Thursday, April 28, 2011

Birth plan redux: The original vs. homebirth

birth interventions tubes monitors


We have a midwife appointment today and were told to bring our birth plan.

I'm not entirely clear if it's supposed to be a formalized sort of contract as you would take to a hospital, or simply a list of our preferences. The midwife put out the suggestion that we decide whether or not Sam wished to catch the baby, for instance.

It prompted me, when sorting through our home birthing supplies, to keep out the birth plan we wrote for Mikko's birth, to see what we could adapt.

Inspired by Missy at a work in progress…, I thought I'd post our original birth plan here, along with notes on how we did or didn't follow it.

And then I'll speculate as to what we'd like to change this time around.

If you take our names out and think through your own situation and preferences, you can adapt this for your own use as you wish. I copied portions from so many online birth plans that I don't even know where to give credit at this point. A lot of this language is common to birthing plans, so let's all not sweat copyright issues, yes?

At a somewhat large font (probably around 12 or 13), this is two pages typed, so we printed it double-sided so it fit on one sheet of paper.

Lauren Wayne & Crackerdog Sam's Birth Preferences

This purple stuff is my comments. Yes, that's Sam's legal name. Just kidding.

Midwives: [Names]

Dear hospital staff:
We didn't have a formal birth plan for use with just our midwives. We intended this plan to be taken with us in the event of hospital transfer, but I think it would have been most useful if we'd transferred earlier (say, transferred care to an OB in advance of labor due to pregnancy complications, or transferred early in labor). As it was, we had only three hours total in the hospital before Mikko was born, and our birth plan never made an appearance. I don't think this was a bad exercise to think through, but it never fulfilled its purpose.
      I was very skeptical of birth plans, in terms of whether hospitals would respect them, but lately I've heard several stories of hospital births that went well because of a well thought-out birth plan that was delivered to hospital staff and put on file in advance. So if you're planning a hospital birth, I do now wholeheartedly recommend creating and passing along a birth plan to everyone involved in the labor. If you're planning a birth center or home birth, it's still worth going through the process and having something prepared — and then actually bringing several copies with you to hand out if you transfer. Wow, we're not even one sentence in, and I've written a page o' comments. On with the plan…


We thank you in advance for attending our child's birth and appreciate your support and encouragement. Best to start off on a friendly note. We intended a home birth, and what follows is our ideal birth in a hospital setting. In an emergency, we will yield to life-saving interventions, upon the briefest of consultation. We're reasonable, see? Otherwise, we ask that you refrain from interventions, seek informed consent for any procedure, and accommodate our preferences below.

ROOM ENVIRONMENT

I will be performing various techniques of self-hypnosis. Start with the weirdest thing first, and bold it. I would like:
  • To bring soft music
  • To dim the lights
  • To ask that the staff kindly use a low voice, avoiding references to "pain," "hurting," or "hard work" and not offering pain medication
  • To address questions to my partner or midwife when I am focusing inwardly
Much of the above wording was suggested in my Hypnobabies study. This is where actually having given the birth plan to the hospital nurses might have been a smart idea. As poetically noted before, the room was bright and noisy, which was not conducive to going inside myself and "focusing inwardly." It was at the hospital that I became very panicky for a span, and if these wishes had been respected, I likely would have been calmer. Now, the midwives, on the other hand, definitely respected our wishes in regards to environment and using Hypnobabies and mostly left us alone to labor in peace. I imagine the birth would have been similarly low-key yet joyful. Oh, well.

LABOR

I'd like:
  • Only my practitioner, nurse, and guests present
  • Ha. I'm pretty sure there was a circus in the hospital room with us. This is one of those hindsight things where I wish I'd had the wherewithal to clear out about half the people milling around and distracting me.
  • My attendants allowed to stay with me at all times: Sam (partner) and midwives [Names] and/or midwifery students (as doulas) Our attending midwife and the students were indeed allowed to stay on in a doula function. The midwife had specifically chosen this hospital and the nurse-midwife practicing there (we drove past a nearer hospital to get there) because it was homebirthing-friendly in terms of not regarding transferring home birthers suspiciously.
  • To eat if I wish to I did at home, but this wasn't an issue by the time I got to the hospital.
  • To stay hydrated by drinking fluids instead of having an IV This ship had also sailed. I'd thrown up so many times that I was seriously dehydrated, and getting more IV fluids was one reason we transferred. I wouldn't be surprise if water was available to me, though, but I couldn't keep anything down.
  • To have a heparin or saline lock if needed It was needed, so I had one. Fortunately, one brilliant nurse was able to find the one vein that could still be found and fix that needle in place with about a roll of tape.
  • To move around and assume positions as I choose Hmm. Well, yes but mostly no. With the monitoring belt, I couldn't go anywhere but the bed. I tried hands and knees for awhile, but it was messing with the stupid belt getting a good reading. I really hated that belt. That said, I wasn't forced to lie flat on my back or use the stirrups — although I did end up in more of a reclining position and the stirrups came in handy. Who knew.
  • To use any equipment that might help my comfort, such as a birthing ball, birthing stool, squatting bar, and/or shower They laughed at me when I asked to shower — there wasn't one. There was a therapy tub, but I wasn't allowed in till after the birth. They did have a squatting bar that they were almost eager to bring out and set up on the end of the bed, as if to prove how helpful they were for natural birthers. It was kind of sweet and amusing. The problem with squatting, for me, was that I could no longer feel the contractions to push with them — the pressure was so intense in that position I couldn't stop pushing. I abandoned that method and they raised the back of the bed so I was semi-reclining instead.
  • To use a birthing tub during labor I don't know how many birthing suites at this hospital had birthing tubs, if any, but ours didn't. I'm not sure what their policy was about water births, either.
  • To record our baby's birth with still photographs and/or video No one stopped us.

As long as the baby and I are doing fine, I'd like:
  • To have intermittent rather than continuous fetal monitoring Ugh. I was under the misapprehension that if you didn't have the type of internal fetal monitoring where they screw an electrode into your baby's scalp that any other, external fetal monitoring would be intermittent. For instance, the midwives used a handheld doppler at regular intervals to check in on the baby's heart rate (and all was well throughout the labor and birth). But the hospital had that stupid stretchy belt; I naively thought they'd get a pattern from it and then take it off, but no. They wanted it on constantly, and the nurse got agitated any time my movements disrupted the readings. If I were planning birth in the hospital or find myself transferring again, I'd be more insistent that they remove it once they'd gotten a baseline, and use it only for occasional check-ins.
  • To limit vaginal exams I really should have insisted on this one with the midwives, and maybe put something in about Sam and me not wanting to know the numbers if we did have any. Hearing over and over that we were "only halfway" there was so discouraging. One reason I chose our current midwife (our former ones are on hiatus at the moment) was her hands-off approach to vaginal exams – she still hasn't done one on me, and she says with second-time moms she usually doesn't bother unless they request one when they're feeling pushy to make sure they're complete. At the hospital I was feeling pushy, so I actually needed the feedback of a vaginal exam, and the nurse-midwife's help at pushing some tissue aside to make me complete, so that was fine.

Please allow our birthing to proceed naturally, in the absence of complications:
  • Without restriction to time
  • Without artificial oxytocin That was actually the other main reason we had transferred, to try to augment the long, slow labor. As it turned out, though, we didn't have time. Phew.
  • Without artificial stripping or rupturing of the membranes The midwife did this at home, as a last-ditch effort to avoid transferring. Next time, I'd like to avoid it and even the thinking that terms interventions as "last-ditch efforts to avoid transferring." I'd like to remind myself that staying put is always easier than leaving, so this time: Stay put, Lauren.

When it's time to push, I'd like to:
  • Push instinctively, using positions I find effective. Please do not direct me in how to push unless an emergency arises. I need to rewatch my birth video. I don't remember any coaching on how to push, just encouragement to keep it up. The nurse-midwife was solicitous of making sure I was pushing only when contracting. It all felt very instinctual to me.
  • Allow the pushing stage to progress free of stringent time limits

PAIN RELIEF

I will be using the following pain-management techniques:
  • Self-hypnosis
  • Bath/shower
I would add, in retrospect, counterpressure on my back and changing positions.

Please don't offer me pain medication or inquire about my level of pain.

VAGINAL BIRTH

I'd like:
  • The room to be as quiet as possible Yeah. No.
  • To have no episiotomy — I would appreciate warm compresses and olive oil massage of the perineum if needed No episiotomy. I know the nurse-midwife was supporting things with her hands, though I don't remember any special compresses or massage.
  • My partner or me to "catch" our baby when possible. This did not happen. Is this even possible in a hospital? If not, please do not pull on the head or use forceps or vacuum extraction except in emergency. That part was fine.

After birth, I'd like:
  • To hold my baby right away skin to skin, putting off non-urgent procedures This did happen, and I was pleased.
  • To breastfeed as soon as possible Yup. My midwife, who is also a lactation consultant, was there to remind us all to give it a go right away.
  • To wait until the umbilical cord stops pulsating before it's clamped and cut The hospital collected the cord blood for their own use, which was fine with me, but it made me nervous that they weren't waiting till the cord stopped pulsing. My midwife assured me, though, that it had stopped. I was the one who got to cut it, which seemed nicely symbolic to me — setting my baby free. Assuming no one's collecting the blood this time, I'd like to wait longer to be sure the baby's finished using the cord.
  • To deliver the placenta without the use of traction unless a complication arises. A pitocin injection is allowed if needed. The placenta came out easily enough (like birthing a jellyfish), but it was so big — the size of a triplet placenta — that pitocin was needed, along with other measures.

C-SECTION

If a c-section becomes necessary, I'd like:
  • My partner present at all times during the operation
  • The screen lowered a bit so I can see my baby coming out
  • Regional anesthesia (an epidural and/or spinal block as needed)
  • The baby given to my husband immediately if in good health
  • To breastfeed my baby in the recovery room
I'll just say I'm happy this section remained untested.

POSTPARTUM

After delivery, I'd like:
  • All newborn procedures to take place in my presence They were all done in my room. I'd have liked it even better if they had been done on the bed where I could see. I kept having to reiterate my wishes to, say, skip the Hep B vaccination, and that made me nervous.
  • My husband to stay with the baby at all times if I can't be there

BREASTFEEDING

  • I will breastfeed exclusively
  • Please don't offer any bottles, pacifiers, artificial nipples, or artificial formula Well.
  • I will feed my baby on demand
  • The baby will be rooming in with me 24 hours To their credit, the hospital not only allowed rooming-in as the norm but turned a blind eye to cosleeping.

CIRCUMCISION

  • If our baby's a boy, we do not want him circumcised. Fortunately, I did not have to fight this.

Thank you so much for your respect and care during our birthing.

[signed by both Sam and me]


Home Birth Plan for Lauren Wayne & Crackerdog Sam

Here are the elements I'd like to include in our preferences for birthing at home:

  • We'd like to give birth at home. (Might as well start with the obvious.) We will set up the bedroom for that purpose.
  • I will be performing Hypnobabies birth hypnosis. I'd prefer a quiet environment with my hypnosis tracks or soft music running in the background and dim or natural lighting. Please allow me to focus inwardly during contractions and avoid references to pain. (I'll just say I feel silly insisting that other people use the Hypnobabies terms of "pressure waves" and "birthing time" instead of "contractions" and "labor," but I will do so in my own head.)
  • Sam will be present with me throughout the labor as my birth partner. I don't require the continuous presence of other attendants, though I am open to intermittent monitoring and conversation as I'm able.
  • We plan to have Mikko downstairs with his aunt (this is what we've finally decided on as our first preference, after a lot of talking through the options and discussing it with Natalie and having her clear it with her employers), although we'll make alternate arrangements if needed. Mikko is free to be present in the room with us or not as he wishes. He's indicated a preference to steer clear of the birth, so we're respecting that. Natalie has a tendency to become, unconsciously, very loud and converse and play boisterously, so anyone is free to remind her to keep things low-key as needed. We will leave out several quiet activities for Mikko to do, and Natalie is free to take him outside as well if either of them needs the break, or to put him to sleep in the other bedroom. (This is assuming we clear enough space in there for a mattress! Eep.)
  • Last time I had a great deal of back labor, and Sam provided counterpressure on my lower back throughout each contraction. If the same happens again, I'm sure he'd appreciate temporary spelling of his duties if someone else would like to step in from time to time to allow him a rest. (Sam says this isn't necessary to include — that he can ask for help if he needs it. I was trying to be nice, but apparently he's tougher than I would be in the same situation.)
  • I'd like very few if any vaginal exams, and would not like Sam or me to hear any of the numbers, unless I'm confirming that it's time to push.
  • I plan to eat and drink during labor. However, last time, I could not keep any food or drink down and needed several bags of IV fluids. I have veins that are hard to find in the best of circumstances, and which can be nearly impossible to locate when I'm dehydrated. If the same situation seems likely to present itself, I'd appreciate a heparin lock placed as soon as possible so that I'm free to move around between IV sessions as needed.
  • I intend to use a birthing tub (either my own or the midwife's rental — we have to talk about this at the appointment today) during labor. I am open to having a water birth but will consider my own preferences at the time. Due to our small water heater, we will likely need help keeping water heating on the stove, electric kettle, and crockpot to add to the tub.
  • I would strongly prefer not to transfer to the hospital this time except in case of emergency. Even if the labor seems long to you, please don't suggest a hospital transfer unless I convey to you that I am in distress, or birth monitoring indicates an emergency situation.
  • I am receptive to intermittent doppler or stethoscope checks of the baby's heart rate, and intermittent monitoring of my blood pressure.
  • We would love any photos or videos of the labor and birth. There are no angles I'd feel uncomfortable having photographed or filmed. We understand you have jobs to do and don't expect anyone to be dedicated to providing photography services for us, but we will have our cameras out and free for use if we're too busy to record anything. Anyone who wants can take as many pictures as desired (including of yourselves!). (We took no pictures of the midwives or hospital staff last time!) We hope to set the video camera on a tripod to make it hands-off, but the still cameras will need manual operating. (We were so alternately focused and discouraged during labor with Mikko that we took almost no photos. I was so happy after the fact that the midwife and one of the students shanghaied our cameras in the hospital [where they were acting as doulas at that point] and took copious photos and video of the birth. Otherwise, we seriously would have had nothing! I know it's not the midwives' job to take pictures, but I do hope somebody will feel the shutterbug urge if we forget again.)
  • I'd like the freedom and encouragement to change positions frequently during labor, including going on walks, taking showers, bouncing on the birth ball, slow dancing with Sam, etc. I'd also appreciate suggestions for pushing positions if I need them.
  • I would like to push instinctively and as gently as possible. I'd appreciate support of the perineum if needed, but it's not required if things are going smoothly without.
  • I might like to assist in catching the baby if possible and if I feel comfortable with it. I would appreciate support and direction, however.
  • Please don't announce the sex, as Sam would like to announce our new baby's name. (This was Sam's idea last time, but Sam says he doesn't care so much this time. Never mind.)
  • Sam would like to cut the cord after it stops pulsating.
  • I plan to hold the baby skin to skin and breastfeed as soon as possible after birth. (Side note: Oh, my gosh, we're having a baby! Oh! Sometimes I forget that part.) We'd appreciate a continuation of the peaceful environment. Again, Mikko is free to come to us to meet his new sibling as he wishes. (And, again, Natalie will likely need to be reminded to keep it down and back off from stealing the baby away. Sigh. I won't direct the midwives on that one — I'll just put it in my list-of-things-for-Sam-to-do.)
  • I am open to vitamin K being administered to the baby. In the absence of any risk factors (of which there are none currently), I'd rather the baby have no other post-birth interventions.
  • I had a great deal of postpartum hemorrhaging last time. I'd like assurances that there are adequate preparations and supplies for stopping postpartum bleeding, and I am open to any measures that are necessary, including uterine massage, pitocin injection, suppositories, and other methods.
  • I'd love for the weighing and checks of the baby's wellbeing to be done next to me on the bed if possible.

All right, that was kind of a lot, but I really am quite flexible about the specifics of how the birth will go. I figure it's worth thinking things through and writing them down while I'm still coherent!

I don't think I'll present the above as a formalized plan to the midwife unless she requests it, but just write the suggestions down and discuss each one with her at the appointment.

Beyond that, I'd keep the same birth plan as Mikko's for another hospital birth, but I'd add some pain-management techniques, put in language that I don't want to know the results of any vaginal exams, change the language about Sam or me catching the baby, and change the wording of "we do not want him circumcised" to "we wish for our son to remain intact" — not for political reasons, but because I was nervous even at the time that someone would glance over and see the word "circumcised" and miss the bolded "not." And just, in general, I would like to be a little more insistent. You know, actually follow the birth plan.

Well, we'll see. The best-laid plans of birthing women and all that…



I wrote this yesterday as I was doing the "homework" for my appointment and did end up turning in the preferences and going over them all with my midwife. The responses I received were illuminating, to say the least, so more on that tomorrow!



Did you or will you have a birth plan, and how did it work out? What do you think are the essentials to include, and what's not worth the bother?

16 comments:

Sybil said...

I didn't have a birth plan either time. My midwives already did things exactly, or as close as possible, to how I would have wanted it, so it was a non-issue. I did transfer to the hospital with my first and I knew that if that were to happen then birth plans would sort of be out the window by that point, anyways. I did have a midwife, student midwife and doula all with me so they were able to advocate and advise me when needed.
For my second she was a homebirth and again, all of those things you listed, my midwives pretty much did automatically for me.
I am really curious to read how birth plans worked out for others, if their care providers actually read and followed them if they weren't accustomed to doing it that way in the first place.

Teni said...

Your original birth plan sounds a lot like mine - only I was birthing in a hospital right from the start - and your notes correspond with a lot of what happened to me too. I was so annoyed having to keep that stupid belt strapped on me for almost nine hours! And every. single. movement. would set off the alarm on the monitor, so I had to stay still. Ugh!

I asked very early on if I'd be able to have intermittent monitoring and to use the birth bath, and was told I could... Yeah, right! I was essentially strapped to the bed, which upped my pain, which ended up being so bad I abused my husband, mum, and doula for simply reminding me I'd told them not to let me have an epidural. I swore at them almost constantly for half an hour (maybe a full hour?) until they conceded and "let" me break my rule. I then waited another hour or so for the anesthesiologist to even get to me :(

...yeah, I really need to talk to someone about how disapointed I am with my birth...

Lauren @ Hobo Mama said...

@Sybil: I hope some of the (planned) hospital birthers chime in on your question. One of the stories that surprised me was the one at a work in progress…. A couple quotes:
"As soon as the baby is delivered, she should be placed skin on skin with Missy and they should not be separated. Newborn evaluations and care can take place there." Missy's in-text comment: "(this was just NOT standard practice for this hospital, so it was all new to them)"

I mentioned that in my comment on the post, and Missy responded:
"One of the nurses just didn't know what to think about us... when she was getting me checked in I was discussing some if the plan with her.. she had such a hard time grasping the fact that I didn't want the baby cleaned, poked, and eye gooped up before she was brought to me. She kept saying how she does all that so that the baby is all ready to breastfeed when I get it! Ha! (she was the oldest one, so probably has been doing it that way for ages)"

I thought it was so interesting that the hospital was willing to forgo their routine based on the birth plan, even though it was so foreign to them.

I wish I could remember where some of the other similar experiences are that I've read recently.

Amanda said...

Is Sam really a pirate?

Lauren @ Hobo Mama said...

@Teni: That's what's so discouraging about birth plans (and about interacting with care providers in general) — when you're assured your wishes will be respected, and then they're not. I hate that stupid monitor. Maybe we should form a league to enter hospitals by stealth and steal them all away.

And, yes, keep talking about your birth. It's only by processing it that you can move forward and heal (and make plans for any future ones, if that's relevant to you). Ignore the people who tell you you're not allowed to be disappointed. I understand.

Megan said...

Thanks for posting this. I'm also due soon and need to get my birth plan written up for my doctor. He is very insistent that all of his patients have a birth plan ahead of time to go over so that things can be discussed and expectations understood. So glad he feels that way! It's so overwhelming to think about though.

Quick question: I know Mikko was a bigger baby and you said your placenta was huge too. Can I ask how big you were measuring before birth? I'm currently measuring 6 weeks big and I just haven't met anyone else who's measured that big and not been having multiples!

Jenny said...

I so wish I'd told somebody the part you put in about the photos for my second baby. For our first (hospital) birth I'm glad there are no photos and especially video because they'd probably just make me cry, and for #3, we learned from our mistake and are happy to have some amazing photos. So I think that is a good thing to include :-)

We didn't need an official birth plan on paper for our homebirths. Although I kept a hospital transfer plan in my purse just in case, my midwife knew me and knew my preferences because we'd talked so much. There was a plan, but not the same kind you'd take to a hospital.

I am glad to see I'm not the only one who worried about somebody accidentally circumcising my baby in case of a hospital transfer. The thought terrified me. My solution was to tell Jordan not to leave the baby's side if we had to have an emergency c-section or something, and make sure nothing against our wishes was done. Of course, we birthed at home so it was never an issue.

I'm interested to see what illuminating things your midwife had to say!

Little Tiny Love said...

I had a planned hospital birth that went pretty well and followed my birth plan, even though I left it at home and our son was 5 weeks early.

3 Things I have to complain about our birth experience at the hospital. First, my labor nurse was a pain in the neck. I could have kicked her. She didn't want to listen to me, and wanted to argue with me when i asked why I needed an IV, as if I wasn't capable of understanding she just kept telling me "to make sure the baby is okay". She got sick of arguing with me and dragged in the doctor who did explain it well, and I accepted the IV - I only needed it long enough to receive precautionary meds because my strep test hadn't come back yet.
Second, the nurse couldn't get my IV in so she called the anesthesiologist to do it and I had to argue with him so he wouldn't give my lydocaine, and he put the IV in my hand which I definitely did not want.
Third, I had the fetal monitoring belt on for a majority of my labor. It wasn't bugging me so I left it be at first. Then I took it off because it wouldn't read when I was in any position other than laying flat. The nurse insisted I needed to be on it for 20 minutes so they could get a reading on the baby, but I couldn't lay down for that long because laying made the contractions stronger.

I wasn't able to use the birthing ball or tub or really get off the bed because labor was so fast, and pretty furious. I did hands and knees and kneeling and leaning over the top of the bed which helped.

My son was put on my chest as soon as he came out. My fiance cut the cord, the doctor even joked not to miss and cut his penis, ha! My delivery nurses were great, even after my son was born and had to stay in the nursery. His nurse was amazing too. Even though he was having a hard time breathing he was stable enough that she let me hold him for just a minute after he was cleaned up and checked on before they had to run him to the nursery.

I hadn't even brought our birth plan because we were in shock my water had broke at 35 weeks, we forgot it. We pretty much played it by ear but our hospital and the *majority* of the staff were amazing.

Joy@WhenDoesDaddyComeHome said...

I did not have a birth plan with my first two. Or I guess I should say I had one but was too shy to give it to my doctor because I didn't want to tell them how to do their job. Oh how young and naive I was!

Most people don't realize that a birth plan isn't a 'set in stone' action plan but just a list of preferences. So I know a lot of people shoot them down.

However I DO think they are important. My third daughter I had a birth plan that my doctor didn't discuss with me; he just wrote his own notes all over it. I switched to midwives at 37 weeks pregnant because he was making me really uncomfortable.

My plan was executed exactly as discussed with my midwives. The ONLY thing I'd add is "Very little to no cervical checks!!!" I'm so with you on that one! Oh and I did want a water birth but the whirlpools were occupied.

Momma Jorje said...

Re: Pushing instinctually - or, more specifically, not being directed. My doctor in the hospital encouraged me to push... gently? I don't remember the words, they didn't want me to push with all my might. I believe it was THIS that saved me from tearing, as I already have scar tissue and had torn twice before.

Re: Catching your own baby in the hospital - my doc was fine with that, but sounded doubtful I'd think of it. I didn't. At all.

WOW - I still have both of my birth plans! (One is 11 years old!)

I think it is worth mentioning Natalie's tendencies to the midwife. You don't have to ask them to step in, but let them know it may be an issue and that Sam is prepared to deal with it.

I may have to write up a post soon about my own Birth Plans. In the meantime (and I know you have a followup post to do), I'd like to share this link with you. I really like what she said about WHY we need a birth plan and how we should view it (certainly not as a contract).

Momma Jorje said...

Oh, and I laughed because upon checking, some of our Birth Plan wording is exactly the same!

fjkelly said...

Lauren, I had a medical condition throughout my pregnancy that made it high risk. As a result, I had an awful labour and ultimately a c-section. I hope you don't have to go there, but I wanted to note that my midwife latched my daughter on in the OR. She happily nursed while I was stapled up. In your birth plan you request nursing in the recovery room. Just a suggestion that you might want to actually include it in the OR. My daughter was a champion nurser from that moment onwards and is still going at 20 months.

Amber said...

I wrote a draft of a birth plan with my first pregnancy, and then I went into labour unexpectedly at 34 weeks and it never saw the light of day.

I planned a midwife-attended hospital birth the second time (actually, the same as I'd planned the first time) and opted not to use a birth plan. I don't regret it. I read "Birthing from Within" and it really resonated with me, and she says that having a caregiver that you trust is more important than writing a birth plan. Since my midwives were able to present throughout my birth except in the case where I'd have a C-section under general anesthesia, I felt confident. And I don't regret not having one.

But if having one is important to you, I think that's great. We need to make ourselves comfortable in birth, not someone else.

rakster said...

Timely post!

I just dug out our last birth plan and started to think through what went well / not so great / what I'd change if I could....

And have had a few long chats to some good friends.

For me, I think the insistence on limiting vaginal examinations and instisting they are done wherever I am at the time (i.e. on the floor in the shower area) for example, as for me last time I think that was the most disruptive and painful part of the whole giving birth experience... it mucked up my own sense of calm and sense of rhythm and way I call 'sway'.. it just felt like riding waves or something and I could manage it myself with no help but doing that while someone is making you move about the room, climb on a bed and sticking their hand up your vagina just isn't quite as easy.... surprise..

anyway, I think I'll follow suit and rethink mine in the same way you did...

Annalisa said...

Very timely for me at 37 weeks! I have been working and editing my birth plan for months -- mostly for me and our ideals but I know anything can happen. My original OB (part of a large practice) kept suggesting the hospital's birth class every time I mentioned reviewing our plan. So, we did 5 weeks of torture and I decided that the hospital was terrible (80% epidural rate, only pushing on your back, nurse with you all the time, baby examined within 1 hr, etc). At 31 weeks we switched OBs and hospitals and think we have our most ideal scenario. I mention this because it seems women are hesitant to switch practices so late but for me, it was peace of mind. I love that my new doc doesn't treat me like a pelvis and is very focused on having a dialogue and not steamrolling patients. When I discussed our birth plan he thought my requests were very normal and natural as where the previous hospital looked at me like I had a 3rd eye. The new hospital seems also very patient centered so I think we're in good hands.

Good luck with your birth! Thanks for the constant inspiration.

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