Please review my birth plan for natural hospital birth

[grey_pony]

Here is a list of my birth preferences - please let me know if I should change anything, word something differently, or add anything! I will be taking this to my next appointment to discuss with my doctor. Thanks

-no epidural or pitocin, any drug to stimulate contractions, or any pain medication unless requested by mother

-use intermittent fetal monitoring, to allow mother to walk around. No internal monitoring (Dr. has to write order for intermittent monitoring instead of continuous monitoring?)

-placement of hep lock without tubing attached, to allow mother to walk around

-Let water break naturally (no artificial rupture of membrane)

-use of laboring positions other than lithotomy (sitting, squatting, hands and knees, lying on side, etc)

-let the mother tear if necessary (no episiotomy)

-immediate skin to skin contact with mother after the birth, and allowing to breastfeed before baby is taken anywhere else

-allow placenta to be delivered naturally, with no traction on the umbilical cord (no pitocin after delivery? not sure if this is really a big deal to have pitocin once baby is born?)

-keep baby in room with parents at all times if possible

-In a medical emergency, mother consents to any interventions necessary

-In the event of a c-section, mother would like to hold baby as soon as possible after delivery

-In the event of a c-section, please do not use restraints on the mother's arms

-In the event of a c-section, the father will be present in O.R. if possible

 

[mamawannabee]

Didn't want to read and run, but it looks good to me. Short enough that hopefully they will read it all, but detailed enough to include everything you want. I have mine made up but have to bring it to my next appt also, so I don't know how realistic all of it is in a hospital setting but it sounds like that is all things they should be able to accommodate. I have also included that I do not want Vitamin K or eye drops given to baby, and I don't know if its boy or girl, but if a boy, your circumcision wishes.

 

[lynnikins]

Here is a list of my birth preferences - please let me know if I should change anything, word something differently, or add anything! I will be taking this to my next appointment to discuss with my doctor. Thanks


-allow placenta to be delivered naturally, with no traction on the umbilical cord (no pitocin after delivery? not sure if this is really a big deal to have pitocin once baby is born?)

OK just 2 points to consider wording differently, i think ur talking sytocin which is the drug that stimulates the uterus to contract the artifical oxytocin, ( BF will trigger your body to natural produce this and release the placenta )

-In a medical emergency, mother consents to any interventions necessary

I woul say, In a Medical Emergancy the Mother and Father both wish to be informed of any interventions deemed nessacary and their wishes on each procedure to be followed

otherwise your almost giving them a free pass to start using "its in the best interest of the baby" and pushing intervention without having actual grounds on which to do so

 

[Mum2b_Claire]

^^ as the OP is in the US their Syntoconin equivalent is pitocin.

I agree about the wording of the bit about medical emergencies.

I would also say that the baby is not to be taken from your room without your permission rather than they should stay in the room 'if possible'

 

[Kess]

I agree that it's not worded strongly enough. A determined nurse/OB could easily define many things as a "medical emergency" (especially if they're the type to not trust labour/birth at all and see potential problems everywhere), and you've then given them carte blanche to do whatever they feel like to you. And "if possible" is easily countered by them with, "Well, it wasn't possible, we 'needed' to take baby to the nursery," or something.

 

[Nikki_d72]

-allow placenta to be delivered naturally, with no traction on the umbilical cord (no pitocin after delivery? not sure if this is really a big deal to have pitocin once baby is born?)

Regarding this, it can be a big deal to get the pit jab after baby is born, because it can actually increase your chances of having a retained placenta that has to be manually removed, which would be a bummer after a nice natural birth. A natural third stage helps to prevent this, along with delayed cord clamping (until it stops pulsating). This allows your baby to get all the blood required, which in turn reduces the bulk of the placenta, making contractions more effective in shearing it off the uterus wall and less likely to get stuck. Breastfeeding will help the natural oxytocin peak and help things along as well. A natural third stage can take longer - anything up to a couple of hours is considered normal - so many OBs or hospital midwives/nurses may get twitchy at the time, you may have to be firm to stand your ground. many come away within minutes though. The injection is really only needed if there is signs of PPH. HTH.

 

[lozzy21]

I would put that if baby needs to be taken from the room for what ever reason then baby must be accompanied by baby's dad or other trusted family member, (grandma ect)

I would also put something about if for what ever reason unable to communicate your wishes then your OH is able to do so for you. Just make sure you let him know exactly what your wishes are.

 

[grey_pony]

Thanks guys, I will re-word it a little more strongly. I just didn't want to come across as too defensive or argumentative... I am really nervous to speak to my OB about it, even though I know they have to respect my wishes, doctors can be so intimidating! It is normal in the US to have the pitocin after delivery - I would rather not since I've read about it making women feel sick and dizzy. I am also reading up on delayed cord clamping. Most of what I've read makes me want to try it, but I think it's very unusual in the US. I know the doctor will ask me "why" I want to do these things, and I really don't like the thought of having to defend myself to someone with 8 years of medical education!

 

[lozzy21]

Thanks guys, I will re-word it a little more strongly. I just didn't want to come across as too defensive or argumentative... I am really nervous to speak to my OB about it, even though I know they have to respect my wishes, doctors can be so intimidating! It is normal in the US to have the pitocin after delivery - I would rather not since I've read about it making women feel sick and dizzy. I am also reading up on delayed cord clamping. Most of what I've read makes me want to try it, but I think it's very unusual in the US. I know the doctor will ask me "why" I want to do these things, and I really don't like the thought of having to defend myself to someone with 8 years of medical education!

I find the words "because i do!" are hard to argue with.

 

[Samantha675]

Unfortunately Grey, you probably will have to be defensive and argumentative. A lot of birth policy in the US, is very entrenched, and it can be a real fight to get things done the way you want them. But remember you are standing up for something that is so very worth it. I hope you are lucky and have an OB who is willing and open to doing things your way, but also remember L&D nurses can also be responsible for deviations in your birth plans, so your DH is going to have to be the one who steps up and is your advocate.

As for the Whys?, print them out, make a nice list, so you can easily have it in hand when he starts to question your wishes, you can just go off it and to feel so intimidated. It is hard, we are brought up that doctors are authority figures. But remember he is a doctor who has been trained to deal with problems in pregnancy and birth, he has not been trained in natural intervention free birth. That is where the problem lies.

 

[Nikki_d72]

Good luck hon, just remember he's a guy (or girl) who went to varsity for years, but just a guy (or girl) nonetheless - he's not super-human, or a God. Imagine him naked, that usually helps! xxx

 

[madasa]

Here is a list of my birth preferences - please let me know if I should change anything, word something differently, or add anything! I will be taking this to my next appointment to discuss with my doctor. Thanks

-no epidural or pitocin, any drug to stimulate contractions, or any pain medication unless requested by mother

-use intermittent fetal monitoring, to allow mother to walk around. No internal monitoring (Dr. has to write order for intermittent monitoring instead of continuous monitoring?)

-placement of hep lock without tubing attached, to allow mother to walk around

-Let water break naturally (no artificial rupture of membrane)

-use of laboring positions other than lithotomy (sitting, squatting, hands and knees, lying on side, etc)

-let the mother tear if necessary (no episiotomy)

-immediate skin to skin contact with mother after the birth, and allowing to breastfeed before baby is taken anywhere else

-allow placenta to be delivered naturally, with no traction on the umbilical cord (no pitocin after delivery? not sure if this is really a big deal to have pitocin once baby is born?)

-keep baby in room with parents at all times if possible

-In a medical emergency, mother consents to any interventions necessary

-In the event of a c-section, mother would like to hold baby as soon as possible after delivery

-In the event of a c-section, please do not use restraints on the mother's arms

-In the event of a c-section, the father will be present in O.R. if possible

It's short and to the point! But if it were mine, I'd make it even shorter Can you fit it on the back of a postcard? (Says the lady who has ALREADY written the birth preferences for #3 and is not even TTC yet... and it is more than an A4 side! But I'm hoping to have a HB with an IMW next time, so anticipating being able to go over it with her with a fine toothcomb before the big day.... in a busy hosp. I reckon they have to be really short to be taken notice of.... )

Honestly, I'd scratch the first line. They can't administer that stuff w/o your consent ANYWAY, so if they suggest it, have your partner briefed to refuse.

On this note - do you have to sign consent forms when you are admitted? Can you ask for these ahead of time so that you can read them through properly when you are NOT in labour, and know exactly what you are consenting to? Could be that any forms you sign supersede the birth preferences anyway, so it would be good to know what is in there so that you can note on it you do NOT consent to those things.....? Just a thought..... No idea if it is viable or not!

I'd also scratch the AROM line - just stay upright and don't let anyone stick their hand in there. I've heard of women who said "no AROM" on the birth plan only to have them popped "by accident" when a VE was done. Well, what can you say to that??!! If it were me, I'd do same as above; if they ask, have partner briefed to politely refuse

Re: positions. I'd just assume what positions I wanted, with the help of my partner and/or doula. I'm not going to ASK if I can squat or tell them I want to squat. I'm just gonna squat!

I thought pit (we call it syntometrin) was no big deal, but I had 2 shots of it and my placenta still didn't budge. I later heard that there is a greater risk of retained placenta with the syntometrin.

I would include a line like "please delay all routine procedures until an hour after delivery".

Any thoughts on vit K? Eye drops? Water or formula supplementation?

 

[PoodleMommy]

I know this is an old thread, but it's been so helpful to me... THANK YOU, both to the OP, and to everyone who contributed!