Birth Plan Thread

stashattack · October 2019

As we get closer to our 3rd trimester, I know a lot of us are starting to think about our birth plans and putting them together. As a FTM, and I'm sure other FTMs are in the same boat, I think it would be really helpful to see at least an outline of what the STMs plan to put in their birth plans for their care providers so feel free to share what you have done in the past, and any tweaks you plan to add this time around.

FTMs, what are you thinking about including in your birth plans?

marebear15 · October 2019

Just some links for FTM (edit: or STM that need refreshers 🙈) that might need some ideas or things to research:
9 different birth plans https://pregnantmamababylife.com/printable-birth-plan-templates-generators/
The Bump has an extensive birth plan https://images.thebump.com/tools/pdfs/birth_plan.pdf
And this is a plan generator https://pregnancyandbaby.com/calendars/articles/937331/birth-plan-creator

FyreFlyeRush · October 2019

I didn't have a formal birth plan, but I discussed what I wanted to do with my OB....Things didn't go according to plan. Life happens and I had to change it up.

1) I didn't want an induction.
2) No meds offered to me.
3) Baby put on my stomach or chest before measurements
4) Mobility
5) No Eye goop
6) I wanted to be able to walk around within an hour.
7) No circumcision.
8) Do not offer baby a bottle or pacifier

Things that got changed

1) I had to be induced he wasn't coming out, my blood pressure was rising and I WAS DONE BEING PREGNANT. She offered, and I leapt with joy at the chance.
2) My mother talked me into an epidural. I won't do that again unless necessary
3) They placed Baby to nurse, rather than on my chest, as was hospital practice for breastfeeding moms. BONUS!
4) My blood pressure was a little icky, and I got stuck in bed. T
5) State law required eye goop. I just wiped it off.
6) Stupid epidural. I wasn't able to walk for almost 3 HOURS!!!
7) I changed my mind on this.
8) The nursing staff gave him a pacifier and he got nipple confusion. It was a LONG 3 days until my milk came in, and still another week or so before he got the hang of nursing.

Come up with whatever birthplan works for you, but remember to be flexible. Don't stick to your birth plan out of principle if it's at the risk of your health or Baby's. If your birth plan gets changed, ask why...but don't be beligerent. And, truthfully, you may feel dead set against induction at 27w, but come 37??? You may be begging for a membrane sweep.THINGS CHANGE. COMPLICATIONS HAPPEN. Babies have a will of their own. Some never want to come out. Others come in a quick hurry. Some come out perfect conehead first...others come out Sunny Side up (OUCH) and still others stay breech. Don't be afraid to ask for pain meds. There is no shame in taking them. Don't be afraid to NOT take them. There is no shame in wanting to experience a med free birth.

leprechaunlady · October 2019

My birth plan previously was go in, take all the drugs, have a baby & technically this is what happened. The bits inbetween & following this werent necessarily expected.
my advice would be do your birth plan as a guideline to how you would like it to go, speak to your delivery team about it, along with your partner & make sure your partner can be your advocate in case you cant.
its completely ok to change your mind at any stage & sometimes things dont go to plan so if medical intervention ends up being necessary try not to get too caught up with not sticking to the birth plan, the health & safety of you & your baby is the most important thing!
All that being said, I hope everyone has the stressfree, uncomplicated birth they desire!

This time, I have requested a c section no matter the circumstances. This will be facilitated as long as i dont arrive in at like 8cm & its safe for me & babies.

eta: my birth plan for this time round

cats_in_a_window · October 2019

Copy/pasting this from the original thread it was in. This example will probably be most useful for those preparing for unmedicated birth, but may also give other FTMs some ideas about format and what to research/include even if they plan to use pain meds. I'm planning to discuss this draft with my midwives at this week's appointment and make changes to as necessary (eg, remove anything that is entirely standard with the practice/hospital I am delivering at). Having a care provider who is supportive of your wishes is probably the most important factor in having a positive birth experience, particularly if some of those wishes aren't standard practice at the place where you will deliver your baby. So, I'm looking as the birth plan as an opportunity to discuss my wishes with my midwives ahead of time (although, honestly, we've already talked about most of this

) and to communicate what we aligned upon with the L&D nurses.
___________________________________

Name: **** Support Person: My husband, *****

Care Providers: ******

We are looking forward to the birth of our third child at *******. Our first child was a high-intervention hospital birth complicated by preeclampsia. Our second child was a low-intervention, unmedicated birth at a freestanding birth center. Based on these experiences, we have the following wishes for the birth of our third child:

1) During Labor: we have prepared for an unmedicated childbirth. To help us achieve this goal:

- We would appreciate being assigned nurses who have experience with and/or prefer to work with unmedicated laboring mothers if one is available.

- If labor is clearly established, I would like to waive the initial 20 minutes of continuous fetal monitoring in favor of intermittent auscultation throughout labor.

- I would prefer the use of intermittent auscultation with fetal doppler. If continuous monitoring is necessary, I would like to use a telemetry unit.

- Please do not offer pain-relief medications. I understand the options and will ask if I desire pain relief medications. Suggestions for non-medication pain relief techniques would be appreciated (I found deep, focused breathing and hip squeezes to be helpful during previous births).

- To aid in mobility, I would prefer the placement of a saline-lock.

- I would like to wear my own clothes (or no clothes) during labor and delivery.

- I would like to be able to eat and drink freely during labor.

2) During Delivery:

- I would like to wait to push until I feel an urge to do so and practice self-directed pushing.

- Please recommend alternative pushing positions that may facilitate delivery and prevent tearing (side-laying was my favorite with previous babies).

- If safe, I would like our baby to be placed directly on my stomach after birth. This is very important to me and, if at all possible, I ask that our baby be placed on my stomach, even for a very short time, before he/she is cleaned off.

- Postpartum Pitocin for management of the 3rd stage of labor is OK.

- Please delay cord clamping and cutting until the cord stops pulsing.

- Please encourage my husband to cut the cord and announce the baby’s sex, if possible.

3) After Birth:

- Please complete newborn vaccinations/procedures in our room whenever possible.

- We plan to waive the routine administration of antibiotic eye ointment.

- We choose to postpone the Hepatitis B vaccine to be given by our pediatrician at a later date.

- I plan to breastfeed exclusively. Please do not give our baby any bottles or pacifiers without consulting with us first.

- We would like to give the baby their first bath and/or delay bathing.

4) In the Event of a Cesarean Section:

- Please allow my husband to hold our baby as soon as safely possible. If our baby should need to leave the operating room, my husband will accompany.

- Please help me in initiating skin-to-skin (in the operating room, if possible) and breastfeeding as soon as possible after the birth.

ponyoisfun · October 2019

I like seeing all of the different ideas.

I have to say, I found mine from dd and have just cracked up laughing. I sound so pretentious and picky. I am not trying to shame anyone if they have the same preferences, but I just think it is so funny how much I thought all of it would matter SO MUCH.

None of it mattered as long as she was healthy and there never was any time to even look at it, much less think about it. If we had transferred maybe it would come in handy, but as that would have been an emergency situation I am sure it would have been thrown out the window.

If anything I should have made a super detailed postpartum plan and meal train system.

Here is my birth preferences below, reproduced in all of its particular glory. There isn't something inherently wrong with the ideas, its just the tone of the whole thing. I would be happy to discuss the plan if anyone is curious.

______________________________

Labor

·      I will be using Blissborn hypnosis during my birth for pain management. I am aware of other pain management options and request that none of them will be offered to me unless I ask for them.
·      I would only like for my husband, doula, and essential medical staff to be present during labor and birth.
·      Intermittent monitoring and otherwise free movement.
·      Minimal cervical checks and natural membrane rupture if possible.

Birth and Postpartum

·      Please use warm compress/perineal massage if the position I am pushing in allows.
·      Try alternatives before suggesting medical interventions such as an episiotomy or vacuum.
·      Delayed cord clamping.
·      Immediate skin-to-skin contact after birth and at least an hour to bond with the baby on my chest.
·      If my baby needs to leave the room, my husband will stay with the baby at all times.
·      My placenta will be encapsulated after birth – please send with my doula, XX.

Baby Care

·      As much as possible, please perform initial exams on my chest during the golden hour after birth.
·      I plan to breastfeed exclusively – No glucose water, formula or pacifiers for the baby.
·      We would like our baby to have the Vitamin K shot.
·      We would like our baby to NOT receive erythromycin eye ointment nor the hepatitis B shot at the time of birth.
·      We would like to bathe our baby after we have returned home.

Thank you for your help in bringing our child into this world!

eta: btw, I had a bleeding issue afterwards and so I was thankful that there were immediate interventions. There was no time to stop and consult a plan.

FyreFlyeRush · October 2019

@ponyoisfun, I remembered my convo with my OB the other day and laughed at how much I've changed. I had all these ideas. And, this time, I went in there and said: Don't offer me meds unless medically necessary, talk me out of them if I ask, and help me with my mom when she pushes the meds on me. Other than that, I'll defer to you. (She has never tells me something needs to be done without explaining why)

cats_in_a_window · October 2019

@ponyoisfun Am I correct in remembering that you’re going to be delivering at a freestanding birth center? This was my experience with DD and, with her, my birth plan looked very different and I agree that it was hardly glanced at during my actual birth (my MWs still encouraged me to put one together and we did talk about it during appointments, regarding what happened with my DS’s birth and how I hoped this one would be different). It comes back to the fact that having supportive care providers is key. Pretty much everything I wanted was standard at the birth center, so there’s wasn’t much to “prefer” over what they already did there.

I’m in a spot now where I have a very supportive midwife practice where most of my wishes will be standard for them, but not necessarily the hospital I’m delivering at. I think this is where the birth plan is likely to come in handy (to inform the hospital nurses of my preferences, since the midwives will already be on-board). Only time will tell if it actually gets used this time, though. I also consider a birth plan to be a great tool to discuss preferences with care providers and gauge how in alignment they are with your wishes. In a lot of ways it’s more useful before the birth, rather than during it.

This is off-topic, and not directed at anyone in this thread, but I did want to point out a phrase that always makes me cringe a little when discussing birth experiences/expectations: “as long as mom and baby are healthy that’s all that matters.” While nearly everyone who uses the phrase means well, it can be dismissive of moms who have traumatic birth experiences since it implies that their experiences don’t matter if everyone came out “ok” on the other side. I can’t tell you how many times I heard this phrase after my first, semi-traumatic birth (many of the times by healthcare providers!) and it always felt like they were brushing off the very real pain and anxiety I had experienced.

So I like to tell FTMs that while of course a healthy mom and baby is the #1 priority, it’s also OK to feel however you’re feeling coming out of your birth. There’s nothing selfish about expressing that your experiences were something other than rainbows and butterflies. ::stepping off soapbox::

Best wishes for happy and healthy birth experiences for all reading this thread!

marebear15 · October 2019

@cats_in_a_window - I kind of adopted the "healthy baby, healthy mama" mindset with my first daughter. I of course had preferences, but in the end I made it my goal to be able to just roll with whatever life handed me. I knew so many women that were so stuck on have a med-free vaginal delivery, that a c-section contributed to some pretty bad PPD afterwards.

I would say I had a "traumatic" delivery. My daughter's heart rate dropped and I had an emergency c-section. It was scary to see the NICU team fill my room as they prepped me for surgery. I wasn't able to see her until 12 hours after birth and she spent several days in the NICU. But I think my mindset beforehand really helped me roll with the punches and I never had any lasting negative feelings over the whole experience.

However, I would never push my mindset on to someone else. While this mindset helped me, your feelings are just as valid!

FyreFlyeRush · October 2019

@cats_in_a_window, I nearly delivered in the car with my first, and had a long, hard physical recovery with my second. Those of us who have had our birthing plans out the window or a traumatic birth or recovery are the ones encouraging flexibility. What I mean by the end goal is healthy mom and healthy baby(ies), is don't be so rigid in your birth plan that you can't roll with the punches. In no way am I dismissing people who have had a difficult birth, recovery, losses, and/or other unexpected events. I've been there...on all accounts. Just be open minded. Remember a birth plan is just that a PLAN...and plans change.

cats_in_a_window · October 2019

@marebear15 @FyreFlyeRush I absolutely agree with both of you that flexibility is necessary for birth as it can never be planned. As of yet, I haven't heard anyone advocating to be rigid with your birth plan on this thread and that's a good thing (really, the term "birth plan" is a bit problematic. I rather like how @ponyoisfun used "birth preferences" instead).

I mostly wanted to reply to advocate for how creating a list of birth plans/preferences can be helpful, since they seem to be getting a bad rap on this thread. If your plan is nothing more than "come out with a baby" that's also 100% fine, of course! Also, I wanted to point out that having a birth plan/preferences won't guarantee a negative experience, just as going in without one won't guarantee a great experience. (Another thing I heard from a few nurses in the hospital with my first was "when I saw that birth plan I just knew things weren't going to go well for you" which, IMO, was a pretty crummy thing to say). I'm admittedly pretty sensitive about all this based on my bad experience with DS and seeing how much better things could be when I delivered DD. I think my birth plan had little to do with either of those experiences, though, which is why I advocate so hard for having supportive care providers!

marebear15 · October 2019

Here's my (rather long) birth plan. Most of it is actually standard care at my hospital, but may not be for some others, which is why I included those points. I also included three sections that aren't usually on a birth plan, but are important to consider and research, and speak with your doctor about. They are emergency c-section, scheduled c-section, and NICU stay. I didn't include anything about induction because I would rather schedule a c-section than have an induction as someone who is facing TOLAC/VBAC. Also, should I reach 40 weeks without going into labor, I will be scheduling a c-section before 41 weeks.

Please Note

· My delivery is a TOLAC/VBAC.

· I would like to wear contact lenses at all times when conscious. (STANDARD)

· (DH’s Name) is my partner and labor support and would like him to be present during labor. (STANDARD)

Labor

· Please perform no routine preparatory tasks (shaving, enema, etc.), unless requested. (STANDARD)

· I expect that doctors and hospital staff will discuss all procedures with me before they are performed. (STANDARD)

· I would like to be free to walk, change positions, and use the bathroom as needed or desired. (STANDARD)

· I prefer to wear my own clothes, rather than a hospital gown. (STANDARD)

· So I can stay as mobile as possible, I would prefer to have a heparin lock administered instead of an IV. (STANDARD)

· I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions. (STANDARD)

· I wish to labor freely in the birthing tub with intermittent monitoring every 15-30 minutes.

· Please provide a birthing ball be brought to my labor room.

· When I reach 8 cm, please rupture my membranes.

· To preserve my privacy and dignity, I would prefer that everyone knock before entering. (STANDARD)

Labor Augmentation/Induction

· Should labor augment, please rupture my membranes before proceeding to a c-section.

· I would rather a c-section than use Pitocin to aid contractions.

Anesthesia/Pain Medication

· Please do not offer anesthesia/analgesia unless I ask for it. (STANDARD)

· If pain relief is considered, I would like to try a narcotic before an epidural.

Emergency C-Section Delivery

· If time allows, I would prefer spinal anesthesia over general anesthesia.

· If (DH’s name) is not allowed in the OR, please have a nurse update (DH’s name) of my condition and baby’s as often as possible.

Scheduled C-Section Delivery

· I would like to wear my own labor and delivery gown.

· I would prefer spinal anesthesia for the procedure.

· I would like (DH’s name) to be present during the surgery.

· Please explain the surgery to me as it happens.

· Please do not strap my arms to the table during the procedure.

· Please lower the screen just before delivery so I may see the birth of the baby.

· Please allow the umbilical cord to stop pulsating before it is cut.

· I would like to be the first to hold after the delivery.

· I would like to breastfeed immediately after the birth.

Perineal Care

· To avoid episiotomy or tearing, my OB will perform perineal massage between contractions. (STANDARD)

· I would rather tear than have an episiotomy.

Delivery

· I prefer to push or not push according to my instincts and would prefer not to have guidance or coaching in this effort.

· I would like a soothing environment during the actual birth, with dim lights, and quiet voices.

· Please tell me progression after each contraction.

· If needed, please use vacuum for extraction.

Immediately after the birth

· Please place on my stomach/chest immediately after delivery. (STANDARD)

· I would like to breastfeed immediately. (STANDARD)

· Please allow the umbilical cord to stop pulsating before it is cut. (STANDARD)

Newborn Care

· I would like to hold baby skin-to-skin during the first hours to help regulate baby's body temperature. (STANDARD)

· I would like to hold baby through delivery of the placenta and any repair procedures. (STANDARD)

· Please evaluate and bathe baby at my bedside. (STANDARD)

NICU Stay

· Please contact me or (DH’s name) before any procedure is done to baby.

· I would like a breast pump brought to me immediately following the transfer to my recovery room.

· Contact me before each feed to see if I have any milk to offer, or can get transported to the NICU for breastfeeding.

Postpartum Care

· If available, I would prefer a private room. (STANDARD)

· If I have a catheter, please remove it as soon as policy allows.

· I would like the baby to be in the nursery and brought to me on request and for breastfeeding.

· I would like (DH’s name) to room-in with me. (STANDARD)

· I would like my other child to have free visitation access. (STANDARD)

· Assuming I feel up to it and am healthy, I would like to be released from the hospital as soon as possible following the birth.

Breastfeeding

· I plan to breastfeed and want to nurse immediately following the birth. (STANDARD)

· Please do not give supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity. (STANDARD)

ponyoisfun · October 2019

@cats_in_a_window Yes, this was for a freestanding birth center, but it was also for use in the event of a transfer. I would say even though it was nice to use it was helpful to make because then I knew what kinds of birth and pp choices I would have to be making. DH was then aware of these choices if for some reason he had to make the call.

Btw, what a lame thing for the nurses to say to you! I think there is nothing wrong with having strong preferences and almost all of the ones outlined in our plans here are actually evidence based, not just made up because we would have "liked" things to go that way.

@marebear15 I like all of your different sections and that you knew it was important to consider and think about all possibilities. I also agree with you that it is helpful to consider what may happen if you wind up at a different hospital. I live in a smallish city so there really aren't many options.

kategancla · October 2019

@leprechaunlady My "birth plan" for my first was basically what you described. I ended up being induced a few weeks early because of IUGR, but labor and delivery was luckily relatively uneventful.

It was events related to feeding my daughter beginning right after delivery that caused a lot of undue stress and anxiety. I WILL go in this time with a specific feeding plan and a request that no lactation nurses visit my room unless I request them.

leprechaunlady · October 2019

@kategancla I ended up having a pretty traumatic birth with dd, which resulted in feeding issues which were stressful & caused a lot of anxiety too. So I am absolutely with you on that one! I hope this time round goes a lot better for you!!

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