Birth Plan, Part One

I have an OB appointment later today and at my last appointment, I heard the NP say that at this appointment, we’d be discussing my birth plan.

I’ve know this was coming and have felt woefully underprepared for most of this pregnancy because really my only “plan” is for this baby to come out of my vagina instead of an incision in my stomach.

Somehow, I feel like maybe that’s not quite enough. And to be honest, thinking about creating a birth plan again kind of stressed me out. I did this the first time. Things still went “wrong.”

(Sidenote: I understand that the birth “plan” isn’t a list of hard-and-fast rules regarding labor and delivery and simply serve as guidelines for what you’d like to have happen in an ideal situation. Which is why “wrong” is in quotation marks. My “wrong” and your “wrong” are likely two different “wrongs.” I am also REALLY aware that labor and delivery doesn’t always follow the “ideal situation” where a baby glides out of a woman’s vagina pain free while wood nymphs flit around her with glitter wands. Or whatever your “ideal situation” may be. In my ideal situation, maybe there are glitter wands.)

Here’s my birth plan:

First Stage (Labor):

• Peace and Quiet.
• Music/TV/Internet of our choice.
• Would prefer to keep vaginal exams to a minimum.
• Maintain mobility (Walking, rocking, up to bathroom, etc.)
• Eat and drink to comfort.
• Heparin lock.
  • I suspect I can’t avoid this one, though I’d like to.
• Intermittent Monitoring (ACOG Standards) with an external monitor.
• Please do not offer me pain medications; I will ask for them if I want them.
• Relaxation techniques (breathing, focusing, etc.).
• Positioning as desired.
• Water (Shower or Tub).
  • I think I’m out for this one based on the fact that I’m VBACing, but it’d be nice.
• Heat or Cold packs.
• Massage (back, foot, counter pressure, etc.).
• Ultra low dose epidural (walking epidural)
  • Pain meds are an option for me, though I’d like to do this without them if possible.

Induction:

• I would prefer to use natural methods to start labor.
  • Basically, I’m saying pitocin=Satan. And he’s scary.

Augmentation:

• I would prefer to walk to speed labor.
  • Thank GOD this hospital is bigger than my last one. Thank. God.

Second Stage (Birth):

• Choice of position
• Prolonged length, if progress is being made
• Spontaneous Bearing Down
• I would prefer to tear than have an episiotomy, but please use compresses, massage and positioning.

Baby Care:

• Baby should be given to mother first for skin-to-skin bonding and early breastfeeding.
• Delay the cord cutting
• Prefer partner to cut the cord.
  • Only if he wants to. Totally up to him.
• Delay the eye medication
• Breast feeding only
• No separation of Mother & Baby

Cesarean Birth:

• Spinal/epidural anesthesia
• Partner present
  • If Dan has to leave to go with New Girl and my mom is able to be at the hospital, I’d like her to be able to come in to be with me so I’m not so completely alone. Or someone. Someone I know, come into the room to be with me so I’m not alone again.
• Screen lowered to view the birth or mirror
• Explain the surgery as it’s happening
• Do not restrain arms unless I become unable to control them. I understand the need for a sterile surgical environment.
• Breast feeding in recovery room
• Baby to be given to parents first barring medical necessity otherwise
  • I think babies should be given to their parents straight out of the womb and not taken to an incubator. We’re not hatching chickens in a factory somewhere, y’all. GIVE ME MY BABY.

Sick Baby:

• Breast feeding as soon as possible
• Unlimited visitation for parents
• Handling the baby (Kangaroo care, holding, care of, etc.)
• If the baby is transported to another facility, move us as soon as possible

In order to prepare for this appointment, at least a little bit, I created this plan. Most of it, I think, is pretty normal and will be supported by the hospital staff and my OB.

But I need some feedback from been-there-done-that VBAC moms to let me know if I’m on the right track. I’d especially like to hear about what your desires were should you find yourself back in the OR, because really, I can handle the unknowns of labor and I feel empowered now to make decisions and stand my ground should I find myself being bossed by some bossypants in the middle of a contraction (not my doctor…I trust him not to boss me).

What I can’t handle without feeling a lump form in my throat is reliving my first OR experience with New Girl should that be the direction we have to take and thinking that the second experience may just be a repeat of the first (though I suspect, once again, that thanks to my new OB, it won’t be the same).

What am I missing?