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-   -   Can you critique/offer any pointer on my birth plan please? (http://www.diaperswappers.com/forum/showthread.php?t=1469649)

EmilyA874 12-05-2012 06:51 AM

Can you critique/offer any pointer on my birth plan please?
 
*another revision is in post 15, thank you all for your input and help!*

I'm aiming for a natural hospital birth. Some of you might know a bit or my story already since I have posted before, we are expecting a boy with the heart defect Tetralogy of Fallot and I will be induced sometime in my 39th week because we live 3 hours from the hospital he needs to be at. So, this is what I have for my birth plan! Can you help me add/take away as needed? Thanks :goodvibes:
The dashes are just where peoples names are, I blocked them out for privacy :)

I feel like it is too long, but I am not sure what to take out.

Birth Preferences for A----- ------
Due Date: 1/14/2013
Patient of ------


We are looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate your reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments.
Thank you!
A----- and S--- ------

Please Note
Our baby boy has been diagnosed with the heart defect Tetraogy of Fallot.
Despite this diagnosis our cardiologist, Dr. -----, has said we can have time to hold and bond with our baby before he is taken to the NICU. Please allow us time to hold and bond with our baby as long as he is not showing any signs of distress. Thank you.

Labor
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
I would prefer to have a heparin lock administered instead of an IV.
Please limit the number of vaginal exams as much as possible.
I wish to labor freely in the tub or shower.
I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler.
Do not offer anesthesia/analgesia unless I ask for it.
If I ask for pain relief, please feel free to offer nonmedical choices for coping and/or remind me how close I am to the birth.
I would rather tear than have an episiotomy unless there is a medical indication.
Please suture tears only if necessary and administer local anesthesia when repairing.

Delivery
Even if I am fully dilated, and assuming our baby is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.
I prefer to not be guided or coached to push.
I would like the freedom to push and deliver in any position I like.
I would like to touch our baby's head as it crowns.
I would like a soothing environment during the actual birth, with dim lights and quiet voices.
I would like to help catch our baby.
Please place our baby on my stomach/chest immediately after delivery.
Please allow the umbilical cord to stop pulsating before it is cut.
My husband S--- would like to cut the cord.
I prefer to wait for spontaneous delivery of the placenta and do not want a routine injection of pitocin or cord traction to be used.
Please remove my IV/Heparin lock/catheter as soon as possible after delivery.

Newborn Care
I would like to hold our baby skin-to-skin as long as possible after birth and attempt breastfeeding.
My husband Sean will accompany our baby for all evaluations and medical treatments.
I do not consent to administration of eye antibiotics. I will sign a waiver if necessary.
I would like Vitamin K administered orally. I do not consent to the administration of the Vitamin K injection.
I do not consent to the administration of the Hepatitis B vaccine.
We are not having our baby circumcised. Please do not retract his foreskin.

Postpartum Care
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.
I would like my other child to have free visitation access.
I would like baby to room with me at all times once he is released from the NICU.

Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.
Do not give our baby supplements (including formula, glucose, or plain water) without my consent.
I would like to meet with the staff lactation consultant.

*In the Event of a Cesarean Section Delivery*
I feel very strongly that I would like to avoid a cesarean delivery, however if a cesarean becomes necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like my husband Sean to be present during the surgery.
Please explain the surgery to me as it happens.
I would prefer general anesthesia in an emergency only.
I would like to have a respectful atmosphere without chatter during any part of the surgical procedure.
If possible, please do not strap my arms to the table during the procedure.
If conditions permit, I would like to be the first to hold our baby after the delivery.
If possible, I would like to breastfeed our baby immediately after the birth.
I would like our plans outlined here for after the birth to be followed as closely as possible.
Please lower the screen just before delivery so I may see the birth of the baby.
I prefer a low transverse incision
Please use double-layer uterine suturing to close my incision.


-----------original below---------


Birth Preferences for A----- ------
Due Date: 1/14/2013
Patient of ------


We are looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate your reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments.
Thank you!
A----- and S--- ------

Please Note
Our baby boy has been diagnosed with the heart defect Tetraogy of Fallot.
Despite this diagnosis our cardiologist, Dr. -----, has said we can have time to hold and bond with our baby before he is taken to the NICU. Please allow us time to hold and bond with our baby as long as he is not showing any signs of distress. Thank you.

Labor
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
So I can stay as mobile as possible, I would prefer to have a heparin lock administered instead of an IV.
I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions.
Please limit the number of vaginal exams as much as possible.
I wish to labor freely in the tub or shower.
As long as our baby is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler, even if my membranes have ruptured.

Anesthesia/Pain Medication
Please do not offer anesthesia/analgesia unless I ask for it.
If I ask for pain relief, please feel free to offer nonmedical choices for coping and/or remind me how close I am to the birth.

Perineal Care
I would rather tear than have an episiotomy unless there is a medical indication.
Please suture tears only if necessary and administer local anesthesia when repairing.

Delivery
Even if I am fully dilated, and assuming our baby is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase. I prefer to not be guided or coached to push.
I would like the freedom to push and deliver in any position I like.
I would like the opportunity to touch our baby's head as it crowns.
I would like a soothing environment during the actual birth, with dim lights and quiet voices.
I would like to help catch our baby.

Immediately after the birth
Please place our baby on my stomach/chest immediately after delivery.
I would like to breastfeed our baby immediately.
My husband S--- would like to cut the cord.
Please allow the umbilical cord to stop pulsating before it is cut.
I prefer to wait for spontaneous delivery of the placenta and do not want a routine injection of pitocin.
Please show me the placenta after it is delivered.
Please remove my IV/Heparin lock/catheter as soon as possible after delivery.

Newborn Care
I would like to hold our baby skin-to-skin as long as possible after birth.
My husband S--- will accompany our baby for all evaluations and medical treatments.
I would like to waive the administration of eye antibiotics.
I would prefer to have Vitamin K administered orally or not at all if orally is not an option.
I would like to defer the following vaccinations: hep B

Postpartum Care
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.
I would like my other child to have free visitation access.
I would like baby to room with me at all times once he is released from the NICU.

Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.
Please do not give our baby supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
I would like to meet with the staff lactation consultant.

Additional notes
We are not planning to have our baby circumcised. Please do not retract his foreskin.

*In the Event of a Cesarean Section Delivery*
I feel very strongly that I would like to avoid a cesarean delivery, however if a cesarean becomes necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like my husband Sean to be present during the surgery.
Please explain the surgery to me as it happens.
I would prefer general anesthesia in an emergency only.
I would like to have a respectful atmosphere without chatter during any part of the surgical procedure.
If possible, please do not strap my arms to the table during the procedure.
If conditions permit, I would like to be the first to hold our baby after the delivery.
If possible, I would like to breastfeed our baby immediately after the birth.
I would like our plans outlined here for after the birth to be followed as closely as possible.
Please lower the screen just before delivery so I may see the birth of the baby.
I prefer a low transverse incision
Please use double-layer uterine suturing to close my incision.

mommycass 12-05-2012 07:21 AM

Re: Can you critique/offer any pointer on my birth plan please?
 
Wow mama, that's awesome! I think you are very well detailed in your plan. I do think that maybe you should have a seperate list of the things that mean the most to you. I'm having a homebirth but discussed the possibility of a hospital birth with my OB and my wants were very similar to yours. My OB told me if I wanted it my way then a homebirth was best. I know your situation is different so I would be sure to have a few people with you that can focus on the labor and delivery and then one to stay with you and one with baby if/when your seperated. Make sure your birth team knows your wants specificly so they can pay attention and advocate for you. I hope you get the birth experience you want:)
Just wanted to mention you left your DHs name at the end and in the cord cutting part.

mommycass 12-05-2012 07:21 AM

Re: Can you critique/offer any pointer on my birth plan please?
 
DP

EmilyA874 12-05-2012 08:10 AM

Re: Can you critique/offer any pointer on my birth plan please?
 
Quote:

Originally Posted by mommycass (Post 16007718)
Wow mama, that's awesome! I think you are very well detailed in your plan. I do think that maybe you should have a seperate list of the things that mean the most to you. I'm having a homebirth but discussed the possibility of a hospital birth with my OB and my wants were very similar to yours. My OB told me if I wanted it my way then a homebirth was best. I know your situation is different so I would be sure to have a few people with you that can focus on the labor and delivery and then one to stay with you and one with baby if/when your seperated. Make sure your birth team knows your wants specificly so they can pay attention and advocate for you. I hope you get the birth experience you want:)
Just wanted to mention you left your DHs name at the end and in the cord cutting part.

Thanks for letting me know about my Dh's name in there still! I have talked with my OB about nearly all of these things and he is very open to what I am hoping for, the plan is mostly t give the nurses and NICU doctors so they know too. Thanks for you tips!

I changed some wording and tried to condensed things a bit, copy and pasted the revision in the original post if I could get some more feedback I'd appreciate it! Thanks!

mommycass 12-05-2012 08:39 AM

Re: Can you critique/offer any pointer on my birth plan please?
 
That's awesome that your OB is open to your plan! It's hard to find that here. Again I think your plan is awesome and well thought out, can't think of anything I would add or take out:thumbsup:

gingerpeachee 12-05-2012 12:43 PM

Re: Can you critique/offer any pointer on my birth plan please?
 
Quote:

Originally Posted by EmilyA874 (Post 16007626)

Labor
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
I would prefer to have a heparin lock administered instead of an IV.
Please limit the number of vaginal exams as much as possible.
I wish to labor freely in the tub or shower.
I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler.
Do not offer anesthesia/analgesia unless I ask for it.
If I ask for pain relief, please feel free to offer nonmedical choices for coping and/or remind me how close I am to the birth.
I would rather tear than have an episiotomy unless there is a medical indication.
Please suture tears only if necessary and administer local anesthesia when repairing.

A hep lock is an IV.... I think you are wanting to say you don't want to be hooked to IV Fluids. ;)

EmilyA874 12-05-2012 12:46 PM

Re: Can you critique/offer any pointer on my birth plan please?
 
Quote:

Originally Posted by gingerpeachee (Post 16009125)
A hep lock is an IV.... I think you are wanting to say you don't want to be hooked to IV Fluids. ;)

:blush: Oh. Thank you for pointing that out!

EmilytheStrange 12-05-2012 02:15 PM

Re: Can you critique/offer any pointer on my birth plan please?
 
great plan - I just would say that you should have a cover sheet with just bullet points. My hospital midwife told me that it should be no longer than one page and be very concise.

If you want to attach something very detailed like this, that's great, but something very simple that a nurse can scan and understand would be ideal.

ETA: I would also say to talk to the hospital about their practices and you could maybe leave some things out. For instance, some hospitals allow food and drink and some don't. So, if yours does or doesn't, then you don't need to put that in there - the rules will apply either way.

If your hospital has rules about the position you'll be in for pushing, then you can't stipulate how that'll happen, but if they do not have any rules, then you'll be fine. Some hospitals routinely give the baby directly to mom for skin to skin contact, so you wouldn't need to stipulate that unless it's not routine for your hospital.

etc etc.. things like that.

cdeweese 12-05-2012 02:33 PM

Re: Can you critique/offer any pointer on my birth plan please?
 
I would also take this to your OB beforehand and discuss if any of these things conflict with hospital policy. That way you can come to an agreement with your OB ahead of time and it will make your arrival at the hospital during labor much less stressful :) I also brought a basket of goodies for my nurses and staff (they LOVED that). I also expressed my gratitude anytime they worked with me on a sticky subject.

KelseyH 12-05-2012 04:38 PM

If you are familiar with the staff at your hospital, then certainly use your judgment, but our local hospital is staffed mostly by medical professionals who see things as "their way or no way" and anything I said that was prefaced by "I would like" or "would you please" or "I prefer such and such" was basically met with "well, that's not how we do things". They were simple requests, too, like a sandwich and OJ during an 18 hour labor. I only got "cooperation" when I said "I WILL eat during labor. Please bring me some food or I will get up and go find some myself." Or when I needed to use the bathroom and they wanted to cath me - at this point I only was attached to a fetal monitor. I politely declined and politely declined and finally had to say, "I am NOT going to be cath'ed, now I will take the fetal monitor off myself to go pee or you can help me wheel all of this crap into the bathroom."

I understand my hospital may (or may not) be the exception to the rule, but I would take out the nice fluff. I will, I will not, I do not consent to, I do consent to, etc. I think I remember from reading some of your posts that you originally wanted a HB (is that right?) and I'm sorry you have to go to a hospital. :( My last birth is exactly the reason why I am planning a UC this time around. I would hope you'd see cooperation from your caretakers with a more kindly-phrased birth plan, but unfortunately (IME) many providers only take "no, ABSOLUTELY NOT" as an answer before they consider alternatives to SOP and totally disregard anything phrased more gently. :( I truly, truly hope that is not the case at your hospital, mama.


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