Let's talk: birth plans

wkuandrea · November 2018

as a FTM, not sure exactly what to put on the birth plan (or not) -- knowing, of course, that it all can go out the window! But I'd like to have some semblance of one. What's important to you? STM+s, what do you have in your birth plans/what do you wish you'd put in your plan?

leighbrek · November 2018

Pain management is pretty much my only plan! lol. I specified no circumcision should my girl turn out to be a boy, that I do want to stay mobile for as long as possible before an epidural... And that's really about it. I think birth plans can create a lot of extra stress when expectations can't be met.

galactickates · November 2018

My sister just gave me a great idea. I told her I wanted to go as long as I can but i'm not going to get worked up if I end up with an epidural and she said make sure your nurse knows to check in with you before you are past the point of no return.

Which sounds so obvious but I would have never thought to actually communicate that.

UnbreakableKimmySchmidt · November 2018

I filled out a birth plan sheet from my doctor for DD’s birth and it was basically a waste of time. I found it was better just to talk about labor plans ahead of time with my doctor and DH and then go with the flow during labor. It’s really easy to have a perfect plan you have to follow and then you end up disappointed if you aren’t able to follow The Plan exactly. Prepare for flexibility in your plan, whatever you decide!

DLpanda08 · November 2018

We spent some time in our childbirth class talking about birth plans and I’m so glad we did. I found out that a lot of what I want is standard procedure at my hospital.

I put med-free pain management, ability to move around during labor (including the bath and walking the halls), and pushing in an upright position in my plan. My midwife actually suggested a few things related to visitors due to my anxiety so DH and I are considering those too.

mtengl · November 2018

I spoke with my midwife yesterday and my current plan is pretty relaxed. I plan on trying to go as long as possible without the epidural just to be able to continue to move around.
I did decide for sure to go with the hospital they prefer, unless the baby is 36 weeks or younger than I will go with the second choice since it has the best NICU here. The hospital I am going to doesn’t have an NICU which makes me nervous but they do transfer to my preferred hospital if needed. The hospital I am going to allows more freedoms during labor which is why my midwives prefer it. They said they have worked really hard to allow the hospital to let women to eat and drink during labor and move around.

Ghostie625 · November 2018

I was given a preference sheet from my OB that was really helpful.
Basically, it listed the different options for things like pain management, labor position, who's allowed in the room, etc. I pretty much knew what I wanted before, but it was nice to know that a lot of things I want are options that are already listed and therefore (hopefully) not things I'll have to fight for. It's also helpful as a FTM because there were a few options on there that I didn't know to I should be thinking about.
I haven't had the next appointment yet where I'll actually discuss the plan with my OB. Fortunately, the hospital where we plan to deliver is rated as "baby friendly" so I'm optimistic that I won't have to fight too hard to get what I want.

For those deciding what they want to include in their birth plan, I'm going to recommend evidencebasedbirth.com. If you haven't heard of it, it's a website that gives a breakdown of common birth practices and the actual scientific evidence behind them. They don't make recommendations, but rather present the evidence and leave it to you to make your choices based on that evidence. (As a science teacher, I love that!)

skilouise · November 2018

I'm hoping to keep my birth plan simple (preferably one page) and focused on my high priority items. For the most part I'm not asking for much outside the "norm," but there are a few things I feel strongly about.

One of the biggest things I want to convey is that I'm open to deviations from the plan in certain limited circumstances, but unless there is an imminent threat to my or the baby's life, they need to OBTAIN CONSENT before deviating. A friend of mine told her OB that she was strongly against getting an episiotomy. He ended up cutting her anyway, 1) without asking or even warning her first, and 2) without a local anesthetic (she didn't have an epidural). She ended up with some pretty severe tearing as a result.

mrsmang · November 2018

@AshVA ugh that’s awful about your friend, and one of my biggest fears. One of the OBs in my practice is known for doing tons of episiotomies. I’m hoping because I know that ahead of time and have DH and my doula on the lookout for that if he’s the OB on call, I will be able to avoid being in that situation. But I only know that because the doula practice and a L&D nurse I know warned me - I feel bad for the other women who don’t have the heads up. He’s an otherwise friendly and understanding OB with great bedside manner, so there’s no real reason to suspect he would do that.

tosh24 · November 2018

I've never written out a specific birth plan. I didn't really have one in mind with DD other than I wanted to labour as long as I could without meds. With DS I had a doula and I felt that really helped because she knew my position on things and could advocate for me and the nurses just assumed I was all crunchy and immediately offered all the "alternatives" (moving around, limited monitoring, dimmed lights, no meds, etc).

I'm going in with the same mindset (and same doula) as with DS. I'd like:
- med-free
- wireless monitoring
- ability to move around
- ability to eat and drink if I want to
- ability to choose my birthing position
- all interventions require my consent (unless there's an emergency)
- dimmed lighting
- immediate skin-to-skin
- delayed cord clamping
- no eye ointment
- BFing only/no formula
- no circumcision (if a boy)

Regardless of the above (except for requiring my consent), I am fully aware that I can change my mind or the situation may call for a change in plans so I am flexible. I just want baby and I to come out the other side happy and healthy and I want to feel like we were informed and involved in any decision making.

kaf1788 · November 2018

I was given a birth plan worksheet to fill out from the hospital I'm delivering at but it was awful. All open ended questions like "what do you envision your birth being like?" that I had no clue how to answer. I went to a birthing class last weekend and the doula mentioned that she also thinks the worksheet is garbage and recommended we print off the checklist from baby center instead.

I understand that everything is subject to change, but some important things for me to include were being allowed to walk the halls and use the shower until I feel I absolutely feel I need the epidural. Also to have immediate skin to skin and delay the weigh in/measurements as long as possible. I'm worried about my ability to breastfeed after a breast reduction so I'll also be writing that I prefer to see a lactation consultant asap and often.

galactickates · November 2018

Edit - Had a freak out..

The TL:DR is I could benefit from a post partum care thread. Even just beyond products. How to survive the first 48 hours with a newborn

sweetyjenj · November 2018

I made a cool plan last time, then forgot to print it, and then really told the nurses the only 2 important parts on it for labor/delivery were that I wanted to tear naturally and I wanted an epidural AFTER dilated pretty far so there was less risk of it slowing things down. Aside from that, I told the nurses I only wanted DH and my mom in the room, so they advocated and told MIL to leave when she tried to enter before I started pushing, and that was nice. Also, after delivery I wanted delayed cord cutting (which I learned was standard at my hospital), about an hour of skin to skin and delayed cleaning/weighing/etc. so long as baby came out ok. We were able to get everything on the list!

skilouise · November 2018

@mrsmang It's one of my biggest worries also. I don't know the standard practices for episiotomies of the OBs at my office. All but one are female though, so I'm hoping on a personal level they'd be less inclined to be overzealous with a knife.

@galactickates I feel you. There are so many things I wish I could discuss in the PG as well. Stupid Bump technical problems.

@kaf1788 Wow, those questions sound terrible! I can't imagine they get many answers that are particularly helpful tothe patient or the medical staff.

Also, I'm in a similar situation regarding a reduction and likely not being able to BF. However, I'm not worried about that possibility so much as (FFTC?) not- so- secretly hoping that's the case. I'd definitely try to BF if it seems like I can, but that isn't looking likely and I'm honestly kind of relieved.

tosh24 · November 2018

@galactickates Eff the lurkers

It's a completely valid concern.

Hospitals here did away with nurseries a long, long time ago. It was room in only even when I had DD 12 years ago. I can't speak for c-section recovery because I've never had one, but I expect that the nurses would offer extra support (or I would hope so, anyway). With both DD and DS the nurses came in only to check mine and baby's vitals, but care for baby was strictly DH and I. Actually with DD, DH was unable to stay overnight so it was all me the first night with no nurse assistance. It's totally doable. I found that I just did what I had to do. With DS, DH was there the whole time and he did all the diaper changes, clothing changes, rocking, and shushing, so the only thing I had to worry about was nursing and resting/sleeping. He also helped me in and out of bed and to and from the bathroom. Hopefully you have a supportive, hands-on husband who will step up and be the caretaker while you're recovering. If not, I might plan to have a supportive relative there to help you out, at least during visiting hours, who doesn't mind looking after things while you sleep.

Exhaustion for me never set in until after the first month with both kids. My mom always told me to expect that and she was right. The first few weeks you're totally in survival mode living off adrenaline.

galactickates · November 2018

@tosh24 thank you for catching my post before I deleted it. That's really what I needed to hear. My husband is a huge support and he'll do whatever is needed. I also, luckily, have my mom nearby and sister. Plus i'm sure his mom will come down. I'm concerned with having that extra help but not feeling like my space is invaded at the same time. It's something i'm going to have to figure out in the moment. I just don't understand how women give birth and then are able to care for this baby right away. I keep hearing how exhausting labor is and then your sling shotted right into being a parent. I don't understand how people do it.
After I posted I talked to another mom who said babies need their rest too! I'll get to sleep and recover when he's sleeping. That gentle reminder really helped.

Mandamay1414 · November 2018

I don't have much of a birth plan other than wanting an epidural at some point. Like others have said, I just want to be kept in the loop regarding what's going on and be part of any discussion regarding additional interventions. With DD, my L&D nurse and the anesthesiologist had a disagreement about how much to turn up my epidural right in front of me! I was still feeling pain, but I guess the RN was concerned that I would be pushing soon and wouldn't be able to feel the contractions if the MD turned up the epidural too much. It was so annoying that neither of them thought to include me in this discussion.

molosmiles · November 2018

I had an episiotomy with DD1. I had the same Dr for DD2 and didn't get one, but I did tear a little. DD1 was 8 lb 3 oz and DD2 was 6 lb 12 oz. I'm assuming the size difference was key, and I was already pushing for 2 hours with DD1, I didn't care how they got her out at that point. I also didn't notice any difference in healing time.

tosh24 · November 2018

@galactickates Ah yes, glad your friend remembered that little tidbit! Newborns typically sleep something like 16-ish hours a day and when they're awake, they're usually eating. There will be short periods of alert time in there too. So yeah, still plenty of time for you to be resting/napping. I remember when DD was born and we brought her home, DH and I would veg and watch entire movies without having to be on baby duty - she just slept the whole time in the PNP beside us!

Kabazaba · November 2018

I guess I have birth goals and then a birth plan.

My birth goals are super straight forward (in order of seriousness): (1) going home healthy as intact as possible with a healthy baby; (2) feeling empowered and heard throughout labor and delivery (I think this is echoed by many of you above re: consent); and (3) I want to have free movement as much and as long as possible until/if/when I get an epidural. Not deciding either way ahead of time, but guessing at some point pain relief will sound better to me than being able to squat or walk around. If I don't have free movement for some other reason imagine I'll be getting an epidural much sooner.

As for a legit birth plan - my midwife group has an awesome one-page handout (if people are interested I can load up a blank one for ideas) that on the top says what their standard practice is (for you to edit if you want - their standard practice is like limit intervention, no episiotomy, limit vaginal checks, etc.), and then on the bottom has a lot of check-boxes for things you want/prefer from circumcision to whether SO want to catch baby, cut umbilical cord, have lights dimmed in the room, wear your own clothes vs hospital gown, etc. It seemed fairly comprehensive to me and really easy format to read. Luckily because the midwives deliver at just one hospital, I guess the nurses there are very used to seeing their specific form as well which means it's more likely to be followed. So yeah, I put in my preferences there (my own music, clothes, dim light, DH has ZERO interest in catching baby or cutting cord and I do not need a mirror KTHXBYE, no set pain management plans, etc.).

wkuandrea · November 2018

@Kabazaba if you would upload that (if you can) that would be great! I have a typed one out... but it's three pages and I feel like that's overkill

Kabazaba · November 2018

@wkuandrea Here you go! First time trying to have an attachment that's not a pic, let's see if this works...

kmos816 · November 2018

My birth plan is pretty simple- no drugs and just my DH in delivery room. My midwives went through a list of questions at my 26 week appointed and took all the info down. I think I wrote a physical birth plan with my first and forgot it but all went according to plan.

My hospital is' baby friendly' so skin to skin after birth is standard which is also important to me.

kianarain · November 2018

I thought my birth plan was going to be "get this thing out w/least amount of pain for me possible", but these are fair points! Copying down tidbits from each of your lists, because these are great!

@tosh24 love the dimmed lighting rec. I get weirdly anxious being in places w/too bright fluorescent lighting, so this would be amazing & I didn't even consider it as an option.

And ugh that we even have to specify that we need to consent to anything not medically necessary. But definitely including that one also. I'll probably separate out the list into a "nice to have" and a "need to have". Consent, BFing only (no formula), pain management, immediate skin to skin, & rooming-in will definitely make the need to have.

pttomato · November 2018

I’m not sure what to do about a birth plan. Everything feels really out of my control. I’ll have to see if I can get my OB to discuss delivery with me, although IME they don’t like to talk about details when there are a lot of uncertainties.

alexandraseattle · November 2018

We have our first meeting with our doula on the 20th. I looked into the pain management scale and while I’d like to think I’m a +3, I’m probably more of a +5. My doctor is not much older than we are so he’s up on all of the latest trends, including episiotomies only if absolutely necessary. At the last centering he said it’s much better to tear on your own and he will only cut if absolutely necessary. I’m trying to go in with minimal expectations. I legit told him my birth goal was not to tear from my hooha to my butthole.

MrsDho11 · November 2018

I got a form to fill out with my plan at my last appointment. It has our preference for circumcision, that I’d like to be asked before guests are allowed in, that I like dim lights, that i’d Like to try non-medicated pain relief first but am not opposed to medication if I so choose, and that I might play music of my own. I think that’s it. It does explicitly name some people who are allowed in and had a spot for people I did not want to have there.

gorgeousariel · November 2018

My birth plan is pretty simple because I have an amazing baby friendly hospital. It's starndard practice for:

Delayed cord clamping
2hrs skin to skin bonding time
Eating/ drinking during labor
Wireless monitoring
Walking around using tub/ shower in every room

The few things I wanted was no episitomy and I wanted to use nitrous oxide as my pain management. If it was not working or I couldn't get the rhythm of using it, then I was open to an epidural.

DD came so fast I didn't have a chance to try anything but breathing through it. I am definitely open to using the nitrous this time but need to double check my OB still allows it. I'm sure he does but need to confirm.

MrsDho11 · November 2018

@gorgeousariel I found out at my last appointment that my hospital now has nitrous, and I’m excited.

nononorman · November 2018

My birth plan will be pretty simple… Skin to skin and hopefully delayed cord clamping with an epidural as soon as possible. I moderately regret not getting in a little bit sooner the first time around but it was “interesting” to see how far I could go before I was done with that shit. I would recommend, if you can, not getting too worked up about a birth plan because everything will go out the window and not just in the obvious ways… Like a C-section. For example with my daughter, I had a bad tear and there was no doctor or midwife available when I gave birth so the nurse (who sucked) cut the cord immediately (yes delayed cord clamping was hospital policy and the hospital ranked third in the country in neonatal care the year prior) and was just trying to stop the bleeding on my vag. The less you expect, the less stress you’ll have if it doesn’t work out. It definitely can work out and it does for a lot of people but I think they’re also lotta people who have guilt and postpartum depression because things didn’t go like they have planned. So I guess I recommend managing expectations.

emmaaa · November 2018

With DD, my birth plan was to have a baby. I really tried not to get my hopes up of the perfect experience. Honestly, the nurses asked me when I checked in if I had a birth plan and when I said not really they were surprised.

I plan/hope to do the same this time. Wait as long as possible for the epidural so I can keep moving, skin to skin once the baby is born, no family in until we've had plenty of time with the baby.

jgil85 · November 2018

My only things I want are an epidural, delayed cord clamping, skin to skin and just a healthy mom and baby.

Ds was premature and I had no control over anything so I know going into it, to not have crazy expectations and to not be disappointed when something doesn't go as planned.

ladystout08 · November 2018

+1 for the I didn't really have a plan and won't this time. I got induced early with DS so everything was sort of up in the air. My only request was to try natural induction methods before we moved on to drugs and we did that.

This time I will ask for delayed cord clamping and skin to skin but otherwise I'll just go with the flow

nononorman · November 2018

@alexandraseattle I’m hoping to not tear FORWARDS. I’ll be ok if they have to give me a new asshole again but I don’t trust them fixing the front end if that’s even a thing they can do.

kianarain · November 2018

wolfmum said:

@alexandraseattle I’m hoping to not tear FORWARDS. I’ll be ok if they have to give me a new asshole again but I don’t trust them fixing the front end if that’s even a thing they can do.

snackheart · November 2018

I had a birth plan with both of my kids and will for this one too. It fits on one page and most of it is entirely optional, written with the understanding that anything can happen.

For us, being Team Green, there is one thing that is extremely important and is highlighted, underlined, and verbally told to every person who comes into the room, which is that MH is to be the one to announce the baby’s sex. Also, because I’m Jewish, we specify no circumcision (since if it’s a boy we will be doing that privately in a bris). Those are two things I think it’s safe to say you can have control over no matter what happens during labor and delivery.

I think no matter what it’s important to have a firm understanding of your hospital’s or birthing center’s policies. For example, the hospital where I delivered my two kids straight up does not ever do episiotomies or forceps deliveries, but they always do skin to skin (unless there’s some emergency preventing it of course). This time I have to deliver in a different hospital (because I’m high risk) and so I will definitely be asking about their policies on all these things so I know whether they need to be highlighted in my birth plan.

skilouise · November 2018

wolfmum said:

@alexandraseattle I’m hoping to not tear FORWARDS. I’ll be ok if they have to give me a new asshole again but I don’t trust them fixing the front end if that’s even a thing they can do.

That and the baby in distress are the two exceptions to my "no episiotomy" rule. If a tear starts going forwards, they should cut away!

gorgeousariel · November 2018

Yes I had a bilateral periurethral tear. The midwife was not very good at stitching me up. It took her almost an hour and THEN decided that she needs to make sure she didn't stitch my urethera. Couldn't find it to insert a catheter so she unstitched one side. Then once it was found she had to stitch it is again. It took full 6w to heal and there was pressure when having sex bit it all eventually turned out ok..

drabong88 · November 2018

My only birth plan with DS was to get an epidural lol. I asked for the epidural pretty much as soon as I got to the hospital (was 4 cm and having contractions every 3 to 5 minutes ) I was so happy to relax and get some sleep before pushing. I plan on getting an epidural again this time too. I also didnt mind having visitors soon after getting stitched up. I couldn't really do anything like walk while my epidural was wearing off so I didnt mind the company. I was also exhausted after 3 hours of pushing so I didnt mind sharing DS for a while

sushilove15 · November 2018

My birth plan with DD and my birth plan this time are the same. Do what feels right. My first labor I was throwing up with every contraction starting when I was dilated at a 5. The pain was so strong so I went with the epidural. My progress slowed down so much so I used a peanut ball between my legs and that sped things up until it was go time.

This time I will labor for as long as I can without an epidural but I am not afraid to get one if I need it.

I guess my birth plan is to listen to my body and go with what feels right. A piece of paper with rules is not something I will stress about. The most important thing is what is best for the baby.

BitterBetty12 · November 2018

@galactickates girl. You’re going to be amazing. You’ll have so much adrenaline and so many hormones coursing through your body in those first couple of days. When DD was born I managed to say up for about 8ish hours (until 1-2am) after already being up 36ish and it was like I didn’t even feel it. Poor DH was dosing off in the chair next to me while the nurse was chatting me up (and he had a full nights rest the night before). By no means is it easy. But you surprisingly just... do it. Plus looking at that sweet baby face that you created for the first time just does not get old. Even when she woke up crying and hungry an hour after I finally did fall asleep I was just in ‘let’s do this’ mode.

All of that is to say - you will most likely surprise yourself with what you’re capable of! But don’t be afraid if the emotions are intense. And definitely make sure someone is looking out for your needs!

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