Post by smilee1079 on Dec 29, 2012 20:39:37 GMT -5
This is something I know very little about but need to do. I am leaning towards natural birth with the option to change my mind and want to be notified when my last chance to choose epidural is.
What are some things I need to include and what are the reasons/benefits for the choices.
Anyone have a format they'd recommend? If you want to email me it, my email is smilee1079 at aol.
I just have a mental list (that I'll put on paper) of things that are really important to me.
-don't offer me an epi (unless the adrenalin from labor is causing my arrhythmias to act up and it's a medical necessity)
-avoid an episiotomy unless absolutely necessary, I would rather tear naturally if possible, this will be stressed to the doctor but I will ultimately leave the decision in her hands (even if it's not life/death, and their strong preference in the moment)
-no IV fluids unless I become dehydrated or need the epi
-maximum skin to skin contact with baby post-birth before basic procedures are done on baby
I really want a natural birth, but have been told that may all go out the window if my heart issues cause problems. They may tell me I need an epi or c-section.
I'm trying to be prepared for everything, yet will have a list of my wants so I have a sense of control.
This was mine last time: Thank you for allowing us to summarize our desires for the birth of our first child. We have decided to have a doula present to assist us in staying relaxed and comfortable. Following are a number of items listed that if at all possible, we would like to accomplish with your help.
If I go past my due date and baby and I are doing fine, I prefer to go into labour naturally rather than be induced. If induction becomes necessary, I would prefer to try natural induction methods or having my membranes stripped. I prefer to have minimal internal exams. We would like the absolute minimum of time attached to monitoring, I would like to be monitored using a Doppler as much as possible. Ultimately, I want to be able to walk around and move as I wish while in labour. Please offer me pain medications only if I ask for them. During labor, we would like the ability to: walk freely, use the shower and labor tub, change positions throughout, have access to clear liquids, have a quiet and encouraging environment, and avoid an IV, if possible I would like a saline lock instead in case it is needed. As long as my birth is unmedicated, I would like to push at my own pace (Mother-Directed Pushing). I prefer not to have an episiotomy, but would rather tear. If labor or delivery seems stalled, we would like the opportunity to try different positions (hands and knees, squatting, birth ball, etc.) If possible please allow the shoulders and body of my baby to be born spontaneously, on their own. No stirrups please unless I’m having a medical emergency or I ask for them. We would like to not have the cord cut right away; we would like it to pulse for at least 2 minutes. We would like the baby to be placed on the mother's chest immediately after birth in order to "bond" and nurse. We would like to have as much time with our baby as we choose before baby is taken for routine procedures. If a C-Section is not an emergency, please give us time alone to think about it before asking for our written consent.
Letting the cord pulse allows more blood to get into the baby. Higher blood volume gives better iron stores, but does raise the risk of jaundice (DS did have a bit of jaundice, but nothing that required treatment). It's been proven most beneficial for preemies.
We took about an hour to cuddle and nurse. He didn't want to nurse RIGHT away, but he got there before we had the newborn stuff done. I think I held him while I was being stitched up, but honestly it's pretty hazy.
Post by smilee1079 on Dec 29, 2012 21:39:53 GMT -5
Thank you for the info.
What are the routine newborn things?
We are having a boy and I was told not to do the circumcision right away at hospital because the clotting factor is better after a few days (I think that was the reason). Can pediatricians perform this! If we wait a week, who would do it? Anyone lse heard that you should wait?
Post by speckledfrog on Dec 29, 2012 21:44:53 GMT -5
You should tour your hospital and see what their standard routines are. Some of the more basic stuff in a birth plan (skin to skin right away, walking while laboring, etc) may be standard already.
As for the circumcision, it depends on the pedi. Ours would not do it.
Mine never left my hospital bag because I had an emergency situation during labor and DD had to be born very, very quickly (or I would have had an emergency C).
My advice regarding birth plans is to think of them less as a true plan for how things will go and more as a list of preferences and just be open to the fact that the unexpected can and frequently does happen.
I think women who have very strong feelings about certain aspects of labor and delivery (I didn't but completely respect and understand those who do) should look seriously into hiring a doula to be an advocate for them in the delivery room if and when things get crazy. I was lucky that I wasn't super attached to any of my preferences so I didn't mind not having an advocate when things ramped up--DH and I did well on our own. But there is nothing wrong with wanting your birth to go a certain way within reason and taking steps to make sure someone can advocate for you when you are in the painful and highly emotional scenario of childbirth.
I would prefer to have a flexible birth environment above all else and want to know my options before any decisions are made.
I would like to go without pain medication for as long as I can tolerate, but I am open to pain relief and will ask for it if needed. In the event that I request pain relief, I would prefer an epidural to analgesics.
I would prefer to tear naturally over an episiotomy.
After the birth, we would like the cord clamping and cutting delayed until it stops pulsing.
We would prefer to delay any non-emergent procedures such as a bath until after breastfeeding has been established.
In the event the baby and I must be separated, husband is to stay with the baby at all times.
We are undecided on circumcision and would like to speak with our pediatrician before it is done.
We never ended up even showing it to the hospital because they planned on doing just about everything and asked about it before I was induced. I had a great birth experience, wound up with an epidural and I don't regret it one bit.
I never printed mine out and my doula didn't make it to the hospital til I was pushing, my labor was crazy fast. However I'd discussed my wishes with my doctor in several appointments, starting early on. I told my nurse I wanted to go med free if possible and she offered to bring in the birthing ball. However I felt the urge to push like 3 minutes later so that never happened, lol.
if you are interested in going med free I recommend the book Natural Hospital Birth
Because I had a copy of my birth plan signed by my OB with me at the hospital, I was allowed whatever drink I wanted, as soon as I asked for it without them having to call my OB. This alone made my birth plan worth the time and effort. Seriously. A cup of freaking apple juice is worth a million dollars to me while in labor. Keep your stupid annoying ice chips away from me.
I had most of the normal stuff in my plan, including let the cord stop pulsing, no episiotomy, etc. I was signed up for a hep lock instead of an IV until I got the epidural. I also had in there that I probably would get an epidural, but I still didn't want it offered to me. Also asked for a mirror.
I also think birth plans are worth doing because it helps make sure that you and your OB are on the same page. If you've gone through a plan and had the OB sign it, then you've hopefully talked about what is realistic and what is not.
I never printed mine out and my doula didn't make it to the hospital til I was pushing, my labor was crazy fast. However I'd discussed my wishes with my doctor in several appointments, starting early on. I told my nurse I wanted to go med free if possible and she offered to bring in the birthing ball. However I felt the urge to push like 3 minutes later so that never happened, lol.
if you are interested in going med free I recommend the book Natural Hospital Birth
I never planned to go med-free, but I did the same with regard to talking to my OB beforehand as well as the first l&d nurse I had. All the birthing suites at my hospital had a white board where the intake nurse wrote down preferences such as meds, plans for feeding, skin to skin, etc. so any staff coming into the room would know them.
We are having a boy and I was told not to do the circumcision right away at hospital because the clotting factor is better after a few days (I think that was the reason). Can pediatricians perform this! If we wait a week, who would do it? Anyone lse heard that you should wait?
Most pedis do not do circs. Especially in metropolitan areas where specialist don't overlap procedures.
The ob does the circ because they are trained as a surgeon. If you want to do this outside of your maternity stay, you would probably contact a pediatric urologist or a mohel. Most privately insured patients get the circ under a negoiated maternity stay, so you'd probably have additional fees outside of the initial hospital stay. You should contact your carrier and get a referal from your chosen pedi before you deliver.