Did You Have a Birth Plan?

I thought a lot about whether to write a birth plan when I was pregnant or to just go with it since it was my first pregnancy and although I educated myself on what to expect, Id never been through such pain and I didnt know how high my pain threshold was. In the end, I decided to write a birth plan and it was the best decision. I ended up with doctors who read and understood that I didnt want an episiotomy, that I wanted to move around during labor etc and basically the plan was there to reinforce what I wanted if I couldnt say so myself during labor. Of course, I knew labor was unpredictable and so I left plenty of room for discretion in emergency situations but my plan helped me have a natural birth. At 6cm dilated nurses were asking me if I wanted an epidural and continued to ask so instead of just getting nasty as I was a VERY grouchy woman in labor, Id simply point them to my birth plan which specified that I would like the most natural labor possible.

I think theyre a good aid but theyre definitely not set in stone.

Sat, 2009-07-04 07:42

I had a birth plan for my first delivery, but not for my second. I like to check things off lists, so it worked great/gave me a sense of calm. By the second time around, I felt confident enough to just do it "on the fly".

Of course, neither pregnancy went according to plan. (I don't know that anyone's does!)

Fri, 2009-05-15 09:31

My birth plan, just like my birthing classes, functioned as a tool to help me thoughtfully envision my labor and birthing process. A birth plan also serves as a fantastic guide for the woman’s labor support, so they can better allow the laboring woman to keep her focus inward and focused on managing contractions and rest, and ultimately, birthing her baby.

I don’t agree that a birth plan should be viewed as ‘obsessive’ or ‘type-a’. And not all ‘birth plans’ consist of a five page computer print-out. It can be as short or long, as detailed or vague as the woman sees fit.

My amazing birthing class instructor, Natashia Fuksman (http://www.withwomannyc.com/live/), shared with us this outline for writing a ‘Birth Vision’
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“Creating a Birth Vision is about taking time to distinguish what your own hopes and desires, as well as fears and unknowns are in terms of your upcoming labor and birth journey. When writing your Birth Vision, you may want to think about it as a letter to yourself and those you have asked to be with you during this special time. Writing a birth vision can be a clarifying process for yourself. Sharing it with your birthing companions can be very helpful for them, as they work on
supporting you in the best way possible way during this journey.
Here are some prompting questions/statements you can work with as you write your Birth Vision:”

What are my hopes and wishes for my upcoming labor and birth?

What are my fears or concerns regarding my upcoming labor and birth?

When I envision laboring, I envision….

In the past when I have felt vulnerable or in need of support, receiving it in the form of…..felt just right. and/or:

In the past when I have felt vulnerable or in need of support, I wished to receive it in the form of…..

Some alternatives to doing what I listed above that might work well for me are….

I realize what I am in control of during labor is…

I realize what I am not in control of during labor is…

Mostly, I just want to make sure I…

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Like Heather mentioned in the clip, a birth plan is a thought provoking tool. It is a beautiful way for a woman to begin to introduce herself to this amazing rite of passage…

Wed, 2009-05-13 21:39

I became very interested in this episode when I saw Nancy O'Dell attached. So glad to see she shares her mom ideas and so glad to see she is a part of Momversation. I must admit I didn't understand the whole hoopla over birth plans when I was pregnant! I, like Nancy, only had a simple verbal birth plan and everything went fine. My philosophy is that you should trust your doctor to make the important decisions and if you don't trust him or her enough, then you need to get another doctor!

Wed, 2009-05-13 09:31

I had birth plans with both my pregnancies.

The first one went to hell for a couple of reasons. 1) I was in labor for 36 hours. 2) I had not yet developed the loud, avocation for myself that I have had necessary to grow as my medical situation has gotten more complicated over the years. 3) There was meconium in my fluid. 4) I found out that while I labored forEVER, once it got down to pushing? That turned out to be my THANG.

Here's what happened:

Nurse: Okay, let's have one more push, and we'll let the doctors get ready. (There were doctors everywhere, including the one I DIDN'T want from the practice I was seeing, but also residents, interns and neonatologists because of the poop in his fluid.)

Me: *thinks to self* I've had ENOUGH pushing. I want this DONE. *pushes son's head OUT*

Doctors and Nurses: O__O GLOVES GLOVES GET ME SOME GLOVES!!

Me: Should I reach down and hold his head?

Resident: *delivers son with one, gloved hand*

Unfortunately, without anyone knowing there was anything wrong he died four days later due heart failure from Hypoplastic Left Heart Syndrome.

By the time my second pregnancy and birth rolled around, I had things much more in hand. I refused to let anyone but MY doctor deliver, circumvented the nurses when they said I had to let whomever was on call from that practice deliver me. I smiled, was put in a room to wait, asked my doula for the phone and called across the street to my ob/gyn's office. As I had lost my child and no one had known there was anything wrong with him, they were well acquainted with me and my freaking out for nine months. The receptionist knew me, got one of MY nurses who told me my doctor was in surgery but that she would make sure someone got him between surgeries, and she did.

When I was put into a room, a doctor from the ER was called up to break my water when I was only dilated 1-2 cm's.

Nurse: Dr. So and so is here to break your water! *cheerfully*

Me: No he isn't.

Nurse: . . . what?

Me: I said no. He is not breaking my water. *to the doctor* You may take your crochet hook and go back to the ER.

Doctor: *looks uncomfortable*

Nurse: But...

Me: Do I need to repeat myself? I said NO.

Doctor and Nurse leave.

MY Doctor comes in to my room in scrubs, hands on hips: What do you think you're doing? (this is a few hours later)

Me: You said not to go into labor on the 19th!! It's not the 19th!! Oh, by the way, some yahoo tried to break my water about four centimeters ago. I sent him away.

My Doctor: If you had let him break your water, I would have had smack you.

Me: I want food.

Doctor to Nurse: Let her have lunch, she's gonna be here awhile.

The end result was, my birth plan went pretty much according to how I wanted it. I had an awesome doctor, and nothing went horribly wrong. Her cord was wrapped around her neck twice, but I had a long cord, and the doctor slipped it out from around her neck and she was fine. Pooped all over me instead of IN me, and I was very very lucky.

I went in when I wanted, had my doula, her sixteen year old daughter took pics, I didn't let my water be broken by a moron with a crochet hook, got my epidural when I wanted it, and pushed her out after 26 hours of labor in less than five minutes.

Birth plans are awesome, but you have to acknowledge that you may have to improvise given any situation that pops up. Knowing where to stand firm, and where to say, "Okay, that might not be a bad idea..." is key.

I was doula for my friend's birth 3 years ago, and my then five year old was present for the birth. Let's just say, her birth plan went out the window, the midwife on call that night was only useful to watch my child, and one of the ob nurses WAS a midwife, and did EVERYTHING possible to help stick to that birth plan and get the baby out. Despite her birth not going to plan (and Willow was born with a cleft soft palate which is a whole nother story) she ended up having a very positive birth experience, because they actually LISTENED to her, and those of us who were there supporting and helping her.

So having a doctor and nurses who respect you and treat you like an adult who knows how to make her own decisions is also key.

In the end? Don't be bullied and know when to bend.

Tue, 2009-05-12 19:14

I am a meticulous planner. I plan everything. But when it came to childbirth, I knew that nothing would go as planned, so I didn't bother doing a birth plan. We played it by ear, and luckily everything worked out.

Tue, 2009-05-12 11:44

I think having a birth plan is a great idea if you feel like it is going to make your preferences better heard and make you an active participant in your birth. I never had a birth plan, but I did have some basic preferences, and I discussed those with my OB. She was very willing to hear me out and follow them as closely as was possible. That said, my first child was delivered via cesarean after 18 hours. Without going into specifics, my doctor discussed every step of what was happening along the way. I felt very involved in what was going on, even though it wasn't my "ideal" birth. It was necessary and I am thankful that we came to the decisions that needed to be made together. Good communication is essential with any care provider and any type of birth you may have. So if a birth plan helps you in this, go for it! I have had two more cesareans after this, and was still able to have a verbal birth plan with these. It made my experiences much more enjoyable and I was able to feel as in control as I possibly could for having a surgical birth. Really good experiences.

The only "problem" I have with birth plans is when they are a gajillion pages long and they are made with the assumption that your care providers do not and will not have your best interest in mind. And that you can through sheer power of the mind and written word completely control your birth. I think since the cesarean rate has inched up, there is almost an undertone of hysteria about medical proffesionals and that they are all out to "trick" moms into a c-section and high intervention tactics. Are there c-sections that are unnecessary? Absolutely. Is the rate too high? I would say yes. However, some interventions and cesareans are very necessary. And at least some doctors do have your best interest in mind. I feel that *some* women's birth plans play into the hysteria. And their goal is to have little to no intervention, that ends in a vaginal birth. These are great goals. The problem is when anything that deviates from this = big fat fail. And then there is regret and upset, and the big evil medical establishment and so on and so forth. There is some extreme rhetoric on both sides. I guess the most important thing is to get a care provider you trust, have a general idea how you want things to go and do your best. That way if things go as planned, great. If they don't, you can have peace of mind knowing you and your care provider did what was best. That way every little detail doesn't have to be wrapped up in an overly detailed birth plan. Because as previous posters have said, birth is unpredictable and we all have to roll with punches to some extent or another.

Tue, 2009-05-12 10:30

I think birth plans are great, but I always suggest to people that they talk to their doctor and get the things that they want in writing as doctor's orders. The doctor's orders and the nurses are what will get you the birth you want.

Hospitals usually have some sort of standard orders. To deviate from that, the nurses have to have orders from the doctor. For example, the hospital may have orders that say,"continuous monitoring". If you want to walk around a lot, the continuous monitoring will make this difficult. To get around this, you get your doctor to write an order that you will be "monitored for 20 minutes every hour" or something. This allows the nurses to take you off the monitor and let you walk for 40 minutes every hour.

The combination of making friends with the nurses (snacks and candy are good for this) and bringing orders from your doctor will really help you out. In addition, this means that you have had a really good conversation with your doctor about what you want. Because doctors forget. If you say, "I have a birth plan" and bring it to the doc, they may glance at it and put it in a file. Then, when it is time to put the baby on your chest, they have forgotten and they hand the baby to the nurse. If you have had the conversation and had the doctor write orders, they will remember.

Tue, 2009-05-12 06:49

I think if you have a five-page birth plan, you need to reexamine your priorities in life. They're doctors, they're trained professionals there to help you, not part of some evil government conspiracy paid off by the drug companies. If the baby comes out healthy and you live, isn't that what matters?

Mon, 2009-05-11 17:43

Waste of time! Not having a "birth plan" is not the same as going into the delivery room with no clue. Obviously you should research all the options and have a clear idea of things that are important to you (natural/epidural, breathing/coping techniques, positions, etc.) But even a planner (like me) should understand that there is NOTHING more unpredictable almost than birth. Want to set yourself up for disappointment? Plan the birth (or your wedding) to a T and then fully expect that it will work out that way.

I know not every doctor is like this, but my doctor wasn't really open to the idea of developing a birth plan. He was certainly open to my priorities, but he didn't want to map it out. I went in with a very open mind, but had things I wanted. Like Maggie, I wanted a natural birth but if it was too much, I was open to drugs. (I had both children drug free.) My 5 year old's birth was by and large pretty standard. My 2 year old's birth was, except that my labor stalled after an entire night and morning of labor to the point where the doctor turned off my pitocin, told me to have lunch and gave me the impression that a c-section could be imminent.

No plan goes out the window more quickly than a birth plan.

Mon, 2009-05-11 16:30

I have been happy to be a passive voyeur on this site, but this conversation moves me to comment. I'm actually surprised that most of the speakers in today's video seemed to find birth plans pretty ridiculous. For me, it was critical.

If you are a considering a drug-free or low-intervention birth, you need a birth plan. That birth plan needs to be written out, reviewed with your doctor, and a signed copy brought with you to the hospital. That is because many of the things you may want/need to labor successfully will run contrary to hospital policy or preferred procedure. The signed birth plan puts you, the delivery staff, and your doctor on the same page.

Specifying that you want the lights dim may sound silly and contrite, until you realize that the difference between a calm dark room and a brightly lit one, are the difference between you being able to concentrate and focus on your body's work or not. Pregnant women are sensitive to taste, smells, and everything else. The laboring woman is the same. Different things work for different women. And different things do not.

Also, constructing a birth plan forces you to actually think about what you want before you're doing the hard work of labor. It makes you have what can be an uncomfortable conversation (asking for what you want), before you're half naked and vulnerable. And yes, that includes simple things like "I want to wear my own clothes instead of a hospital gown" and "I'd like be able to eat and drink while laboring." Most women take their ability to these things for granted, until they are in the throes of labor and being told "No" repeatedly.

That said, yes, of course, the birth plan is a set of guidelines, not a set of commandments. Although I experienced unexpected complications following delivery, I am quite happy that my labor and delivery went almost exactly to plan (two exceptions: my doctor manually broke my water; and the cord had to be cut immediately, because it was wrapped around the baby's neck). If it were not for my drafting the birth plan and discussing it with my doctor, I'm not sure I would have wound up having the birthing experience I wanted. Instead, I sat on a birthing ball wearing my own clothes, drinking gatorade, and listening to music from own iPod, while moaning through each contraction in the dark.

Mon, 2009-05-11 13:24

I definitely think that making a plan is important, but as most of the women have said you need to be ready to change plans if necessary. My Father works at an Respiratory Therapist, so he is present at births to attend to mom and babies respiratory needs. He's expressed his distaste for birth plans in the past because many parents who have come in with plans over the years don't realize that this isn't a to-do list this is a changing and evolving process. He's seen Drs get in arguments with yuppie fathers with plan in hand, and the Dr tells them, your baby will die, your plan no longer applies. I think ultimately it's more important that you and your dr/midwife are on the same page, and that you're as informed as possible about the process.
PS everyone should watch the Business of Being Born it's a great movie.

Mon, 2009-05-11 12:49

Ok, I've had 3 labors. I didn't have any written birth plans, but I still felt I had to fight for my wishes to be followed.

With the first, I was really young and didn't research a lot of things about labor. I knew I didn't want pain relief, but I knew nothing about pitocin, which I happily allowed them to hook me right up with since I was a whole week late and all. All they said was that it would start my labor. They didn't tell me it would take me from 0 to 60 and that my body might not be ready. I labored in "transition" pain for 20 hours and dialated from 2 to 3. I had a very incompetent dr, but my nurses were great and gently talked me into an epidural. My daughter was born 8 hours later.

With my second, I was 10 days overdue and they could tell he was a really big baby, so even though I didn't want to experience pitocin again, I consented to being induced. They started with Cirvadil, but that did nothing, so I cried as they were setting up the pitocin. Again, I would have liked a med free birth, but I learned from my first labor that if I was getting pit, then I was getting an epi. My son was 11lbs, 1 oz, and I really appreciated the dr I had with him. She was in my opinion as non-invasive as possible.

With my 3rd, I was determined, DETERMINED to go into labor on my own. She was 6 days late, but I actually started contracting on my own this time. I walked and walked for 9 hours before heading to the hospital. After I was there 6 hours they wanted to give me pitocin to "speed things up".
I was really irked and told them I wanted to try walking around. I really just wanted to stay in bed and labor, but I felt I had to do something to convince them that I was trying to get this baby out. Thanks to an emergency c-section of twins on my floor, I was left alone for a few more hours and progressed enough that they "let" me keep going on my own. Next they kept losing the heartbeat on the belly strap thing, so they wanted to do a c-section. I was transitioning as they were attempting the spinal tap, and I pushed my daughter out on my side on the c-section table. My third labor was med free, and "natural" but I feel I had to fight for it every step of the way.

If I ever have a 4th, I'll probably stay home for as long as possible, because the pushiness of the medical personell scares me.

Mon, 2009-05-11 11:37