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-   -   Do you make up a birth plan? (http://www.diaperswappers.com/forum/showthread.php?t=382389)

keegans_mommy 04-02-2008 08:01 AM

Do you make up a birth plan?
 
I am busy putting mine together and I wonder how many OBGYN's actually GET one from their clients? It seems to me that most women will just turn the reigns over to the OB and do what he/she says.

I am in the process of deciding on what I will and will not allow. So far I want everything I can have with a homebirth with NO vax's and no eye goop. I am looking into the oral Vit. K instead of the injectable. No circ is also on the list. Now, if I can just avoid the hep lock!

OneFabMama 04-02-2008 09:07 AM

Re: Do you make up a birth plan?
 
I didn't make one last time. Because I had a hossy birth. I didn't want to get my hopes up, and then be seriously let down when something on the plan didn't happen. But, I had a great hossy birth.

I am not sure if I am going to do one this time either. Since, I AM having a HB - during the birth I can just say "I don't want that" or whatever. We'll see. I have an appt. today and am gonna ask her.

sunnymw 04-03-2008 02:55 PM

Re: Do you make up a birth plan?
 
I had one for my first birth, most of which was disregarded. Even though it had all 3 OB's signatures on it for approval. Go figure.

We're UCing this time but I will have a backup of "Things I prefer" and "I DO NOT CONSENT TO...xyz" etc. Otherwise I'll get railroaded into some horrible stuff w/o even being asked again. I mean jeez, I didn't even KNOW they had given Hep B until I saw the bill for it! The I DO NOT CONSENT TO list will be taped up by DH in several places as soon as we arrive, if there is time.

keegans_mommy 04-03-2008 03:11 PM

Re: Do you make up a birth plan?
 
Sunny, that's horrible! I so hope that our hospital will respect us, I am one mean mama bear when the line is crossed concerning my children!

mhaddon 04-03-2008 04:07 PM

Re: Do you make up a birth plan?
 
Hmm... I had a birthing plan w/ DS1 and they didn't respect anything b/c everything was deamed medically necessary :irked: I think if they want to do it they will find a way around it. Good luck!

ClothDiaperMePlease 04-03-2008 04:13 PM

Re: Do you make up a birth plan?
 
Here is mine: Obviously the layout is prettier in Word, lol.

The following notes represent both Carl’s and my choices concerning the labor, birth, delivery and immediate care of our child.
Carl and I have considered these choices very carefully, and have discussed them with care providers. However, we do recognize that we need to remain flexible and open minded about these decisions. We understand the need to be prepared for any last minute and urgent changes that may occur.
Foremost, we wish to be informed of medical reasons, benefits, risks, alternatives, etc. of each procedure prior to it being preformed; also, we ask for time to discuss the options with staff prior to treatment. We are looking forward to being actively involved in the birth of our third child.

Labor
¯ My support is Carl *** and Sara ***. I would like them to be present at all times during my labor and/or delivery.
¯ We would like to be free to walk around during labor, as well as to be able to move around and change position at will throughout labor; including the option to use the birthing ball, squat bar, music and bath as methods of relaxation, stimulating progress, and pain relief.
¯ We do not want an IV unless it becomes medically necessary; we also prefer that no or minimal labs, vaginal assessments and fetal monitoring be done.
¯ We would like the lights in the room to be kept low during my labor.
¯ We do not wish to have an episiotomy, however if it were necessary, after discussion, we would ask that a pressure episiotomy be preformed. No local anesthetics please.

Labor Augmentation/Induction
¯ We do not wish to have the amniotic membrane ruptured artificially, unless signs of fetal distress require it.
¯ We would prefer to be allowed to try changing positions and other natural methods (walking, nipple stimulation) before any medications are administered.

Anesthesia/Pain Medication
¯ We realize that many pain medications exist — I'll ask for them if I need them, however I have taken Bradley Classes, and have had 2 prior natural births. We are prepared for the discomfort that undedicated and natural childbirth brings.

Delivery
¯ We would like to choose the position in which I give birth, including using the squatting bar.
¯ We would like to have Carl or the nurses to support me, and my legs, as necessary during the pushing stage.
¯ We would like a mirror available so I can see my child's head when it crowns.
¯ I would like the chance to touch my child's head when it crowns.
¯ We would like to have our child placed on my stomach/chest immediately after delivery.

Cutting the Cord
¯ We do not want the umbilical cord cut or clamped until after it is finished pulsating; we realize that this may take a little while, but feel it is the best for our child.
¯ Carl does not wish to cut the cord, but I do.



Immediately Following Delivery
¯ I would like to attempt to breast feed/ nurse immediately.
¯ We would like to delay any routine procedures until after the first feeding.
¯ I plan to keep my child near me following birth and would appreciate if the evaluation of my child, and warming, can be done with my child on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.
¯ I would like to hold my child while I deliver the placenta and any tissue repairs are made.
¯ If my child must be taken from me to receive medical treatment, Carl or some other person I designate will accompany my child at all times.

Postpartum
¯ We do not wish to be transferred to any area of the hospital other than the maternity ward.
¯ Unless required for health reasons, I do not wish to be separated from my child.
¯ I would like to have my child 'room in' and be with me at all times.

Breastfeeding
¯ I plan to breastfeed my child and would like to begin nursing immediately after birth.
¯ We do not wish to have any bottles given to my child (including glucose water or plain water).
¯ We do not want my child to be given a pacifier.

Circumcision
¯ We do not want my child circumcised.

Photo/Video
¯ We would like to have still photographs taken during labor and the birth.

Other
¯ At any time I may decide to not allow certain staff or family members to remain in the room. Also, I do not wish any family members, other than my husband and possibly my older sons, to be present for the delivery. Sara *** is a support for me and will be asked to stay with me.

Cesarean
¯ If a Cesarean delivery is inevitable, we would like to be fully informed and wish to participate in the decision-making process.
¯ We would like Carl ** and Sara ** present at all times if my child requires a Cesarean delivery.
¯ We wish to discuss different forms of anesthesia.
¯ We would like one of my arms left free for touching the baby and such.
¯ If our child is not in distress, s/he should be given to Carl immediately after birth.
¯ We would like the option of nursing our child immediately; with either Carl or I holding him/her.

goldmama22 04-03-2008 04:50 PM

Re: Do you make up a birth plan?
 
As a doula, here is what I do.

What we make are 3 different birth plans. One is the "partner plan" and it looks like the above poster's plan... it has all the details of what the couple prefers for the birth, to help Dad advocate for their wishes if he forgets during the course of the birth.

One is the "doula plan" and it reminds me of their wishes not only for medical intervention but for comfort measures (i.e. "prefers Dad to massage legs/feet instead of doula"). Obviously if you don't have a doula you don't need this one and would only have 2 if you go with my method.

The third is the hospital birth plan. It is way shorter than the partner plan. It only includes things that are 1) not already normal hospital policy, 2) are actual choices you can make at that hospital, 3) are not things that are really easy to communicate or do yourself at any time (for example, keeping the lights low or keeping yourself mobile and active). Also, the birth plan is an effort to make your birth personalized - so make sure it doesn't sound like you are depersonalizing the nurses! The best birth plans make the nurses get invested in you and your care. Making the tone very personal and about your emotional needs, as well as making the tone very respectful of the nurses and the fact that they are there to help you, can help them become real team players with you.

That said, the partner plan (aka long version) should either be shared with the doctor, or the mom should already know that her doctor is OK with everything on it (or ask specifically about anything she is unsure about). If there is anything she and her OB/midwife have agreed upon that is not normally OK at that hospital, the birth plan will not do a darn thing, even if it is signed by the doctor. The doctor may be willing to write standing orders into the mom's chart ahead of time; otherwise, the nurse will have to call the doctor to get those orders, and you can imagine that they don't like to do that at 3am (nor do the dr's like to be called at 3am).

Keegans_mommy, if you would like to share what you've written I can specifically comment. Similarly, ClothDiaperMePlease, I would be happy to show you how I would whittle yours to bring as your hospital birth plan.

Hope this helps.

:) Megan

ETA: I just realized I am in a due date month I don't even belong in! Sorry to intrude! I just saw this as the most recent post under "pregnancy" and didn't notice the subforum!

glorybee 04-03-2008 05:05 PM

Re: Do you make up a birth plan?
 
Quote:

That said, the partner plan (aka long version) should either be shared with the doctor, or the mom should already know that her doctor is OK with everything on it (or ask specifically about anything she is unsure about). If there is anything she and her OB/midwife have agreed upon that is not normally OK at that hospital, the birth plan will not do a darn thing, even if it is signed by the doctor. The doctor may be willing to write standing orders into the mom's chart ahead of time; otherwise, the nurse will have to call the doctor to get those orders, and you can imagine that they don't like to do that at 3am (nor do the dr's like to be called at 3am).
Goldmama22 : This part confuses me a little. If you get your Dr to agree and sign on something isn't it okay even if they are not there at the time?

Quote:

Similarly, ClothDiaperMePlease, I would be happy to show you how I would whittle yours to bring as your hospital birth plan.
Goldmama22: I would love to see how something like this would be altered for the hospital. We are currently starting mine and it will be something similar to this. Thanks ClothDiapeMePlease! I was thinking on having the baby and birth separate though? Any thoughts you would share with the rest of us if this one was altered for hospital? P.S. I thought it was for the hospital. (:

goldmama22 04-03-2008 05:32 PM

Re: Do you make up a birth plan?
 
Quote:

Originally Posted by glorybee (Post 3219527)
Goldmama22 : This part confuses me a little. If you get your Dr to agree and sign on something isn't it okay even if they are not there at the time?

Unfortunately, because it is your personal document and not part of your chart, the hospital does not need to honor it, and to cover the hospital's behind as well as their own behinds, the nurses do need standing orders in your chart, or phone orders. Your birth plan is not orders. If it's something that is OK with the hospital but not their usual routine then the birth plan, or your spoken preference, should suffice.

That said, you always have the right to say, "I do not consent to this procedure." You may have to sign a form saying that you are going against medical advice, releasing the hospital from all liability. And they actually do have the ability to try to get a court order to force you, if they think it's that big of a deal for the baby (or their own legal protection).


Quote:

Originally Posted by glorybee (Post 3219527)
Goldmama22: I would love to see how something like this would be altered for the hospital. We are currently starting mine and it will be something similar to this. Thanks ClothDiapeMePlease! I was thinking on having the baby and birth separate though? Any thoughts you would share with the rest of us if this one was altered for hospital? P.S. I thought it was for the hospital. (:

Yes, it was meant for the hospital, which is why I don't want to show how I would change it for hospital use without her permission. I don't want to be rude. It's just a lot longer than what I would recommend to my own clients. If ClothDiaperMePlease doesn't want me to interfere, then you can feel free to PM me with yours when it's done and I can comment on it (actually you can do this regardless).

:) Megan

ClothDiaperMePlease 04-03-2008 05:56 PM

Re: Do you make up a birth plan?
 
I had 2, one for L&D and one for recovery.

That was my "inclusive" list for the doctors ;) feel free to do what you want with it, lol.

I am doing HB this time.

To be honest, both of my births were oncall doctors with the hospital and not my doctor, so nothing was followed.


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