance of the same thing happening.
For me personally, I would always go the hospital route because I feel to many things can happen unexpectedly.
BFP: 8/11/18 Due: 4/26/18
My only plan/requests have ever been to refuse any preemptive IV (they let me do this all three times, but I had to be really assertive). This time they already told me no way (I didn’t even raise it, the midwife did) because with all three babies I hemmorrahged Post-birth (not uncommon with lightening fast labors—the uterus kinda goes into shock and misses the memo to start contracting). So this time I will be getting an IV port once labor begins. I also pushed to have tub/shower access which was never a problem. My only other “demand” is that I refuse to rate my pain on a pain scale. It is arbitrary and I’m not asking for drugs, so it doesn’t matter. With the first baby I said I was at a “7” and the nurse said I was not possibly at a 7 yet because I was still in early labor and had a long way to go (she was wrong and he was born an hour or two later). After that experience, I just tell them I refuse to participate in that process. It’s all about advocating for yourself, but realizing when an intervention is probably necessary.
In the US out of hospital birth is actually statistically safer than giving birth in a hospital.
Also, my midwife has been delivering babies for 30 years; just because they aren't doctors doesn't mean they lack experience/knowledge.
ETA: I realize that qualifications for homebirth midwives vary by state, but overall there is no country wide governing body or way of ensuring that the midwives are qualified.
prevously helloblueeyes
Me:32 DH:33 Married:04/2012 DD:07/2014
BFP 8/14/2018 #2 due 4/18/2019
https://evidencebasedbirth.com/what-is-home-birth/ (Read for good home birth candidates)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399594/ (Probably worth reading past Methodology, which is where I stopped for now)
There are certainly statistics that indicate that c-sections rates are drastically lower in planned home births than in hospitals (like 5% vs 30%). It’s important to note that planned home births are only suitable for low-risk pregnancies (which are unlikely to need interventions like c-sections) and therefore some of that difference can’t be attributed to a simple difference in care model. And of course, some of the difference CAN be attributed to the US’s ACOG mode of care, which you can see when you compare the US to other developed countries. I haven’t seen comparative stats for other interventions, though, and I haven’t seen anything that does hospital vs birth center vs home. There appears to be a lack of data on the differences in qualifications of the birth attendant (eg CNM vs CPM vs etc). The third link goes into more detail.
I say all this wishing I was not so high risk that I have to deliver in a hospital.
DD born: 3/31/19
DS1 is 7. DD is 1. DS2 is coming in late April.
Eta: also as someone who has been on the bump many years, this is super tame.
prevously helloblueeyes
Me:32 DH:33 Married:04/2012 DD:07/2014
BFP 8/14/2018 #2 due 4/18/2019
She didn't ask for opinions and her mind is clearly already made up and I doubt asking anybody for citations changes minds.
I don't deny death is an issue. But this is not the time or the place to start fear mongering. Nobody here wants me to tell them horror stories about what I have personally seen happen at hospitals. I wouldn't start spouting that at someone who just said they want to give birth in a hospital. It needs to stop being "I'm giving birth at home because doctors kill babies and anyone who goes to a hospital can blame themself when their baby dies".
"I'M having a baby at home because that's what I believe in" serves the same purpose without the judgment.
Also it's rich having someone tell people to be welcoming and respectful when there's 4 TOU violations in her avitar...
If you say say that you are more comfortable with a home birth because you believe it’s a better atmosphere that’s totally fine. That’s an opinion. If you state that it’s safer because of xyz, that’s not an opinion, it’s a statement and it’s perfectly reasonable to want information to back it up.
I have zero interest in home birth because my opinion is that it doesn’t feel safe. But I am not saying it definitely isn’t safe.
prevously helloblueeyes
Me:32 DH:33 Married:04/2012 DD:07/2014
BFP 8/14/2018 #2 due 4/18/2019
Yes a home birth can be routine, amazing, safe and better than a hospital birth. and if that’s the choice you want to make go for it.
The statistics between home birth and hospital birth will be skewed, high risk, multiple babies and women in emergency situation are more often in the hospital than at home and that makes it more likely for there to be more deaths.
I have friends that thought all was normal and would have died if they had stayed home. (4th degree tear, post-hemorrhaging)
I have friends and family that started at home and ended up in ambulance ($2-4000 usually) rushes to have emergency c-section.
I have friends that had amazing experiences in home birth.
I have friends that the hospital treated them wrong and their delivery was hard and scary because of it.
My delivery was long and exhausting and if we were at home (35 min from a hospital) I think it would
notmhave ended well or without ambulances and csection.
All that to say. The best thing for you is to be knowledgeable, prepared and an advocate for you and your baby. After that, a spouse, family member or doula who also has those attributes.
Every person is different and each living situation and pregnancy is different.