Friday, December 23, 2011

Birth Plan

Bradley Method process does recommend a Birth Plan. Have you used one? How was it received? Our doctor even recommended one when we were pregnant with Sasha. (He is our doctor again with Spencer.)

I've been quite offended by the attitude I've received from some nurses about Birth Plans.I have even heard nurses refer to Birth Plans as "Failure Plans." I think I know why, though. If you use wording that suggests you will not waver in your preferences, they find it harder to take you seriously. It is good to have your perfect birth in mind, but you need to be flexible. Remember that the real desire is healthy baby and mother. The experience, while very important, is not the MOST important.

Some other key points to keep in mind: Keep your birth plan down to one page (even if it is front and back). If your plan is too long, no one will read it. Even our doctor told us that we should be able to summarize our plan. We can and did last time, "We want minimal intervention." Also, I used a check-box birth plan creator, then just tweaked it to suit my needs. The site is credited below as well as on my actual printed birth plan.

Once you have "finalized" your birth plan, have another mother (with similar philosophies to your own) review it for you. They may think of something else or improved wording. Then you should take your new "finalized" version to your doctor. This should be done in the weeks preceding your birth! You may find you have more adjustments to make once you've done this step. Once you have a final, final, final version of your birth plan, make several copies (front and back if it is two pages). Pack them into your hospital bag. Hand them to every single staff person with whom you deal at the hospital.


Here is our birth plan, as an example. Please feel free to use as much of it as you like, but be sure to make it your own with any of your preferences. We are planning a hospital birth, so this version applies specifically to a hospital birth. Also, this particular birth plan takes Spencer's Down Syndrome into consideration. I definitely suggest planning for the unexpected (like emergency Cesarean Section).



Axline Family Birth Plan


Mother-to-be: Jorje Father-to-be: Elmo
Practitioner: Dr. Ross Place of Birth: (hospital name)
Doula: Jenni Newborn's Name: (if known)

This birth plan is intended to express the preference and desires we have for the birth of our baby, Spencer. It is not intended to be a script. We fully realize that situations may arise such that our plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options. Thank you.

First Stage (Labor):
  • Dim Lights.
  • Would prefer my own clothes or nude to gown.
  • Would prefer to keep vaginal exams to a minimum.
  • Maintain mobility (Walking, rocking, up to bathroom, etc.)
  • Clear fluids. Food, as desired, to keep blood sugar level.
  • Heparin lock.
  • Please do not offer me pain medications.
  • Relaxation techniques (breathing, focusing, etc.).
  • Positioning as desired.
  • Water (Shower or Tub).
  • Heat or Cold packs.
  • Massage (back, foot, counter pressure, etc.).
  • Acupressure
Induction:
  • I would prefer to use natural methods to start labor.
  • If induction becomes necessary, please discuss our options with us.
Augmentation:
  • I would prefer to try nipple stimulation or breaking of waters.
Second Stage (Birth):
  • Choice of position
  • Prolonged length, if progress is being made
  • Spontaneous Bearing Down
  • I would prefer no episiotomy. Please use compresses, massage and positioning
  • Local Anesthesia (for repair) if necessary
  • Leave vernix intact. Do not rub baby down.
  • Skin-to-skin contact as soon as possible
  • Placenta to be delivered without tugging and given to doula immediately.
Baby Care:Pediatrician: Dr. Ross
  • Leave penis intact. Do not circumcise nor retract penis.
  • Delay cord cutting, cut cord after placenta is delivered & pulsing stops
  • No eye medication
  • No Vitamin K injection
  • No vaccinations
  • Breast feeding only - would like to see the Lactation Consultant
  • No artificial nipples without consent
  • No formula
  • No separation of Baby from Mother, unless requested by parents
  • If separation is necessary, no separation of Baby from Father
  • Delay bath. Prefer a parent bathe the baby at our convenience.
Cesarean Birth:
  • Spinal/epidural anesthesia
  • Coach (husband) and doula present
  • Lower shield and do slow birth to mimic vaginal delivery
  • Explain the surgery as its happening
  • Free (at least) one hand to touch the baby
  • Skin-to-skin contact as soon as possible
  • Breast feeding in recovery room, with Lactation Consultant assistance
Sick baby:Pediatrician: Dr. Ross
  • Breast feeding as soon as possible
  • Unlimited visitation for parents
  • Handling the baby (Kangaroo care, holding, care of, etc.)
  • If the baby is transported to another facility, move us as soon as possible
Testing:
  • Echocardiogram
  • Hearing
  • Leukemia / Transient Leukemia?
  • Platelet Count?
  • Cataracts
Compliments of Childbirth.org
http://www.childbirth.org/interactive/ibirthplan.html
mailto:info@childbirth.org


Again, what has been your experience with birth plans?
If you received a negative reaction, how did you handle it?

9 comments:

  1. I am a firm believer in birth plans, but I think they should be called birth preparations, as it should be used to prepare you and make you think about all the alternatives surrounding birth, rather than a PLAN for the actual day, as such.

    I think birth is like the ultimate exam. You can study as much as you like, but you don't know what the questions are going to be and the better you've studied the more likely you are to be prepared for the questions, but there's always the possibility of a curve ball that can totally change your outcomes!

    I like your birthplan. It covers a range of bases. And some of the options (like no separation from father) made me tear up a little. *hugs*

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  2. I love that you included the c-section possibility. So many people leave that out and then have no idea what to do if it comes up!

    Our birth plan was not received very well by anyone. My OBs wouldn't even go over it with me - I had to force it on them! At the hospital, the staff wouldn't look at it. I am so glad that I went over (and over and over and over) it with my husband. I explained that he had to act as my voice on most matters because I know me in labor - I need to concentrate on getting through contractions and didn't want to be disturbed by having to make sure everything else was going how I planned. He did a good job. One of my clearest memories of lobor with little guy is of my husband running around the room, birth plan in hand, saying: "Wait a minute! What are you doing? Hold on... there's something written here about that... let me see... Oh, Here it is!" He managed to delay them long enough that I had no interventions (no IV or even EFM!)

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  3. We had an excellent experience with our Bradley birth and birth plan. Once we gave it to our midwife and nurses, it was never mentioned again and no one ever mentioned medications or anything else we had on the plan. Everything was just done without discussion, just perfectly. However, we didn't include any details about what would happen if there was something wrong, and I wish we did. I think it's great that you've included a "sick baby" section. When Burkley was whisked away to tne NICU, my husband did go with, but there were some things that took place for which we would have appreciated some explanation.

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  4. @Luschka ~ Thank you. I didn't cover quite as many bases with Sasha, but knowing that there is an increased chance of dealing with NICU I made sure to add extra stuff. The testing section was also special for Spencer.

    Oh, and Elmo went to the nursery with Sasha. I don't recall what, but they wanted to do something (giver her a Vit K shot, perhaps) and he INSISTED they come ask me. He wasn't positive it was in the birth plan, but he was certain enough. He had to really argue which is not within his comfort level when it comes to medical staff, so I was so proud of him!

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  5. @Alicia ~ Thank you! I think all three of my birth plans have included a section on cesarean section, just trying to be prepared. I have absolutely no reason to expect one (I've had 3 successful vaginal births). I think it is important to be prepared for as much as possible. I don't think it is possible to be prepared for everything. I was so irritated that the nurse was rubbing Sasha's vernix off of her and would NOT stop! Now it is in the plan!

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  6. @Adrienne ~ That sounds so nice! We've gone over our birth plan with our doctor and he didn't have any problem with most of it. He had 1 issue with it, let us know what the hospital had available, and I have altered the plan to fit.

    I am so hoping to avoid the NICU altogether... it is going to be so hard for me to not go with him if that is how it has to work. Ugh.

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  7. Your birth plan looks excellent; comprehensive yet brief and to the point. I am a firm believer in birth plans for hospital births, too. I have had 3 hospital births, 2 with midwives, and had birth plans for both. Mainly I wanted to communicate who I was (a crunchy type; otherwise how would they know?), what I preferred, and in particular how that differs from the norm/protocols. I also included research references, because in my case often normal protocols had not caught up to research (I have diabetes). And I found the hospital and my midwives to be very receptive, supportive, and respectful of my decisions. I refused continuous EFM despite being VBAC for both my VBACs and one nurse said, "Oh I don't know about that!" and went and checked with the head nurse. In Canada you can refuse anything you want, in any hospital, so the head nurse just said, "She can do what she wants!"
    I didn't even know this happened; I was in the tub and my midwife told me about it later.

    I hope you avoid the NICU too; I had a separate post partum plan for if our baby needed NICU care!! The NICU does a lot of life saving, but they also tend to be virtually unaware of the emotional and spiritual impact of the post partum period and the importance of infant-mother proximity and skin to skin contact.

    You're a very prepared momma, and I admire your research and preparedness. Best of luck! Can't wait to see pictures of Spencer!! =)

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  8. Thanks Melissa! I'd be very interested to know what you did / said differently with your diabetes!

    Our nurses last time pretty much summed it up or understood it thus: We want minimal intervention, we just want to birth in your space.

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  9. Thanks for sharing your birth plan! I didn't do one the first time around, but I think I'm going to be doing one this time, if even just to be prepared for the unlikely necessity of interventions.

    Regarding "failure plans," I thought you might be interested in this post by Kristen at Birthing Beautiful Ideas, in which she responds to my question about whether or not there is any actual truth to that particular birth plan myth.

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