Birth Preferences…Revision 1

I’m sure this will keep evolving, but for those who are interested (and for my own records), here is the first revision of my thoughts!
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FYI for my readers, this will be a hospital birth, but that birth will be attended by my midwife –ย notย an OB – unless an emergency c-section is necessary.
My midwife’s responses are in color (Erin)… generally she said no problem… I’ve included text if she elaborated. ๐Ÿ™‚ย 

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During Labor
-This will be a midwife assistedย hypnobabies birthย – please keep lights and voice low. Minimal coached pushing.
-I doย notย want any meds offered to me or pain scale questions asked of me. If any medical interventions become necessary, I want to be fully consulted first.
-I would like to be assigned a nurse that is partial to natural birthing. They can’t guarantee this, though my midwife said that most of the nurses at our hospital are very supportive of natural labor patients. I will be making it clear that I want only positive, supportive people around me! ๐Ÿ™‚
-I want to be able to walk, move, or change positions as desired during labor. No problem, though they require a 20 minute time period every “couple of hours” where I lay down and get monitoring to ensure all is well with the baby. Other than that I’m free to walk around, get in the tub, etc.
-I want to have the option of eating/drinking during labor. She recommends staying home as long as possible so that I can eat/drink/move without any hassle. She agrees with the importance of nourishing a laboring body, but “the nurses are very strict about not eating,” she said… so I pushed and asked who gets final say – the nurses or the midwives? She sort of stammered… “well, we do.” Then extrapolated that I should definitely bring snacks, and when the nurses leave the room feel free to eat something light and high protein. Hm. Weird. Obviously I need to get on the nurses’ good side or make sure my midwife on call asserts her ability to make the final call.
-I do not want a routine episiotomy. No problem – their practice has the lowest episiotomy rate in the state.


Post Birth

-No cord traction for placenta removal / No Pitocin (though after delivery to assist with placenta expulsion is okay – please consult first) No problem, barring any complications with the baby of course (regarding pitocin necessity).ย 
-Delay cord clamping until pulsation has ceased Again, no problem, as long as the baby is doing fine. Cords usually quit pulsating within a couple of minutes.ย 
-Immediate skin-to-skin contact between mother and baby, please delay any cleaning or rubbing. No problem.
-No Vitamin K shot (look into oral options?)… or is this necessary for blood clotting reasons if it’s a boy and circumcision is being done? She highly recommends this shot, especiallyย if it’s a boy b/c of the circumcision. What do y’all think about this shot?ย ETA – ย we ended up giving Stella this shot because she had a bruise on her head when she came out. Either way I think we would have done it.
-No Antibiotic Eye Ointment (NO silver nitrate, and I am allergic to the alternative option of erythromycin so could baby be?) I can do a STD test pre-delivery to rule out any chance of passing on gonorrhea or chlamydia if that’s the only concern. If there are other concerns, what are they? She recommends getting the STD tests pre-delivery if I want to not do the ointment. That’s fine by me.ย 
-No Hep B shot – delay to at least the 2 month immunization schedule. Pretty sure this is fine – just communicate with the nurses, b/c they will routinely do it otherwise.


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After all of my questions, she said – “remember, this is your body, you baby, your birth. you can decline anything you want.” That’s good to remember! (though as you’ll see 2 paragraphs from now, I need to stand up for myself more strongly)


At this point, she said I should be feeling movement about 10x every 2hrs… if I’m not, I’m supposed to drink some sugary juice, lay down, and “tune into my baby and my body.” She said I would then often feel 10 kicks in the first 15 minutes (and if so, don’t bother laying around the full 2 hrs unless I need to *grin*)… basically, stay hydrated and rest whenever I feel the need. Not enough movement or 5+ braxton hicks contractions in an hour = call them.

They also did the glucose challenge test on me yesterday (I’ll get the results Monday – no news is good news *fingers crossed*)…. and they also drew my blood to confirm I was A- and RH- to confirm I needed the RhoGAM shot. I didn’t realize that shot was scheduled to happen so early so I hadn’t researched and wasn’t prepared to ask questions about it. I just read this (http://www.vaccinetruth.org/rhogam.htm) and am fairly frustrated that when I asked my midwife why I needed this shot during pregnancy, she sort of blew me off and said it was important. Everything I’ve read this morning basically says the same thing – the important one is POST-delivery. UGH. I hate feeling like I should have taken the time to research something sooner… praying now that I’m not in that percentage whose babies are affected by this shot. *sigh*

On a happy note, I’m also at the point where I start going back for appointments every 2 weeks. HFS!!! I remember how LONG it was between appointments in the beginning, and now we’re already at the every other week point. Eek!!

Stats at 28w appointment:
BP: 115/74
Fundal Height: 27 (they want to see within 2+/- of the week I’m at)
Baby HR: 130s

I asked if it was normal that the heart rate keeps getting slower (160s/160s/150s/140s/130s), and she said yes, that she would be more concerned if it was still in the 160s. She said the baby is more comfortable and not in a constant state of flight or fight anymore, and it’s common to have the HR get slower throughout pregnancy. Okie dokie…

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23 comments

  1. Wow, so much to think about. I'll definitely come back to these posts when I'm in your position. Again, your midwife sounds awesome!Yay for more ultrasounds! The more we get to see rockstar the better ๐Ÿ™‚

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  2. Looks like you are prepared!! I hope your labor is everything you are hoping it will be and that you get an awesome nurse!

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  3. I ate until I hit about 6-7cm and then at that point, eating is pretty much the LAST thing you want to do. ๐Ÿ™‚ And high protein is tough, you want something you can just snack on real quick between contractions and that will be easy coming back up (sorry!). I was hugely addicted to the plain goldfish crackers. Like thought they were sent from god to make my labor better. Then I was drinking water and juice through out. Just my two cents. OH! And best advice EVER, make sure that Charlie does not eat ANYTHING that will make his breath potent. You will want to kill him anytime he's near your face. I made E have a plain subway sandwich and NO spicy chips. ๐Ÿ™‚

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  4. Wait, so they gave you the rhogam shot already?? I have to get that shot as well but they say right after delivery. As I had to get it right after our miscarriage as well. Hmmm. I'm confused. You seem so prepared with your birth plan! Can you write mine next spring hahah

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  5. I'm so glad you are documenting this. I want a lot of the same things and this is an awesome resource.Also, listen to Oak when she tells you not to let Charlie eat anything that will affect his breath. In fact, I would recommend that you force him to eat gum and mints continuously. My husband is a smoker and when I was having the girls he was in my face with the worst breath I have ever smelled. Lesson learned ๐Ÿ™‚

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  6. This is so interesting. Don't beat yourself up about anything…you are far more prepared than most I am sure!You guys are cracking me up about your husbands breath.

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  7. Wow, so much good information. Thanks for sharing. Like the other ladies, I will be back here when it's my turn to plan the delivery so I can use all your awesome research!Also, what a good idea for the husband to have fresh breath. I never thought of that! Lol. I learn something new everyday.

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  8. Hopefully C is completely on board and understands all of this too so that he can help to make decisions if they are urgent at the time. That really is a lot to think about.

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  9. Girl, don't be so hard on yourself! You are WAY more prepared that most moms and 100 times more knowledgeable than I was. I'm glad it sounds like you will get most everything you want!

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  10. Great answers. Basically they will let you do what you want it sounds like, but it all depends on how the baby is doing and what not. You have to be comfortable. I was gun-hoe about the tub, but never got to a point where C was healthy enough to actually do it. So we didn't. But I was on that ball like it was my job. Seriously the best place ever.As for the shot and the eye ointment. I was against it until I read more about it really not effecting them the way that some predict. I was afraid that with that oinment that it would interfer with nursing… him not being able to see the nipple and all. I had them done and didn't see my baby until 4 hours after he was born and he went right for the nipple as soon as we touched. It wasn't a problem at all. The shot. I didn't want to have a single worry about clotting for whatever reason. I just didn't. So I got it. As for the eating while in labor. My hospital said no. I couldn't even drink water freely. I was given ice chips and that was it. Oh and popsicles. But seriously. Hospitals are dry. I wasn't hungry during labor. I was in the zone and just wanted to have more fluids. I can't tell you how many times I had ice chips or how many times my husband had to run and get more. It was crazy. But it's the only thing I could get.When I went into labor, I had literally just left the dr.'s office after having her strip my membranes and it sent me right into labor. I was also sent right to the hospital because of my blood pressure at 40 weeks and 6 days of pregnancy. It was 9am… I had only had a piece of toast. That was it. I didn't have anything from 9am to 9am or later the next day. It was crazy but I seriously wasn't hungry.This is so great! I'm glad you're thinking about all of these things. You never know what's going to happen so even if you change your mind, it's good to be educated.Sounds like some great responses too!

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  11. It's so great you're already this far into this process!Definitely have C become very familiar with the parts that are most important to you or that you're most worried about because you likely won't remember/won't be thinking of it when the time comes.Also, kind of a combination of what Oak said about what to eat and what other said about what your husband should eat: don't eat anything fragrant yourself. I smelled the peanut butter covered bagel I ate for lunch for a long time after that :)As for the eye gunk, I remember learning about it in our birthing class and having very strong feelings about it one way or another (I'm assuming that I didn't want it) but I honestly can't remember. I can't remember what I wanted and I can't remember what actually happened.So like everyone else has said so far, be proud that you're this prepared! You're already an amazing mom!

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  12. Also, as for my personal opinion on baby shots/vaccinations (I so sincerely hope neither you nor any of your readers are offended by this), I'm almost always in the camp that they are necessary. Of course, I research them first. But I always lean toward getting them. I worked at the children's hospital near here (one of the top in the entire country) and saw enough to realize how important these vaccines are. I'm definitely not saying that people should blindly follow their doctors orders EVER. But the vast vast vast majority of the time, they have your child's interests at heart.

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  13. I have to agree with Sheelah on the vaccination question. First of all, the original paper connecting vaccines with autism has been thoroughly debunked and the lead author had his medical license taken away because he committed fraud in publishing lies.Second, I have a hard time reading a page that says you can change your Rh status with a straight face. that is *impossible*. Your Rh status is coded in your genes, and there is NOTHING you can do to change it. It is much more likely that one of the two blood tests was incorrect than that the person's Rh status actually changed.Third, I am also Rh negative, and it actually never occurred to me to question giving the Rhogam shot at 28 weeks. That IS a good point – what is the purpose of giving it then? I guess it's in case there is some kind of trauma, or maybe an early, unexpected birth, but chances are that it probably is unneccesary and I think that is a good point. Overall, though, Rhogam has saved hundreds of lives, and made subsequent pregnancies much safer for women who are Rh-. I know someone who had Rh sickness in her second pregnancy and it was not pretty.Finally, there are very few vaccines given to pregnant women that do contain thimerosal anymore – you can check with your doc, but chances are that yours did not.xo ๐Ÿ™‚

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  14. I was so impressed with your original post about your plan i actually started to talk things over with my hubby. we only have 3 weeks left, and had not discussed any of this. ifigured since i hwas having a c-section, i didn't have any choices to make. so , i sat down with my hubby and my sister (a past land d nurse and a current NICU nurse.) I love all your decisions except for 2. the first is the eating. there is a HUGE reason for this. it has nothing to do with natural delivery. it all has to do with if you end up needing a c-section. GOD forbid something happens and you need and emergency c-section. they have to put you COMPLETELY under….intubation and all. IF you have eaten in the past 8 hours, it increases you risk of aspirating into your own lungs during surgery. this is the BIG reason that nurses dont let you eat. it isn't because they are mean or don't want you to have a nutritious labor…it is to ensure that if the worst case scenario happens, your body is prepared. i would suggest the stay at home as long as possible route, because i guarentee the nurses, no matter how nice they are, will let you eat….at leasst in our hospital, it is protocol, and IF something happens to you because of eating prior to surgery, the nurses liscence can be on the line. We will just pray pray pray that you get the beautiful natural birth you want.The second, and this is where i AGREE with you, but have gotten sooooo much resistance from my sister and everyone else is the HepB shot.i doNOT like all the vaccines that are given now a days. Meningitis, HPV, chicken pox, i think some of them are completely unncessary. BUUUTTTT that being said, out of all of them, my sister says that the HepB is the one to LEAST worry about. there are no side effects, and no thimerosal or mercury that was POSSIBLY linked to the autism claims….the biggest thing shesaid is to space out the vaccinations, as opposed to avoiding them all together. However, i told my mom I wanted my old records so i could see what they gave us 30 years ago and when, and go by THAT schedule as opposed to the current, 5 vaccines in one sitting schedule, AND avoid any unnecessary vaccines:-) Neither of these were meant to change your mind, just letting you know what i found after deliberation and research:-) Other than that, I LOVE your plan. I cannot WAIT to see how everything goes, and you are the first "real" person i have heard of usuing the hypnobabies, so i would love to see how that workss to control the pain:-)

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  15. I'm not against vaccines in general – just the "routine" way they give them (and so many at a time instead of spacing them out). I was asking specifically about the VitK shot and WHY you did/didn't do it. My midwife even told me that your RH status can change, and that's not the first I've read of this. Rh is actually measured on a sliding scale, and it can be affected by diet, etc. Also, have you heard of this? …. "There is a very weak variant called the "Du" variant. It is actually an Rh Positive antigen, which would make a woman "Rh Positive," but since it is very weakly expressed in tests, it's possible to be mistakenly read as Rh Negative. Today, any Rh Negative woman should be tested further for the Du variant. If it's positive, then the blood type is corrected to Rh Positive, and no Rh Immune-globulin need be given." Also, even if there is an early or traumatic birth, there is a 72hr window in which you can receive the Rh shot – I really see NO reason I should have been given the shot yesterday. I'm fine getting it post-birth to help prevent any issues with a subsequent pregnancy, but why in the world give it to me NOW while I'm carrying a child and there's even a chance of it causing a complication?

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  16. @Radiant Redhead: I have to disagree with you on the eating thing… like you said, the ONLY reason you would need an empty stomach is if you were undergoing general anesthesia – which is both VERY rare AND if you're someone that happens to, the chance of aspirating is also very rare. I'm honestly not concerned about it. I think the benefits of having the strength to do a natural labor far outweigh the incredibly slim chance of an emergency c-section with general anesthesia in which I aspirated anything. Honestly – I've seen the vaccination schedule they used on me 30 years ago, and even with that schedule, my Mom said I had a VERY BAD reaction to the shots (MMR if I remember right). I'm still doing more research on all of that. I see no reason to have to do Hep B at birth – 2 months is plenty early.

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  17. I'm glad that you got answers to all your questions and in most cases they were in line with your wishes. I remember for me I wasn't hungry at all, ice chips were the only thing that sounded good. I just had so much else going on in my head, eating wasn't on my mind. But it's nice that they said you can bring in snacks if needed. Bi-weekly appointments already?! Yay!!!

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  18. Wow! SOooo much to think about. But you sound like a researcher and a planner like me ๐Ÿ™‚ I'm following keenly because I can pick up a thing or two. Seems like you're on the right track with all your preparations. Glad you have someone who understands your needs and is willing to make sure your wishes are carried out.

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  19. Love that you are educating yourself, FOR yourself. Nothing frustrates/infruriates me more then parents coming into office saying they won't do this that or the either without the ability to verbalize why. If they want a delayed vaccine schedulem,fine, but they need to decide how they want to do it. If they want to have some control in the situation – do.the.research!We will not be doing the Hep B shot in the hospital – she will be getting it at 2,4,6 months. So many of the protocols ARE set up to protect kids, as a vast portion of the population does such a horrible job getting prenatal care and education, AND providing health care to their babies.As for the Rhogam shot – it is to protect you ahead of time IF you have some sort of traumatic injury, and your baby happens to be Rh+. E.g. abruption, traumatic emergency C-section, etc… Some doctors are doing this now even if a women has spotting in the first trimester.Keep educating yourself girl, discuss questions with your medical providers, and make the decisions that are best for you and your family… despite what the rest of us may say!:)

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  20. I just got my Rogham shot yesterday too.. I also had to get it after I had an Amnio done.. And, I got it after all my miscarriages ๐Ÿ˜ฆ I need to do some more research on the vaccinations, because I'm leary about the schedule as well.. i think shooting them up with all these things right away is just crazy.. Good Luck with your birth plan.. You are a brave Woman.. Our birthing experiences are going to be completely different, and I can't wait to see how they both pan out ๐Ÿ™‚ We're in the home stretch!!!!

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  21. Go Josey! I just wanted to weigh in (after a long silence, I know) on the Vitamin K shot. I've done a little research on vaccines, etc, and we did turn down the eye ointment. But we went through with the vit K. It seems like even many hard-core anti-vaccine (and natural birth) people still go with that shot, especially for boys getting circumcised. Good luck, I can't wait to hear when your little RockStar arrive!

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  22. It's so interesting – in Canada they don't put restrictions on moving around or eating drinking during labour. In fact we've been told to bring a cooler full of snacks for hubby and I both to have during our labour.I have no problem with the vit k shot.They don't use silver nitrate here in Canada (according to my instructor this past weekend at prenatal classes …can't remember what they use instead) but apparently we CAN NOT refuse the eye gel they use – no matter the fact we already got tested for all STD's etc when we got pregnant.

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  23. I just read this blog post and thought of you: http://www.kitchenstewardship.com/2011/10/04/the-evolution-of-a-birth-plan-three-kids-later/. Good info especially on the vitamin K thing, which you were wondering about.

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