Birth Plan for Hospital

[mollym]

Others are right: it's way too long and nurses aren't going to read it. Imagine--they have other patients and a lot going on. This is too much. So consider this your personal plan, review it with your birth team (husband, labor coach, doula, whoever). And then write a Cliff Notes version for the nurses.

My birth plan was really brief. It started with a nice, respectful intro that basically said, "I've put a lot of thought into what kind of birth I want to experience. I would like to avoid any unnecessary medical intervention, and this plan is designed to help achieve that. I understand that plans may change to make sure everyone turns out healthy, so I'll be flexible if necessary."

Then I made a bulleted list of just four things, in about 20-point font:

* I don't want pain meds. Please don't offer to me. If I change my mind, I'll let you know. I have prepared a whole bunch of alternative pain management techniques: bouncy ball, massage, etc.

* I want to be free to move around and try out different positions. I'd prefer not being hooked up to anything that limits my motion.

* When the baby is born, I want to hold him/her immediately. Please delay all non-essential tests for at least 30 minutes.

* I want my husband to announce the sex of the baby.

All of the above is paraphrased from memory, but you get the idea. Those four lines basically encompassed the most critical parts of the birth for me. A lot of other things (circumcision, breastfeeding, pacifiers, shots, etc.) had a standard hospital policy that meant I'd have to give approval or have the option to deny so no one was going to do anything without my consent.

As it was, I arrived at the hospital 10cm dilated (whoops!) so a lot of my very short list was not even applicable. Still, it helped that I had a long list (for me, husband, doula, and discussed with doctor in advance) and the nurses understood from my short birth plan that I was both informed and reasonable.

[MyLovely]

Just curious, since it has been mentioned that she "might not have a choice" in terms of a hep lock or eating/drinking freely...is there actually any way they can enforce that? I mean, if I show up and say "nope, no thanks" to the heplock and pull out some gatorade and pretzels, what would they do?

[mollym]

MyLovely, you certainly can refuse an IV or choose to eat. The doctor and nurses can't MAKE you do anything. On the other hand, I believe in picking and choosing your battles. You want these people to like you because your care will probably be better if they do.

My mind was set that I'd agree to a hep lock (even though I didn't really want one) and I'd bring my own food to eat if I was hungry. As it turns out, I showed up at 10cm dilated and the medical team was so busy that I was able to sneak by without an IV (woohoo!) and my birth was fast enough that I never got hungry until after my son was born.

[faithfulorangekids]

Originally Posted by MyLovely Just curious, since it has been mentioned that she "might not have a choice" in terms of a hep lock or eating/drinking freely...is there actually any way they can enforce that? I mean, if I show up and say "nope, no thanks" to the heplock and pull out some gatorade and pretzels, what would they do?

Since I have a milk protein allergy, I would probably have to bring my own foods since I'm afraid of what foods they have for it

Thanks for the tips! I didn't know that my tone came off mean sounding. I'm usually laid back. So I'll change my plan to short and sweet and to the point.

After someone mentioned a doula, I decided to research it and I definitely will get one.

I researched some more and decided I'm willing to sacrifice a water birth and go ahead and do it at Anne Arundel. Because I can have a midwife and they are pro natural births. I'll be going there for a tour beforehand. My insurance won't cover any home births/ birth centers so this would be second best.

[Tris]

Hospitals really aren't the enemy, they aren't some big scary monster waiting to tie you down and force you to labor on your back strung up on meds ( anymore!!). I would find out what your hospital actually does in terms of all of those, and then re-write accordingly. Make a detailed list for your H, so he knows what you want and can advocate for you in case you can't, and make a separate list for your nurses, nothing that includes standard procedure. It could be like, please don't offer me meds, after the babe is born I want to delay newborn procedures for immediate tummy time and I want to catch the babe. Please let my H announce the gender. Stuff that in the moment could be hard to say, and that if you told one crew wouldn't be passed to the next crew. Keep it simple and people will be more likely to read it positively

[MyLovely]

Oh, I definitely don't think that doctors are out to get me. I just hear all the time about how women get heplocks and forego food and beverages because it's hospital policy and they're "not allowed." I guess I'm just curious as to how hospital policy is actually enforceable.

Oh, and I understand it can be beneficial to have a heplock in place in case of sudden emergency. But if a paramedic can quickly put an IV in someone bleeding out, upside down and stuck in a car, I would think a doctor could wrangle one into a lady laying on a bed

[Caz]

Special Beginnings does births at AAMC as well as at the Birth Center, according to their website. Will your insurance cover a hospital birth with the SB midwives?

[z2akids]

Originally Posted by MyLovely Oh, I definitely don't think that doctors are out to get me. I just hear all the time about how women get heplocks and forego food and beverages because it's hospital policy and they're "not allowed." I guess I'm just curious as to how hospital policy is actually enforceable. Oh, and I understand it can be beneficial to have a heplock in place in case of sudden emergency. But if a paramedic can quickly put an IV in someone bleeding out, upside down and stuck in a car, I would think a doctor could wrangle one into a lady laying on a bed

The hospital's first priority with any patient is safety. These are things that are evidenced based to keep patients safe. The problem is that the people who are more likely to refuse an IV and insist on eating are also likely to be the same people who don't want to be monitored, want to avoid exams, etc. All in all, those patients are the ones who - if something goes wrong - are less likely to be caught early due to the cascade of choices that are made.

I suppose if you really wanted to look at it, these policies are not completely enforceable. No hospital has the staffing for 24/7 continuous care of every patient who might need emergency surgery. If you want to sneak food, then you will have opportunities to do so. The hospital however will make your status NPO, which means that food services is not going to bring you a tray. In an emergency, you cannot uneat the food in your stomach. And, because your digestive system slows during labor/delivery, anything you eat is going to sit around longer to be aspirated in an emergency. Honestly, my first two labors were both close to 24 hours and I don't think I ever once thought about food. My body was far too busy doing something else (and my digestive tract was slow) to be worried about food.

The difference with paramedics is that those people who are bleeding out in the ambulance are already dead without extreme circumstances. If they get in a line, great. If they don't, they don't. Anyone in that situation who makes it to the hospital alive and survives is a life saved that would otherwise have been list. Those paramedics are good, but sometimes they cannot get a normal IV started. When they can't, they can put in an interosseous line. An IO line goes into the bone. It is quick, efficient, nearly certain access and definitely used in emergencies and not routinely. No one is sitting in the ambulance trying over and over to stick a patient who is bleeding out. A try or two and they move on to IO or other options.

However, in the hospital, if a mom in labor begins to hemorrhage, and they cannot get a line in, it is 2 lives lost that should have been saved. Absolutely an IO line can be put in in the hospital. But, there is increased risk of infection. Removal is very painful. But, if you refuse IV access during labor, it may be the only quick means of knocking you out for an emercency C-section or other lifesaving treatment. No one plans to be the person will need emergency access. If we could plan that, then we could avoid putting IVs in the majority of hospital patients.

[EmilytheStrange]

Originally Posted by z2akids The hospital's first priority with any patient is safety. These are things that are evidenced based to keep patients safe. The problem is that the people who are more likely to refuse an IV and insist on eating are also likely to be the same people who don't want to be monitored, want to avoid exams, etc. All in all, those patients are the ones who - if something goes wrong - are less likely to be caught early due to the cascade of choices that are made. I suppose if you really wanted to look at it, these policies are not completely enforceable. No hospital has the staffing for 24/7 continuous care of every patient who might need emergency surgery. If you want to sneak food, then you will have opportunities to do so. The hospital however will make your status NPO, which means that food services is not going to bring you a tray. In an emergency, you cannot uneat the food in your stomach. And, because your digestive system slows during labor/delivery, anything you eat is going to sit around longer to be aspirated in an emergency. Honestly, my first two labors were both close to 24 hours and I don't think I ever once thought about food. My body was far too busy doing something else (and my digestive tract was slow) to be worried about food. The difference with paramedics is that those people who are bleeding out in the ambulance are already dead without extreme circumstances. If they get in a line, great. If they don't, they don't. Anyone in that situation who makes it to the hospital alive and survives is a life saved that would otherwise have been list. Those paramedics are good, but sometimes they cannot get a normal IV started. When they can't, they can put in an interosseous line. An IO line goes into the bone. It is quick, efficient, nearly certain access and definitely used in emergencies and not routinely. No one is sitting in the ambulance trying over and over to stick a patient who is bleeding out. A try or two and they move on to IO or other options. However, in the hospital, if a mom in labor begins to hemorrhage, and they cannot get a line in, it is 2 lives lost that should have been saved. Absolutely an IO line can be put in in the hospital. But, there is increased risk of infection. Removal is very painful. But, if you refuse IV access during labor, it may be the only quick means of knocking you out for an emercency C-section or other lifesaving treatment. No one plans to be the person will need emergency access. If we could plan that, then we could avoid putting IVs in the majority of hospital patients.

I love this

You never think it'll be you or your baby. But it's someone and it's someone's baby.

Besides, we get more difficult to stick with a needle when our contractions are coming quickly and we're in the 'do not touch me!' or 'I'm contracting, I can't sit still!' state of mind.

It is amazing how little I cared about food though. Didn't even really want it after 24 hrs either. Had to literally force myself to eat telling myself I needed the calories to make breastmilk. This continued for about a week for me. If it wasn't the desire to nurse, I think I would have simply survived on adrenaline.

[Tris]

Ita with z2a. I actually did a heplock with my med free hospital birth, because its there for an emergency. It didn't hurt, it didn't hinder me in any way, it didn't make the nurses or doctor want to hook it up and take charge or anything, it's there for the emergency best of my and my kid to be. Same with the food, I actually had absolutely zero urge to eat anything but ice chips, but even if I had I wouldn't sneak it because it can be dangerous to have food in your stomach during anesthesia, again, if the case arises. I've heard recommendations to keep it simple, Cheerios or saltines if you are really hungry, but it's something I'd run by the nurses if the case arises.