Thursday, December 13, 2012

What is so controversial about having a birth plan?

Being a medical professional, it seems like most people I encounter give a major side eye to birth plans.

I've even heard recently that nurses will "mark" longer than normal birth plans with the comment "C-section" at some hospitals.  

I guess my question is: what is so wrong about having a plan?  

Sure, there are tons of things that could go differently than you'd wanted them to, but isn't going in without any frame of expectation or desired outcome just setting yourself up for the ideal birth of your doctors and nurses?  To me- that seems off.  They're obviously not the ones lying in the bed, birthing the baby!

Obviously- when you're considering a birth plan, you have to be flexible.  That's understood.  I don't know of any mother who would say, "Um, that's not on my birth plan, so even if the baby is in danger- I'm not interested," for no concrete or educated reason. 

With little man, we had a birth plan laid out.  

Things didn't go as planned.

My water broke on a Saturday night at 9p.  By the next morning at 7a, I was being pressured to take Pitocin due to my contractions "not being strong enough."  I stalled for a few hours at that point.  But being a first time mom, and not really being all that well-educated on that specific situation, I went ahead and agreed.  I made it probably 6 or so hours on Pitocin before I had the epidural.  

My birth plan had clearly stated that I did not want any medicine for laboring or pain if possible.  But obviously, that didn't happen, and it's okay.  I still birthed a beautiful, amazing little man who was perfectly healthy and I came out of it with no lasting effects.

However, even when I bent and agreed to things I had to compromise on, the medical staff continued to press me on other portions of my birth plan.  I was asked several times about an episiotomy- even after it was discussed with my Ob prior to labor/birthing, it was on my birth plan, and I explicitly stated that I did not want one when getting ready to push.  As mentioned previously, I also asked the nursing staff not to count and to let me push on my own schedule.  They again didn't listen, and I feel like this is why I did tear more than I probably would have otherwise.  

A birth plan is just that- a plan.  

Considering the fact that I am the mother, the "patient", and the person undergoing the medical treatment while in a hospital to birth my child, I don't think it's an insane request to have my wishes known. 

Or respected.

And- to be totally honest- if you are either a doctor OR a labor and delivery/postpartum nurse and you DON'T respect birth plans or individual mother's wishes?

You are 100% in the wrong field.  

I'm serious here.  If you scoff at birth plans or women's requests during birth, then I will say it outright.  You probably suck at your job and you should consider switching specializations or possibly even careers.  

I have NEVER met a patient or client whom I've been able to progress through therapy without being respectful to their specific needs, personal desires for outcome, and wishes during treatment.  It just isn't successful when I'm the dictator and they are the peon.  That's not how effective healthcare works.
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That being said (rant off?  lol)- if we do end up in the hospital this time around, here is our plan:

- Labor at home as long as possible, if not birth at home.

- If that is not possible for whatever reason, we'll go to the hospital.

- While in the hospital, I do not want any interventions I do not ask for or deem medically necessary.  Please do not offer me pain medication.

- Any interventions you do suggest or state that I need must be accompanied with a reason for that procedure as well as a list of possible outcomes if I choose to refuse that intervention.

- I do not want a million people in my room during birthing.  This includes students and residents.  I apologize, I realize everyone has to learn, but to me, birth is private and if you're not necessary- you're not invited.

- I would like the room to be dimly lit and my choice of music to be playing.

- I would like to be free to labor in the tub and shower as desired.  

- I would like to be free to move around the room while laboring.  If monitoring is required, I would prefer intermittent monitoring.  

- I would like a mirror while pushing.

- I would like to push in my chosen position as able- not to be lying on my back.

- I do not want anyone counting while I push.

- I do not want an episiotomy.

- I would prefer to catch my own baby.  I want the first hands that hold her in this world to be mine.

- I would like immediate skin to skin after birthing.  All testing/procedures may be done while she is in my arms or may be delayed.  Eye drops will be delayed if not declined.

- No bath is necessary until we leave the hospital.
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So far, that is where I'm headed with the birth plan.  I'm still kind of sticking my head into the sand and hoping that we won't need it and we'll be able to home birth with the midwife and her assistant.  However, as I mentioned before and as we understood last time around, I will to be open minded to all of the possibilities and be prepared for whatever direction this baby takes us during her birthing.  

Did you have a birth plan?  Were you able to stick to it?  What were the areas in which you needed to be flexible?

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5 comments:

  1. I didn't have any plans to make a birth plan until I found the Earth Mama Angel Baby checklist & it made doing one too easy to pass! I've heard the nurses at my hospital are extremely respectful of birth plans so I'm going to be printing it and putting it in my bag soon.

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  2. I hadn't seen this! Thank you for letting me know, I will be sharing that birth plan! :)

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  3. Why not a bath? Just wondering the reason not judging your choice

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  4. We delay the bath for the health benefits of the vernix as well as the fact that the soaps they use in the hospital have tons of chemicals that I won't put on my babies. (We bring our own diapers from home for the same reason.)

    Here is an article with WHO information on why we delay a bit! Hope this helps!

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  5. Great post! I was always so annoyed when people rolled their eyes at my plan.

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