Sunday, October 12, 2008

The Birth Plan (or Not)

So when we asked my doctor about a birth plan, she said that in her opinion, a birth plan was like a guaranteed ticket for a c-section. She recommended keeping an open mind, and going with the flow during the birthing process. That is not to say that she recommended we be ignorant or uneducated, rather that we should not have strict expectations about what would happen that day.

In the end, I wrote up some "birth preferences" but used them mainly to make sure that the big man and I talked through the possibilities and what we might do in different situations. We didn't show it to anyone else, and we kept an open mind. For instance, I didn't know what I would decide about the epidural until I'd been in labor for 8-10 hours. And I didn't know that the final deciding factor would be sleep! I went into labor in the late evening and by the time I was seriously considering a epidural, I'd been up all night. I don't do well with lack of sleep. The doctor told me I could take a nap if I got an epidural, I was in! I slept for about 4 hours - right through transition. Nice!

I got some template off the internet and modified it for us. So here in all their glory are my birth preferences (is all this detail TMI?). It's funny to re-read them, as some of them were absolutely followed, and some were pretty unimportant in retrospect. My retrospective comments are in ALL CAPS.

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My support
My support person is my husband and I would like him to be present during labor and delivery. IMPORTANT.
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Labor
I would like to be free to walk around during labor for as long as possible. MEH.
Before any medical interventions, I would like the opportunity to discuss the benefits, risks, alternatives and timing of the medical intervention. IMPORTANT.
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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. DID THIS.
I would prefer to be allowed to try changing position and other natural methods (walking, nipple stimulation) before pitocin is administered. NOPE. WENT STRAIGHT TO PITOCIN.
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Anesthesia/Pain Medication
I would like to work with the doctors and nurses to choose what pain relief, if any, I need once my labor has started. IMPORTANT.
If I choose to have an epidural, I would like for it to start with a low dose of medication, which can be increased if I desire. I GOT AN EPIDURAL WHERE I COULD PUSH A BUTTON IF I NEEDED MORE DRUGS. I NEVER PUSHED THE BUTTON.
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Cesarean
Unless absolutely necessary, I would like to avoid a Cesarean. SCORE! NO C-SECTION.
If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.
I would like my husband present at all times if our baby requires a Cesarean delivery.
I wish to have an epidural for anesthesia if our baby requires a Cesarean delivery.
If our baby is not in distress, our baby should be given to his father immediately after birth.
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Episiotomy
Per Dr. Sander's recommendation, I would prefer a small tear to an episotomy, and I would prefer an episotomy to a large tear. DEFINITELY TMI.
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Delivery
I would like the chance to touch our baby's head when it crowns. DID THIS! HOW COOL!
We do not know the sex of the baby. I would like for my husband to be the one who announces it. ALSO SUPER COOL.
I would like to have our baby placed on my stomach/chest immediately after delivery. I WASN'T REALLY WITH IT AT THIS TIME... THEY SHOWED HIM TO ME AND I HELD HIM, WHICH WAS AWESOME.
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Immediately After Delivery
I would like to hold our baby while I deliver the placenta and any tissue repairs are made. HUH? I DON'T REALLY REMEMBER THIS PART EITHER.
If our baby must be taken from me to receive medical treatment, my husband or some other person I designate will accompany our baby at all times. YUP - THE BIG MAN WAS WITH THE LITTLE MAN.
I would like to donate the umbilical cord blood if possible. DID THIS.
I would like to see the placenta after it is delivered. SEE ABOVE - THIS WAS THE LAST THING ON MY MIND.
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Postpartum
I would like a private room, if available. GOT ONE.
I would like to have our baby 'room in' and be with me at all times, unless I request otherwise. YUP - THIS HAPPENED.
If a normal private room is not available, I would like a suite. THIS WAS SPECIFIC TO OUR HOSPITAL - THE OTHER ALTERNATIVE WAS A SHARED ROOM.
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Breastfeeding
I plan to breastfeed our baby and would like to begin nursing very shortly after birth. DID THIS... PROBABLY THE MOST IMPORTANT THING ON THIS LIST.
Unless medically necessary, I do not wish to have any bottles given to our baby (including glucose water or plain water). HE DID NOT GET ANY BOTTLES.
I do not want our baby to be given a pacifier. HE HAD A PACIFIER AND IT DID NOT RUIN HIM AT ALL. WE WERE WAY TOO SCARED OF PACIFIERS... NOT NECESSARY.
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Circumcision
I do not want our baby circumcised. (INSERT STUPID JOKE HERE.)

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