How's my birthplan? Any tips or suggestions?

Question

First Stage

-If I am under 4 cm dilated when I arrive, I would like to be sent home. If I am at least 4 cm dilated, I would like my pool to be set up.

-I want to enter the pool at about 5 ½ cm dilation.

-Please keep the room as calm as possible (dim lights, quiet atmosphere, minimal visitors).

-I would like to be able to wear my own clothes and move around as I wish.

-Do not offer me pain medication, but feel free to offer tips for natural pain relief.

-I don’t want an IV of any kind unless it is absolutely necessary.

-Light food and drink if I wish

-Please keep vaginal exams to a minimum.

Induction/Augmentation

-I do not want any type of chemical/medical induction or augmentation. Please allow my body to work at its own pace.

-If I am not progressing, remind me to walk and let gravity aid the baby.

-If baby is not in distress, I would like to wait patiently for him to come.

Answer 1

Just remember that hospitals do things out of regulation. They probably won't honor EVERY single one of your expectations.... you won't be their only patient. Why is the eye medication such a big deal? They put some of it on and then they put the baby in your arms... 30 seconds tops. Also usually with a C-section they don't allow the father to cut the cord. They are trying to keep everything as sterile as possible.

I think it's a good thing that you have a birthplan... but be flexible and work with the professionals... They know what they are doing.

Answer 2

This HAS to be your first baby because no one who has already given birth would be so ridiculously anal like this.

I've given birth a couple times so let me explain something to you... when you finally go into labor there is going to be stuff flying, bodily fluids leaking everywhere and you are going to be screaming bloody fricken murder. Let the hospital and doctor take care of all these details. You are going to be outta your mind with the pain.

Some things you just can't plan.... I went to the hospital in April in a blinding blizzard and I was d**n glad to get there. You're not going to want to go home.

Answer 3

Its nice and well written but not very realistic. I am not trying to be ugly but very few births actually go according to plan. Once labor begins, you'll understand. It is good to let your Doctor know your preferences although sometimes those change when labor becomes difficult. Also, I am sure you are well aware of the risks of having a water delivery? Also, if you were to progress rapidly after you are dilated to near 4 cm and they send you home, you could deliver at home which could possibly cause multiple problems for both you and the baby.If you are comfortable with all of that, then good luck to you.

Answer 4

Are you birthing in a hospital or a birthing center? If it's a hospital - you may have to have an IV or do whatever "Hospital rules" are - this would also include having to change into a gown and possibly being hooked up to a monitor. When I was in the hospital (after having 2 babies at home previously) - I had to have an IV, change into a gown, have a monitor, baby had to have a vitamin K shot, etc...I also was not allowed to eat. My water had broken and I wasn't allowed to walk around - you will have to ask your caregiver about that. Sometimes they worry about a prolapsed cord if your water has broken and they want you to stay in bed.

I think you need to just be at the hospital even if you are at 2 cms and not be thinking about going back and forth - you could potentially dilate very fast from 3 to 6 cms. Trust me, you don't want to be in a car when that happens. You will want to be in the water from 3-4 cms on too. You can't just decide at 5 1/2 cms that that's the right time when you don't know how you'll be feeling. I was in a bathtub at 4 cms and that was where I wanted to be.

I will warn you - if you have back labor (which I had every time and it makes labor 10 time worse than it should be) - being in a tub isn't going to work. I had to have my husband pressing as hard as he could (counter-pressure) against my back from 6 -10 cms. There is no way he could have done what I needed him to if I was in a tub.

If you are not progressing - depending again on hospital rules - your baby could easily go into distress. They will do whatever to get you to progress or you will have a c-section. I am all about natural birth - I had 4 - but I was always willing to do WHATEVER to keep my baby safe. There is a fine line from no distress to suddenly baby is in distress. What happens if your contractions aren't regulated? Will you allow them to rupture your waters? Will you be willing to take a whiff of pitocin? There is a point that you might have to have something - so you need to be a little more flexible in your plan. With 3 of mine, I had nothing, with my 3rd daughter, I had to have a whiff of pitocin because my contractions were piddling out. It was fine. It's not like I was induced, I was already in labor with water broken spontaneously.

What about no episiotomy unless it's an emergency? What about Perineal Massage with oil? What about "Please do not allow me to tear - allow baby's head to crown very slowly, helping skin to stretch - unless there is an emergency.

I would talk all of your plan over with your caregiver - there are parts that they might help you with - other parts that you might not be able to have. And MAKE SURE the nursing staff gets it at the hospital. I said I didn't want to be offered drugs and sure enough, a dumb nurse came in and said, "oh honey you're in so much pain, let me get you something" - I was SCREAMING at her to get out.

Good Luck!

ALSO - check into circumsion on the 8th day. There are lots of good articles online about it. I would never have my son circumcised in the hospital by an unknown doctor. My son was circumcised on the 8th day (less risk of hemmorhage) and by a female OB/GYN in her office, not tied down. A nurse and I held him. Seriously, check into it. I also chose not to give him anesthesia because of risk of allergy - under doctor's advice. She said they feel "a stick and a burn" regardless of anesthesia or not - so I just opted to be as safe as possible. He only cried for 10-15 mins total and that was all, but I was with him and nursed him immediately. He was just fine. Something you may want to consider because at the hospital, they just give babies anesthesia I believe. The dr warned me if there was a reaction, there isn't much they can do - it could be really bad.

The part about the c-section: They will not just hand the baby to your husband - the baby will be wiped off and wrapped up first, apgar checked, etc... It's not the same as vaginal birth because their lungs are still filled with fluid more, etc...He will get to see the baby as soon as possible. My friend is a nurse in high risk OB.

You may wish to ask for baby to room with you unless he is ill. My 3rd daughter stayed with me the whole time (I walked down to see her first bath and everything - they just waited for me to be ready to go, like 3 hours after her birth) and I recommend this! With my first baby, I had her at home, so she was always with me. I was very possessive with her though - I could hardly handle letting anyone else hold her, except my husband. I let family members hold her, but inside, I thought I would come unglued and I just wanted her back - even though she was 1 foot from me! SO, consider it. I never let my daughter go to the nursery - she stayed WITH ME. That was you can feed him on demand, etc... and bond more. Tell them you want to be there for the bath and ear testing and measuring, etc...

Answer 5

I just had my child 5 months ago. I never made a birth plan and it went fine. you normally won't be sent home if your contractions are 5 minutes or less apart for your safety and the baby's. I give you so much credit you want to do this without an epidural or pain medication. My water broke at my visit to my OB/GYN and by 3 cm I was in excruciating pain I had to have medication (I also had back labor which made it very uncomfortable). They will probably ask you later before it's too late if you change your mind about no medication, just to be sure people do change their minds. Vaginal exams kind of kept me up to date and helped me to feel like (and know) that i was making progress and it was exciting to know the birth of my son was getting closer and closer. I had an epidural so when I started to tear i did not know it (as i had an epidural) and by my doctor giving me an episiotomy when he saw that happening he may have saved me from having a 4th degree tear which is from front to back. I had a 3rd degree tear (almost all the way) it was very painful recovery so I'm glad I trusted my doctor to make that decision.   My son when he was born had breathed in some of the amniotic fluid when he turned around (he was facing forwards and turned while he delivered) so he was rushed off to the NICU. My husband did get to cut the cord (he had changed his mind because he was dead set on not doing it so it was nice he was asked again) I had wanted to nurse right away but i was exhausted and wasn't able to do anything after the birth.  I had always thought of how I wanted to spend those first few minutes with him. It didn't happen, but I don't feel bad, he was getting the help he needed and it was actually somewhat of a blessing to get to rest a bit after the exertion. I didn't want a pacifier given to my son and they did in the nicu but I'm glad because it calmed him down and i believe helped him to get better quicker than if he was having a stressful time. I got to nurse in the NICU whenever I wanted and i was worried that because i didn't nurse right away it'd be a problem but it ended up being fine so don't worry too much about that first successful latch on. Sometimes the baby will latch right on sometimes it takes time and practice. and my son wasn't circumcised til day they were releasing him from the NICU and if it he hadn't needed to go there they wouldn't have done the circumcision til the day after the delivery.   Normally if you want a vaginal birth if they decide you need to have a c-section its an emergency situation and if it's in the middle of active labor they decide you need a c-section, getting a second opinion could be precious time wasted while your baby is in distress.

it's an amazing process giving birth and a birth plan is helpful. i only went in with ideas of how i wanted things to go. I made sure my husband and my mother (both were with me in the room) knew as well what I wanted I also trusted my husband would make a decision if need be if I was not able to do so. I didn't follow a plan because I know things do not always go how you like. I know women have been giving birth for many years and I had complete trust in my doctor so I knew I could trust his judgment if something went wrong. I had a general idea what i wanted and i made sure that my husband mother and doctor knew.  

just figured I'd let you in on my experience (without a set in stone birth plan) it's a great idea to have a plan and I give you so much credit for deciding to go at it without pain medication. Your plan looks pretty good but remember it's not a bad thing to change your mind. and don't feel bad if you go off your plan, it's an amazing and sometimes unpredictable experience. As long as you enjoy it and you have a healthy baby it'll be an experience you'll treasure forever.

Answer 6

well im no expert but the only thing you MAY have trouble with is the being sent home at under 4cm the only reason i say this (and everybodys different) you can go from 4 to 9 like BAM! or it could take 3 days (ah the unknown) maybe you could have a midwife stop by your house to check you incase you start progressing rappidly and also if you want to labor at home why not just have a home birth? you can buy a pool and set it up in your house and/or get in your bath tub just wondering why if a home labor is so important then why not just stay at home?

Answer 7

Sounds good to me, but my hospital is so strict, I couldn't get away with most of those things... At least, as far as I know... They make it sound like this is how it is, so, deal with it. :(

Good luck, but, do remember to be flexible... It might be necessary. Seems you're prepared, though. :)

Answer 8

Looks good.  The only thing you might reword is the stuff about antibiotic eye treatment.  Most states DO require it/do it routinely , so if you don't want it (and yes, you can refuse it just as you can refuse any 'routine' treatments) you need to make it clear.  If you're sure you don't want it (and you know that you free of STDs), just say so.  (And check into the specific laws in your state so you know what your rights are.)

You might also just be a bit more concise. Instead of starting every line with "I would like..."  or "Please..." just present your wishes as a clear list.

Answer 9

Wow, this is so detailed and thought through...

I have just become pregnant recently (about 1 month along now), and I am reading a book on pregnancy that talks about all these issues you mention.... But as I am reading it, I keep asking myself "Is this how I want it done?", and "Is this how I would prefer the birth?" and in most cases, I honestly HAVE NO IDEA what is best and what I would prefer. Can I ask you - have you had a child before? How do you KNOW how you'd like to do things? How do you know when and where and how and in what order things are done best? I am 36 and always thought of myself as a fairly practical, intelligent and cluey person, but when it comes to this stuff, I always assumed that the medics involved will know what's good and safe and best for me and the baby... maybe I am very wrong and I need to start thinking of my own birth plan... Why give birth in a pool? Why cut the cord only after it's stopped pulsating? Why not have any medications for pain relief? How do you know what's best? [e-mail]

I would appreciate your input! I live in Sydney. Thank you. ann

p.s. I am with you all the way about the circumcision! The only way a man's p***s should be. Cleaner, safer, aesthetically 100% better. I don't know ANY MALES who are 'resentful' or bitter about their parents having had it done to them at birth... But I know plenty who are uncut and as adults are finding it very impractical, smelly and off-putting for their sexual partners. I am one of the many women who would never sleep with an uncut man. It is my choice. I will definitely cicumcise my child if it's a boy.

Answer 10

THIS SOUNDS GREAT!  Congrats & good luck!  I wish I had done this with baby #1 but I think I'll do a cut & paste of yours for #2.

Just one suggestion-I would like the baby to be come directly to me and to remain there unless there is a problem with his health.

If his temperature is low I DO NOT want him placed in a heater but he should be placed on my chest covered with several blankets.

Answer 11

Sounds good.  A bit long.  I think I would take out the part about the c-section.  You will be given an epidural unless it doesn't take, and then they will have to put you under.  In the case of a c-section, you should probably just let the doctors "take over" as it may be a life/death situation for you or the baby.

Answer 12

I think it sounds great. As another person said, however, I would be very clear about the eye antibiotics. And you may need to verbally address this when you get to the hospital. They do it routinely, so unless you make it absolutely clear that you don't want them, they are going to go ahead and do it. I refused them when my last baby was born, and although I think they would have liked him to receive them, they didn't give me any grief about it.

The only other suggestion that I have is to see if you can possibly make it shorter. Nurses have been known to ignore long, very detailed birth plans, so I would keep only what you think absolutely needs to be stated. For example, even though I think it is great that you want to wear your own clothes, I don't know if you need to include it. Nobody is going to rip your clothes off of you without you knowing it, so I don't know if that needs to be in there. In other words, it can be addressed by a simple "I don't want to wear the gown" when you get arrive at the hospital.

The other thing I might change is the part about going into the tub at 5 and 1/2 centimeters. I assume that you want to wait until you are in active labor, but I would just go with what you are feeling rather than how much you are dilated. You will likely know when you are in active labor because of your mood and behavior. I would let that be the signal. If for no other reason, I would want to avoid vaginal exams.

Finally, my advice is to wait until the last possible moment to go to the hospital. I think that is the best advice for someone who is wanting to have an intervention-free birth. I waited until I was doing nothing but concentrating on contractions (which were every three minutes lasting for over a minute) before I left my house. I was at a 7 when I arrived at the hospital.

Best of luck to you!

ADDED: In regards to the people here who are telling you that none of this matters, I completely disagree. I have given birth four times; I used a birth plan with three births.

Just because a mom has a detailed birth plan does not mean that she has any illusions about the fact that things can change. The point is that she has certain preferences, that if things proceed normally, she would like them to be honored.

The person asking the question has obviously done her research. And she knows that every intervention introduced into labor, from an IV to pitocin, has the potential to complicate an otherwise normal, low-risk delivery. That is NOT some hippy, radical theory; it is supported by solid research. She wants to minimize the risks to herself and to her baby, so she wants to keep interventions low. And she knows how she needs to do it. There is nothing wrong with that. There is also nothing unrealistic about it. I have had three intervention-free births. But I didn't accomplish that goal by taking the attitude of "I won't really care what happens to me in labor" or "things don't ever go as planned." I accomplished that goal by doing my research, talking to my care provider, and making decisions about what I wanted my labor to look like. I accepted the fact that emergencies happen, but I wasn't complacent about things. And it paid off.

I think this woman is smart for making a birth plan. And I think her desires are realistic and completely obtainable.