Wrote up my birth plan (using the BabyCenter template as a starting point) for my appointment on Tuesday, where we'll go over it with the midwives. Our birth center's standard policies are pretty much what I want anyway, and this is the second time I'm birthing there, so I really don't have much in the way of reservations or need to specify with them. The main reason I want a detailed birth plan at all is in the event I "risk out" to the associated hospital, which there is a fairly high likelihood of since the limit at the BC is 41 weeks and I just barely made it in under the wire with DD1. It's not a terrible hospital, and the midwives still travel with you and act as your main caregiver for a normal birth over there, but there's definitely a lot more to fight and stipulate when it comes to the standard hospital policies.
If you wouldn't mind looking this over--especially those of you who have experienced a hospital birth--and letting me know if you see anything obvious missing, I'd appreciate it! I tried to keep it as short and to the point as possible, since I do want some chance of people actually reading it. :)
Birth Plan for Leigh M______
I'd like the following people to be present during labor and/or birth:
Porter M______ (husband)
I'd like to:
dim the lights
wear my own clothes during labor and delivery
allow pictures during labor and delivery
HOSPITAL ADMISSION & PROCEDURES
I'd like the option of returning home if I'm not in active labor.
Once I'm admitted, I'd like:
my partner to be allowed to stay with me at all times
only my practitioner, nurse, and partner to be present (no residents, medical students, or other hospital personnel)
to eat if I wish to
to try to stay hydrated by drinking clear fluids instead of having an IV
to have a heparin or saline lock only if IV is medically necessary
to walk and move around as I choose
As long as the baby and I are doing fine, I'd like to:
have intermittent rather than continuous electronic fetal monitoring
be allowed to progress free of stringent time limits and have my labor augmented only if medically necessary, after consultation with me and my husband.
I may like to use a:
I'd like to try the following pain-management techniques:
Please don't offer me pain medication. I'll request it if I need it.
When it's time to push, I'd like to:
do so instinctively
be allowed to progress free of stringent time limits as long as my baby and I are doing fine
I'd like to try the following positions for pushing (and birth):
hands and knees
whatever feels right at the time
During delivery, I'd like:
no mechanical interventions unless medically necessary and agreed on
to give birth without an episiotomy
my partner to help "catch" our baby if he chooses
After birth, I'd like:
to hold my baby immediately, delaying any procedures that aren't urgent
to wait until the umbilical cord stops pulsating before it's clamped and cut
my partner to cut the umbilical cord
to breastfeed as soon as possible
not to get oxytocin (Pitocin) after I deliver the placenta unless it's necessary
If I end up needing a c-section, I'd like:
my partner present at all times during the operation
the baby to be given to me or my partner immediately, if medically safe
to hold and breastfeed my baby as soon as possible
After delivery, I'd like:
all newborn procedures to take place in my presence
24-hour rooming-in with my baby
my other child brought in to see me and meet the new baby as soon as possible after the birth
to decline the Vitamin K shot unless necessitated by clear evidence of birth trauma
to decline the erythromycin eye ointment
my partner to stay with the baby at all times if I can't be there
to stay in a private room or to have a bed provided for my partner if necessary
I plan to breastfeed exclusively
Do not offer my baby:
That looks pretty good to me.
If you do get admitted to the hospital, it would probably be due to some complication, right? That would likely interfere with a lot of the requests you listed. I'd guess you know that, though. ;) I'd ask your caregiver about some of the hospital policies and how it has gone for others in her care who transferred.
I've had mixed experiences from my hospital births (2 different hospitals). None were perfect, but they all turned out fine in the end. The only time I wasn't handed baby right away and encouraged to BF right away was when DS1 had to go to NICU.
I was always encouraged to room in and a couch/cot were always offered to my husband (even during labor with DS3!)
I hope your discussion with your doctor goes well and that you get a nice, easy delivery at the birth center. I'm jealous. I would have loved to use a birth center with one of mine but there has never been one nearby.
Nope--I could easily risk out just from going over 41 weeks with no other complications, which is what ALMOST happened last time so I am preparing myself for the very real possibility again. As long as nothing else is going on, all that means is that I will have to submit to NSTs and ward off induction, but once I go into labor, I should be able to get what I want even in the hospital, as long as things go smoothly.
Oh, okay. I didn't realize they had an earlier cut off like that! Hopefully you won't go that late since it's #2.
At the hospital a lot depends on the nurse you get. I was out of luck last time (hospital was crazy busy) and got a not very natural birth friendly nurse. She kept finding hospital policies for why I couldn't do things my MW was fine with (like nipple stim instead of pit). It was obviously annoying my MW as much as it annoyed me. I was told usually the nurses try to work with providers who have a similar outlook. If I get to labor this time hopefully I'll get someone better. or have a more outspoken MW (I missed out on my favorite by about 30 minutes last time. boo.)
I have heard that that's big at this hospital too. I will add to my hopes that I get a strong-willed midwife if I end up going over. My DH is also not at all afraid to advocate either, as I learned and very much appreciated last time!
Yeah, the early cutoff is the worst thing about the BC, but their hands are tied--they have tried and tried to fight it, but it's a rule imposed by their liability insurance and they just won't budge. I am *hopeful* that I will go a little earlier since it's my 2nd, but I'm trying to be mentally prepared for the alternative since I think my anxiety about ending up in the hospital last time turned out to be a big factor in the length of my labor.
Looks good to me. Maybe add no bathing the baby for 8 hours.
I had the same experience as Pico's #2. My nurses were not as chillax as my midwife, but my midwife was not taking control of the situation. One thing I suggest if you end up the hospital route...walk or hang out on the toilet as much as possible. The intermittent monitoring is a joke. It was every 30 minutes...which sucked because that was the whole reason I got no sleep before my labor. But they left me alone when I went for walks and went to the toilet.
I would also ask your midwife/potential hospital the rules on water breakage and meconium. The first the nurse wouldn't let me walk around since I had meconium in my waters. But the 2nd shift nurse said it was completely fine. I would also check on your hospital's policy on pitocin. My midwife told me that if I had progressed to a 5-6 at 12 hours (post water breakage) that we could avoid pitocin as long as I kept progressing, at 12 hours I was barely at 3cm and she gave me one more hour because I cried about receiving pitocin. But at the 13th hour I was still at 3cm so I had to get started on pitocin. SUCKED. Pitocin ruined my birth experience. The hospital also had a rule if meconium is in your waters and its been 18 hours you have to go on IV antibiotic drip and baby will have to have vagal suction at birth and no immediate skin to skin and cord will be cut immediately. That news broke my heart.
Anyways, you are going to have an amazing natural birth at your birth center. I bet you go into labor before 41 weeks this time and I bet your birth will go much quicker this time. So you really shouldn't concern yourself too much. But it can't hurt to ask the what ifs, in case you have to go to plan B. I did not ask the what ifs and I felt like I could have been better prepared to advocate.
Also mention any visitors you do/do not want during labor or immediately following birth. I was so annoyed that my whole family was there before I could even move up to the postpartum area. I just wanted to be naked and breastfeed my baby and sleep. Instead I had to greet a bunch of people after not having slept in 2 days.
The only problem I had at the hospital was eating. Once I was there, they didn't want me eating anything in case I needed surgery. The nurse joked that if you've eaten a full meal before you get there, they won't take it from you but once you are there , they can't let you eat anything.
They didn't monitor me between when I got there and delivery because I was only 2-3 cm when I got there. They left me in triage because I wasn't far enough along and it was my first baby. I couldn't bear the thought of getting back in the car so we walked around the ward. They apparently had all kinds of things to use during labour but my nurse kept telling me it would just get worse and people didn't have their first babies very fast. I was done 4 hours later.
With my second, it was already a high risk situation and I knew I wouldn't get to hold her. I had no break in my contractions and my husband wasn't there yet. I didn't think I could do it for very long because I couldn't stand without throwing up and walking was the only way I got through my first. However, my nurse kept telling me that I had done a natural childbirth before and I could do it again. Some hospital nurses are very supportive!
Elizabeth--thank you, yes, I forgot about the bathing thing! I'm adding that. And thanks for the tips on hanging out in the bathroom/walking to avoid constant monitoring. Got it. ;)
Good thoughts on everything else, too. I know that unfortunately we do have a 12 hour post water breakage clock too (at the birth center OR the hospital--same liability rules :() but at the birth center last time they offered me a chance to try alternating cohosh tincture for a couple of hours first before going straight to pitocin, and that worked like a charm for me--I went from 5-6 (where I had been for like 16 hours) to complete and pushing in an hour and a half (3 doses)! They didn't have any on hand and actually used mine that THANK GOD we'd put in my birth bag, so I will definitely do that again this time and just try that at 9 hours or something if it comes down to it.
I know they don't like you eating at the hospital but actually encourage it at the BC. I will probably just not ask if I want to eat at the hospital and do it when nobody's in the room, although last time I didn't want to eat AT ALL anyway. No wonder that sandwich I had after like 36 hours of nothing but a few sips of juice was the best thing I'd ever tasted....it annoys me not to even have the option, though, so I like to have it in there.
Looks like you have your bases covered! I sincerely, wholeheartedly hope that it isn't even necessary since that stuff is pretty much par for the course at the BC (from my understanding). The hospital where I had DS is supposedly VBAC friendly, but I got there and was pretty quickly told my birth plan was totally meaningless and every single time someone walked into that room they were talking c/s and about how I wasn't progressing, and how my water had already broke etc. Nightmare! I'm glad that you got a NB and I'm sure you will again because you are strong and determined and have all the support necessary for it. If you do end up at the hospital instead, I would suggest calling Erin to be your enforcer. I'd like to hire her as my doula/bodyguard for my next birth.