"Things usually don't go as planned."

[SpotlessMind]

So I've had some ups and downs with my doctors. Sometimes they're great, but other times they say things that just really piss me off! At my last appointment, I brought up a birth plan and my doctor immediately cut me off by saying "Labor doesn't usually go the way mother's describe in their birth plan," almost as if to say it was pointless to have one. Wth? Like, I get it, there are almost always changes, but surely he should want to know my wishes even if I can't get all of them? Or is he just going to be making all the decisions for me? Anyone else feel their doctor/midwife doesn't always cooperate the way you'd like? Ugh, kind of wishing I could have a homebirth

 

[iwantabub]

oh huni... i think its a male thing hahahah some men even after being an obgyn or mw dont understand how hard and stressful things can be in pregnancy and birth...

hugs...

u write what u want and have whatever u want! your birth not his!!!

 

[SpotlessMind]

LOL that made me giggle, thanks!

 

[Mrs Bee]

I'm one of those people that agrees with your doctor, saying that he should have been more professional and not dismissed ur plan.

 

[katsbump]

I wonder if he emphasised this because strict birth plans can lead to post natal depression if you don't end up with the birth you want. Just a thought.

 

[mummie2be]

I agree with what was said above ^^ but he definitely should have been a lot more sympathetic about the way he went about saying it. My best friend worked on her birth plan for DAYS and when she got to the hospital nothing went the way she wanted it to, and she was completely crushed because she had spent so much work on her birth plan.

I don't think that it is pointless though to make one, I have one even thought I've been told there is an 85% chance I will need a c-section, I still wrote one up. Maybe he is just worried about you making it and getting your hopes up and not getting exactly what you want.

 

[Julesillini8]

oh huni... i think its a male thing hahahah some men even after being an obgyn or mw dont understand how hard and stressful things can be in pregnancy and birth...

hugs...

u write what u want and have whatever u want! your birth not his!!!

Hm. Yes he could have definitely discussed this with less harsh words. Shouldn't have brushed it off, maybe just explained while its ok to have one, be prepared for other possibilities.
I however do have a male OB and he is AWESOME. Would never want anyone else! Just the luck of the draw I guess.

 

[NoodleSnack]

Some women really write "Birth Plan", like "I want a water birth with so and so music and rose scented candle with the light out so it will be peaceful for baby ...", so some doctors get ahead of themselves. I think you should know your preferences (which family members can stay in the room? vit k or no? Who cuts the cord? Managed third stage or no? What to do with the placenta? etc) because you need to plan before hand but as one of those whose labour went downhill around the second stage, I agree that it's better to realise that things might not go to plan (but you can always plan for when things don't go to plan which I also did ).

 

[OmiOmen]

I don't agree it is a male thing and think many women who have had kids will agree. The truth is that often things don't go as planned and getting prepared for that can help you cope when they don't. This said, he should have explained that nicely to you rather than dismissing you.

 

[yoshy]

I completely agree (based on friends' experiences not my own yet) that things usually don't go as planned, but I think that having a birth plan is still really important.
It shouldn't be "this is how my birth is going to go", but rather "these are the things I would prefer. If possible, go according to these instructions. If not, adapt accordingly".

I plan on writing one with a few different contingencies, in the hope that it's more likely to be possible to stick to it.

 

[Eurydice]

As someone working on this document right now, I think the whole problem is with the word "plan." It *is* really about preferences, and it can help you & your birth partner just as much as the medical team attending you. In writing it, you become more aware of your options.
Do you want them to offer you medication? If so, what kind?
Do you want to be able to move around during labor, if it is possible?
Do you want the option of a water birth, if it is available? You'll need to find out if your birth place offers this option and mention that you'd like a room with a tub upon admittance.
Do you want the freedom to push in any position that feels best? (If so, be aware that this might be impossible if you get an epidural or have an IV.)
After the birth, who clamps the cord and when? Do you want immediate skin-to-skin contact with your baby? Do you want all of the routine tests performed immediately, or delayed while you bond with your baby? Do you want to breastfeed? If so, how do you feel about the baby being fed formula, getting a pacifier, etc when out of your sight? That said, do you have the option of rooming in with your baby, so that he/she doesn't leave your sight?
A good practitioner will take your preferences into account whenever possible. After all, it is YOUR baby and YOUR birth experience, and you only get to do it once with this baby.

 

[nevernormal]

My doctor was the same way, and I ended up telling him that I was writing a birth plan regardless, as I wanted to have a clear way to make my wishes known to the hospital stafff, and a way for my DH to have it all in front of him as he is my only labor support.

My doctor asked me to go ahead and bring a copy in then, and after I did, he was fine with it. This was my "plan":

Spoiler

Birth Plan For an Uncomplicated Vaginal Delivery

Persons Present:
• My husband is the only non-medical person permitted in my room during labor and delivery.
• I would prefer that any students, residents or interns, if present, only observe.

During Labor:
• I will not accept an IV upon admission. A saline lock is okay.
• I prefer to stay hydrated with clear liquids, if approved by my doctor.
• I prefer a wireless monitor for fetal monitoring, if one is available.
• Please do not offer me any chemical pain relief. I’ll request it if I need it.
• I’d prefer as few interruptions as possible. I would like to labor in solitude and/or with only my husband present.
• I’d like as few vaginal exams as possible.
• I would like to discuss the choice for an enema when the time comes. I prefer not to have an enema if I have had a bowel movement on my own in the past 24 hours.
• Please do not shave my pubic area.
• I would like to labor in whatever position is most comfortable for me.
• I would like to bring a birthing ball with me and have it available for my use as I wish.

When It’s Time to Push and Deliver:
• I’d prefer to push instinctively
• I would like to deliver in whatever position is most comfortable for me at the time, even if that’s not on my back in the bed.
• I would like to push without time limits, as long as the baby and I are not at risk.
• I prefer natural tearing to an episiotomy.
• If an episiotomy is necessary, I would like the reason why explained to me before it’s performed.
• If an episiotomy is necessary, I prefer a mediolateral cut to a midline cut.
• When the baby is delivered, please delay cutting the umbilical cord for 2-3 minutes, or until the cord stops pulsing.

When the Baby is Here:
• I intend to participate in the “Golden Hour” as per hospital policy.
• I’d like to breastfeed as soon as possible.
• My husband will accompany the baby if the baby must be removed from the room for any reason.
• Please do not offer my baby formula, sugar water, or a pacifier without my consent.
• If the baby is a boy, my husband must be present at the circumcision.
• Please do not give my baby the Hep B vaccine or antibiotic ointment before discussing it with us.
• I do not wish for my baby to have a bath for at least the first 24 hrs.

If Circumstances Require a Deviation From this Plan:
• Please explain the circumstance, our options, and how long we have to make a decision
• In the event that I am admitted for an induction and not while already in labor, I will accept an IV.
• In the event of an induction, I may want my parents present during the early stages of labor to keep me company.
• If I am positive for Group B Strep, I will accept antibiotics intravenously.

In the Event of an Emergency:
• My husband will make decisions if I am unable to do so.
• Time permitting, please explain the nature of the emergency and our options for proceeding.
• If I require an emergency cesarean, I would like my husband present.

Please Note:
• I normally wear contact lenses. If I need to remove them in the event of a cesarean or another circumstance, please let me know. I do not see well out of my glasses and would prefer not to wear them if I do not have to.
• My blood type is A-, and I may have an rh incompatibility with the baby.
• My scalp is sensitive to sulfate-containing shampoos. Please do not use any soaps or shampoos containing sulfates on my baby. I will have sulfate free products with me when the time comes for baby’s first bath. It is fine to use sulfate containing products on me in the event of a cesarean to sanitize the area. One exposure will not be intolerable as long as it is rinsed away in a timely manner.

As you can see, my "plan" has more to do with expressing how I'd like certain situations handled, rather than dictating what the situation will be. I'm fully aware that things don't always go according to plan, and that's fine. But I'm also fighting a really old-school system here, and I have to be clear to the doctor & hospital staff that I'm not just going to be stuck on the bed, on my back, just "because." I'm not going to accept a "routine" episiotomy. Some people are content to let the doctor just make those decisions for them, but not me!

 

[ChelliBelle]

My midwife and myself discussed the birth plan this week- and to be honest i've only got 2 things on my list that i have made comment on
(no students and please please please don't cut me unless baby at risk!) I have discussed things with my mum (she will be there with DH) and i have mentioned some of the things i'd like (being able to walk about if possible)

apart from that we have put on that i am open with the plan as long as they help me get my little girl into the world as quickly and safely as possible.

I do think some people do have very unrealistic expectations of how things should be during their labour- BUT i do think they have a right to have the birth plan in place to ensure that they have control over a worrying time. I think it is just important to be realistic- and be prepared that things don't always go as plan!

The doctor should discuss this with you better- I imagine he has had some real out there requests in the past and you can understand why they can be dismissive.

Like you say- do your plan but be open minded about your expectations- the most important thing is that your baby is born healthly

Good luck

 

[fionar]

I think your doctor was rude in how he handled the issue.

That said, I think that a birth plan/list of preferences is absolutely essential. BULLET POINTS. Keep it brief. Keep it to essentials. "Don't offer medication, I will ask for it." "Baby is/is not to be circumcised if it's a boy" "No erythromycin drops for baby" "Prefer not to labor on my back" "Prefer to remain active throughout labor" "dad will cut the umbilical cord" "We prefer to wait until the cord has stopped pulsing to cut it" "Prefer to have immediate skin to skin contact after birth" rather than a long narrative of how you want your birth experience to be will be much better received.

Don't spend too much time on it, just jot down some simple preferences - it'll help staff care for you in the manner you prefer without bugging you with questions every five minutes - and be ready to be flexible about it as labor changes and your preferences/needs change.

 

[yoshy]

Nevernormal, that looks like a wonderful birth plan, very similar to what I'm planning.
Mind if I pinch it to base mine on?

 

[SpotlessMind]

Don't get me wrong ladies, I totally understand that things often change and I have to be adaptable to circumstance. I did not know that people who spend a lot of time on their birth plan and don't get what they want increases the risk of postpartum depression, though, so it makes sense that he'd like to warn me. I guess I just wish he'd have been a little more tactful and not made me feel like he was dismissing it completely. I just found one online that asked questions and filled it in for me, and while I will be kind of excited when it's printed out and looks all nice to hand out to everyone involved, I didn't put much effort into it so I definitely understand that if things change, they change and that's it!

 

[nevernormal]

Go ahead Yoshy!

Like I said, my birth plan is mostly a way for me to let my doctor & the nurses know that as long as things are progressing normally for a vaginal delivery, then I expect to have more freedoms than what is the typical policy around here. At our childbirth prep class the nurse basically told us that by the time you're hooked up to the monitors, IV, etc. you're basically bed-bound. Ummm.... NOT HAPPENING! My doctor originally told me that he routinely gives enemas to women in labor, and also routinely does an episiotomy for the first birth. Also not happening. That same nurse also told us plainly that our area is not progressive at all. We'd watch videos in the class that detailed a lot of more current practices, and then she'd contradict it when telling us what to expect here.

If things change, then they change. If there are complications, then we'll take them as they come. I've tried to keep my primary end goals as "healthy mommy & baby" and the means that we get there doesn't bother me as long as I'm not receiving unnecessary interventions.

 

[d_b]

My doctor just sort of rolled his eyes and said "we'll see about that" when I told him I planned on not getting an epidural.

Anyway - sometimes the birth DOES go according to your plans, mine did.. I didn't actually write it down tho as I was afraid it wouldn't go according to plan!

 

[Jess137]

My hospital actually provides a "birth plan" that they encourage everyone to complete, have their Dr sign off and bring it with you when you come to deliver. It's basically just preferences about pain meds, how you want to push, who you want in the room, etc. I prefer to do things naturally, and thankfully my Dr was fine with everything I prefer (and actually already does many things how I'd like anyway such as delayed cord clamping, immediate skin to skin, no episiotomies, etc). The only thing she mentioned was where I said I didn't want my water artificially broken...she said I may want to be flexible on that in case (for example) I get to 8 cm and labor stalls or something. So I'm very happy with that, and I'm just hoping everything goes how I'd like.

 

[sophie22]

In a way he's right. I don't even want to make one this time as I think it's pointless, mostly because I don't really know what I want until I'm there and I do t really care as long as everything goes okay! But I'm pretty go with the flow anyway so that's probably just me.