Birth Plans....

[mommyof3girls]

What all goes into a birth plan?

I watched Pregnant in America tonight and it was a real eye opener for me.

With my first pregnancy I dilated to 3cm and then stopped. I was given pictocin (sp?) and then I got an epidural. I didn't feel a thing but had a normal vaginal delivery.

My 2nd pregnancy was semi-natural. I was only given pain meds through IV 4 hours before I delivered. I went from 4cm to 10cm in 15 minutes and that is no lie. So I had a normal vaginal delivery with no epidural. My recovery was great.

My 3rd pregnancy I made it to 6.5 cm dilated before I got an epidural. I think the only reason why I got it was because the nurse kept on asking if I wanted one. She said that it would help things go faster. I went on to have an normal vaginal delivery.

My 4th pregnancy the nurse insisted that I get an epidural because of the amount of pain that I was in. I agreed. The guy doing my epidural had to stick my back 3 times before he got it right. The 1st time he stuck me the tingly feeling that is suppose to go down your legs, went up my back instead. I went on to have a normal vaginal delivery.

Now I know that at any given time I could have said no to an epidural but its almost as if they pressure you to get one.

I just want a drug free birth this time. I don't want to feel pressured in to doing anything. This is for sure my last pregnancy and I want it to go the way I plan.

So if you are doing a birth plan or have done one before what all did you include in it. Does the birth plan include post postpartum also? Does the hospital have to obey your birth plan or can they go over it even if there is no emergency? My 4th pregnancy my daughter came in contact with the herpes 1 virus (cold sores not the other kind) when we found out the doctor said that she could have got it from any of the visitors that we had or someone on the nursing staff since my husband nor I did not have cold sores. She was put in the NICU for a month because of that. If my plans includes that all assessments must be done in my presence do they have to obey that?

You would think that being my 5th pregnancy I would have went over this all before.

Thank you for any and all help.

 

[bmuir11207]

didn't want to read and run i am not sure really....sorry I am not more help

 

[ciarhwyfar]

I'm afraid that a birth plan is more of a guideline as far as most things go. Be sure to speak to your partner and your doctor/midwife a few weeks before the expected birth and go over what you have in mind. Bring a copy with you and go over it again with your partner and medical staff when you get to the hospital. Keep in mind that things can change at any time.

As far as after birth goes, know what you want and insist on getting it. Again, having things written is good since you can't remember everything right after birth. When my last daughter was born, they were doing the infant evaluations in the middle of the night (I kid you not) but I am not having any of that this time. They can do them during the day when I or my partner can go to the nursery with them. Even though you have a choice here, I keep my baby in the room with me and insist on one of us going any time they take the baby out of the room.

Here is a copy of my last birth plan (with personal information removed) though it is not updated for this birth. It should help give you an idea of things you want to discuss with your medical provider and partner, at any rate.

Regarding Labor and Birth – (mother's name)
Due Date:
Patient of Dr.
Scheduled to deliver at (hospital)

LABOR
I would like to be free to walk around during labor.
I wish to be able to move around and change position at will throughout labor.
I would like to be able to have fluids by mouth throughout the first stage of labor.
I would prefer to keep the number of vaginal exams to a minimum.
I do not want an IV unless I become dehydrated.

MONITORING
I do not wish to have continuous fetal monitoring unless it is required by the condition of the baby.

LABOR AUGMENTATION/INDUCTION
I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.
I would prefer to be allowed to try changing position and other natural methods (walking, nipple stimulation) before pitocin is administered.

ANESTHESIA/PAIN MEDICATION
I realize that many pain medications exist I'll ask for them if I need them.

CESAREAN
Unless absolutely necessary, I would like to avoid a Cesarean.
If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.
I would like (coach) present at all times if the baby requires a Cesarean delivery.
If the baby is not in distress, the baby should be given to (coach) immediately after birth.

EPISIOTOMY
I would prefer not to have an episiotomy unless absolutely required for the baby's safety.

DELIVERY
I would like to have the baby placed on my stomach/chest immediately after delivery.

IMMEDIATELY AFTER DELIVERY
I would prefer that the umbilical cord stop pulsating before it is cut.
I would like to hold the baby while I deliver the placenta and any tissue repairs are made.
I would like to have the baby evaluated and bathed in my presence.
If the baby must be taken from me to receive medical treatment, (coach) or some other person I designate will accompany the baby at all times.
I would prefer to hold the baby rather than have (him/her) placed under heat lamps.
I do not want a routine injection of pitocin after the delivery to aid in expelling the placenta.
I would like to bank the umbilical cord blood, and have made arrangements to do so.
I would like the baby to only receive the vitamin K shot and eye medication, no other immunizations.


POSTPARTUM
Unless required for health reasons, I do not wish to be separated from my baby.
I would like to have the baby "room in" and be with me at all times.

BREASTFEEDING
I plan to breastfeed the baby and would like to begin nursing very shortly after birth.
I do not wish to have any bottles given to the baby (including glucose water or plain water).

OTHER
My support people are (support people) and I would like them to be present during labor and/or delivery.

 

[mommyof3girls]

That gives me a really good idea. Thank you so much.

 

[Keeley220886]

that birth plan is fab! im on my 3rd child and things have never gone smoothly enough to follow a plan nor if i admit have ever made a plan, my waters always brake at 36 week and i get induced, i labour very fast, with dd i was in labour 1 hr 50min, and ds 1hr 20min, no lie, i go very fast thats from stating the drip, it may sound great going that fast but let me assure you id rather it have slowed down a little haha, i feelthis one will go the same so ill have no chance of following a plan but if i could and if i turned up to my hospital with a great birth plan like that they would just look at me as if to think and who the hell do u think you are haha, iv never felt in control ov my labour and thats quite sad xxx

 

[lynnikins]

Heres mine from last time

Name: ****** EDD ******
Hospital *******

Prelabor, I would like to wait as long as possible before medical Induction and may consider having daily fetal monitoring if i go past 42 wks and would like my GP/MW to advise me in this area

Birth Partner,
I would like my Husband ****** as my Birth Partner but depending on circumstances he may not be with me in the early stages of labor and I would like the MW's to call him in when i reach 5/6cm so he arrives in good time for the birth, He is to be kept informed of all choices regarding my care and will make decisions in my place if I am unable to do so so should be given the pros/cons of any procedure for me or the baby

Labor,
I want to have an active labor with limited monitoring and to avoid unessacary internal examinations.
I would like assitance where required in labour with the fitting of my TENs unit when nessacary and the pad placement/condition to be checked regularly.
I want to be able to eat and drink during labor when i feel the need

Pain relief,
I would like to use my TENS as well as have the option of using the Birth pool or a bath where a birth pool isnt avalible during my labor
I would like to avoid use of any Drugs in labor unless both my husband and myself feel that I am in need of them and before they are given i would like to have both my husband and myself informed of the risks of the drug given.
I plan to use Breathing and Relaxation techniques in labour
Please make the Gas and Air ( entonox ) avalible to me for the final stages of labor and delivery as I may very well want to use it.
I very well might want to take my pain tablets ( codine ) prescribed by my MW and doctor during labor as I have severe SPD which causes me pain in movemnt
Intervention,
I do not wish to have the waters broken, If induction is required i would like the lowest dose and to be able to continue my plans for a natural labor with little monitoring unless it is required for the health of the baby.
I do not want drugs to "speed up" the labor if things arent progressing well and there is risk to baby i would like to be informed of all my options
I would like to avoid an episiotomy unless it is felt that my exisiting scar would rupture causing more damamge if I were to go without.

Delivery,
I would like to be lying on my side with upper leg supported for delivery, NOT on my back, My physio and I have come up with this as the safest Birthing position for my SPD/PGP and I would like that respected.
I know where my stretching limitations are for my SPD and would like MW's to respect that when I say no I am trying to avoid futher damage to my unstable pelvis.
My Birthing partner is equipped with this information as well so If i am unable to comunicate my needs then He will in my place.

Post delivery,
I would like baby brought to my chest for Skin to Skin and for any examinations to be done while baby is on my chest,
I would like the cord left intact untill the blood flow stops then my Husband to be given the option to cut the cord
I do not want the injection to speed delivery of the placenta instead i would like to nurse my baby to encourage my body to make the hormones to allow it to come away naturally.
If stiches are required I would like to be allowed to bond with my baby through Skin to skin time before they are started.
The first person aside from myself to hold my baby should be my husband

Baby,
If baby is in good health at birth please follow my birthplan
If baby requires medical treatment please inform us and give us the chance to consider any treatment,
Myself or my husband are to be with the baby at all times and no medication given to the baby without it being approved by us.
WHere possible we want to allow mother and baby to bond and for baby to nurse in the first min of life ,
If baby is well then ******* my husband will take care of dressing etc... if I am unable to do so myself.

Feeding
I intend to breastfeed and would like no bottles or fluids given to baby if something is requiered I will express for the baby and it to be given by syringe or cup methods.
I would like a BF support worker to visit sometime in the first 24 hours after baby is born to check things are going ok.


Little was i to know when writing this that I was going to be induced at 10days overdue, have a under 8 hour labor where my husband was there for only 23min of the end of it, be transfered rooms in the last hour of labor right on the MW shift change so had a new MW who was still reading my birth plan when i started pushing lol.
I had to give them the instructions from my birth plan myself like the "no injection" after birth { she had the needle literrally an inch from my thigh and i had to should NO at her a few times } and that my husband was to cut the cord and to "back off" after the birth and let me nurse lol, Thankfully my husband arrived in time to be the one supporting my leg so my "pain free gap" was preserved and no damage done to my pelvis, lol
It doesnt always go to plan but if you have your goals of what you want and have considered your options for pain relief and know them it will help when the time comes, just make sure your birthing partner knows all this info too lol

 

[Kmx]

Can I just ask why you ladies didn't want the injection for the placenta to come away? This is my first birth so I'm a but clueless

 

[lynnikins]

it is another drug that is unessacary IMO, it actually increases your chances of post birth hemorage or PPH, because it in fact stops your bodys production of oxytocin which is needed for your body to expel the placenta and replaces it with a synthetic form which can inhibite breastfeeding as oxytocin is an important part of that process as well,

If they dont give you the injection your body does what it wants to do naturally and expels the placenta as once the baby's cord stops pulsating the placenta detaches itself and slides out, with the injection your body is forced into contractions which really quickly contract the uterus down and if the placenta doesnt come away they are pushing on your stomach and pulling on the cord to get it to come out and if it doesnt then you need to go to theatre and have a doctor put their arm in there and try to scrape it out and if that doesnt work you wind up in surgery.
plus once the injection is given the cord has to be cut as the drug shouldnt be allowed to cross the placenta to baby as its harmful and cutting the cord early can deprive your baby of upto 15% of their blood volume resulting in jaundice and other complications.

but they do give it 90% of the time without even asking you they just jab the needle in and if the worst happens they will say " it could have happend anyway and if we didnt give you the drug it could have been worse"

I had it with ds1 and had 2 MW tugging on the cord while another was pushing on my stomach trying to get the placenta out, ( not what i really wanted right after giving birth and having my baby taken off me to be "checked over" in the hallway by doctors i didnt know! ) not having it with ds2 was much nicer and you have the option to take it if after an hour or so the placenta doesnt come away itself , its normal for the placenta to take 10-40 min though to appear depending on your hormone levels with EJ it was about 20 min i think

 

[amipregnant]

Wow thanks for all the brilliant info. so glad i found this site lynnikins you have really made me think differently about my birth.

 

[Clover Jane]

My understanding of "birth plans" is that they are really meant to be shared with your partner and whoever else will be with you, so they can help advocate for you.
When you're in labor, it's hard to find the energy to argue effectively with pushy medical staff.
As the threadstarter said, a nurse made her have an epidural... but if she had a birth plan which precluded epidurals and had shared this with her husband, then he could've stepped in and said, "No, wait... she said NO epidural."

Maybe that's not what a birth plan is, but that's what i thought it was.
It's definitely not something set in stone, because you never know what complications may arise or what interventions may be necessary.

 

[lynnikins]

its not set in stone but its good for your wishes to be written down so the staff dealing with you can see what it is you want. it helps because they see you have actually thought about things and might not be so pushy about unessacary stuff if they can see you have already weighed up the pros and cons and made a informed choice.

get your MW's help with your birth plan and if you want a natural birth then the Natural birthing section can be a source of great info

 

[mommyof3girls]

Thank you girls. All the help means a lot to me

 

[lynnikins]

no worries

 

[ciarhwyfar]

There are a lot of places with examples and stuff online but I did find many of them hard to wade through last time. Looking at the last one from posting it here, I realized how little of my wishes were followed but I know much of that was from a really lousy doctor (and it was mine). I have a great doctor this time and I will make sure that my partner has a better idea of some of the important points so we can avoid a repeat.

My biggest concern is that I might have to have a scheduled induction as I did last time and didn't know I was in labor when I got there. It was less than 45 min from my membranes being broken and only about an hour from getting to the hospital to baby being born. I want to be at the hospital and have certain people with me for birth. Since we have limited transportation, not even I could get to the hospital that fast once I realized it was time.