Birth plan - What did you include?

[BabbyO]

I saw my doc yesterday and realize...gee, I should probably be getting my birth plan together and start thinking about packing my bag...and figure out what we're going to do with DS while I'm in the hospital (pretty sure DH is going to stay with us in the hospital).

Anyway, at the last hospital they gave you a form that helped you outline your birth plan. The new hospital doesn't give you a form...and for the life of me I can't remember what was all on the form.

So what did you include?? The only things I can think of are (for me) no epidural and I don't want an IV prior to giving birth (I will agree with an IV port/access point).

DH will be the only one in the room during labor unless I ask for my mom. I just can't think of anything else.

[brittone2]

Originally Posted by BabbyO

I saw my doc yesterday and realize...gee, I should probably be getting my birth plan together and start thinking about packing my bag...and figure out what we're going to do with DS while I'm in the hospital (pretty sure DH is going to stay with us in the hospital).

Anyway, at the last hospital they gave you a form that helped you outline your birth plan. The new hospital doesn't give you a form...and for the life of me I can't remember what was all on the form.

So what did you include?? The only things I can think of are (for me) no epidural and I don't want an IV prior to giving birth (I will agree with an IV port/access point).

DH will be the only one in the room during labor unless I ask for my mom. I just can't think of anything else.

I think it depends on what the standard hospital policies are. For example, if you are at a hospital that "allows" eating and drinking in labor, you probably don't need to include that on a birth plan. If your hospital encourages rooming in as standard, you probably don't need to include that. If you are going against the tide, it might be helpful to include some of those things if you have a preference.

I don't know if you are planning to BF but perhaps you might want to include some things about that if possible, depending again on what the standard tends to be where you are delivering. The CDC/BFing thread has some info on the baby-friendly policies that could be included in your birth plan, possibly.

I included different things when I was having a hospital birth vs. a birth at a freestanding birth center vs. a homebirth, because the "default" in each of those scenarios was different. I also tend to put a blip in there about what I use for childbirth prep (hypnobabies/hypnobirthing) and explain that I prefer to focus inward, prefer a quiet environment, and other things that help me labor more easily.

I include things like not wanting an episiotomy unless there's an emergent situation, that I would like to keep vaginal exams to a minimum, that I don't want AROM, etc. Again, some of that is going to depend on what you want, your relationship with your care provider, and what the default is in the hospital where you are delivering. Do you want to give the first bath, or have them do it? CIrc or leaving intact if a boy? Rooming in or not? Pacifier in the nursery or not? Again, it depends on what the environment is IMO.

[AnnieW625]

The only time I did a birth plan was with the baby we lost.

With DD1 I never thought to do one, and honestly I had no idea what one was. I did tell my nurses when I checked in that I wanted to not have an epidural unless it was truly necessary. They did follow that, however for my sanity dealing with pitocin I ended up getting one (I went from not contracting at all to probably 7 cm in less than an hour, and within an hour of getting the epidural I was 10/1/2 cm and ready to push; so the pitocin worked in just about 3 hrs). I had filled out the admitting paperwork in advance too and I am sure I put down some likes and dislikes on it then.

With DD2 I didn't do one either and my only real request was that I would stay at home as long as possible. So I didn't go to the hospital until my water broke. I also told my nurses when I checked in this time that I didn't want an epidural unless I had to have pitocin, which I didn't so I delivered DD2 without drugs (I did have some nubane which helped with the early contractions, but it had worn off by the time I was 8 cm so I couldn't get any more).

I agree with Brittone that if you have a really strong preference about things then it's best to write things down.

In both cases the hospital tour both time did answer a lot of my questions as to how things were done and I was comfortable with that so I didn't have many questions to ask and nothing came across as "oh I need to avoid that."

[swissair81]

I didn't have a birth plan. With DD3 I discussed my wishes with my doctor well in advance, and spoke about it with the other 2 doctors in his practice. All 3 of them verbally agreed with my wishes. They also wrote down what we discussed in my chart. I knew the group well enough that that was enough. Also I have a history of precipitous birth, so my doctor comes in to the hospital when I show up. I knew I wouldn't be left to the mercy of the (super nice) nurses.

[daisymommy]

My midwife requested a birth-plan with all 3 of my children. The first was born in a mainstream hospital (which was so behind the times it wasn't even funny; so it was really important for me to have everything in writing, approved by my midwife and the back-up physician, and signed off on). The second was in a birth center attached to the hospital, so still under hospital rules and mentality for the most part. And the third was at home. Even still, it was good to have it all on paper.

Here's a copy of my birth plan for #1, so you can get an idea. I copied and pasted from a Word document, so I have no idea whats up with the font here!
Fwiw...I had to spell everything out for them, and I'm glad I did. They would have rather give me an IV of fluid than let me drink water or have ice-chips. Forget about eating. Ugh.
--------------------------------------------------------------------------
My name
Due date
Midwife's name
Birth location

This birth plan is intended to express the preferences and desires we have for the birth of our baby. We fully realize that complications beyond our control may arise and in such instances trust our physician or midwife to make necessary decisions. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options. We greatly appreciate your cooperation in helping to realize our plan.


Labor

• I would like my husband (name) and my mother (name) to be present during labor and the birth.
• I would prefer intermittent electronic fetal monitoring.

• I would like to be free to walk around and change my position throughout labor.
• I would like to be able to stay orally hydrated with clear fluids, popsicles, and ice chips.
• I do not want an IV unless I become dehydrated. I would like to use a heparin or saline lock.

Induction/Augmentation

• I do not wish to have my amniotic membranes artificially ruptured unless medically necessary.

Pain Control

• I would like to use natural pain relief before using any pain medication.
• If I am not able to cope with the pain using other natural methods, I would like to use a low dose epidural.

Episiotomy

• I would prefer to tear rather than have an episiotomy, but please use warm compresses, massage, and positioning, as well as guidance in pushing to allow the perineum to stretch and remain intact.

Delivery

• I would like to try different positions for delivery, including: squatting using a squatting bar for support, Hands and knees, side-lying. I do NOT want to deliver flat on my back.
• I would like to push when I feel the urge with a contraction. I do NOT want to use breath holding and counting.
  
• I would like to view the birth using a mirror
• If an assisted birth becomes medically necessary, I would prefer vacuum extraction over the use of forceps.

Post Birth & Baby Care

• Please delay umbilical cord clamping and cutting until after the placenta has been delivered, or until the cord stops pulsating.
• I would like to breastfeed shortly after birth (within the first hour). Please delay bathing and newborn procedures until after this time.
• We would like to forgo antibiotic eye ointment; all of my tests have come back negative for any infections or disease.
• If my baby is a boy, we do not consent to circumcision.
• We would like to room in, and breastfeed exclusively. Please do not give any bottles of formula, or pacifiers.

[BayGirl2]

I have Kaiser (NorCal) and just got done completing the standard form this weekend with my Doula. Most of the basic stuff Kaiser does, but I find it helpful to say that I don't want to be offered pain management, I want delayed cord cutting, want a quiet, darkened room, etc.

Just googled and found their form online: http://www.permanente.net/homepage/kaiser/pdf/52087.pdf

I agree with PPs, go on a hospital tour and hear what their standard procedures are. No need to specify things that you agree with, but if there are certain things you want that are not standard, those are the ones to mention. I think keeping it short, easy to read, to the point, and flexible, is most important.

[SnuggleBuggles]

I had a birth center birth but could have wound up at the hospital if there were problems. So, I wrote a plan for a normal birth center birth (short b/c I was on the same page as my midwives!), hospital, induction and c-section. Writing them all made me more aware of the risks, benefits and options I might not know about otherwise. I don't like the 3 page long check box birth plans...too wordy.

I focused on normal birth, augmentation (my thoughts on it and how I'd prefer), newborn care and postpartum stuff.

this is what I used for a hospital birth. I'd probably change it some if I was re-writing now but the gist is the same:
Dh and I are hoping to bring our son or daughter into this world without pain meds or interventions. We understand that some things can't be predicted or planned for. In those cases then we would like to give our informed consent to any proposed interventions along with being offered alternatives. Thank you for helping me be a partner in the birth of my baby.

Labor and delivery:

I have a few requests that might not be standard.
-I am afraid of IVs. So, unless there is a true medical need I do not want an IV or heparin lock. I am willing to sign any necessary paperwork. If one becomes necessary and there is time I would like EMLA cream (or similar).
-We want to delay the cord clamping and cutting till the cord has stopped pulsing.
-I do not want the routine shot of pitocin after the birth if all is well.
-We will be having the PKU and Hep B done at the pediatrician’s office. I ask that other newborn procedures be done but in the presence of mom and dad and after 1 hour has passed.
-If distress is indicated (and there is time) I would like to have a fetal blood sample done before continuing with further interventions.

There are some special things I would like to use in my labor and would appreciate your help in making them available. They are: a birthing ball, rocking chair, mirror to watch the delivery and use of a bathtub or shower.

I trust that my body knows what it is doing and will be able to safely deliver the baby if I am able to relaxed and in control. It will do things in it’s own time so I would prefer no augmentation or induction unless medically necessary. Please help me avoid any situations where I won’t be able to follow my body’s lead (laboring bed, continuous monitoring, and pain medications). Limit activity, voices and lights so that I can stay relaxed and focused.

I know that pain medications are available but I am choosing to avoid them. Please offer support, encouragement and help rather than pain medications. Please do an internal exam before I accept pain medications. Low dose epidural is my preference if I chose pain meds.

When it is time for the baby to be born I would prefer perineal support, like warm compresses, perineal massage and controlled delivery of the head, and shoulders rather than an episiotomy.

We plan to keep the baby with us at all times if everything is well. We request the nonseparation policy. I will be breastfeeding and would like help.

I would like to make our hospital stay short so that we can all go home and start our lives’ together.

Thank you for your help


I have copies of those other birth plans around if you want to see them.
Beth