The Importance of a BirthPlan

Sharon - posted on 08/03/2009 ( 14 moms have responded )

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Its a big now-a-days to have a birthplan. Only most women I talk to on the internet don't call it that.



A birth plan details what you want and how you want it in the delivery room. Its not enough that you have one in your head and its not enough for you mention to your doctor "I don't want a c-section."



You have to show why. Longer recovery time, no support system at home for the invasive procedure after care, whatever and why ever - you have to spell it out. No episiotomy - you'd rather tear (I've heard, I really have) etc. If your doctor won't accede to your plan - you're going to have problems in the delivery room and that is something no one wants.



SO. Now you have a doctor who agrees with everything you want. You have to make sure the birthplan is in your file and is on file at the hospital you intend to deliver at.



I got lucky with my first son and had an excellent delivery team. My second son - not quite as smoothly and the new birth plan thing I had learned about wasn't in my file so when we got to the hospital and my doctor was out of town I panicked, fortunately my doctor remembered the quirky lady with all the crazy new fangled ideas and said to do things my way. And I got my way.



My third child - almost peferct. The anesthesiologist was late in getting to my room and was an asshole to boot but otherwise I got exactly what I wanted.



Here is some more help...



http://www.birthplan.com/

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Gina - posted on 08/06/2009

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Honestly I wrote one but it never got used. We did not have a chance to drop one at the hospital before we went in to have our baby. By the time we got to the hospital I was almost fully dilated and there was no time to pull out the birth plan (my husband wanted to bring chocolate treats for everyone to go with the birth plan I have heard that the nurses are much more willing to help you in your birth plan when you bring them treats). However, I had discussed everything in advance with my doctor and his partner i.e. back up doctor (for when he is on vacation). He sees so many patients that he did not remember exactly what we wanted, but we made sure that he remembered that we wanted to discuss things as they happened and our options. I stayed calm and focused on the birth of our baby. Because I remained calm, and my husband remembered the important things, and we made sure that the doctor talked to us I got almost everything on the birth plan and the things that were missed were minor things that in the end were not really important. I think the doctor we had was the greatest contributing factor in getting what I wanted.

[deleted account]

My birth plan not only detailed whether or not I wanted an epidural, episiotomy, and things like that, but it also stated who could be in the room at what point (you don't remember to tell friends to GET OUT when the baby is coming because you are focused on the baby, not your friends!), whether or not "students" can observe, whether or not the baby was to get formula fed (some hospitals will do that), and all sorts of things. I made sure the plan fit on ONE page - and we taped copies on the walls/cabinet doors of my pre and post natal rooms. I thought it was VERY useful - especially because I forgot things myself in my sleep-deprived, drugged out stupor!

Malinda - posted on 08/04/2009

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I do agree with Mary that your thoughts, fears, and preferences need to be discussed with your providers beforehand and that you must be familiar with the policies of the place in which you are giving birth, but I still contend that this isn't always enough. If you can't afford a doula, at the *very* least have a family memeber, friend, or support person there to advocate for you and make sure that they are familiar with your plan. The nurses and doctors in your hospital are very busy and are NOT using your birth plan as any kind of checklist, and that makes it very easy for things to be overlooked or ignored with or without intention even if everything goes as "planned."

Sharon - posted on 08/04/2009

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RIGHT! The flexibility thing, lol I'd forgotten that some people plan something and then can't bend when it CANNOT happen the way they dictated it.



I totally understood that even though I wanted a vaginal delivery and no episiotomy I may be forced to go to the OR for a c-section because of the crush injury my pelvis suffered. I was lucky. No OR but I did need an episiotomy.

Mary - posted on 08/04/2009

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As an L&D nurse in the US, I have really mixed feelings on birth plans...they can be either a really good thing or a REALLY bad thing, depending on the person. The key, I believe, is how realistic and flexible an expectant mother is. I have come to believe that pregnancy, and labor, are Mother Nature's way of teaching us that we are no longer in complete control of our lives...the needs, wants, and well-being of our child should now be our guiding light.

All women have a responsibility to educate themselves about labor, and the birth process as best they can. Part of that should include discussing your needs, fears and preferences AT LENGTH with your provider, well in advance of your expected due date. Just because you want things a certain way does not mean that your OB or midwife is in agreement with your mindset, and this is something you really need to establish before going into labor. For example, some women are adamant about not having any type of IV access while laboring...at many US hospitals, this is NOT an acceptable option, so you had best have that clarified beforehand. Or...you don't want an episiotomy, but you have somehow managed to choose an OB who cuts an epis on all her patients, needed or not...might want to know that ahead of time so you can switch providers. You want your partner, both sets of grandparents, 3 sisters and your best friend present at delivery...and your hospital only allows 3 support people in the room at any given time....need to have that ironed out beforehand, 'cause they aren't going to magically change their policy just b/c you wrote up a birthplan! I could go on, but I hope you get my point...the key to having your birthplan followed is discussing it with your provider, and the facility of your choice well in advance, and seeing just how reasonable your desires are, or the likelihood that they can be met.

Cathralynn - posted on 08/04/2009

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We have kaiser and you get whatever doctor is on staff at the delivery room when you get there. So it helped to have a birthplan in case you didn't get your own doc at the time you give birth. I still think its a good idea in case of emergencies and so you discuss things you hadn't thought of before. If you don't care bout music and stuff whatever. But what about the hospital giving the baby directly to you so you can bond for an hour before they do all the tests, or some docs automatically do episiotomies whether or not they think you might tear, or you never want your baby out of your sight and want you or your family member to be present for all procedures, or never give my baby a pacifier cause I don't want to introduce them, I could go on and on.

Malinda - posted on 08/04/2009

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Honestly, I think you're better off having a *doula* than simply a birth plan. Mine was entirely ignored, even down to what I wanted done with the placenta which had nothing at all to do with the circumstances of my birth. A doula would have been able to advocate for my wishes when I wasn't able to. A peice of paper can't do that for you.



Yes, doulas have a cost associated with them, but think of how much money you would save in the US if having one avoids other much more expensive medical interventions like anasthesia or c-section....

Krista - posted on 08/04/2009

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I looked at sample birth plans online while I was pregnant, and was really overwhelmed by all the options that were given that I had never thought of. Did I want soothing music played during delivery? Did I want the lights dimmed? I didn't give a crap! I also realized that I didn't need to specify that I only wanted an episiotomy if it was necessary, or that I only wanted a cesarean if necessary, or that I'd rather he didn't jam forceps up inside me unless he really had to....I trusted my doctor and I knew that he would only use what interventions were absolutely necessary.

Sarah - posted on 08/04/2009

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I think birth plans are a good idea. I do think however that you should definitely be flexible and realise that you might not get exactly what you wanted.
I've women say they were really depressed and things after not getting the birth they wanted. I really think the main thing is safe delivery of the baby.
So i think birth plans are good guide, but you should be prepared for it not going quite according to plan! :)

Minnie - posted on 08/04/2009

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The great thing about having only two midwives who run their own practice and having a homebirth is I don't need a birth plan- I have complete confidence that they won't ever do anything that I don't want, that they'll be respectful and ASK me my opinion, and I know that I agree with everything they believe.



I love my midwives.

Leigh - posted on 08/03/2009

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I loved having a birth plan. It gave me focus. It also made me think about what I wanted. It helped that I had a great midwife & that the birthing system in NZ was structured so that the person who's pregnant is in control. My midwife came to my place of work or my home for my visits, I never went to the hospital until I went into labour. She also came to visit me every day for a week after I had my son, & then once a week for 6 weeks to help with my postnatal care. Huge advantage when having your first & being totally uneducated on what to expect. Never had a Dr for anything, my midwife was enough, huge shock when I moved to Australia & realised that the same did not apply, that I had to go to the hospital & be herded like all the other 'sheep'. Lucky there was a birthing centre that believed in writing a birth plan, so the same applied. Of course nothing is predictable, things can change, it can't be black & white, but it gave me peace of mind. It's funny these days (my last child is now 13) when I speak with family members & ask how their huff & puff classes are going to be told, yeah did that on the net, ok, lets see how that helps when you're having the baby, they always come back to me & say, you never told me... & I say, but didn't you learn it all from the NET? lol!!

Sharon - posted on 08/03/2009

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Ok birth plans can even cover some emergencies. But OBVIOUSLY they can't cover every single contingency.



Like a friend of mine who went into labor 3 months early and got stuck in another state where her insurance co. refused to cover her.

[deleted account]

I could have used my well thought out, well researched, detailed birthplan as toilet paper. That's about how useful it was. I took all the classes, exercised, ate right, did everything right and when I got to the birthing center I ended up having 18 hours of back labor and never progressed past 5 cm. I ended up getting an epidural which kicked everything in gear but by that time I was so exhausted I couldn't push so I had forceps, a huge tear/cut and a million stitches. The second one went smoothly according to my birth plan because I got an epidural early which helped my dilation. The third one I had a bad infection and had to be induced, the last one was footling breach with almost no amniotic fluid so there was no way to turn him. I had a C-section and after that I SO wished I'd had a C-section with my first child. When it comes to birth plans, it's all well and good but I have to go back to that old saying, "Man (woman) plans, God laughs".

Cathralynn - posted on 08/03/2009

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I would agree, but also to being flexible. I had a birthplan, on file etc. But sometimes things don't go as planned or as with me, if its your first, you have "ideas" and these aren't always reality. Be able to let minor things go and you will breathe easier. But be firm on what is non negotiable. The staff is there to support your decisions and advise you medically but not railroad you! Before birth its best to plan out what you'd like and discuss it, so you keep surprises and stress to a minimum. But don't think you will have the exact birth your peice of paper describes!

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