Wednesday, March 16, 2011

What's What Wednesday: Planning Birth-Part One

Photo by Bella Photography by Nicole Aarstad
One of the first things I did when I found out I was pregnant with Delilah was to start developing a birth plan. I heard all sorts of mixed messages about birth plans. Some said that hospitals were annoyed by them and wouldn't even read them. Others described wonderful experiences in which the hospital staff was receptive to and supportive of birth plans. Some say that birth plans are too rigid, and that developing a specific birth plan can lead to disappointment if everything doesn't go according to it.

I found birth planning to be extremely helpful. Considering all of the different options and acquainting myself with the different stages of labor, birth, and all that comes after helped me to get a feel for what was important to me. My care provider enthusiastically looked over my birth plan, placed it in my chart, and was optimistic that it could be carried out to the letter, barring any complications.

When I ended up in the hospital due to some complications at 35 weeks, I was pleasantly surprised that several of the hospital staff we dealt with had read my birth plan before approaching me. The events of that weekend lead to the drafting of an alternate "In Case of Cesarean" birth plan, which ended up being the plan we relied on, and which I will share next week.

In my experience, birth planning was beneficial. My suggestion to every pregnant woman who plans on giving birth in a hospital setting is to develop two birth plans: one for herself and one for the hospital. The birth plan for herself should be comprehensive and include every last tiny little detail and be as long as she wants it to be. The version the hospital sees should fit on one typed page. If it doesn't, the chance that they'll just skim it or ignore it all together increases. The hospital version should be concise and include the most important factors. Both mother and father (and doula or other birth attendant, if you have one) should be well-versed in the personal, comprehensive birth plan, to ensure that wishes that were left out of the version the hospital received are tended to.

Keep in mind that if you are giving birth in an environment other than a hospital, such as at home or at a birth center, it is much more likely that a more comprehensive birth plan will be respected, and even appreciated. Regardless of the birth setting, it is important to remember that while it is helpful to have a plan, you won't be able to control every last detail, and if complications arise that require deviating from the plan, it does not make you a failure, nor does it make your birth plan worthless.

I will leave you now with my original birth plan, to provide a framework and to give an idea what a birth plan looks like. Next week, I'll share my Cesarean Birth plan. If anyone is interested in writing a guest post on home birth or birth center birth plans, I'd love to hear from you! Send and e-mail to delilahfineandfair (at) gmail (dot) com if interested!

My original birth plan:

Our wishes for Childbirth

Mother’s Name: Joella [Last Name]
Father’s Name: Tyler [Last Name]
Name of primary healthcare provider: Dr. [First and Last Name]
How would you like to refer to your baby? Delilah
I would like to be free to walk around, move around, and change position at will throughout labor.
I would like to be able to have food and fluids by mouth throughout the first stage of labor.
I would like the environment to be kept as quiet and dimly lit as possible.
I would prefer to keep the number of vaginal exams to a minimum.
I do not want an IV unless I become dehydrated.
I would like to wear my glasses at all times.
I would prefer not to have continuous or internal fetal monitoring unless it is required by the condition of the baby.
Labor Augmentation/Induction
If labor is not progressing, I would like to have the amniotic membrane ruptured before other methods are used to augment labor.
I will try changing positions and other natural methods (walking, nipple stimulation) before consenting to the administration of pitocin.
Anesthesia/Pain Medication
I realize that many pain management options exist. I'll ask for them if I need them. Please do not offer them to me.
If a Caesarean birth becomes necessary; please see “Modified Birth Plan”
I would like to choose the position in which I give birth, including squatting.
I would like the chance to see/touch the baby's head when it crowns.
Even if I am fully dilated, and assuming the baby is not in distress, I would like to try to wait until I feel the urge to push before beginning the pushing phase.
I would appreciate guidance in when to stop or slow down pushing so the perineum can stretch.
I would appreciate having the room as quiet and as dimly lit as possible when the baby is born.
I would like to have the baby placed on my stomach/chest immediately after delivery.
Immediately After Delivery
I would like to have my husband cut the cord after it stops pulsating.
I would like to hold the baby while I deliver the placenta and any tissue repairs are made.
I would like to have the baby evaluated and bathed in my presence.
I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.
If the baby must be taken from me to receive medical treatment, my husband will accompany the baby at all times.
I do not consent to a routine injection of pitocin after the delivery to aid in expelling the placenta.
I do not
consent to erythromycin eye ointment.
I would prefer vitamin K be administered orally rather than by injection.
I would like to keep the placenta after it is delivered.
I do not consent to a Hepatitis B vaccination.
I plan to breastfeed the baby and would like to begin nursing very shortly after birth.
I would like to meet with a Lactation Consultant.
If supplementation is required for any reason, I would prefer to use donated breastmilk instead of formula.
Any supplementation should be done by cup, syringe, or other non-nipple feeding method.
I may like to take still photographs or a video recording during labor and the birth.
I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.

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  1. That is such a wonderful, well thought out plan. My first birth had a similar plan in that it was quite detailed. And I learned so much from that birth! It was a great experience... one that I cherish and am very, very proud of... but it ended up pretty different from the plan :) With each subsequent birth, I have made changes to my mental birth plan but never went in with a written one. I always learned something new and always came away from the experience in utter awe of it!

  2. Thanks for sharing this! I haven't written our birth plan yet but I think I will use something similar!

    Audrey @ House of Boys

  3. Great advice! I, too, was really glad that I had a well-thought birth plan and it was well-received by all of the hospital staff.

  4. I came across your blog through Picket Fence Blogs and am enjoying it.I was wondering if the name for your blog was based on the song Samson & Delilah? I saw the title and it caught my eye because of the song. Then when I came by and saw that your daughter is named Delilah, I naturally assumed that this was where the name came from.

  5. Thank you so much for sharing this. I have two children and have never written a birth plan. I thought about it with both pregnancies but never actually sat down to do it. With my second son I declined the Hep B vaccine but his chart shows that he rec'd it (several days after birth, which I find odd). I still do not know if he actually got it or not as I've received conflicting statemetns from the hospital. I had two great hospital births, but this still bothers me. If we have a third I think it would be best to put this in writing.

  6. Hi Michelle, Actually the Grateful Dead song WAS where I first fell in love with the name Delilah, and yes, the name of the blog comes from the lyrics to that song. I've been working on a post about how Delilah (and this blog) came to be named; your comment has inspired me to get it wrapped and posted already! :)

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