Birth Plan

At my weekly appointment this week, we went over my birth plan with my midwife.  I was really excited to put this plan together because it outlines the kind of a birth I am hoping and planning to have.  Some have a very negative view of birth plans as they feel you are trying to tell the medical professionals how to do their job.  Do their job?  Aren’t we as women the one’s giving birth?  The medical professionals jobs are to make sure baby is healthy, mom is healthy, and to assist in the delivery of the baby.  Everything else is up to us and our bodies, so why is it crazy that I have some preferences on how that goes?  I am really hoping to do a post on birthing in America but I’m struggling on how to write it… as I don’t want to sound judgy but rather just present the facts.  I’m working on it 😉

After a bit of research on natural birthing classes I decided Hypno-birthing was the right fit for Ryan and I.  Although similar to the Bradley method, it is also very different.  I really wish they would change the name from Hypno-Birthing to something that sounds less… weird.  Because clearly, Ryan is not going to sway a pendulum in front of my face and I’m just going to be in a daze through out my birth.  What it means rather is total relaxation.  Teaching myself to achieve deep relaxation through breathing and imagery.  The whole idea is to get your mind out of your birth and give your body total control in the birth of your baby.  Trust your body and rid yourself of fear.  The mind is very powerful and can release different hormones based on either fear or relaxation.  Did you know when you are happy and relaxed the brain will release endorphins, which is the bodies natural pain management.  In fact, there isn’t a pain medication stronger than what we already have within ourselves!  However, when fear and tension is identified by the mind it releases the fight or flight response which sends the blood to all of the extremities.  Guess where you need oxygen and blood the most during labor… yeah, not in your hands.  More to come in a future post on hypno-birthing and natural birth.

I condenced my birth plan into one page.  I didn’t feel the need to hand our nurse a book to read when we arrive at the hospital.  My hope is that from reading our birth plan she will gain a sense of what kind of environment we are hoping to achieve during the birth of our baby.

With out further ado, this is my birth plan:

Should a special circumstance arise that could cause us to deviate from our planned natural birth, we trust that you will provide us with a clear explanation of the special circumstance, the medical need for any procedure you may anticipate, and what options might be available.  In such an event, please know that you will have our complete cooperation after we have had an explanation of the medical need and have had the opportunity to discuss the decision between ourselves.  In the absence of any special circumstance, we ask that the following requests be honored.
(This is paragraph is located at the top of our birth plan.  I feel it’s important to let the medical professionals know that we respect and value their expertise and that they will have our 100% cooperation should a special circumstance arise.)

During thinning and opening phase of labor

We request:
*The patience and understanding of medical caregivers to refrain from any practice or procedure that could unnecessarily stand in the way of our having the most natural birth possible.
*Only necessary hospital staff are to be in the room at any given time.  No medical students, nursing students, residents, etc.  We ask that staff honor the need for quiet and refrain from references to “pain”, “hurt”, or any offer of medication unless requested.  (I am delivering at what is considered a “teaching hospital” so it was important for me to include this.  I don’t consider me giving birth a “medical condition” so I don’t want anyone in the room at any time other than my nurse and midwife.)
*No IV prep unless absolutely necessary (My midwife informed me this is their one and only rule.  Patients have to have at least a Hep Lock.  So it doesn’t look like this preference will be honored.)
*Husband is to be present at all times
*To be free of blood pressure cuff between readings
*In the absence of a medical necessity, only intermittent monitoring of baby’s heart with fetoscop/doppler or manual use of EFM
*To take nutritional snacking if labor is prolonged
*Minimal number of vaginal exams – with permission to avoid premature release of membranes. (I’m also refusing vaginal exams at my weekly appointments.  There truly is no need and the exams don’t indicate anything.  Just because I might be 2cm dilated right now doesn’t mean I am any closer to going into labor than someone who hasn’t dilated at all.  There is a risk of these exams causing the premature release of membranes and can cause you to go into labor.  For me the “benefit” doesn’t out way the risk.  The office I go to routinely starts these exams at 38 weeks but my midwife is 100% fine with my decision.)
*Not to be offered pain management such as an epidural
*To use natural oxytocin stimulation in the event of stalled or slow labor
*No augmentation of labor via Pitocin, amniotomy, or stripping of membranes without discussion and explanation of need.
*To be fully apprised and consulted before the introduction of any medical procedure
*To have the use of a birthing ball if one is available

During Birthing

We request:
*To allow natural birthing instincts to facilitate in the descent of the baby, as much as possible, with mother-directed breathing down until crowning takes place.
*Use of Hypnobirthing breathing techniques without staff prompts
*To birth in an atmosphere of gentle encouragement during the final birthing phase without coaching.  Please – calm, low tones, free of “pushing” prompts
*Episiotomy only if absolutely necessary and only after consultation.
(I can’t tell you how many women have said to me, “They have to cut you.”  Already having done research and educating myself, I knew this was not the case.  My midwife said she has delivered over 700 babies and has maybe done 4 episiotomy’s and they were due to emergency’s.  She said “this is not routine anymore by most physicians and studies have shown a women heals better tearing naturally, if she tears, rather than by an episiotomy.  She let me know that they use perineal massage and lubricants to assist with birthing.  Perfect.)
*Use of suctioning device rather than forceps if assistance is medically necessarily
*Allow up to 30 minutes if necessary for natural placenta delivery
*Uterine massage to assist birth of placenta
*No cord traction, Pitocin, or manual removal of placenta unless there is an emergency.

For Baby

We request:
*Delay cord clamping and cutting until after pulsation has ceased.  Father will cut cord.
*Delay eye drops for 1-2 hours after birth
*Allow baby to remain with us for bonding 1-2 hours
*Breast feeding several times during the first few hours after birth
*Breast feeding only. No bottles, formula, pacifier, artificial nipples
*Decline Hep B vaccine.  Baby will receive it at first pediatric appointment.

So there it is!  I’m curious to see how many women use a birth plan.  Take the survey below!

2 thoughts on “Birth Plan

  1. I think it’s important and thoughtful that you have the “special circumstances” paragraph at the beginning of the plan. I think birth plans might get a negative connotation because some women stick to them as rigid document, and like you explained, sometimes deviations are needed when there are special circumstances that could threaten the health of the mother or baby. But it makes sense that the health care provider should explain that to the family, and it really should be considered a partnership between the two parties. (Although unfortunately, many providers do feel hamstrung by legal liabilities.) But I think everyone’s end goal is to have a happy, healthy baby in the end! I know my dad always felt that way during his OBGYN rotation and days when he used to deliver his patients’ babies. Excited to meet Baby Slicer soon!

    • Exactly. It’s a partnership. The only reason I am delivering at a hospital is for unforseen circumstances. I want to have the best care for my baby at a moments notice should he need it. You are so right on about legal liabilities. Unfortunately, Ohio has one of the highest liability insurance premiums for OBGYN’s and I feel that is what drives a lot of decisions. Doctors want that baby here as quickly as possible and that isn’t always in the best interest of the patient or baby.

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