4 Our Health

Question:

Anyone care to share their birth plans??
I really want to write one, and stick to it... but I have *no clue* where to start.

Answer:

Babycenter has a VERY thorough and in-depth one. It's a good place to start thinking about what you want. However, I would never actually use one as long as theirs; no one in the hospital will read it!!! Try to keep it very simple, one page, preferably large-print. The simpler and more to the point it is, the more likely your wishes will be followed. Print it up on colored paper or with color ink, and make several copies. Tape one to your labor room door. Give it to your Dr, nurses, everyone -- be sure they all see it! :) Good luck!

Answer:

Here is the one I wrote while in the hospital after my water broke at 33.5 weeks:
A Plan For Birth
We had intended a home birth, at our home in the woods. We recognize that circumstances have changed and certainly know that our "ideal birth" has twists and uncertainties we cannot imagine or predict. This plan is merely meant as a guide to who we are and what sorts of feelings we have in the circumstances we have been given. While our baby is being born early, and will itself likely require interventions and medial assistance in its first days of life, it is our reasonable belief that labor and birth are best done gently, naturally, and relatively quietly to effect the best health outcome for our child.
* I wish to labor and deliver naturally, choosing my positions, actions, and interruptions.
* I am aware of my drug options and prefer to use none. I do not wish for them to be offered- if I want them, I will ask.
* We have prepared for this birth using the "Birthing from Within" course and book.
* I would prefer my doulas, my husband, and our midwife present. No other guest without my approval during active or later stages, and would like minimal staff and interruptions.
* I will likely wish to labor in the tub during active labor.
* Once labor has clearly started or is starting or we are attempting to go ahead and start it naturally, I would like my heplock/IV to removed and the on-bed fetal monitoring to stop. I have good, easy-stick veins, and if an IV again becomes neessary, a nurse should be able to quickly re-catherterize as needed. Very intermittant portable doppler fhr monitoring may be used.
* It has been recommended to me by my care providers that because of the extra inward curve of my tailbone, I should push and deliver in either a squat or all fours position, and this feels most right to me, as well.
* Delayed cord clamping, if possible, is preferred. We believe that the additional blood gained by the baby is especially beneficial for premature babies.
* If bulb suctioning is not clearly indicated, we would prefer it not be done.
* Barring necessary emergency medical care, I would like immediate skin on skin contact with the baby without others touching, cleaning, or otherwise interfering- blood and vernix will not bother me.
* I may wish to catch the baby myself.
* If or when the baby does need to go to the nursery, DH will accompany it and stay with it.
Unless something happens to change this, the baby does not yet have a name and should be referred to as Baby <lastname>.

Answer:

I think that is a very well written birth plan.
When you do make one, make sure to go over it with your caregiver before you go into labour and if possible get him/her to sign a copy that you will be giving to the labour/delivery staff. If it is shown that your caregiver is on board with it, it may get them to go along with it more.
I have never done a birth plan, with the exception of my first child my dr(I changed) was on board with everything I wanted. Dh wasn't so I probalby should have made it known to him the specifics on why I didn't want narcotics, although that probably wouldn't have stopped him from approving it. :angry

Answer:

Since I delivered at a birthcenter I was pretty confident that they would treat me and the baby the way I wanted to be treated, so I never had a birth plan.....but if I had a hospital delivery I would definatly write one. I would also check out what the typical hospital policies are so that I could specifically address the ones that concerned me.
:OT HI Carrie! Nice to see you here!

Answer:

I am having a hospital birth, and I was originally planning on writing a birth plan, but as I've preparred for this birth, I changed my mind. I am the type who finds security in planning things, especially if I feel the situation is out of my control, and I found myself getting really caught up in trying to control my labor/birth through the birth plan. I talked with my doula about this a lot, and I came to the conclusion that I would most likelly be setting myself up for deep disappointment if the actual birth diverted too much from any "plan" I tried to hammer out. So rather than investing a lot of energy in writing a plan, I've clearly communicated my wishes to my dh, my doula and my OB and I have focused my energy on letting go of my fear and letting go of my need to control things. I trust my dh and doula will advocate for me, and I trust that my OB will allow me to birth as naturally as possible. (In talking with her, I found out she gave birth to both her children naturally - this really helped put my mind at ease... I don't feel like she'll be pushing drugs or looking down on me for doing it the "hard way".) I will, however, be posting a sign on the door (a la Birthing From Within) directing anyone entering the room to not offer me any drugs. I figure that's something a member of the nursing staff might think is helpful and by the time it's been spoken, it's too late for my dh or doula to advocate for me, so I'll take the preventative measure.
So anyway, I know how I want things to go, and I've let everyone know my wishes. If for some reason things don't go exactly as I'd hoped, I feel better preparred to handle that disappointment than if I had set it all in stone.
I guess you could call it my birth non-plan. :)
Megan

Answer:

Hi, I knew you were here. I was wondering when we'd run into each other.lol
I do agree that with a birth plan you have to be prepared that things may not go the way you wish them to.

Answer:

In addition to my birth plan I wrote a birth philosophy so that if all other details fell apart the staff I was working with still knew what my priorities were. For example, even if an emergency had come up I still wanted the baby respected and not poked and prodded any more than necessary, I still wanted full decision making ability and time to consider my options. I think that helped me feel like my birth would be successful even if not every single detail went as planned. But thankfully for me - everything did!! And I give 100% credit to great preparation and a wonderful midwife/doula team! They said having the birth philosophy helped them feel like they could have guessed my preferences on things if they couldn't find a specific item in the plan.
So consider attaching a short 4-5 sentence birth philosophy to your birth
plan
Kelly

Answer:

I used this tool to help me get started with my birth plan. It helped me to remember all the different areas I wanted to cover. hth

Answer:

pm'd you mine ;)

Answer:

BIRTH PLAN FOR XX & XX XXX
IN EVENT OF TRANSFER OF CARE TO A DOCTOR OR HOSPITAL
DUE DATE September 03, 2002
MIDWIVES XXXX Midwives
PARENTS XX & XX XXX
LOCATION OF BIRTH Home
DOULA XX XXX
ALTERNATE LOCATION XX XX Hospital
My husband and I are expecting our first child and are expressing the following wishes for the birth of our child. We have taken advantage of many sources of information so that we could make informed decisions about our care. As such, we are aware that giving birth is an unpredictable experience, and that these choices may need to change in an emergency.
DESCRIPTION OF THE BIRTH EXPERIENCE WE ARE HOPING FOR:
- A birth which resembles a home birth as much as possible, emphasizing on natural alternatives whenever possible.
LABOUR
- Labour to start and progress naturally, without any time limits and without augmentation.
- Please DO NOT offer pain medications, I will request them if I feel the need.
- Maintain my mobility throughout labour
- Vaginal exams kept to a minimum.
MONITORING
- After the initial strip, to have only intermittent monitoring done via fetoscope or Doppler.
- No internal monitoring unless baby has shown signs of distress.
BIRTH
- Once fully dilated, to try to wait until I feel the urge to push before beginning the pushing phase.
- Delivery to be self-directed with the option of using various positions including squatting.
- Please do NOT give me a routine injection of oxytocin to deliver the placenta, unless my bleeding is heavy, or other factors are present that may predispose me to heavy bleeding.
- Baby placed immediately on my stomach or chest after birth.
- Husband to announce the baby’s gender, and be given the option of cutting the cord.
- Delay clamping and cutting of corduntil the pulsing has stopped.
NEWBORN CARE
- I will be breastfeeding and would appreciate that no artificial nipples be given to the baby.
- Would like to postpone weighing and routine procedures for an hour after birth to allow bonding time for parents and newborn.
CAESAREAN SECTION
- Should a caesarean section become necessary:
I would prefer an epidural or spinal anaesthetic
I would like my husband present during the birth
Would like one arm free to hold baby after birth
Would like the opportunity to breastfeed immediately
UNEXPECTED OUTCOMES
- If I am unable to care for my baby, I would like my husband to care for him/her. I would prefer that the baby receive my breast milk.
- If the baby is ill, would like unlimited visitation for parents as well as handling and breastfeeding the baby (kangaroo care). If the baby is transported to another facility, please move us as soon as possible.
- If my baby is stillborn or dies after birth, and organ donation is possible, I would like the baby to be an organ donor.

Answer:

Thank you all so much for sharing, I am getting tons of ideas!!
organ donation is possible, I would like the baby to be an organ donor. That is something I would have never thought of, dh and I are both organ donor's, God forbid something happens to Peanut, we would want him to help another baby live.

Answer:

Well I am birthing in a military hospital in Sicily. Mine is EXTREMELY detailed. I gave one to my doc, one in my file and one we will be bringing with me. I have also made signs for the bassinet and signs for the door, as well as a shortened verson of the birthplan we will have the corpsman read. Mine is detailed because I don't know who will be delivering the baby. Probably my doc but there could be a chance it will be some random military doc who doesn't know what I want. I also asked about the procedures of the hospital and basically wrote what I wanted in regards to all of those procedures. My doc has agreed to it all and has been really supportive.
I don't think it will be a problem EXCEPT for the newborn procedures. Also they want to take the baby off in a warmer for two hours to monitor him/her. I am saying no way but I imagine it will be a fight.
here is is:
This birth plan is intended to express the preference and desires we have for the birth of our baby. It is not intended as a script. We fully realize that situations may arise in such that our plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to guide us toward the birth experience we desire.
We have prepared for the birth by taking childbirth classes and reading many books on childbirth and natural labor. We expect to be part of the decision-making when interventions are needed. We do not want any medical procedure done on either mother or baby unless one of us has given explicit consent to that procedure. We would like to stay in charge of our own labor, with assistance of the hospital staff where needed. We are trying for a gentle, unmedicated birth.
Fetal monitoring: We do not wish to have continuous fetal monitoring unless required by the condition of the baby. We expect that there will be a period of being monitored by the external fetal monitoring upon first arriving at the hospital, and afterwards monitoring will be intermittent as long as everything looks ok.
IV/Heplcok: I do not want an IV unless I become dehydrated. I will accept having a heparin lock inserted into a vein upon admission to the hospital, but without the IV being connected until it is needed. No medication should be given to me in an IV unless fully discussed with my husband and me.
Internal exams: I would like to keep the number of internal exams to a minimum.
Artificial Rupture of Amniotic Membrane: I do not wish to have the amniotic membrane ruptured artificially before the birth unless signs of fetal distress require an internal monitor. I do not want the internal monitor unless the baby has already shown some sign of distress.
Pain Relief: I am planning on an unmedicated, natural childbirth. Even if I am screaming for drugs, I would prefer that none be offered to me. Instead I would like to use relaxation techniques, breathing, massage, water therapy, position changes, walking and emotional support to deal with the pain. In the event that I do decide I would like some pain relief, my husband will inform the birth team of our decision.
Pushing: If there is a small remaining "lip", but the urge to push is quite strong, I may request manual assistance in the final dilation (although we know this is a very painful technique).
I would like to push in a variety of upright positions to enable gravity to help the process. If, however, second stage is proceeding very rapidly (as it occurred in my first labor), I may elect to lie on my side, to allow for a slower and more managed delivery. I request that hot compresses and perineal massage with warm oil be performed during second stage to help the perineum to stretch and to reduce tearing. I request manual perineal support during pushing contractions to reduce tearing. I also reserve the right to change my mind about any/all of these measures at the time if I find them too distracting, uncomfortable, or unhelpful.
Episiotimy: I does not want to receive a routine episiotomy; I prefer to risk a natural tear. I would prefer, if it came to it, to tear than to be cut, since research has shown that "natural" tears heal more quickly and with less pain than episiotomies. One possible exception to this is buttonholing", where a cut would be performed to direct 3rd degree tearing away from the anus and rectum; or situations of severe fetal distress, where the baby needs to come out extremely quickly.
WHEN OUR CHILD HAS ARRIVED
We feel that our child is part of our family the moment s/he is born. We want to give our child as gentle an entry into the world as possible. As with our older child, any (non-emergency) procedure on the baby will be done only with our explicit permission, and in a way that we are comfortable with.
When our child is born, we want her/him to be placed on my belly barring any medical problems. I plan to breast-feed as soon as possible and we would like our child to be checked out while he is lying on top of me, skin to skin.
I would prefer to discover and announce the baby's sex. It’s a surprise! PLEASE don’t say anything until I get the chance to look!
Following Delivery: Immediate and prolonged skin-to-skin contact between mother and baby and immediate attempt at breastfeeding to promote natural delivery of placenta.
Umbilical cord: Clamped and cut by baby's father after it has stopped pulsating.
Newborn screening/testing/vitals: We would like weighing of baby and footprints to be postponed several minutes; we would like to delay any drawing of baby's blood until later.
• Please no antibiotic eye ointment. We will sign a waiver if needed.
• If we have a son, no circumcision.
• Please, no PKU test until the baby has had a few days of breastmilk. We realize that breastmilk has lower levels of phenylalanine, so it takes longer to build-up in the blood of the baby. Our research has shown that tests given to breastfed babies within the first 24 hours are often inaccurate. We will sign a waiver if needed.
• We do not want our child to receive the vit K either orally or by injection unless a traumatic birth has ensued (a bruised head, trauma to one or both arms, necessary instrumental delivery or if any extra stimulation is required to start breathing). If we decide for the vit K, we prefer the oral administration to the IM vit K due to its link to childhood leukemia. We will sign a waiver if needed.
• We do not want our child to receive the Hep B immunization.
Separation: We feel very strongly about not being separated from our baby at any point. When necessary for the baby to leave my side, Nate (Daddy) will accompany him.
Feedings: I plan on breast-feeding exclusively. Please no suppliments, bottles or pacifiers.
CONTINGENCY PLANS
C-Section
We want to discuss any problems and the associated risks unless there is a medical emergency. If I require a C-section, we want Nate to be present unless there is an emergency. We would like to use an epidural anesthesia rather than general unless there is an emergency. We prefer that the anesthesia take effect before the catheter is inserted and that there are no "hot spots" (areas which are not yet numb) before the surgery begins. We would like to hold the baby after delivery if she doesn't need immediate medical attention.
Ill Baby
If complications arise with the baby, we would like to remain as involved in her care as possible. If possible, we still want to hold and nurse the baby as soon after delivery as is reasonable.