Thursday, March 26, 2009

My Birth Plan & How It Went

So I know I said I'd post this, like, 5 months ago. *grins* But better late than never. With friends Carolyn and Emily thinking about their own plans, I decided I'd copy down what I printed and gave to the nurses at the hospital, and what I liked, didn't or would change next time.

Here's what I had gone over with Jonathan, and brought with me in triplicate to the hospital. My nurses had one in there, one was for J to reference, and they sent one to the nursery once she was born. Also, at J's suggestion I put asterisks by the items that were my "hills to die on" - i.e. items I did not want to budge on. Really good since a husband can be overwhelmed at the list. I also tried to keep my items as concise as possible (1 page total) in items/wording so that it would be easy for the nurses/doctors to reference. Highly recommend that format! Don't be wordy!
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Birth Plan

LABOR – I’d Like:
· My husband Jonathan to be allowed to stay with me at all times
· To wear my own clothes during labor and delivery
· To take pictures during labor and delivery
· To stay hydrated by drinking clear fluids instead of having an IV
· To walk and move around as I choose

As long as the baby and I are doing fine, I'd like:
· Intermittent rather than continuous electronic fetal monitoring
· To be allowed to progress free of stringent time limits (i.e. Failure to Progress)

When it's time to push, I'd like to:
· To be coached on when to push and for how long so the perineum can stretch (and perineal massage if offered)
· Whatever position feels right at the time (semi recline, side-lying, squatting, hands/knees)
· **To risk a tear rather than have an episiotomy**

PAIN RELIEF:

I'd like to try the following pain-management techniques:
· Bath/shower
· Massage
· I prefer Systemic medication to an epidural

C-SECTION:

If I have a c-section, I'd like:
· My partner present at all times during the operation
· The baby given to my partner as soon as it's dried (as long as it's in good health)
· To breastfeed my baby in the recovery room

POSTPARTUM:

Post-Delivery Care – I Prefer:
· Not to get Pitocin or pulling of cord to help deliver the placenta

Baby Care – I Want:
· All newborn procedures to take place in my or my husband’s presence
· To hold my baby right away, delaying any nursery procedures for an hour to give baby a chance to nurse (we will hold baby for APGAR)
· To breastfeed as soon as possible
· **To wait until the umbilical cord stops pulsating before it's clamped and cut**
· My partner to stay with the baby at all times if I can't be there
· Nothing offered to my baby at any point (formula, water, etc)
· **NO Hepatitis Vaccination for the baby**
· **No Silver Nitrate in baby’s eyes**/ Prefer No Antibiotic Ointment Drops in eyes
· Me to give the baby the first bath
· **24-hour rooming-in with my baby**

I plan to: Breastfeed exclusively
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Now, the nurses I ended up delivering with were amazing at making sure everything was followed. I even remember right before delivery the nurse telling the doctor, "She doesn't want an episotomy" and also her telling the doctor I didn't want pitocin for the placenta delivery. I wasn't always concentrated on what they were doing when I was in the throwes of a contraction.

Labor: The only part of this I would change would be to ask for no hep-loc. I could care less about it, except that it was a big hassle to have on my hand when I was trying to labor! Especially during the pushing stage, which was 3 hours for me, and I would grip Jonathan or the bed's rail, I hit that thing more times than I can count. When they finally took it out they said, "I doubt this would have worked, it's so badly pulled out/crooked now." So that's why I don't want it. I have no problem if it weren't such a hindrance/irritant to my whole labor process.

Pain relief: Ha, no massage or bath taken. Had baths been available I would have used it, but I didn't need to say that. Massage was not anything I wanted during labor.

Post-Delivery: Actually, the doctor did pull on the cord gently, and I noticed and didn't care. I was so relieved to have the baby out, and I could feel the pressure of the placenta in, that I just wanted it out. I did not care about the tugging. So I'd leave that out, but still not want pitocin.

That's it. Everything else went just as I asked for it. I was so happy about it!

One interesting thing I've noticed is that some books and friends talk about the birthing environment being one of peace, tranquility, and such. Some even talk about candles, soft lighting, and music. I have never though this sounded do-able for me, but now I don't know. I think maybe it would work with a home birth, but doing that in a hospital still wouldn't seem to change how I'd view it all. Not sure. Have any of you done this? Now, laboring at home like I did (15 hours) I could create my own environment. Jonathan and I watched football, I took multiple baths, we played chess at Starbucks, took a mile+ walk, used my heating blanket, and watched Expelled (got tired of all the concentration required by listening to it and laboring). I guess it seems like people want the environment to distract from labor contractions, whereas I wanted it for the boring in-between contraction stage. But when it got serious, at the hospital, all I wanted was some sleep or a mild distraction when I wasn't contracting.

Of course, every labor/delivery is different, so please give me your thoughts and experiences! I love talking about it and like to learn what I can from each person's story!

9 comments:

Carolyn said...

For me, I want a peaceful enviroment. I found other stuff going on to be really bothersome during intense contractions - but the candles and all that wouldn't really help me any. I was helped by certain kinds of music because it aided my visualization and focus (not for distraction so much). Of course, everyone will be helped by different things.

I like your tip about the asterik. I thought about bolding a few of mine.

Did you ever post your birth story? I don't remember reading it, but I would love to if its not too personal for you!

S and H said...

Denise,

This is a post Stuart and I will definitely look back on when we prepare to have little ones in the future! Also, thank you so much for your sweet comment on my Paris post. It is so wonderful that you can be so positive and encouraging to others when you are missing your own beloved so much!
Thanks, sis!

Anonymous said...

You need to be careful with your birth plan, nurses/doctors do things for a reason-like monitoring you baby with a fetal heart monitor and giving you pitocin afterwards so you don't bleed too much. Just be careful..esp all that you had to do to get to where you are to have a baby. Birth plans are not a bad idea...but I'll tell you that all the nurses that I work with fight over who has to take "the lady with the birthplan." I would suggest just verbalizing your wishes instead to your nurse and doctor. But it's your choice, just giving you my thoughts.

Herb of Grace said...

I tried to post the other day and something happened to my comment... hmm. Anyways. I think it's a great birth plan and I'd like to link back to it in an upcoming post I'm doing about birth plans!

Sarah said...

Re:Anonymous -
I believe having a birth plan very important, if you don't want things just done automatically "just because that's how they do it". I wouldn't have a problem with a dr coming to me and saying, I understand you prefer not to have _____ but in your case I would highly suggest you reconsidering because of ____. That's too bad that the nurses are like that. Sounds like they are there for their own benifit and not the patients.

Denise, I really like your plan. I'm working on coming up with mine again for this time. Mostly in my head so far. I really liked my plan for last time, but I want to condense it a lot and keep only what is super important for me. I may steal part of it to start my new one. :)

Lindsey said...

I am due in June and want to know if you arranged to labor at home for so long previously with your doctor...that is something I would love to be able to do to stay calm and comfortable and as distracted as possible...how did you arrange this? Thank you SO MUCH for sharing your details...it helps a lot to a first time preger!!! You can email me at lindseyolindsay@gmail.com...i'd love to chat more about l&d as I'm a little nervous!

Susannah Forshey said...

I 'd planned to stay at home for the majority of my labor, as well, and wanted the whole Private, Candlelit, Tub-soaking experience. I never got the kiddie pool set up in time, so I didn't get that part, but my husband did dim the lights and played harp music softly for me while I labored with an exercise ball on the living room floor. My labor experience was pretty short, though, and very intense, so I didn't experience one IOTA of the boredom that Denise talks about. I needed Quiet, Dark, and people's hands to grab or push on during contractions. Focus was a key thing, and with closed eyes and little interruption, I managed to achieve it. Based on my experience, the tub of water would've been WONDERFUL, since I had 4 hours of leaking amniotic fluid (so I had nothing but a t-shirt on....embarrassing in retrospect, but better than changing pads every 5 minutes), and it would've helped me achieve some stretching positions better...which I had to attempt to get over a cervical lip. One last thing, to Lindsay: laboring at home is WONDERFUL, but be aware that doing all that traveling, meeting strange people, getting into hospital environment, distraction, etc. can hamper your labor progress. I am pretty sure that's why I slowed down so abruptly from 9.5 cm upon arrival....and then FOUR long hours later, the final 0.5 cm. Your body may respond with a "fight or flight" reaction if you pick up and move when you think "It's time."

Rebecca said...

It's funny, for Kathryn we had the whole mood set with a bath and candles and soft music, and I think it made me so relaxed that we didn't realize we should have gone to the hospital sooner. So with Daniel's birth, it seemed very uneventful (nicely so) having a few hours in the hospital watching TV instead of being home. Didn't have the same mood per say, but it was SO much more relaxing in the long run since we didn't have the fear of Daniel being born in the car like we did with Kathryn! :) I did have a birth plan with Daniel, although it was pretty minimal, as I wanted to be sensitive to the nursing staff (I have a few different nurse friends who say it can be hard to work with someone with a super extensive birth plan). I just kept telling the nurse, "these are my preferences, but I realize things might have to change." And in the end, I was very pleased with the whole birth experience. The important thing in the long run is a healthy baby and healthy mama, and I think everyone involved in the process wants that. :)

Chavia said...

chris is your brother in law?! he is awesome! thanks for the complements on my blog!