Did you have a birth plan to take to the hospital?

Margaret - posted on 06/13/2011

My biggest wish was not alot of drugs. and No C section!
I had health issues and left alot of it up to my really good docs. they were so good. Amber had her own ideas and the docs knew that and didn't tell me things until it was over! i had to have a c Amber had the cord around her neck@! I was happy when they asked my sister if she wanted to come it along with my husband. that was very special to me. I was awake for the whole thing so I got to see her as soon as she was wrapped up.

Kimberly - posted on 06/13/2011

I had one with my first child and we got zero of the things we wanted, but it did give me a better understanding of what everything was when labor took a turn in a way that we weren't expecting. I did have a doula if you have given that any thought. She was there for the entire process and she was essentially there to speak for me. She had an intimate knowledge of everything that my husband and I wanted and she was able to deal with the labor and delivery nurses when they started trying to push me in a direction that I didn't really want to pursue. She also knew the staff and was able to talk to me about options.

Rachael - posted on 06/13/2011

A birth plan is a good way for you to research what you would like to happen if everything goes to plan. But like most women have said thing don't always go to plan and it is best to go with the flow. I did hypnobirthing so I knew I wanted a drug free natural birth with my first my waters broke prematurely but never had strong enough contractions to be in active labour so I was induced 4 days after my waters had broken to avoid risk of infection. I was ready to be induced because my cervix was ripe and I was already 3cm dilated. I had this baby in under 4 hours. Second baby I wanted to have naturally as well and went into active labour naturally at 41weeks. However this time baby was big 4.5kg and in postirer position so I dilated but after 10 hours of active labour and 8cm dilated baby was still in my pelvis so my only option was to have a c section. I am pregnant with baby 3 and will be only having this one 12 months after baby 2 so my birth plan is flexible to cater for both natural and c section if baby or I could be at risk during birth.

Rae - posted on 06/13/2011

I had a birth plan, but never gave it to the midwives. Mine was mainly written for my support people (my husband and my mum) and I gave it to them a few weeks before I was due so that they could read it and we could all discuss it in advance. I think it helped relax them a bit more, knowing what they could do to help me and support me if I was not in a place to speak up for myself. I also had second plans on there - my plan A was a spontaneous drug-free labour and birth, but I also put in my requests for induction or c-section and for if my baby had needed emergency treatment at birth. Thankfully though, I got my plan A, thanks to my support people confidently knowing what I wanted from my labour and them being able to communicate with my (incredible) midwife about my wishes on my behalf

Kami - posted on 06/13/2011

Yes I did, but as it was I encountered complications we never would have been prepared for and the majority of my birth plan went OUT the window! and sign the epidural agreenment EVEN if you dont think you want one. I have a fear of needles and was pretty darned sure I didnt want one but I signed anyhow. Thanks goodness!! with out that epidural I would have been in trouble! Never hurts to be prepared even if it doesnt go the way you want it too!

Frances - posted on 06/13/2011

I had a birth plan in mind from the time I was only eight weeks along. I was able to get my birth plan filled because I hunted until I found a doctor who was in favor of it. I also was allowed to eat and drink during labor. My last labor was 33 hours and I don't think I could have done it if I had been without food for all that time.

Julie - posted on 06/13/2011

No I didn't have a birth plan I went into hospital with an open mind with both of my kids. As the midwife said in our antenatal classes it's better to have an open mind then having a plan as things always don't go to plan so we took her advice and it worked out well.

Dani Jo - posted on 06/13/2011

Hi Cynthia, I have lots of experience in this subject and I would tell you not to do a birth plan just ask the nurses for whatever you need I am sure that they will help you in any way they can. good luck

Julie - posted on 06/13/2011

I don't recommend a birth plan, in my experience, women who have a birth plans guarantee themselves to be victims of Murphy's Law.

Amy - posted on 06/13/2011

I had one, but there was no time at the hospital to give it to anyone! I found it helpful though, because we had an "ideal" plan in mind and had thought of all the choices, if we were faced with unexpected decisions. I am sure most of the staff at the hospital would have respected my plan, had they seen it. I was trying for an intervention-free birth (and got one), so an important part of my plan was that no one ask me about pain or whether I wanted an epidural. If you don't want to be reminded of your physical sensations, I would suggest including that (you can ask for an epidural when you need one). The only time I saw a doctor before I was 10cm, he popped in to ask me about pain-- it seems like something they routinely do. I was annoyed but OK with it, since I knew I had things under control and I didn't need the meds. Anyway, I think a birth plan helps with focus both before and on the big day. It's not necessary though--- it's a completely personal choice.

Annette - posted on 06/13/2011

Yes, I had a birth plan as I had a vbac, and knew that i would come across the hospital wanting me to birth their way, which involved intervention. With a birth plan and a doula, I had the natural birth that I planned. I feel that these days you do need one, they nurses are too ready to interveen and with intervetion can eventually come c-section. Sadly Qld has the highest rate of c-sections in australia. I believe c-sections have their place, but they are too enthusiastic to persuade the mother to go down this path when it's not needed.

Schmoopy - posted on 06/13/2011

Don't bother with a birth plan unless you have someone to implement it for you on the big day. You'll be way too busy to pay any attention to detail!

Jennifer - posted on 06/13/2011

I didn't write one up and when my doc asked if I had one I said "Yep, no c-section if we can avoid it, and I want my epidural!". He laughed at me but that was all I really wanted that he, or the hospital staff would really have any sort of input in.

Also, as someone that now works in a labor and delivery unit, let me say, if you do make one...KEEP IT SIMPLE!!!! The longer and more detailed it is, the more likely you are to end up disappointed. We have women that come in with 6-10 page birthing plans and Murphy's Law loves to bite them in the bum. We end up sectioning a good number of them, or something else happens that throws their "plan" out the window. Not to mention, the more details you are focusing on about your plan, the less you're really focusing on the process your body is going through and, it seems to me, the more stressed you are and less able to roll with the punches.

Giving birth is not a precise science and if you keep that in mind the more smoothly it seems to go and the happier those moms seem to be with the whole process.

Amy - posted on 06/13/2011

I did do a birth plan. It did help even if the hospital didn't follow it completely. They kinda made a big deal about bringing one which makes me think most people don't have one. My biggest reason was because I wanted to have a natural birth and breastfeed right away. I think in the long run it was very useful.

Johanne - posted on 06/13/2011

Yes we did have a birth plan even though ended in casaerian. It was nice to have just to follow as things went on. The nurses kept to it as best they could. I think it helped them to know what i wanted. You just have to make sure that you don't get upset if it doesn't go to plan.

Melissa - posted on 06/13/2011

I gave birth at a hospital known to push for c-sections. Didn't have one for the first, and ended up regretting it. I was attempting a VBAC on my second, and we wrote a birth plan. If your hospital is known to be pushy on things like IVs and c-sections, it might be helpful. I got them to leave me alone about the IV by letting them put in the port. It made them relax about emergency access, but let me walk more easily while I labored. Our birth plan also let our nurse know what we wanted to do. That meant she ran interference with a pushy Dr for us. It was a huge help. It also was a way for my husband and I to get ourselves ready for the birth.

Nadine - posted on 06/13/2011

I found a birth plan helpful in that it made me think about what choices I might want in certain circumstances. I was lucky in that my midwife looked at my plan and said, "yep, that's pretty much how we do things here", meaning minimal intervention, so it went more or less according to "plan" ha ha. If you have a partner going in with you, make sure you drill THEM on what you want - it seems nearly impossible to convince a man that you're okay with the pain. Yes honey it HURTS but NO I DON'T WANT THE PETHADINE!!! Good luck, and remember that in the end, no matter how it happens, its the end result that matters, ie a healthy baby and a healthy happy mum!

Delia - posted on 06/13/2011

Susan,

Re: fluid intake

In Europe, it is standard for women to eat and drink during labor. Studies show that women who eat and drink as they desire, have shorter labors and more effective contractions. The aspiration you talk about was a fear related to general anesthesia of the past and not epidural anesthesia. By the way...who starts labor naturally with a truly empty stomach???? Anecdotaly speaking,It's easier to throw up something rather than bile, and though I have been with women who vomited, I've birthed 5 and never vomited once (and you can be sure I ate and drank as desired at my hospital births).



Please be advised that according to ACOG (American Congress of Obstetricians and Gynecologists) recommendations, "women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks...... Women who have uncomplicated pregnancies and are scheduled for a cesarean delivery may also drink these clear liquids up to two hours before anesthesia is administered."

Nicky - posted on 06/13/2011

I started visualising the birth as best as someone who hasnt gone through it can do, for a few months prior, and I think that is the most important planning you can do, get your brain ready first. In hindsight this helped immensly on the day because I didnt panic, and I was relaxed and happy for the most of it.
For a homebirth the plan was about what to get, and what to do, i.e get drop sheets and towels ready to lay on the floor, plan where the pool would go, what music i wanted, i also had a contingency plan of course which was a hospital bag ready just in case, and the trust in our midwife to make the call if need be.
I went into labour 2.5 weeks early, and that day I was supposed to be making the music playlist, and finalising the birth plan with our midwife!! But I was mentally prepared, and the rest just flows, if you have the support of others they can take care of things you might have left out. But certainly, if you are in hospital, you need to have some things that your partner will enforce should you not want them. My cousin's husband flatly refused internal monitoring of their child during labour as they had agreed, the doctor was pressuring heavily, and the midwife thanked him afterwards for being so strong, the wife had no idea what was going on at the time, so defenitely pays to have some sort of intervention limit plan in place if you are in hospital. best of luck!!

Claudia - posted on 06/13/2011

I had a birth plan with my first child in 1995. The nurse completelly disregarded it and even went so far as to tell me I was crazy for avoiding an epidural. I was not asking for much at all. For my second in 2008 I thought doctors/hospitals had gotten better, but they had gotten worse. My supposed "natural birth" doctor insisted I get an IV upon arrival to the hospital. I had the model healthy pregnancy and great veins. I got a midwife instead and had that baby/ my second at home in a birth tub. It was beautiful, wonderful: the best decision I have ever made.

Sarah - posted on 06/13/2011

I don't think it's necessary, but you should talk over with important parties things like circumcision (yes or no) and pain meds. It might be a good idea to jot some things like that down. But in the end be prepared to throw a good portion out of the window. I had a lengthy one from a form I form online and ended up having an emergency c-section. But having it did give me piece of mind during my last trimester.

Delia - posted on 06/13/2011

Goodness Susan, what job do you have in L/D? I am a Registered Nurse with a BSN and best practice is not reflected in your posting re: episiotomy or fluid intake.
Re: Episiotomy
Episiotomies do not heal better than tears, and women who have an episiotomy have a 26% greater chance of having a tear requiring suturing. The majority of 3rd and 4th degree tears (into or through the anal sphincter) result from extensions of the episiotomy (think of how hard it is to tear fabric until you snip it and then it tears right apart) and can result in painful sexual intercourse and fecal incontinence latter in life. The ideal rate of episiotomy is 5 to 10 percent of all vaginal births, and they should be done only in urgent situations, such as fetal distress due to a compressed umbilical cord, that require a hasty vacuum extraction.

I strongly encourage you to get current with the evidence available in medical journals, nursing journals and the gold standard -The Cochrane Library data base so that you may give EVIDENCED BASED information vs emotional/ anecdotal/that's the way we've always done it advice. If you don't have time for that, then may I direct you to the books "Obstetric Myths vs Research Realities" and an even quicker easier read "The Thinking Woman's Guide to a Better Birth" both by Henci Goer.

Lorna - posted on 06/13/2011

I did do a birth plan which I took to the hospital but I totally changed my mind once I got there!! It does help though as the midwife is aware of what you want as you're just trying to get through the labour and not really thinking about it all!! I originally wanted a birthing pool labour which I'm sorry now that I didn't stick to. I also stated I didn't want an epidural which they respected and never asked if I'd changed my mind about which never made me feel under pressure to have one. My reason was the worry about the possible risks of it so if it's something you do want or there's anything else you specifically want I'd do a birth plan but if you're open to anything there's no real need for one.

Amber - posted on 06/13/2011

We did not have a specific birth plan. We packed clothing and feminine hygiene products for me at home. The pads at the hospital are necessary that first day but they are HUGE! Bring your own. Also, remember you're not going to be your pre-baby size so bring comfy sweats that make you feel pretty (VS) but don't bring your jeans that you could wear before getting pregnant. With labor and delivery everything seemed to go out the window once I started labor so any birth plan that we maybe would have written out would have been null and void. My husband ended up running for all of the baby supplies while I was in the hospital but if you want to be prepared beforehand make sure you have an infant carseat, newborn clothes, and diapers. Don't stock up on newborn diapers because they're in them for a very short time before getting to big. A breast-pump is also a good idea. The nurses can teach you how to use it and if you pump and nurse, your milk will come in faster. Trust in the professionals at the hospital. They are the best birth planners out there!

Sadie - posted on 06/13/2011

With my first I had a very detailed birth plan, and the delivery went absolutely nothing like I had planned. With the second I kept the birthplan short and simple. This is what it said:

Please honor the following requests if possible during my delivery:


1) Permit my husband and my mother-in-law to be present at all times

2) Do not offer pain medication unless I ask for it or if it is medically necessary

3) Give me the freedom to change positions as needed in labor and while pushing

4) Episiotomy only if medically necessary

5) After birth, immediately place baby onto my abdomen

6) Perform initial care of baby while baby is on my body

7) Permit breastfeeding only – no bottles or formula

8) Allow rooming in with baby and perform all exams of baby in our presence. If baby needs to be removed from room for an exam please have her accompanied by my husband or my mother-in-law.

Melissa - posted on 06/13/2011

Yes. I did both times, but I didn't need to use them, thankfully. Our home births went well, even the twins'.

As a nursery nurse of 20 years, I would encourage you to have one, and even hire a doula as well. You need someone to speak for you and pamper you and your coach so you both can concentrate on labor.

Tracey - posted on 06/13/2011

I wrote one, but the last line was "All of the above is subject to change depending on events." And BOY did it change!!

Honestly, the best plan is to go in knowing that your baby is going to be controlling the day. You're just there for the ride. Be as comfortable as possible, for as long as possible, and ask questions if you are ever in any doubt.

Good luck!

Tamie - posted on 06/13/2011

Yes, I did and I felt it was very important. I put everything that I was willing and not willing to have done to me. From no medication to not wanting to be cut if the need arised, that I would prefer to tear and be sitched up. However, you have to realize that if in any cause that the baby is in distress or your life is in danger that this plan is out the window and you need to except this quickly. Also, you have to realize to that you are not always sure how you are going to react to labor even if this is not your first so you also have to give yourself a break if you are unable to follow thru with what you want on your birthing plan. Just keep in mind this to will pass and that you will have a beautiful baby in your arms in the near future that is a wonderful gift from God.

Lyndsey - posted on 06/13/2011

Well my expiernece was so different from my plan!! ha ha. You cannot plan nature!! Nice to know and have planned what you would like to happen but i say keep an open mind!

Doreen - posted on 06/13/2011

I didn't write one but before having my girls, I did jot down what I wanted, what I didn't want and sort of relayed that to my midwife as we got closer to giving birth...I also relayed exactly what I wanted once I got to the hospital and that was pretty much to be left alone by the nurses...I wanted as much privacy as I could possibly have for my family and I as we went through labor...=)

Tricia - posted on 06/13/2011

I wrote one for my 3rd baby but not my first 2 - I didn't feel like the first 2 births were "wrong" or that I wasn't in control, I just wanted my opinion out there for my doctor (who was different because we had moved) to know & understand before going into labor. I felt like my voice was there & I wouldn't have to be asked in the middle of labor. Plus, my births are fairly fast (9 hr, 4 hr, 2 hr, for 1st, 2nd, 3rd, respectively) so I wanted to make sure we were on the same page. There are also plenty of women who want drugs for a pain-free experience so some nurses/doctors just assume you do & may accidently pressure you into using them (trust me, labor puts you in a totally different mind-set!). OR the nurses/doctors are used to women going drug-free & don't think to ask if you'd like anything (again, not something you should feel like you need to remember concentrating on with the business at hand!). It's up to you. I actually stated in mine that if the most horrible scenario were to happen that they should save me & let the baby go (hate me if you want, my opinion is that I've got a husband & other children that need me!) but my doctor just chuckled & reassured me that they have that mind-set in place (which I didn't know). I also wrote it with the assumption that it would not work out how I imagined - like Ink Ette said, it was to let everyone know my preference.

Frances - posted on 06/13/2011

I was taught in prenatal class that episiotomies cause tears. I had a second degree tear and an episiotomy with my first one because she went into fetal distress and the doctor was in a hurry to get her out. Cutting can often cause tears. It is like pulling hard on a piece of cloth; it is more likely to tear if you snip it first.

Jodi - posted on 06/13/2011

yes-and i'm glad I did... there weren't any questions as to what i wanted when the time came-i didn't have to decide anything, just focus on my baby.. my ob was wonderful... we had a plan A-what my ideal birth would be, a plan B in case things weren't perfect and then a c-section preference list with things like how i didn't want an intern or resident cutting or sewing-only my ob, having my husband go with the baby and my sister to join me in recovery, etc... I felt that by doing so, I was more in charge of how things happen to my body and my baby. Things went very smoothly and according to plan A. No drugs, cord cut after it stopped pulsing, breastfed to deliver placenta, no eye goop, it was wonderful!

Krista - posted on 06/13/2011

Please also be aware that, like me, you may actually loudly utter the words, "FUCK MY BIRTH PLAN!" at some point during labour...

Alexandra - posted on 06/13/2011

I didn't have one, but then agian I was given the wrong date. By about 5 wks. So I didn't really have the time to prepare one.

Claire - posted on 06/13/2011

I had one with my first child and it was helpful for me to feel that if emergancy intervention was needed my needs would be met but you quickly realise once your in labour that what you put on your birthing plan counts for nothing because anything can happen, you can change your mind once your in that situation and what does it matter anyway when the midwives ask you it all again when you get there. Besides if push came to shove and there was an emergancy they are going to do whatever they have to not what it says on your birth plan. so with my second and third I didn't even bother and it made absolutely no difference to the service I got or how any of my children were delivered they were all still the most amazing experiences ever no matter what happens that can't be beat. Seeing your baby's face what could be better so who cares what a piece of paper says so long as they arrive into the world safe.

Krista - posted on 06/13/2011

I think that making a birth plan is a valuable exercise, as long as you are fully aware of the fact that things may go completely upside down.

Creating my birth plan was a good exercise for me, just so that I could figure out what was important to me and what was not. It was very important to me that the baby be placed skin-to-skin with me right away, that he not be circumcised, and that the eye drops be delayed. So I was really glad to have the chance to put that in writing.

I wrote down some other preferences, and wound up having none of them, just due to the circumstances of the birth. But that was okay.

So yes, birth plans can be helpful, but more to get your thoughts in order, than to actually dictate what the birth will be like.

Takenya - posted on 06/13/2011

With my first and only son I did not have a birth plan and didn't feel it was needed. The only plan was that I didn't want an epidural (which I expressed to my OB weeks before my delivery), I wanted an IV drug. In my opinion you can plan all you want, but when it comes to childbirth things most likely won't go according to your plan. All that mattered was that my son was healthy (which he was, at 8lbs 7oz) and whatever was necessary to get him here without complications was all that mattered, not a plan to try to stick to.

Dianna - posted on 06/13/2011

I think a birth plan is one of the most ridiculous things ever. It's just not something you can plan. I'm all for taking the classes and knowing approximiately what's going to happen and being prepared as possible, but a birth plan is just silly.

Michelle - posted on 06/13/2011

Hi Cynthia - I think a birth plan is key if there are specific things you feel strongly about for your labor: epidural or no? Hep B vaccination at birth, or no? Do you want to be induced, or no? Water broken or no? Cord cut right away, or wait until the blood stops pulsing through so baby gets the most out of it? Vitamin K injection, or no? Antibiotic eye drops, or no? Many things that happen during labor or upon birth (like Hep B, Vit K and eyedrops) are 'automatically' done, unless you speak up. Also, and more importantly - in the midst of laboring and giving birth, there is already so much going on, you don't want to have to worry about whether you forgot to tell the doctor, nurse or midwife you are working with, what you want and don't want. Having a birth plan (I recommend sticking to one page, with bulleted points), helps narrow down the specifics that are most important to you, in an easy to read manner for the practitioner you are using! As long as it's written in a friendly and polite manner, they will most likely appreciate it too!

Bobbie - posted on 06/13/2011

i never had a birth plan with my first. i am hopefully guna have a bt ov one with this one and i want to be more prepared x

Kristi - posted on 06/13/2011

I never had one rlly they asked me all the questions anyways

Rebecca - posted on 06/13/2011

Sometimes I think not being too attached to a birth plan is the first step in becoming a mom, the first lesson that no matter how much "planning" you have, sometimes it just does not go the way you want. Just like being a mom.

Sure, you can have a list of birth requests or desires - research away. Be aware of all your options, but the only plan you can really be certain of is that you are planning to have a baby - period.

Susan - posted on 06/13/2011

Ok, Qi if you had a magnesium drip, it WAS necessary.. if not you or baby or both could have died. They will not do it for the heck of it. Anyone not wanting an episiotomy is asking for trouble. Better to be cut than to rip. If you were to tear, it's more difficult to heal causing you unneccessary pain. As for the no water, if you were to need surgery and had liquids you could asperate. And if you were to have baby vaginally, you don't want to be throwing up if don't have to be. Liquids can make you vomit. I've seen it time and time again. Popsicles are ok as is ice

Bridget - posted on 06/13/2011

Yes, I had a very basic plan, that while it wasn't in writing had been discussed with the husband, doctors, family. However nothing happened as plan.
My best advice is to have a plan, but to be flexible.

Heather - posted on 06/13/2011

For my first baby I filled one out that the hospital provided but I think it gave me more expectations than I would have had without it. Besides, who knows if they really want a squatting bar before they're actually in labor? (Turns out I didn't.) The whole thing went out the window because my water broke and I was induced and my doctor was out of town anyway. All I told the doctor on call when he came in to deliver was that I'd rather rip than snip (no episiotomy please). With my second baby I asked my Dr. if she wanted me to fill it out or if it would help the nurses and she said I could if it helped me communicate but otherwise they didn't need it. I totally agreed and didn't have one the second time. I told my Dr. that my first priority was a healthy baby, my second was to not have a c-sction and other than that I wanted to go as natural as possible for as long as possible. It was just as well because my second delivery was as identical to the first as is possible to be but I got my first two wishes so I couldn't have been happier. Of course I wanted her on my chest ASAP and her bath and tests done in my room but that's standard practice at the hospital where I delivered. If you have those kinds of preferences you might want to write it down because things can get busy during delivery and people come and go throughout (my nurses changed shift about ten minutes before my second popped out).

Megan - posted on 06/13/2011

I had a plan for my first one. Everything did NOT go as I hadplanned and I ended up having PP anxiety because I couldn't let it go! With my second child, I refused to have a set plan-told the dr whatever was necessary to have a healthy baby & mom in the end- and things went great! My thoughts on a birth plan are it is great in theory, not in practice. There are so many things that can go wrong or differently than you wish and in my experience it is easier just being laid back. Now if there are specific things that you do not want, then def tell your practitioner. They will respect your wishes, but don't assume that havinga plan means that it will happen that way. :)

Chauncie - posted on 06/13/2011

It's definately necessary! It ensures that the doctor and nurses do ONLY what you want them to do to you and the baby. I was going to use a midwife that would enable me to do EXACTLY what I wanted, but I had twins instead.
I told him that I wanted 1 family member with each of us (me and both babies) at all times, so they could make sure the doctor team weren't doing anything contrary to my wishes. I didn't want any Assisted deliver techniques (forceps, C-section, Episiotomy) unless life saving. I asked to delay the introduction of the IV feed unless needed. And I wanted the option of eating/drinking/walking/trying different labor positions. I made it clear that I wanted to be informed before they did anything, and that they would explain it so I could understand, and maybe even make alternative therapies if possible. I wanted Daddy to cut the umbilical cords. And it was very important to me that I was allowed to hold and nurse the twins immediately after they were born. It's also a good idea to mention if you want them to be exclusively breastfed (i.e. no bottles, water, pacifier, etc) without prior approval.
When you're writing it, it's important to be polite, but firm. You might not get everything that you want, but the doctor his utmost to fullfil your wishes if he knows what they are. That's why you want to write them down and have all parties sign it.
Hope this helps :)

Cassandra - posted on 06/13/2011

My first was an emergency c-section...so if there was a plan at all it was out the window!. My last 2 were scheduled c-sections... so there was no major plan. Show up on time, get numb, have a baby with out an ounce of energy needed and stay at the hospital for 4 days. If i planned anything, it was just packing my bag....

Heidi - posted on 06/13/2011

I guess that I did not find one necessary. My birth plans were to HAVE my babies. I wanted to have them naturally but my labor stalled with my 1st one and after 24 hours in labor I HAD to have a c-section. With my 2nd one I HAD to have a repeat c-section because of our hospitals policy.