Let's Argue! (About Babies!)

[diggitydot]

DH has always said that birth plans are only useful for predicting c-sections. Rarely do they see patients with a birth plan where things don't go south.

In and of themselves, BPs are fine. Just be flexible and realize that very few births are "textbook" and that you can't exactly plan a lot of things during labor. You can try, but just be flexible.

[HouseofWool]

This is going to be brief... I had epidurals with both kids. I am a GIANT pansy and have no desire to experience any pain that I don't have to. With DD, I would have like the laughing gas option, my pain was pretty minimal even at 6-7 cm (before the epi). It would have been nice to been able to hold off on meds longer and only use what I truly needed.

As for planned inductions: I was induced for health reasons with DS and we had scheduled an induction for DD because E was going to be leaving again for residency interviews and I wanted him there for the birth. E was out of town Monday, Tuesday, returning on Wednesday (my best friend came and stayed with me) and was leaving again less than a week later - we had a pretty narrow window to work with. I was obviously pretty close anyway because I had spontaneous ROM 36 hrs before the scheduled induction. Honestly, I don't think doing it before 38-39 wks is a good idea in case there is any doubt about dates. But, I am obviously a hypocrite because I was damn well ready to have DD and wanted her out.

I remember lots of massage by the MD during DD's birth (vaguely) and a tear that was just barely 2nd degree, however, she was sunny side up with her fist along side her head.

[bokelley]

I am never having sex again. Lol

[HouseofWool]

I am never having sex again. Lol

Pretty sure I am in the same boat.

[SoonerTexan]

I know that my knee-jerk reaction is that his statement comes across as very judgmental, but could there be a grain of truth to this?

I say yes it could be detrimental if you aren't willing to be flexible, but I still think it is a good idea. The midwife/nurses read both my baby and birth plan and followed them to the T--it was nice not to have to think about certain things as I was so out of it. Going over it with DH was also helpful.

Mainly it was useful for determining if the hospital/care provider was on board with what I wanted. I discussed it with my midwife 10 weeks in advance and had the doula that did our birth classes (who was familiar with both the hospital/midwife) help me tweak it/take out unnecessary parts.

Just for the heck of it, I'll post mine exactly as I gave it to the hospital/midwife. As you can see, I changed my mind about the pain drugs, but they were never offered to me! And I appreciate that, because if they were, I would have done it earlier and I didn't need to.

Birth Plan

We are attempting a natural childbirth with as few interventions as possible. We understand situations may arise that necessitate the use of medical intervention and would like to discuss the implications/options with our care provider(s) if this is the case. Thank you for taking care of us during this special time in our lives!

· --I would like intermittent fetal monitoring.

· --I would like to avoid an epidural or pain drugs and would prefer not to be offered them.

· --I would like to avoid an episiotomy and would prefer to tear naturally. In the case an episiotomy may be necessary, I want to be informed before the procedure is performed.

· --I would like to do everything possible to avoid a C-Section. In the event a C-Section is unavoidable, I would like my husband to be present until the baby is born (and then he should be with the baby).

· --I would like to let the cord finish pulsing before it is cut.

· --I would like to discuss all options before receiving post-partum pitocin.

· --I would like to make sure the baby is Rh + before receiving Rhogam. If possible, I would like thimerosol-free Rhogam.

Newborn Plan for Baby C:
(We’re expecting a girl)

· --I would like to let the cord finish pulsing before it is cut.

· --If our baby is not in any distress, I would like it to be placed on my chest for skin-to-skin bonding immediately after birth before any exams/procedures.

· --We would like to delay antibiotic eye ointment until the baby has had a chance to breastfeed and bond with us.

· --We do plan on breastfeeding. Please consult with us before giving the baby bottles/formula or pacifiers.

· --We would like our baby to room in with us and not stay in the nursery.

· --We would like a parent (or immediately family member identified by us) with the baby at all times and during any exams/procedures.

· --We will be delaying the Hepatitis B shot until a later date.

· --If our baby is a boy (not expected), we do not want him circumcised.

A few other things didn't work our/changed our mind on:

--N had meconium, so they warned me in advance her cord had to be cut immediately and they would need to suction her before I got her back. I actually did get her for a minute or two immediately, but it was nice to know that they understood what we wanted and explained why it couldn't be done. Didn't bother me.

--This particular hospital is gung ho about the erythromycin (eye gunk)--you decline it, they threaten to call CPS. I was fine with getting it, I just wanted to breastfeed her first. If I didn't let them know, they probably would have done it automatically, and she did have trouble focusing, etc. after they put it on her.

--We were so exhausted we didn't care when they took her for exams as long as they proved they were legit hospital staff.

[SoonerTexan]

PS--I totally brought cookies and had DH drop them off at the nurses station when we arrived.

[GreyhoundsRUs]

ST - a lot of what you included in your baby plan is standard practice at our hospital I'm glad you had a good experience!

[diggitydot]

I think your plan is entirely reasonable and much of it is SOP.

[Phoebe]

Epidurals: do they possibly encourage a more severe degree of tearing than what could naturally occur during delivery?
Unsure.

Selective Induction: aside from mandating maternal/fetal health problems, do you believe this is a good idea?
I believe there may be times when it is helpful. Personally, I am not a fan based on experience of an induction being 5 days late with DD2. I was 2 cm to start the induction, but there were several compliccations and I was close to needing a C-section. I will not choose an induction again unless medically necessary. I was 8 days overdue with DD1 and begged my OB for an induction, but he refused saying since it was my first labor and delivery I would end up with a C-section. I am glad now that he stood his ground.

Perineal massage: crunchy and unnecessary, or a wise and helpful decision to prevent tearing?
Never tried it and not sure I want to.

Episiotomy: an outdated practice, or something needed to prevent severe tears during deliver?
I haven't read statistics on it being an outdated practice. I had my first episiotomy over 10 years ago because I was tearing. I think I had subsequent episiotmies in the area of my first epi scar because it wasn't stretching. My epidural spot always hurts worse than my episiotomy healing. I have never had a problem with them.

[SoonerTexan]

I think your plan is entirely reasonable and much of it is SOP.

Most of it was SOP at the hospital I delivered at (and I chose it for that reason). However, the friend I mentioned earlier delivered at a different hospital in the same area, wanted the same things but because she didn't expect a hospital birth she had no plan and had a DRASTICALLY different experience. As in, nurses who got touchy when she said she didn't want an epidural and a few other things.

What bothered her (and me) the most was what happened after the baby was born. They took him at midnight for his 24 newborn exam and she woke up 3 hours later wondering where the hell he was because it was past time for him to eat. She called the nurses station to find out that during the checkout he started screaming and took a long time in between breaths. Nurse checked his oxygen and it was low, so they admitted him to the NICU and put him on a sugar water IV. (what's the technical term?) In the end, they just said he had a temper. I think it was a legitimate thing to do...but why didn't they let her know immediately? Or at least in a timely manner? They were in the hospital for 5 days because when they tried to leave, they told them they would be leaving AMA and their insurance likely wouldn't cover the stay. She was on COBRA and they already had to pay the midwife, so they felt forced to stay.

Maybe if it had been spelled out on a piece of paper some of it wouldn't have happened? Maybe not. I don't know.

[SoonerTexan]

Also, I think this is the study regarding Episiotomies

http://jama.ama-assn.org/content/293/17/2141.abstract

[GrayMatterWife]

I don't really care what other people choose, and I just dismiss anyone who is judgmental and weird about their point of view on this stuff (even if they share mine), because for reasons that i cannot fathom, some people are absolutely religious (and proseltyzing) about their opinions on the subject. Personally, I am of the view that what you do with your whoo hoo is up to you. Alone.

My first came on the due date with no induction scheduled. Second was by induction. Third was scheduled for induction but came ten days early. I had no problems with any of the births, other than DD#2 was precitious. But all went fairly smoothly. Induction was nice for convenience.

Had no episiotomies. Bad rip with first (even my never-gets-seasick NSG husbans winced). Minor rip with second. No rip with third. Didn't plan epis v. Rip. Just happened.

Had epidurals with all three. Not into pain, and not interested in the crunchy, earthy natural experience. To each his own,i say. Whatever gets it done.

No massage of any sort. Psychologically, i do not enjoy being touched when i am under a lot of stress or in pain. It does not relax me and often hurts. I wish that were different. I love massages otherwise.

[spotty_dog]

they warned me in advance her cord had to be cut immediately

It's this kind of thing that I think makes a birth plan valuable, so the staff knows what your expectations are, and how to manage them in a way that respects you. Some things didn't work out for us either, and anyway almost every one of my preferences was SOP for the midwife if not the hospital, but I liked having things in black and white for my own sake.

Your plan sounds like mine, almost to the word.

[MrsK]

My birth plan was to do whatever my OB told me to do. If she advised extracting the baby through my navel with a tweezers, I'd have said "all righty!" Turns out I had an emergency c-section with K1 due to complications discovered during an office visit. Never went into labor. With K2, I had a second c-section - labor was not progressing and my first section was too recent to permit pitocin. Turns out, my uterus was so thin that it was "like cellophane". Before the ob made the incision, the student over her shoulder said "Whoa, I can see his face." (K2 was sunny side up. They could see his face through the uterine wall.)

[civilspouse]

My birth plan was almost exactly like Sooner Texans. Even though most of it was SOP for our hospital and midwives, I think it was a good way to talk through everything with dh. I didn't have any drugs and ended up with a small tear (ds had his hand up to his head). I was ten days overdue and was scheduled to be induced. I was very upset and walked 12 miles in two days and finally went into labor the day before we were scheduled for induction. There was meconium so they had to cut the cord right away and take him to be checked. I was bummed, but at least they knew what I wanted and could explain why that couldn't happen. I think it's best to do inductions only if medically necessary.