Birth Plan

12 posts / 0 new
Last post
AnnaRO's picture
Offline
Last seen: 3 months 1 week ago
Joined: 07/06/08
Posts: 7033
Birth Plan

I am working on writing up a birth plan, per my OB's request even! Biggrin I want to be thorough without going over the top. I know a lot (if not all) of you have written up a birth plan at some point and I am hoping that you are willing to share some pointers or key things that you felt were important. What is absolutely necessary and what is more flexible in your view? I won't complain if you share your complete birth plan, or just share some ideas.

TiggersMommy's picture
Offline
Last seen: 2 years 7 months ago
Joined: 02/14/10
Posts: 6043

My birth center didn't require a birth plan. Their standard care aligned perfectly with my birth plan so I didn't need one for them. I did have one just in case I transferred though. Oooh, and birth plan survived my hard drive failure! At least I have that. :rolleyes:

Anyway, I'll share the whole thing because copying and pasting is easy! Mine is probably a bit more confrontational than you might want yours to be. I chose to use language such as "I do not consent" when touching on certain topics to make it quite clear that I would sue the living crap out of them if they did it without my consent. I also used language such as "I will" instead of "I'd like" in instances where I would be doing something my way regardless of how much the doc yelled at me. I knew the "rules" of the hospital I'd be transferred to so I knew which things I'd likely have to fight for and which I wouldn't. Write everything out but keep in mind that everything goes out the window in an emergency and it really depends on the doc as to whether or not they'll read it in a non-emergency.

This is the one for a non-emergency transfer (ie going "post-dates"):
First stage:

• Do not offer pain relief, if I need it I will ask for it at which point I prefer IV narcotics over an epidural.
• If IV access is required, I request that a Heparin Lock be placed and left unattached.
• I would prefer that fetal monitoring be done intermittently with a Doppler or fetoscope by my midwife.
• I would like to try breaking my water, nipple stimulation, walking, and relaxation before any discussion of a medicated induction.

Second stage:

• Do not engage in directed pushing unless it is to allow for perineal stretching once the baby has crowned.
• I will give birth in a position I find most comfortable or that my midwife deems appropriate.
• Please avoid use of vacuum or forceps.
• I do not consent to an episiotomy, I would rather tear.
• If possible, my husband would like to “catch” the baby.
• Avoid suctioning of the baby’s airways.
• Place the baby directly onto my skin following birth.
• My husband or I would like to announce our baby’s sex.
• Please allow the cord to stop pulsing before handling/clamping/cutting.
• Please allow me or my husband to cut the cord.

Third stage:

• I do not consent to cord traction.
• Please allow 1 hour after birth for delivery of the placenta before intervening.

Newborn care:

• Our baby is to be left with my husband or me at all times.
• We do not consent to routine nursery time.
• We do not consent to the administration of the following and will sign any forms necessary:
o Hepatitis B vaccination
o Erythromycin eye ointment
o Vitamin K shot
o Any other vaccines
• If our child is male, we do not consent to a circumcision
• We will give baby his/her first bath.
• Do not offer bottles or pacifiers.
• We would like to delay our baby’s checkup for a minimum of 2 hours following birth.

In the event of a C-section:

• My husband is to be in the room.
• I would prefer a spinal over general anesthesia.
• If possible, the baby is to be immediately handed to me or my husband.
• Please allow my husband or I to announce our baby’s sex.
• Please allow the cord to stop pulsing before cutting.
• I would like to attempt to initiate breast feeding ASAP.
• If separation of the baby from mom is necessary, my husband is to accompany baby at all times.

SHORT AND SWEET EMERGENCY LIST:

• We do not consent to the administration of the following and will sign any forms necessary:
o Hepatitis B vaccination
o Erythromycin eye ointment
o Any other vaccines
• If our child is male we do not consent to a circumcision
• We will give baby his/her first bath.
• Do not offer bottles or pacifiers.
• Baby is to be accompanied by me or my husband at all times.

Offline
Last seen: 3 years 11 months ago
Joined: 12/10/05
Posts: 1681

As someone who works in maternity, I highly recommend finding out what are normal practices at the hospital where you'll be delivering. Talk to your OB about what is standard and do a tour so you can ask questions.

I am fortunate to work in an extremely natural childbirth friendly hospital (lowest c/s rates in our province!), but sometimes we get couples arrive with guns blazing and birth plan in hand... Then we read it and find nothing we don't ordinarily do.... Things like hydration in labour, mobilizing in labour, putting newborn skin to skin with mom immediately, auscultation with doppler is standard (unless you're high risk), no IV's (we don't put them in routinely), no soothers/bottles, etc. I have never written out a birth plan.

I know not everywhere is like this, but it will help to do your research first.

AnnaRO's picture
Offline
Last seen: 3 months 1 week ago
Joined: 07/06/08
Posts: 7033

"kris_w" wrote:

As someone who works in maternity, I highly recommend finding out what are normal practices at the hospital where you'll be delivering. Talk to your OB about what is standard and do a tour so you can ask questions.

I know not everywhere is like this, but it will help to do your research first.

Done!! Biggrin I had a long visit with my OB and then immediately toured the hospital birthing center with the perinatal educator, so I am aware of their routine policies. The hospital is surprisingly very natural birth friendly despite natural unmedicated birth not being at all popular in this region. My OB requested that I write out my birth plan simply because there is a possibility that another OB might be on call when I go in and there are 'a couple that have a different comfort level' with some of my wants. Should I end up with one of 'those' OB's the birth plan will ensure they consult with me before doing anything. Since unmedicated birth is so uncommon where I live, I want to be thorough about what I want, but before I give my birth plan to my OB, I wanted to see what some others had on theirs so that I don't overlook anything that might be important that I may not be thinking of.

Offline
Last seen: 3 years 11 months ago
Joined: 12/10/05
Posts: 1681

Gotcha! I'll keep my fingers crossed that your regular OB is on when you deliver Smile

I would say the main thing to stay away from, if you're trying to pick your battles, is continuous fetal monitoring - which is NOT recommended in low risk women as per the guidelines on fetal health surveillance. Without that there is no reason they shouldn't let you mobilize and be in whatever position works for you for labor and pushing.

momW's picture
Offline
Last seen: 1 year 4 months ago
Joined: 09/29/09
Posts: 5634

I agree with the fetal monitoring. It's one thing I had forgotten to talk to my OB beforehand about (one of only a few things I forgot). Apparently he had wanted continuous monitoring but Clara was flip flopping so unless I stayed still she wouldn't stay on. I made it clear to the nurses I had no intention of staying still so they finally called dr and he said intermittent was fine, about 15 minutes an hour give or take. I pretty much called the shots on that one and they pretty much let me but it's still something I wish I had talked to him about before.

Here are some other things I talked to my OB about beforehand that I'm glad I did and a few things I wish I had discussed.

*fetal monitoring (forgot)
*heplock instead of fluids
*ability to push and deliver in whatever position I felt the need to
*no eye ointment (they did it anyway when they took her away to get her breathing but the nurse apologized profusely for it and in the end I guess it wasn't something I was up in arms about cause I let it go)
*no bath in the nursery (forgot)
*no bottles or pacifiers

You've read my birth story so you know there were some things I wish I had done differently. Honestly, the things I did talk over with my dr and make note of were things I learned from reading other people's birth stories (esp the stories from this page!). I also tried to learn from other people's birth stories, the ones that didn't go well.

waitingimpatiently614's picture
Offline
Last seen: 4 years 2 months ago
Joined: 02/17/09
Posts: 386

i'm still working on my birth plan, too, but i did get a couple sample ones from my MW that were helpful, and there are some posted on this board, too...up on one of the stickies? i didn't have a birth plan for DS1's delivery. the big things i want to avoid this time are continuous monitoring (they insisted on it with DS1 and it totally derailed my labor and delivery), episiotomy, and anyone offering/pressuring me to get an epidural. if i can get my birth plan done, i will cut and paste! Smile

ourfirstblessing's picture
Offline
Last seen: 1 year 5 months ago
Joined: 01/07/07
Posts: 1094

Thankfully my hosp is also very ncb friendly. There are key points though that I have for me.
Please do not offer pain meds, I know my options and will ask if necessary
Encourage various labor positions for natural pain relief
Hep lock instead of hooked up
Immediate placement of baby to mother
Allow and support immediate nursing
(My hosp I very pro nursing and does not have pacis and discusses formula for severe situations)
No eye ointment
If baby needs to leave for any reason father will accompany
Delay stats and first bath until we are ready, we will let you know

That's pretty much our key points. I would write a detailed plan for the case of having a different ob. Good luck hope you get an awesome experience

Marite13's picture
Offline
Last seen: 3 years 4 months ago
Joined: 08/07/09
Posts: 3368

Everyone is giving you a lot of good ideas...I can post a copy of mine below. I will say, the hospital I delivered at is the most NCB friendly in the area, and my midwife was very receptive to the birth plan....that said, I took a NCB class where we were helped/coached through writing a birth plan, and one of the things that the teacher stressed A LOT was keeping the whole thing under two page, if not down to one. Yes, that means short bullet points, and maybe including broader statements instead of detailing every single little thing. I was lucky that I actually KNOW the nurses who worked with me read the plan (they referenced it after the fact), but, if your birth plan is 6 pages long, and it's a busy night on the ward, you're setting yourself up for it to be ignored.

Here is my plan (I see now again, that it fits on one page, so that was obviously what my doula/teacher stressed- keep it short!):

Birth requests for Mara S
Due April 28
Supported by husband Joel S, mother Sarma and doula Jessica

Thank you for being a part of this most memorable experience; bringing our first child into the world! We really appreciate your expertise and look forward to working with you.

Requests if everything is normal:

During Labor:
• Freedom of movement, including laboring in water
• Limited EFM; use Doppler instead
• No food/water restrictions
• No IV or heplock
• No medications (pain or labor stimulants). Please, do not offer them.
• Limited cervical exams

During Pushing:
• Choose my own pushing position
• No time limit on pushing
• No coached pushing
• No episiotomy
• Opportunity for Mara to catch the baby if position allows, and for either Mara or Joel to announce the baby’s sex

After Birth:
• Allow cord to pulsate
• Natural delivery of placenta; no routine Cytotec
• Save placenta
For baby:
• No eye ointment, Vitamin K or Hepatitis B injection
• No circumcision
• Breastfeeding only- no supplements, bottles or pacifiers
• No bath- we’d like to do it ourselves

In the event that a c-section is medically necessary, we request:
• Joel with Mara while anesthesia is administered
• Joel and Jessica in the OR for the surgery
• Skin-to-skin contact on the operating table
• Double-stitching for VBAC
• Baby to go to recovery room with Mara and Joel

TyrantOfTheWeek's picture
Offline
Last seen: 4 years 3 months ago
Joined: 12/26/05
Posts: 1147

My home birth midwives already do everything that would be on a birth plan anyway. If I need a hospital transfer, it will be for an emergency where there wouldn't be time for a birth plan.

cactuswren's picture
Offline
Last seen: 2 years 7 months ago
Joined: 10/19/09
Posts: 4658

I wrote out a long one much like Erin's, but then realized how Angel the longer it is, the less likely they are to read it and (b) how many policies in some of those sample birth plans are already covered by our hospital's not-terrible policies. Also, I knew my midwife would be going with me if I had to transfer. So I basically pared mine down to the overarching essentials, more or less: I would like my birth to be as natural and private as possible, and I do not consent to any intervention without consultation. In the event of an emergency, please consult with DH before proceeding. Then I made sure DH knew all of my wishes in the event of a c-section, etc.

Starryblue702's picture
Offline
Last seen: 3 years 4 months ago
Joined: 04/06/11
Posts: 5454

I think you said it all... as long as you know that somethings (if not all, as you said!) may change then I would put anything and everything on there that you would like! I wrote mine up this last time, and I think the only things that stayed the same was baby being put on my chest immediately after birth, the room was kept dim and quiet during L&D, and baby was never taken from me. All else went by the wayside lol! Oh well, as long as baby arrives safe and sound! Good luck!