birth plan in case of transfer?

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Joined: 03/16/15
Posts: 53852
birth plan in case of transfer?

Hey ya'll -- I got a question... did you write up a birth plan for a hospital in case of transfer?

It wasn't even something I thought about with DD#2 as I transferred to a birth center just a few weeks before DD#2 was born. I was trying to get away from the hospital as fast as I could.

Now that I'm about to have #3, I'm starting to wonder if I should have one "just in case." Mostly Murphy's law and all... I'm one of those people who if I do it, I won't need it but if I don't, Murphy will come in and poof... I'll wish I had one. Anyways... just wondering if it something I need to worry about or not.

Jen

renee24's picture
Joined: 08/06/06
Posts: 1096

thanks for reminding me, I'd forgotten to write one, lol. As for your question, I'd probably do it just in case, you don't want Murphy to get you.

Joined: 01/18/06
Posts: 1626

Doesn't take long and it can help even with just preparing yourself for a change in frame of mind in the event of a transfer.

I had 2 homebirths and had a transfer plan in place for both times.

Joined: 11/29/06
Posts: 1316

After my transfer I now have mixed feelings about a hospital transfer birth plan.
I had one prepared, but as soon as we got to the hospital it went out the window!

With my next birth, if we do hospital transfer, I will insist on being informed of everything and will ask questions and will be the one to say "yes" or "no" - not my OB. This is MY birth not theirs.
I will also be bringing my support team with me! Hospital rooms are so small, so I will limit it to my DH and another person (most likely my Mom, but if she can't be there than one or both my sisters).

I think having great support who know your wishes and can speak for you (a labouring woman is in no state to make decisions for herself) is better than any piece of paper (that the OB isn't going to read anyway).

That being said: it felt good getting all my thoughts/wishes out on paper, and will probably write out another birth plan, but won't be giving it to my OB because the chances of them reading it and following it are slim to none. I will rely on myself and my birth team to stick to my plan and closely as possible.

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

I had one and as Jordan mentioned, it helped to get it all written down. We spoke with my MW about it beforehand and decided to actually write two. One was for a non-emergency transfer (post-dates, "failure" to progress 24 hrs post ROM, etc.) and contained pretty much all my wishes including labor requests. The other was for an emergency and as I would likely have little to say in the face of a true emergency C/S and they probably wouldn't read it anyway it basically said to ask us before doing anything, don't circumcise, and give me (or DH) my baby ASAP. It was helpful to know we had a "plan" just in case things didn't go to plan. Thankfully, we didn't need either :p.

Here are mine JIK it helps: (NOTE: we knew T was a girl but put in circumcision stuff JIK we'd missed a penis on the U/S ;))

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
• Do not offer bottles or pacifiers.
• Baby is to be accompanied by me or my husband at all times.

mommys's picture
Joined: 05/08/06
Posts: 6264

This is a great topic. I hadn't really thought about it. I guess I kind of assumed that it would be "lost" in the case of an emergency anyway. I should write it all up though and give it to my doula who will help advocate for me wherever I birth.

Erin, thanks for sharing yours.

Spacers's picture
Joined: 12/29/03
Posts: 4100

We had a hospital transfer plan both times. My midwife had a copy, and she came with us when we transferred with Weston. My HMO also had a copy in my records just in case we ended up at the hospital without the midwife, as we did when Tiven was born. My doctors *did* read my plan during Weston's labor (one of them had it in her hand when she came in!) and they did pretty much follow it. I don't know if that's because they read it, or because my midwife was there with me making sure things went my way. I do highly recommend taking along your midwife & support team if you need to transfer. Honestly, you need them *more* at the hospital than at home!

emommyof2's picture
Joined: 09/26/10
Posts: 310

On behalf of Murphy's everywhere... I'm sorry Blum 3

As to the birth plan, I am not doing one mostly because home/hospital/side of the road, my midwives will be there with me so its pretty pointless. Even in an extreme case of issues where I end up in section under OB care, I'm always "technically" my midwives patient and they know exactly what I want... as does hubby a trained ninja so Blum 3 no worries there. HEHEHEHE

But if you aren't in that position, and if you would be transferred to another care provider in the event of a transfer, then yes, I'd do one.

Does that even make sense? darn preggo brain I can't think straight today!

cactuswren's picture
Joined: 10/19/09
Posts: 4658

Ditto Erin, although after doing a long version, I ended up keeping my filed one mainly to the short and sweet blanket stuff "I don't consent to anything until asked, leave me alone except as necessary, and at minimum DH is with baby at all times." and trusted the midwives to know what I wanted when it came to specifics (since what I wanted was pretty much standard for them anyway)

I agree that just having it written down allowed me to relax a bit knowing I could just refer to that and not have to think in a crunch. And when I was asked questions when I was not in a good place to make decisions, it did help to be able to mentally refer to what I'd thought out and written down when in a better frame of mind :).

Joined: 03/16/15
Posts: 53852

I just wanted to thank you all for your input. I really appreciate it...

Since the back-up OB for my MW is someone I've never met... I'm going to write out a transfer plan JIK. I like the short and sweet one in case of emergency vs a non-emergency transfer.

I actually went back and looked at my birth plan from when I had DD#1... oh my goodness how my attitudes and ideas have changed. LOL! I thought I had it all down back then... not so much. It's a starting place though and I'll ask my MW if they will come with me in the event of a transfer...

thanks again --
Jen

Amber_daisy's picture
Joined: 10/17/06
Posts: 567

We did a transfer birth plan as well. We kept it very short and sweet and included the few things that would remain important in the event of an emergency...like declining the erythromycin ointment and vitamin K injection, and who would go with the baby if he needed to be taken to the nursery or NICU. Oh, and issues pertaining to breastfeeding.

It was also important for me to put in that I was not to be given penicillin under any circumstances. My 3 year old is allergic to it, and is still nursing. It's not listed on my health records as an allergy, since the allergy isn't mine, but it could be disastrous if I receive it. Just thought I'd mention that in case anyone else is in a similar situation and just haven't thought of it....