Birth Preferences

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alwayssmile's picture
Joined: 08/26/07
Posts: 14483
Birth Preferences

Okay, give me your comments! Did preggo mind forget anything? Or misspell yet another word?
I plan to bring this to my 36 week appt Thursday and will ask for comments at the VBAC meeting Saturday assuming I'm able to go (it's in another city). Trying to keep it short. I left food and water off because it's flat out hospital policy of nothing by mouth other than ice chips, so it will have to be snuck to me (and I do plan to eat before going in assuming my body is able to handle it).

All of the question marks are where my bullets are on my version.

Birth Preferences

During Labor:
? Use of heplock instead of attached IV.
? To use wireless monitors instead of being hooked up to a stationary monitor.
? Refrain from discussing pain levels and any offering of pain medication unless requested.
? Freedom to walk and move during labor and assume labor positions of choice.
? Minimal number of vaginal exams.
? No intentional rupture of membranes.
? To be fully appraised and consulted before the introduction of any medical procedure.

During birthing:
? To assume birthing positions of choice.
? Risk a tear rather than have an episiotomy.
? Push on my own, but be advised to stop or slow down to avoid or minimize tearing.
? To be allowed to push without time constraint, assuming both myself and baby are handing this phase well.
? Immediate skin to skin contact on my chest and breastfeeding if baby desires.
? Delay cord clamping and cutting until after pulsation has ceased.
? No cord traction, pitocin, or manual removal of placenta unless there is an emergency. I will consider a pitocin shot if needed.

Baby Requests:
? Allow vernix to be absorbed into baby?s skin; delay ?cleaning or rubbing.?
? Allow baby to remain in room with mom as long as there are no health concerns.
? We decline eye ointment, vitamin K injection, and Hepatitis B vaccination.
? I am a breastfeeding mom.

We understand that a VBAC is not guaranteed. If for some reason a cesarean delivery is indicated, we want to be fully informed and to participate in the decision-making process. I do not wish the baby to be separated from me unless she is in distress. If the baby must be taken away the father will accompany her. I do want the opportunity to breastfeed as soon as possible.

Please do not dispose of the placenta as we do want it. (this will be bolded)

jperry5683's picture
Joined: 02/13/10
Posts: 525

great list.. I didn't notice any misspellings but I am not the best at proofreading. Can you tell me about the bullet point on absorbing the vernix? I have never heard of this.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483
AnnaRO's picture
Joined: 07/06/08
Posts: 7033

I would very clearly state that you do NOT want the baby given formula for ANY reason. I know it seems self evident, especially since you've already indicated several times that you are breastfeeding and wish to do so ASAP. I personally, think it's best to be very specific.

I didn't see any spelling errors, but did you mean apprised instead of appraised? ? To be fully appraised and consulted before the introduction of any medical procedure.

I think it's a perfect birth plan. It covers all the important points and clearly so that there is no confusion about what you want to happen.

Joined: 06/22/10
Posts: 5602

i agree with the formula bit especially if the baby develops jaundice or has low blood sugar. that is when my hospital starting busting it out

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

"AnnaRO" wrote:

I didn't see any spelling errors, but did you mean apprised instead of appraised? ? To be fully appraised and consulted before the introduction of any medical procedure.[COLOR=#333333]

Uhhh yeah. Things like that. Thanks. lol.

As far as BFing goes it's a baby friendly hospital. Formula has to be requested by parents or parental permission is needed before giving a child any formula. There's not even a nursery. Hence why I left that off and just stated that I'm a BFing mom. There are no pacis there, no gift bags in rooms, etc. It's the one thing that the hospital does do well according to other moms I've talked to.
The downside? The gift bags moved to the practitioners' offices. :roll: Already got one....

BuckeyeK's picture
Joined: 10/23/06
Posts: 3087

I think it looks pretty good. I pulled up my list of birth preferences from Lainey and I think you have everything I had.

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

I can deal with the hassle of my site problems to help you out here.

Things I would add:
No catheter
Who is allowed in the room and who is NOT (ie students if that's a possibility and you're not interested in being a teaching piece)
Preference for who catches baby (if your DH is interested)
No automatic deep suctioning of baby
Preference for who cuts the cord
Length of time you'd like to see pass before doc is allowed to mention intervening in placenta delivery. I said an hour.
If baby needs to go anywhere, you or DH are to accompany her
No bottles or pacifiers
You want to see an LC within the first 12 hours

You should have both a short and sweet emergency plan for if you require an emergency RCS and a detailed CS plan should you require a non emergency CS. Things like whether or not you want the curtain lowered, where Zoe will first BF, etc. To have a plan in place does not decrease your resolve to have a VBAC. It means you recognize the real chance that you might require a RCS and you're prepared. I used my CS plan as a way to consider that possibility, put it down on paper, and then shove it out of my mind. It helped me not to worry about that aspect during my labor because I knew I'd already made my preferences clear. It *might* also help you "own" your CS if it should have to happen. Which it won't because you're going to rock pushing Zoe out your vajayjay!

In general, you should limit your verbiage. Make it shorter so that they don't have to spend more than a moment reading it to get the gist that you're going natural and you mean business. They won't take longer than a moment to read it so you want to get the most out of it. For example, put "We will give baby her first bath" instead of the part about the vernix. Make sure your DH knows why this is so important to you so that he can fight them over it if you're not able to. Personally, I made mine more aggressive in tone. Ie, I DO NOT consent to cord traction. Mine was solely for if I needed a transfer so I didn't feel I needed to be cordial. Don't go crazy and say you'll sue their asses but make it clear that you know your rights, have done your research, and that some points are non-negotiable (even though, obviously, they are when either yours or Zoe's safety is concerned).

Make sure you have several copies printed and stashed in your hospital bag. Don't rely on the doctors and nurses fishing it out of your file to read it.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

A couple of those things I've left out on purpose. DH doesn't want to cut the cord or catch the baby - he's awfully squeamish about those things. Left off catheter b/c they only do them with epis and c/s from what I've been told. Baby friendly hospital - they have no bottles or pacifiers available period. (Formula is the pre made bottle kind which is only available on request.) LC visits are routine for every mom who states that she is breast feeding. I've left the tone positive because chances are high I'll have one of the 4 midwives around for my labor and delivery if all is going well - the ones I'm going over my birth plan with!
Deep suctioning of baby is not routine here, especially with my practice, for normal vaginal deliveries with no complications.
Length of time for placenta is something I'm going to talk to the MW about at my appt - I want to know their stance before picking a battle I don't need. I do know it's hospital standard to do the bag of pit, which is why I said I'd consider the pit shot instead - which my practice has zero issues with.

Great point about others in the room. I keep forgetting that technically this is a teaching hospital so it is possible. I'll ask the other moms and the MW their experiences about that.
Which reminds me I should add that I'm doing hypnobabies.

I want to have a pleasant birth experience and not be battling things. I'm working on letting some stuff go because is it a mountain I want to die on? Honestly having a RCS is the least of my concerns about listing information on because the hospital and my practices' standard procedures as light years better than where I had Aiden. The things that topped my list of things I wanted to change about his CS are standard here. While it's not quite a "natural c/s" it's close and I'm willing to let it be. I hashed out my c/s fears and questions already.

This hospital actually has its own birth plan form for moms to fill out. I'm thinking I'll fill it out and put it behind mine. They even have a blank for if you're interested in a massage. Mine is a lot shorter than theirs by far.

Have I mentioned how happy I am that we moved?!?! Lol

KittyRN's picture
Joined: 02/03/09
Posts: 1260

Sounds great! Just a question, why no pitocin for placental delivery? Just so you dont have an iv attached??? I'm just curious. I had an iv/induction with Simon so I know they gave me a big dose after he was out, but deattached the IV very shortly thereafter. I had very minimal minimal bleeding too which was nice.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

It's just another intervention that's not really needed for a normal birth. I have no issues using it if I have excessive bleeding or retained placenta, but I'd rather give nature a chance first since there are side effects to pit in this stage of labor still. Effects are less with a shot and many time it's all that's needed if a little help is medically necessary. Since I shouldn't have an IV line in me during birth, the pit wouldn't start till after Zoe is born and then I'm stuck waiting for the whole darn bag. Rather than fight the whole pit train, I discussed with a MW last appt about compromising with a shot but pointed out I'd rather let me body (and BFing) work it's magic first.

ange84's picture
Joined: 12/28/09
Posts: 6564

I hear you on long hospital birth plans, the one from the hospital for Ronin was about 3 pages long. It looks good and seems to cover everyhing.

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

Well, I had some but they've been covered. Nice job! Smile

stacymh's picture
Joined: 03/16/10
Posts: 1807

Jackie, that sounds like a great birth plan. I'm so glad you are at such a baby friendly hospital. The only thing I saw was the "during birth section: ' myself and baby are handing.....did you mean handling?

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

handling that phase of labor. Aka, no big heart decelerations (which could mean a uterine rupture) and I'm not completely wacked out.

While I do feel sooooo much better about birthing at this hospital compared to the one in Del Rio with Aiden, part of me is still a bit nervous. Writing out the birth plan makes me feel less nervous at least. I just don't like hospitals period. Kinda hoping I have a fast labor and can just stay at home. Blum 3

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

Right, but she meant you're missing an "l" Smile

stacymh's picture
Joined: 03/16/10
Posts: 1807

Hopefully you can stay at home, if not all the way through, at least most of it. Leigh caught what I meant on the spelling. Thanks Leigh.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

"cactuswren" wrote:

Right, but she meant you're missing an "l" Smile

Oh GOD!!!! ROFL

stacymh's picture
Joined: 03/16/10
Posts: 1807

No worries, you are tired today and chasing a toddler that is now feeling good after being sick. You have a great excuse.

tink9702's picture
Joined: 09/28/08
Posts: 2977

looks good to me. I agree with the quick shot of pit after the birth if needed vs. an IV. Much much faster and you can go to the bathroom easily! Smile

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

I sent this to the local mama friend I've made who's had 2 VBACs through my practice (well, one didn't make it to the hospital the other she did). She said it was close to hers and that the only thing they might have an issue with is the hep lock and that's only if I test positive for GBS. Stupid, but with luck it won't be an issue for me.

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

I believe we have the same rule here, but thankfully my GBS was negative...I was really nervous until I got the result, though!

KittyRN's picture
Joined: 02/03/09
Posts: 1260

They shouldnt have a problem with a hep lock even if you're gbs positive. The antibiotic is given every 4 hours and only takes 30 minutes to go in. No reason they cant lock it off in between doses.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

"KittyRN" wrote:

They shouldnt have a problem with a hep lock even if you're gbs positive. The antibiotic is given every 4 hours and only takes 30 minutes to go in. No reason they cant lock it off in between doses.

that's my thought. I'll cross that bridge if necessary.

ange84's picture
Joined: 12/28/09
Posts: 6564

I don't think I was even tested for GBS here, I'm trying to remember but pretty sure after my GTT at 28 weeks I had no further testing.

jolly11sd's picture
Joined: 02/02/05
Posts: 3327

Looks good! Erin added some other good ideas along the lines of what I would have mentioned.

You should find out from your doctor what they require as far as leaving with your placenta. At our last place the placenta had to be out of the building within 2 hours and they would only release it to you if you had a cooler. We had no idea but luckily had a cooler in the van an ice machine in the building since we were no where near home. Wish we had known ahead though. At the hospital with DS2 you had to get it a few days after the birth. Good idea to check ahead.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

I'm meeting with the lady who will pick up my placenta and encapsulate it Thursday after my appt. Since she's the only one who does it professionally east of Raleigh, I'm sure she's very familiar with the procedures of the hospital. I know there's a time limit, but not like 2 hours.