BR: How Important is a Birth Plan?

LauraR326 · November 2011

If you've already had your first child (or are pregnant and thinking about this as well) did you have a birth plan? What was in it? Was it priority?

Im obviously lost with this part of the process and not sure what needs to be done. Please help!

LindsayB0505 · November 2011

I think it depends on if you have very specific things you want/do not want to happen during L&D.

My hospital recommended doing one, and I'm really glad I did. I was having crazy strong, quite close together contractions by the time I got to the hospital. So DH just had to hand the nurse my birth plan and she knew what I wanted and I didn't have to answer lots of questions or try to explain to her through the contractions. I found that she then really advocated for me to my doctor (who had also seen the plan previously) when the doctor wanted to do things I didn't want (i.e., do an episiomtomy)

I think the key is to keep them pretty short and sweet though. I will try to find the document of mine and post it for you.

LindsayB0505 · November 2011

Ok, I'm copying and pasting from a Word document, so hopefully the formatting isn't messed:

Birth Plan for: (our names)

Due Date: October 5^th

Doctor: Dr. Hoven (or Dr. Konynenbelt)

Please note that I am RH negative

What we would prefer for labour and birth:

? I would like to avoid any labour augmentation unless the baby is in distress

? We would like to walk around during my labour, use the birth ball and spend time in the tub or shower

? I would like to avoid an IV unless medically necessary and would like to drink water and juice during the labor and eat small snacks if I feel hungry

? Please do not offer pain medication unless asked for. My goal is to avoid drugs, except perhaps Entonox. I would appreciate your advice for non-medical ways to manage pain.

? I would like to try pushing squatting or on all fours or whatever feels right at the time, I would like to try a squatting or birth bar if available.

? I would rather have a small tear than an episiotomy, and neither if possible

After the birth:

? We would like the baby to be placed on my chest and wait to clamp the cord for a few minutes until it stops pulsing. Brice would like to cut the cord.

? I?d like to hold my baby right away, putting off any procedures that aren't urgent to breastfeed as soon as possible. If possible would like newborn assessments to be done bedside.

If things do not go the way we hope they do:

? If I have a caesarean birth:

o I would like to be awake and have Brice with me

o I would like to have the screen lowered so I can watch the birth

o All other plans for our baby would remain the same

LauraR326 · November 2011

Thank you! That helps a ton.

MariaIsMarried · November 2011

I am anti-birth plan. I've read and heard from many people that a birth plan is a sure fire way to end up with an emergency c-section. Flame me if you want. My hospital does not encourage them. You are asked for approval along the way and need to trust that your doctor/midwife is doing what is best for you. It is a very personal practice, so they knew me well.

I've never heard of anyone with a birth plan whose birth went as planned.

LauraR326 · November 2011

A birth plan isn't mandatory but I did see it on my hospital papers. I'm packing my hospital bag and it was on the list of things to bring. It just said "bring your birth plan if you want to follow one". I was just wondering if it was really necessary or just something people have. I do have a card that I (or whoever is with me) have to show when admitting that I am RH negative and will need another shot.

C_mo · November 2011

I had a 'birth plan'... needless to say it completely went out the window.

I wanted to labour at home for as long as I could before going into the hospital, and getting as little medication as possible (non if I felt I could do it), and absolutely no epidural (more because I was scared of it than anything). I also wanted to breastfeed right away.

I ended up unable to labour at home at all, having 2 failed induction attempts before going home and starting labour on my own when I was already exhausted. When I finally started dilating my contractions were so irregular that they said it would take me another 2 days to finally get to 10 cm, so I took the epi... then when he was finally born, I wasn't able to BF right away because of my tearing. They thought I needed a blood transfusion so they took Wyatt away pretty quickly.

I would say for a 'normal' delivery a birth plan could be very helpful, but sometimes nothing goes according to 'plan', and you have to know when to just go with what happens rather than worry about what you wanted to happen. I'm still learning that.

LindsayB0505 · November 2011

I'll just add, that I think it is good to have a plan, but you need to know/be willing to stray from the plan if need be. Basically when it came down to it I just wanted to do whatever was best for me and the baby.

Even though on paper my birth experience was pretty close to what I wanted I still have a lot of disappointment/regret. I think that's normal. Because I had so much damage (and pain afterwards for like 6 weeks!) I kind of wish I had just had a C-section. Also, my main reason for wanting to avoid drugs was so that the baby would be more alert for BF-ing right away. Well, we had a hell of a time BF-ing in the hospital so I may as well have just had the drugs.

I still think it's important to have an idea of what you want. Unless you really don't care one way or the other.

AlyciaandRich · November 2011

I had a very simplistic/ flexible "plan" I think it is more like a wish list. Most of what is in my plan is hospital policy anyway. I say if it makes you feel better to have one then have one. Here is mine copy/pasted from word.

Birth Plan:

Full name: Alycia

Partner?s name: Richard

Due date: OR Induction date: June 26, 2011

Doctor?s name:

Hospital name:

Please note that I:
Tested positive for group b strep
Am Rh incompatibility with baby

My delivery is planned as:
Vaginal

I?d like?:

My partner present during labor and delivery and no other guests unless I decide during labor that I would like to have my mother or another person there for support.

During labor, I?d like:

Hospital staff limited to those who are medically necessary as I have been known to get anxious when I begin to feel claustrophobic.
To wear my contact lens the entire time/ as I feel comfortable
To stay hydrated with clear liquids and ice chips

For pain relief, I?d like to use:

I would like to labor as long as I can and then get an epidural when the pain becomes too much.

As the baby is delivered:
My partner does not want to cut the cord or help catch the baby. He will most likely want to stay by my head at all times. He is nervous about feeling nauseous and dizzy so he may need to sit down if he feels this way.
I do not want a mirror to see the baby crown, if I would like one I will ask for one.
I do not want to be asked to touch the head as it crowns.

Immediately after delivery:

I do not wish to see the placenta

If a C-section is necessary, I would like:

My partner to hold the baby as soon as possible
To breastfeed as soon as possible

I would like to hold baby:
As soon as possible.

I would like to breastfeed:
As soon as possible after delivery

I?d like my family members (Gail F, Ken F Kelly C and Mike C (Grandparents))

To join me and baby in the room later after my husband and I have some time alone with the baby. I would like to limit visitors throughout my hospital stay.

I?d like to feed baby:
Only with breastmilk
With the help of a lactation specialist

If we have a boy, circumcision should:
Be performed

If baby is not well, I?d like:
My partner and I to accompany it to the NICU or another facility
To breastfeed or provide pumped breastmilk
To hold him or her whenever possible

sstara · November 2011

While birth plans aren't necessary I think they are a really helpful way to communicate your wishes with your doctor and team of nurses. It was really helpful for me because we went through 4 nurse changes from the time we got there until the time Parker was born. I didn't have to go over everything again, they just read my birth plan and knew what I wanted. PM me your email and I will email you a copy of mine. It is too long to post here.

LauraR326 · November 2011

YGPM

indomesticbliss · November 2011

sstara:
While birth plans aren't necessary I think they are a really helpful way to communicate your wishes with your doctor and team of nurses. It was really helpful for me because we went through 4 nurse changes from the time we got there until the time Parker was born. I didn't have to go over everything again, they just read my birth plan and knew what I wanted.

I completely agree. In addition, making a birth plan (even if you don't bring it with you) with your husband helps to bing up the "what if's". As in...Where do you want Edgar to be if you and the baby are in different rooms (ie: baby goes to the NICU)? Do you want him with you or the baby?

We had one nurse, but I went in at 6 cm and I had zero desire to talk to her (she was a PITA). I basically handed my plan to her and told her to read it. For me, it was important to have a plan-my hospital is very pro-drugs and interventions, even though my midwife practice is not. I bypassed a lot of discussion time with the nurses because I had in writing my medical wishes (ie: no saline lock, no pain medication offered to me, no cervical checks unless medically needed, etc..)

I am using the same plan this time (let me know if you would like a copy) since pretty much my labor and delivery went exactly how I wanted. Post-Partum things got a little scary with a PPH, so from the time A was out until I was in "recovery" was completely different than planned, but we also had PP wishes in there (S to attend circ, rooming in, etc...) that helped to clarify my expectations to the nursing staff.

LynetteWhit · November 2011

I did not have a birth plan. I honestly think the best plan is just to go with the flow because anything can happen and you really don't know what to expect until you are in the thick of it. I think you just need to communicate with your H on what your "ideals" are before hand (drugs, interventions, etc), but it's just a minute by minute thing that I feel like having a step by step written plan is why some people end up disappointed with their birthing experience.

mrsdan2009 · November 2011

i had an idea of what i wanted but as soon as i was put on bedrest i knew that the chances of getting a labor and delivery how i wanted were slim. Because of pre-e i was on an iv and bp monitor the entire time I was in labor. this meant i didn't get to walk or labor in the tub as i had wanted to. oh well though eli is here and we were all healthy in the end. it wasn't ideal but it worked.

Johlise · November 2011

I've been working on my birth plan the last week or two. When I asked my Dr. about it she said that it is definitely a good thing to have one because if you have specific requests then the hospital staff can familiarize themselves with it prior to you coming into the hospital. You are supposed to take one along when you go for your hospital tour and give it to the head labor and delivery nurse. Make sure your Dr. has a copy and take a few extra's along when you actually go in.

I bought a book on Amazon that really has helped me out a lot! It's called "Creating Your Birth Plan" The Definitive Guide to a Safe and Empowering Birth, by Marsden Wagner. I've found this super helpful and totally recommend it to everyone!

Johlise · November 2011

LindsayB0505:
I'll just add, that I think it is good to have a plan, but you need to know/be willing to stray from the plan if need be. Basically when it came down to it I just wanted to do whatever was best for me and the baby. I
I still think it's important to have an idea of what you want. Unless you really don't care one way or the other.

This, so I don't think you can completely say that no you don't need a birth plan it's good to write one out. With every birth there are variables so whatever you do when you write on up don't expect it to go according to you birth plan by 100% because generally it won't. It just helps the Dr.s and nurse's to know what you would like.

misskris927 · November 2011

LynetteWhit:
I did not have a birth plan. I honestly think the best plan is just to go with the flow because anything can happen and you really don't know what to expect until you are in the thick of it. I think you just need to communicate with your H on what your "ideals" are before hand (drugs, interventions, etc), but it's just a minute by minute thing that I feel like having a step by step written plan is why some people end up disappointed with their birthing experience.

This exactly! Well said!

krissyrose210 · November 2011

misskris927:
LynetteWhit:
I did not have a birth plan. I honestly think the best plan is just to go with the flow because anything can happen and you really don't know what to expect until you are in the thick of it. I think you just need to communicate with your H on what your "ideals" are before hand (drugs, interventions, etc), but it's just a minute by minute thing that I feel like having a step by step written plan is why some people end up disappointed with their birthing experience.

This exactly! Well said!

I agree with this. We did not have one. Matt knew what I wanted and we discussed 'what ifs'. He was my advocate and the nurses were awesome.

MariaIsMarried · November 2011

krissyrose210:
misskris927:
LynetteWhit:
I did not have a birth plan. I honestly think the best plan is just to go with the flow because anything can happen and you really don't know what to expect until you are in the thick of it. I think you just need to communicate with your H on what your "ideals" are before hand (drugs, interventions, etc), but it's just a minute by minute thing that I feel like having a step by step written plan is why some people end up disappointed with their birthing experience.

This exactly! Well said!
I agree with this. We did not have one. Matt knew what I wanted and we discussed 'what ifs'. He was my advocate and the nurses were awesome.

I agree.

I find it interesting that hospitals encourage them -- mine very much doesn't, not that they'd say you shouldn't have one. I feel like this is another Bump-generationness. Reading a lot of your posts I know I didn't need one because I trusted my doctors/midwives/nurses.Do you not trust the medical professionals? Call me crazy, but I'd rather have them make the decisions about the health and safety of myself and my baby.

That said, we have one practice at our hospital. The office is on the other side of the wall from the ward. So I think bigger hospitals may be different.

blueandgold749 · November 2011

I'm confused as to why asking the medical people not to push certain things on you and why stating that you don't want to see your baby crown = not trusting your doctor.

I'm fairly certain that all people around here are level headed enough not to say 'It's MY way or the highway, Mr. Doctor man!' And they've made it pretty clear that you still have to be flexible WITH a plan.

C_mo · November 2011

MariaIsMarried:
krissyrose210:
misskris927:
LynetteWhit:
I did not have a birth plan. I honestly think the best plan is just to go with the flow because anything can happen and you really don't know what to expect until you are in the thick of it. I think you just need to communicate with your H on what your "ideals" are before hand (drugs, interventions, etc), but it's just a minute by minute thing that I feel like having a step by step written plan is why some people end up disappointed with their birthing experience.

This exactly! Well said!
I agree with this. We did not have one. Matt knew what I wanted and we discussed 'what ifs'. He was my advocate and the nurses were awesome.
I agree.
I find it interesting that hospitals encourage them -- mine very much doesn't, not that they'd say you shouldn't have one. I feel like this is another Bump-generationness. Reading a lot of your posts I know I didn't need one because I trusted my doctors/midwives/nurses.Do you not trust the medical professionals? Call me crazy, but I'd rather have them make the decisions about the health and safety of myself and my baby.
That said, we have one practice at our hospital. The office is on the other side of the wall from the ward. So I think bigger hospitals may be different.

I can understand not wanting to trust the doctors/nurses... in my area I know a lot of people with horror stories worse than mine, and it's because it's not a very personal practice. You go in not knowing what doctor is going to be there, and that doctor has probably only seen you (and hundreds of other women) once or twice in the past 9 months.

Next time I would like more control over things, and I think a birth plan represents being 'in charge' of your birth to some people... but birth plan or no birth plan, your chances of things going exactly how you want them are still slim to none.

Cristin23 · November 2011

I didn't have one. I'm in the firm belief that there is what I want, and then there is reality.They don't tend to co-exist in my world. Wink

That being said, I did discuss with my doctor that yes, I did want an epidural. I suppose if I really wanted specific things I could have asked, but I didn't need to. He went over what would happen play by play, from tearing, to what happen after KR was born and I felt completely comfortable with it.

I'm very aggressive though, so if I thought something was wrong, or if I wanted to do something in particular I would voice my opinion (in a nice way). Except when I kept trying to convince my nurse after the epidural that I needed to go to the bathroom. She kept telling me no, and I kept saying yes.

Turns out, I needed to start pushing.

becky5858 · November 2011

I never had time to put my birth plan into writing (although it probably wouldn't have mattered anyway since I had PIH and a breech baby). But, I discussed what I wanted in a lot of detail with Alex and I'm so glad I did. He knew exactly what to do and who to go with when the baby was rushed to the NICU after he was born. It wasn't a fun situation, but I was so glad Alex didn't have to make a decision about staying with me versus with the baby (he stayed with the baby).

We also discussed my plans and wishes regarding breastfeeding, pacifiers etc so Alex could request that Andrew not have formula (he ultimately had to have some, but it was after a discussion rather than as a matter of course).

Also, as everyone else said, it's important to be flexible because things change. I thought I'd want to have the screen lowered at my c-section to witness the birth but when the time came, I did NOT want to see myself laying open on the table and elected not to.

Good luck whatever you decide!!! I'm so excited that you're next :-)

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