Non-overwhelming Birth Plan

I may change my mind on this after years of doing this, but I am pretty sure that my view on birth plans is going to be different than with most doulas. Here are two presuppositions that make my view the way it is:

1. I assume that a shorter birth plan is a good idea, especially if you are planning on using adoula. Let me explain. A doula understands what it takes to have a natural childbirth in a hospital setting. Therefore, we automatically advocate for such needs whether it’s written on a piece of paper or not.
2. I assume that since you are giving birth in a hospital, you are understanding the “battle” for that birth plan and therefore desire to do everything in your power to make it a team effort, not a war zone. Let me explain. There are doula’s out there in this great big world that are angry, frustrated and bitter with the fight for natural childbirth in a hospital setting and therefore do not trust anyone that is in said hospital on their payroll. This make it very hard for them to work in a way that promotes unity. However, if you approach it with the expectation that you may run in to road blocks, but that dialogue goes a long way, then advocating for the patient may not create the “war zone” some are familiar with.
Back to the birth plan. Understanding that a long birth plan only frustrates medical staff, even the nicest of doctors, will help you understand that a shorter one may go a lot farther. Also, understanding that having a doula is statistically proven to increase your chances of having that birth plan succeed makes a longer birth plan unnecessary too.
Here is an example of a “longer” birth plan. And this one is even longer. Here is my point: these birth plans are great to get acquainted with, but will be scoffed at if handed to a doctor. But if you aren’t planning on having a doula, by all means take it and keep it with you so that you can refer back to it yourself when “road blocks” start happening. And expect them too. It’s only “natural,” its a hospital.
But if you are using a doula, I believe the following birth plan (with anything else added that you want to add) covers the biggest “road blocks” that may come up:

1. I would like to have SROM. (spontaneous rupture of membranes/bag of waters).

2. I would like freedom of movement after SROM as long as head is well engaged. (That is generally accepted to be -1 station, to prevent cord prolapse).

3. I prefer to have EFM for 20 minutes out of every hour. (ACOG standards are 30 minutes for first stage labor.)

4. I would like a HEPLOCK only, and no IV fluids unless dehydration is suspected.

5. I do not want to be offered pain medication. If I need it, I will ask.

6. I do not want to have an Episiotomy.

7. I prefer not to be coached in pushing, rather to push when I am ready and for as long as I am comfortable. No counting, please.

8. I would like to push in any position that is most comfortable including: squatting while standing on the floor, all fours while in the bed or sitting up. I do not wish to push inLithotomy position.

TTThere you have it. Obviously you can add any that you want for after birth:

I would like for the cord to stop pulsating before it is clamped.

I want to wait for the placenta to deliver on its own, without forced pulling.

I I would like to nurse the baby immediately to help with bleeding, as opposed to using Pitocinautomatically.

Then there are the issues dealing with the baby:

I Whether you want the Vit K shot or not, the eye ointment or they baby bathed in yourpresence.

I really do hope this helps. It is important to know that the goal is to be firm but kind. Understanding that the battle is against a culture of “how things are done” not a personal attack on “someone.” At the end of the day we are all people with feelings.. so be firm in what you want, but don’t make people feel like idiots for doing what they do naturally. If that makes any sense. Sounds like what I want to say about some of the medical staff and their treatment of moms and doulas. But it does go both ways.

I

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s