Birth Preferences – Revised

Like I mentioned yesterday, my midwife (CNM) and I went through everything below, step by step, and she had a lot of incredibly positive feedback for me. Shawna told me that honestly, if she is my midwife, I wouldn’t even need to bring this because it’s exactly how she prefers to see births proceed. She did say that it’s a good idea to have it with anyway though, just in case I feel like my husband or the nurses need a visual reminder of my hopes and desires for this experience. 🙂 I also received a phone call this week from one of the Family Center/Hospital nurses (who happens to be my neighbor down the street), and she is really interested in getting together to talk about the HypnoBabies program and to get a better sense/feel of what it is and how to best support me during my birthing time. How cool is that?

I’m feeling SO positive and optimistic about the whole birthing experience at this point. Thanks to my HypnoBabies home study course, I’m listening to my Joyful Birthing Affirmations every day and to other relaxation and self-hypnosis tracks every night. I’m aware that complications can arise and that things rarely go exactly according to plan, but much more strongly, I’m aware that my body was made to do this, and that going into it without fear is going to make a world of difference in my experience. If worst-case scenario happens and a c-section is required to ensure the health and safety of momma or baby, I still believe that being educated and informed about my options and the procedures and having a thorough knowledge of self-hypnosis and relaxation techniques will allow this to be the best experience possible for me and for RockStar.

 

I’m including my midwife’s responses and/or my reasonings for certain requests in orange. Obviously this will be more less wordy/more streamlined when I bring the final version into the hospital as well.

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Our goals with this plan are centered around the following wishes:
-To be allowed freedom of movement for a comfortable labor
-To avoid medications
-To allow nature to take its course, particularly avoiding inductions.
-A safe, healthy baby and mother at the end.

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Requests Prior to Labor
-Minimal internal exams
-No artificial induction (including stripping of my membranes or breaking of my waters) GOOD to specify – Shawna has seen the nurses break the bag of waters without consulting anyone. Make sure this is communicated when I arrive at the hospital.


Requests During Labor
-This will be a HypnoBabies birth. Please assign a nurse that is partial to natural birthing. This is something I’ll request right when I’m checking in. So far it seems like most of the nurses are very supportive of natural birthing at my hospital, which makes me very happy!
-Externally monitor the baby if possible, and please do as seldom as possible. No problem – internal monitoring is only done in the rare occasion that a baby appears in distress and they need closer monitoring.
-Please keep lights and voice low. No problem – Shawna says she likes to have the room practically dark when the baby joins the world. 🙂
-No artificial induction (including pitocin) No problem.
-No meds offered or pain scale questions asked of me. If any medical interventions become necessary, I want to be fully consulted first. Good for you!
-If an IV is needed, please use a hep-lock. No problem. I requested this so I can still use the tub/shower.
-Please refrain from injecting anything else through the IV without consulting us first. Good to specify. Sadly, sometimes meds are administered by nurses without consultation first.
-Be able to walk, move, or change positions as desired during labor. Definitely.
-Be allowed to eat/drink during labor. As long as labor is progressing naturally (without pitocin, etc) she has no problem with this. 
-No routine episiotomy. Definitely not – their practice has one of (or maybe THE?) lowest rate of this in Colorado.
-Minimal coached pushing. No problem – Shawna likes to sit back and let nature takes its course – a very “hands off” approach.

Requests for Post Birth

-Immediate skin-to-skin contact between mother and baby, please delay any cleaning or rubbing if baby is doing fine. As long as baby is breathing fine, this is not a problem.
-Breastfeed asap. Yep.

-Delay cord clamping until pulsation has ceased. Definitely. I want this done because of all the research that shows numerous benefits to allowing the oxygen rich blood to continue to transfer to the newborn. Why would we cut that off? Even the WHO has removed the practice of early cord clamping from their list of guidelines.

-No cord traction for placenta removal. Definitely not. Deliver the placenta unassisted and avoid pitocin if possible. We discussed what “unassisted” meant to me. No manual extraction without meds, etc.



Please delay newborn procedures for at least two hours: I had written one hour, and she suggested two, because the first two hours are when the baby tends to be awake and looking around, and that bonding time is so important.
-We choose to waive the Antibiotic Eye Ointment* Sounds good. This is really only done routinely b/c of high risk deliveries to mothers who have STDs.
-We choose to delay the Hep B vaccine** Good for you. Again, only routinely done b/c of high risk deliveries to mothers with Hep B (who also tend to be mothers who don’t bring their babies back in for routine checks ups and later vaccinations, so docs figured one dose of the Hep B vaccine was better than none). Since I don’t have Hep B, she has no problem with me delaying this until an age I feel comfortable with.
-No artificial nipples (bottles/pacifiers) to be used at any time. I had “please avoid using” and she suggested saying very clearly NO (and making sure a sign to that effect was also posted on the crib).

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The one change I made to the plan was removing the request to skip the vitamin K shot (which helps with blood clotting). I’m not a fan of how huge the dose is in the shot (something like 20,000 times higher than the needed level), but I’ve read (and been told) by my midwife that the oral dose isn’t as effective because the baby’s body can’t yet process it correctly. We had considered only doing it if RockStar comes out a boy and gets circumcised, but I’m still kind of on the fence. For now, I’ve removed my request to skip the shot… we shall see.
ETA –  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. There has also been a great new article released about this from Evidence Based Birth.

Helpful Links:

http://green.yourway.net/our-bradley-method-birth-plan/
http://simpleorganic.net/10-childbirth-norms-parents-can-refuse/

*I’m getting tested for gonorrhea and chlamydia pre-delivery to 100% rule those STDs out since that is the only reason that hospitals routinely use silver nitrate or erythromycin on baby’s eyes.
**I’m working on our delayed vaccine schedule and will post when I have it all worked out.

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15 comments

  1. I think I just learned a whole lot :)You should sell your birth plan to confused expectant mothers 🙂 Im still in awe that this is about to happen for you!!! Time flew by!

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  2. I love this!!! This is a really great plan!!! 🙂 I love it!!!

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  3. I am so impressed with all the research you have done! I think you have a great birth plan laid out and a great team of professionals who support your wants.

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  4. Great to have a plan. It will be interesting to see how things play out.Wishing you the best of luck…

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  5. This looks like a great plan, and I hope you get to follow it!

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  6. This is great, and so positive! I hope that everything goes how you would want it to, and that your little RockStar is born into a warm, welcoming and loving environment!

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  7. This sounds so great! You definitely have done your research, and you have a great team supporting you!

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  8. As usual you are on top of things. Great job Josey. Looking forward to seeing this plan come to life.

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  9. I feel smarter having read this! Much smarter. Good luck with this plan Josie. It sounds like that little RockStar is going to have a healthy, peaceful entrance into this world and into your arms. I'm very happy for you guys!

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  10. Very helpful and hope things work out this way! I'm with you on the newborn procedures! Won't be long now…:]

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  11. Looks really good. I changed my mind about the vitamin K shot too. I was going to do the oral one, but saw some info about it being not as effective. He didn't even notice getting a shot.

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  12. I wish we had the option of not having the erythromycin drops/ointment but sadly it is MANDATORY here – regardless of whether you have been tested prior to delivery for STDs. I've been told that some hospitals here will call child protective services if you try and declince. So our little one will be getting the ointment about 1hr after birth along with the vitamin K shot (which we do have the choice to decline).

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  13. Hi – i just wanted to say I am feeling the same way you do – I also dealt with IF and I am due with our first child in Jan. I also have a blog – and I just learned about your blog.

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  14. Your requests during labor are great! Walking and being mobile helped a lot; Combine that with hypnobabies and you sound prepared for the big show!

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  15. This sounds a lot like my birth wish "plan" — only it looks like yours would fit on one page 🙂 I went over my wishes with my OB last night and she's down with everything. I'd just like to get everything down to one page so it can be looked at in a single glance if need be.

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