Tuesday, September 25, 2012

Our birth plan of broken dreams...

I am hoping for an unmedicated birth. There are so many reasons I feel this way. Some are research-based and some are ME-based. None of my reasons are "judge other moms who don't do the same"-based. Just to be clear. Statistically, in normal pregnancies/ births, unmedicated births tend to have less complications and a slightly lower associated csection rate. Let's all just relax and agree that statement is generally true. There are a lot of very specific reasons I want to forego drugs, and I am happy to tell you all about them if you're interested. But there is one VERY specific reason to get pain meds: BECAUSE YOU FEEL LIKE YOU ARE DYING. And I got a taste of that on Saturday night, and seriously, I've never felt more empathy for other humans in my life.

Anyway, in order to prepare for the arrival of our son, I have spent a lot of time educating myself about all types of births. And that is really the only thing that I feel very strongly about: birth education. No matter what your birth plan is, you have nine months to prepare. Get your ass to Barnes & Noble and read a book. I say this with some attitude because it is amazing to me when I talk to other pregnant women and come to find that they are less prepared for birth than the liars on "I didn't know I was pregnant."

Today, I am here to talk about birth plans and our birth plan. Hospital births have become so routine (around 90% of women get epidurals in major hospitals), that if there is anything specific you want for your labor, it's a good idea to get it in writing because nurses/doctors are going to do whatever the "norm" is unless you specify otherwise. Of course, you can't "plan" birth, but when there are no red flags or indication of complications, you can reasonably assume that everything is going to turn out ok.

We gave our birth plan to the doctor last week, and let's just say that A LOT of it got shot down (highlighted in red). The really annoying part is that all the things he refused are backed up by research AND were taught to us by the hospital birth class. Like intermittent fetal monitoring. It's not like I just read it on some pregnancy blog and slapped a birth plan together.

If you are SUPER committed to getting your dream birth, I'd recommend going to a birth center and/or interviewing a lot of doctors/midwives. At this point, the things I am having to be flexible on are not worth changing doctors or hospitals, but I can see other people feeling very differently.

So here is the plan. I am just providing it in case you a. are wondering what the hell a "birth plan" is or b. are looking for an example of one for your own birth. We called it a "wish list" so that it seemed less demanding/confrontational. Surprise surprise - doctors and nurses don't like to be told what to do by first time know it all moms like me, so I tried to be as unagressive as possible. Also, I'm a huge baby and find ordering pizza to be slightly more confrontational that I am comfortable with.


Patient: Lauren Dougherty
Father: Thomas Dougherty

To hospital staff and all care providers,

We are committed to a natural and unmedicated birth. This birth wish list is based on the assumption that labor and delivery will be without complications that are a threat to the health of mother and/or baby. We fully understand that the introduction of elective or necessary medical interventions can drastically change the options available to a laboring mother. We are prepared to be flexible, but would like to actively participate in any discussions that deviate from the following wish list.

We have chosen our doctor and hospital based on a trust for the quality of care and expertise of the care providers, and we appreciate your support and sensitivity during labor.

  • It is our understanding that there are two rooms that offer a bathtub. If a room with a bathtub is available and membranes have not yet ruptured, we would appreciate being assigned to one of those rooms. Lauren would like to use the tub and/or shower as a means for natural pain management.
  • We would prefer to be assigned a nurse that is comfortable with and supportive of natural birth plans.
  • Lauren prefers to not receive IV fluids unless shown to be necessary. She would rather have a heplock put into place should the need for IV fluid or medication arise.
  • As per ACOG recommendations, we would prefer to have intermittent fetal monitoring instead of continuous fetal monitoring.
  • Lauren prefers cervical checks to be kept to a bare minimum.
  • As long as baby and mother are not at risk, we would prefer to be allowed to labor and progress without stringent time constraints.
  • Lauren prefers to forgo the artificial rupture of membranes until the late stages of labor.
  • Please do not offer chemical pain management. We are both fully educated on all the options, and will request a discussion with a nurse or doctor should we elect to use one of them.
  • We plan to use natural techniques including hydrotherapy, a birthing ball, practiced breathing exercises, music, and massage to manage pain.
  • Lauren prefers to push instinctively and with minimal coaching.
  • Lauren prefers not to be given an episiotomy unless medically necessary.
  • Lauren would prefer the option to push in different positions possibly including: semi-reclining, side-lying, squatting with a bar, or any other position that may feel more productive or comfortable.
  • Lauren prefers to be given a reasonable amount of time to deliver the placenta before pitocin or other augmentation be used.
  • We would prefer that the umbilical cord not be clamped until 2-3 minutes after delivery. Thomas would like to be the one to cut the cord.
  • We would like the baby to be immediately placed on Lauren’s chest and to remain there until aftercare is necessary.
  • We strongly prefer that the baby have the opportunity to breastfeed before taken to the nursery.
  • We prefer that the baby spend as little time in the nursery as possible and to be accompanied by one parent at all times.
  • Please do not give the baby formula, sugar water, a bottle, or pacifier at any time without our explicit consent.
  • We prefer that the baby room-in with us in the postpartum room.
  • We plan to have our baby circumcised and will discuss procedure and options at the appropriate time.
 Thank you for cooperation in this momentous occasion!

Lauren Dougherty                                                            Thomas Dougherty
Mother                                                                                Father

What is in red are the things we already know we aren't getting. The only one that really bugs me is the delayed cord cutting. Research shows that waiting to cut the cord results in a lower incidence rate of infant anemia. My doctor literally used the word "malarkey" when I mentioned this to him. But either way, who cares? Is one extra minute that big of a deal? Can he not just sit there and wait for an extra 60 seconds. It's only my baby's blood supply that I am concerned about. Ugh, whatever. Don't want to talk about it.


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