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:
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- 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?
Miranda, I think it sounds great! Caroline (my 2nd) was a VBAC with no meds and it was very doable. Will they be doing an ultrasound to measure the thickness of your incision site? I was high risk s the perinatology office did it. Apparently they can measure to see what the thickness is and can determine if it’s safe to be in labor for a longer period of time.
I’m not sure why you don’t think you can do the water… I was able to take a shower during labor but they did not let me eat. They were afraid if I did need to do a c-section that I wouldn’t have any empty belly.
I can’t think of anything you are missing, except that I made sure that Matt was the one who said, “It’s a girl!” (although you already know that!) 😉 You will be amazed at how different this delivery will be!
I think I’ll be able to shower in early labor, but I wouldn’t be able to submerge myself in a tub.
As for the u/s, I don’t know. My doctor is incredibly good at VBACing women and hasn’t mentioned it as a precaution we need to take, so I haven’t asked. Basically, I’m trusting him.
Just seeing some of the things you’ve included make me start to understand why you hated your first experience so much. To not be able to hold your baby or have it be mandated that you’re alone would be as emotionally traumatizing as birth is physically. When I wrote my first birth plan and discussed it with my doctor, there were only 2 items that were not hospital standard and they were accommodated easily. So much so that I didn’t write a plan for the 2nd, just made sure that our parents were notified sooner. First time, my husband did it when we came out of recovery. This time, my delivery nurse called them as soon as we were in recovery.
I hope this delivery is as close to your plan as possible. 🙂
Most of the women I know who’ve had c-sections haven’t been able to hold their babies immediately after giving birth the way moms who birth vaginally can, and I think it’s incredibly unfortunate for both mom and baby. Even if the baby is handed to Dad I think it’s better than being whisked away to the table to be cleaned up so that this tiny little bundle all wrapped up in blankets is presented instead of the messy, gooey baby that was just born. And yes, not making it standard for someone else to dress in scrubs and take the husband’s place is incredibly depressing. Mom shouldn’t be left alone in that moment.
As you know my girlfriend just VBAC’ed with the same doctor. She said that they were SUPER accommodating. She did say the one thing that she wished she had put was information in case she needed a blood transfusion {which she did}. It is a rare thing, but she still felt a little overwhelmed by what was going on because she hadn’t said she wanted to be kept in the loop.
I hadn’t even thought about reasons why I might need a blood transfusion! I’ll be googling birth plans with that sort of information now!
wow, you are way ahead of where i was, i did not exactly have a “plan” per say, more of a, “i’m just gonna get this baby out” kinda thing, i didn’t care what it took, although, in hindsight, i wish my daughter’s birth could have been vaginal, unfortunately after 22 hours of labor it wasn’t happening.
I mean, “I’m gonna get this baby out OF MY VAGINA” is pretty much my plan. 🙂
Hi Miranda,
I found your blog after the birth of my son a year and a half ago. The long story short is that I ended up having a c-section (completely not what I had “planned”), and while the experience brought me my beautiful spirited boy I found myself quite depressed and grieving for a long time over the experience I wanted to have or felt like I lost. I felt so guilty feeling this way and alot of people couldn’t truly understand how I was feeling, or maybe I wasn’t explaining how I felt well enough. I felt like I had failed myself. my son. Anyways, in my journey to understand these emotions I found your blog and for the first time I felt like someone “understood”. It’s nice to know I’m not alone out there…:) I am now expecting my 2nd child and determined to have a VBAC come hell or high water! Thank you for sharing your journey and I wish you the birth experience you are hoping for:) Many blessings to you and your growing family!
You are most certainly NOT alone in feeling this way about having had a c-section. There’s a whole slew of us out there. If you haven’t already looked for it, see if there’s a local chapter of ICAN (International Cesarean Awareness Network) near you. They can help you with resources in your area to give you the best chance of VBACing your second baby! Good luck to you!
Hey Miranda!
I’ve been reading for a while, but I think this is my first comment. I had a c-section and PPA / PPD w my first, and I relate to so much of what you write. Expecting #2 in June and really hopeful for a VBAC! Like, really hopeful.
Anyhoo, just wanted to let you know that our plans are very similar, except that I’m avoiding pitocin at all costs. I’m 99% sure that my OB won’t allow induction w a VBAC, because the risk of major complications goes up. I love that my OB supports me but is fairly conservative as well. Interested to see what yours says!
I am so hopeful that you will have the VBAC you want, and will be following your story!
Best,
Andrea
My OB does use pitocin in small, small doses, and usually only as a way of jumpstarting a labor that might have stalled. Or as an ultra-slow induction that begins with a Foley bulb. It’s not the “we’re jacking this dose up every 15 minutes!” kind of administration that my old OB did during my delivery with Joshua. I, however, still want to avoid pitocin at all costs because that drug is Satan.
My plan sounded similar to yours. My first was a c-section due to breech presentation. I tried all the natural remedies to flip my son, but he wasn’t going to budge. I was upset at first, but had 5 weeks to wrap my head around it before the c/s took place.
He was born just perfect and my recovery was a breeze. I was more scarred from the fact that I never got to experience a contraction or have my water break. I felt gypped. I knew that the next time around, I was going to VBAC.
When I got pregnant with my daughter I was so excited. This was it. I would study my Hypnobabies, go to the chiropractor early on to make sure my pelvis was nice and open so she would present vertex.
I had a plan. I wanted little intervention. No way was I going to be induced. I wanted to stay at home as long as I could and be comfortable. When I got to the hospital, I wanted a room with a tub (which my doctor was 100% fine with water and VBAC.) I wanted to be monitored intermittently and be free to labor how I saw fit. My doctor was okay with that up until I got to 7 cm and then I needed to be monitored, but I could labor in any position I wanted while being monitored.
At 33 1/2 weeks, I went into preterm labor. Threw my whole plan off. I wasn’t ready to have this baby. I was given meds to stop my labor and was sent home a few days later on a prescription to keep the contractions at bay. I was on bedrest until 38 weeks.
The good news is, I didn’t go into labor until the morning of my actual due date. I labored at home until 10 pm when my husband got a little nervous:-)
At the hospital, they respected my wishes. At one point though, I was hooked up to the monitors and my daughter wasn’t having accelerations after her decelerations with my contractions. I had every nurse in the unit come in when her heart rate bottomed out and didn’t come back. At this point my doctor asked to break my water because she needed to see if there was meconium or something else causing distress. My water broke with a bright red gush. I had a placental abruption and it was causing distress to my baby. As much as I was hell bent on a natural VBAC, the minute I saw the look of concern on my doctor’s face, I was okay with where it was headed… Emergency c/s.
My daughter spent her first 12 days in the NICU with a life threatening infection. It was the hardest 12 days of our lives.
Luckily, she is doing great, but I tell you this because you need to be prepared and flexible for whatever gets thrown your way. You sound like you have a great doctor and have everything researched and ready. I hope that you have a successful VBAC. I have come to terms with the fact that I won’t, but I LOVE when I hear about them. I also love reading about people who are so educated about patient rights and pregnancy in general. I can’t wait to hear about your daughter’s birth:-)
Thanks for sharing your story. I say what I say next not out of disrespect but out of…self-defense, maybe.
While I believe your intentions in sharing your story with me were no doubt good, sharing a story of “what went wrong” is kind of counter-intuitive to what I needed from this post, particularly when I said “I’m aware that things don’t always go according to plan” in the post itself.
I know that there are circumstances that are beyond my control. I know that there are situations that may present during labor that necessitate another c-section, and I’m prepared for that should those situations occur. Should I end up with a c-section with this doctor, I will know that it’s because there is no other way to get this baby out safely. That I’ve done all I could do.
I live every day with “what if this doesn’t work?” running through the back of my mind. I live every day with “how the hell does a baby ever fit through a vagina!?” too. But, at the end of every day, I know I’ve done the best I can do to help my chances of VBACing this baby by switching to my current provider and trusting his wisdom and my body.
Great plan Miranda! I was trying to relate my plans back with this one and my biggest was “mommy holds baby FIRST” before anything else happens!
Also, you could add a plan in for Joshua. I spoke with the nurses the morning of my c-section with Park and told them that after we came out of recovery I would like them to have the room cleared out of all visitors so Jager could be the first to meet his little brother. I was so very proud of the outcome and Jager loves telling the story about him “meeting his brother first”. Of course we tried to do the same when Em came along but she had a long visit in the NICU before anyone got to meet her.
So happy for you guys!!
I so want to make this a reality for us. I want him to be the first to get to meet her besides us. I’m just scared of the timing of everything. If I’m in labor during the day and Mom and Co. can be at the hospital with us, Joshua will certainly be the first to meet her. If I deliver in the middle of the night, I won’t wake him to have him brought to the hospital, you know? If he were older, I would.
The timing of all of this is the one downside I can see to not having a scheduled induction or repeat c-section. I need a crystal ball to know how to plan for everything.
I have to say that however well intentioned, I would get INSANELY and ABSOLUTELY frustrated when people would tell me their stories so that I would be “as prepared as possible.”
Folks, this woman is prepared. She’s been through the circus before. She knows that she cannot “control” things in the sense that she can demand whatever she wants in the name of her child’s safety. I get that it’s out of the right motivation, but I personally just find it the wrong thing to say. Many people said the same thing to me while I was pregnant, and I found it very hurtful. Why? Because we can just.be.supportive. We can just say, “GOOD LUCK! YOU WILL DO FABULOUS!” Without adding our personal stories or what we heard from this person or this doctor or your 3rd cousins best friends sister.
Birth is mutually exclusive. What happened to you has absolutely no bearing on what will happen to me, or what will happen to Miranda. Whatever happens to Miranda, she will be successful because she was an active agent in planning her birth, not passive, and she was prepared. You are freaking amazing, Miranda.
And to answer your question, I would try and avoid even the hep lock as long as you can (if you are contracting on your own, that shouldn’t be a problem, I am not sure why it would be?). Also, for natural induction, maybe list foley bulb because many people don’t even know about it, so knowing may allow you to do it when I don’t think it’s routinely offered.
I love you. You will rock this. Because it is YOUR birth, and no one else’s.
Pretty sure this comment was directed towards me, so I would like to respond.
I said my story because I was in the same shoes as Miranda. I wanted a VBAC come hell or high water. After my research, I felt it was the best decision for me and my family.
I was let down the first time, much like Miranda, because I had a c/s and there were other options I could have tried if I had been more educated. So I educated myself fully. I knew my rights, I knew my options, and I knew my limits and I was prepared to exercise them fully.
This time around, shit didn’t go as planned and I thought I would be really bummed, but I am not. I’ve got a great daughter and didn’t get the chance to VBAC.
I was commending her for her knowledge and her decision. I shared what happened to me because I felt it was relevant to the post.
YES, every birth is mutually exclusive. But hearing others’ stories are what help us gauge and learn and get ideas for further research and mold our plans.
She will rock this birth, no doubt, and I felt that my post didn’t suggest otherwise.
See, Courtney, this is the thing.
I am not disagreeing with your fundamental issues. I am not implying that you should feel badly about your experience, or saying that you were uninformed. But I am willing to bet that any woman going to have a baby has already heard every type of experience possible.
Your words were: “Luckily, she is doing great, but I tell you this because you need to be prepared and flexible for whatever gets thrown your way.”
The *connotation* of that is STILL that things may not work out. Of course they may not. Of course she is well educated and informed of that possibility. It is not what she needs to hear, because it does not elicit positive reactions. It elicits, instead, potential fear and worry and doubt.
I did not reply to your comment specifically because this is not directed at just your comment. It is also a result of what I heard, and what my friends hear, and what I see people say on a daily basis. I find it counterproductive, and I, when I was pregnant, would have much preferred to hear people cheering me on instead of reminding me what could go wrong.
See, the thing is, personal stories are the best way to hear every type of experience possible. At least in my opinion.
Here’s the thing, Sara. In general, I agree with you. Hearing personal experience stories is beneficial, but only when they are solicited. In this post, I wasn’t soliciting worst-case-scenario VBAC stories. I was soliciting advice on 1) whether my birth plan seemed sound and 2) what other VBAC moms who found themselves in the OR requested. I was also clear to point out that I am aware that things can and do go “wrong” during labors.
Your blog, your restrictions. Thanks for the correction.
I asked about avoiding the hep lock and the OB said it’s not likely based on hospital policy. It’s one of those things where I know he wants to continue to provide women in the area VBACs and this is one of those things that is sort of a lesser issue, you know? It doesn’t HURT me to have the hep lock even if it’s annoying. It’s a compromise I’m willing to make.
As for the foley bulb, that’s totally where he starts if he has to induce due to post-dates. He can’t use Cytotec because research shows that prostaglandins contribute to uterine rupture, but the foley bulb is the alternative.
And thank you, as always, for your love and support, Isha. 🙂
I’ve got awhile before we are ready to try again, but I may use your plan as a template. I am very much hoping for a successful VBAC next time. Good luck!
Use away! I used a birth plan generator that I found by Googling to create this and just amended it as I saw fit after it was in document form.
Good luck to you for next time, whenever that may be for you!
dude. your list-making abilities are award-winning. seriously.
this is impressive.
Dude. I Googled “birth plan generator” to make this. New Girl has stolen my ability to function at any level higher than making a bowl of cereal and a cup of coffee. and she’s not even here yet.
This is a wonderful plan! It looks like you really thought of everything very well before the big day. I wish you the best
I hope I did!
I love your plan, it obviously took you a lot of work and it is so well thought out. I may have to use parts of it if we ever get pregnant with #2. Even if we are to have another C/S one of the things I’m going to demand is skin to skin much earlier. Even in recovery (emergency C/S) I didn’t get the skin to skin with Hayden and I was so disappointed. I feel like that’s partially why we failed at BF’ing and at 4 1/2 months I’m still exclusively pumping.
First, I commend you for EPing. I did it for 4.5 months when Joshua refused to nurse after I went back to work. It was grueling and I don’t wish it on anyone. But, it was also rewarding in a way and I know I’d do it again if I had to. (Plus, he had a dairy allergy. The alternative was the hypoallergenic formula. Which, hello expensive.)
Second, feel free to use any of this that you want to use for your #2, but know that I googled “birth plan generator” and then amended this to make it work for me and my situation.
I hate that there’s no skin-to-skin in the OR, at least not in any hospitals around here that I know of. Even if it were skin to skin with the dad instead of the mom since mom is lying flat, it’d be better for the baby and bonding than the current practice.
I’ve meant to comment on this since reading it. First off – holy mother. I had no idea you could ask for half of this stuff. Honest. This was so eye opening even for someone who didn’t have a c-section.
Second, you are super prepared and that makes me think that no matter what, you are going to be totally ok at the end of this. Whether it goes by the book or things get thrown your way, it really does sound like you have an idea of both the perfect plan and the other plan – but both are realistic and manageable – and you chose them this time. You won’t be in there grasping at straws trying to figure out what is going on.
I’m rooting for you hardcore. I am so proud of your decisions to do this and make this work for you, from the birth plan to the Dr.
((((())) Sounds good to me! I can’t wait to hear about New Girl’s arrival!