Something I hadn't really considered until recently was creating a birth plan, which is basically a list of preferences for how we wish for our delivery to be carried out under normal circumstances. Obviously, some of the preferences go out the window if something unusual should happen, but most of the articles that I've read say that having a birth plan going in is a good idea.
I have my own ideas of what my labor will be like, but before now, the thought of writing out a birth plan had never crossed my mind. Luckily, Kaiser hands out generic birth plans to patients during their 3rd trimester. It is broken down into different categories and you check off your preferences within each category. After completing the birth plan, you take a copy to your monthly appointment and your caregiver puts the plan in your chart. The idea is that when you're admitted, all the nurses and staff will review your chart and be aware of your wishes during labor.
I've become keenly aware that when it comes to the topic of birth and babies, people can be very opinionated. I've encountered people (normally perfectly rational) that state their point of view in an overtly matter-of-fact way, as if to say "well isn't that cute...but it's wrong!". We're certainly not qualified to write a book on birth and babies, but we're rational human beings who have consumed enough literature and consulted enough actual parents to where we have an idea of what our preferences are. Our ideas may be 180 degrees from where they will be a couple of months from now, but we'll simply have to go down that road to find out.
Birth plans can be as simple or as complex as the parents want, but we just went with the pre-fabricated one published by Kaiser. The five categories on this particular one are: Environment, Labor, Pain Management, Delivery, and Postpartum. Brandon and I went through each preference and have completed my birth plan as follows:
Environment
- I would like the lights in the room to be lowered: It just seems like any pain would be intensified with 4000 Watt ultra-white light shining on every moment. Besides, who wants to be able to see that untimely zit, ashy elbows, or a stray gray hair on the happiest day of one's life?
Labor
- I would like to be out of bed as much as possible during labor (such as walking, rocking): I dread the idea of being bound to the bed for 24+ hours.
- I prefer to have intermittent fetal monitoring: Same as above; as long as Dunebuggy appears to be doing fine, there is no need to monitor every single contraction. I think all of the bleeps & bloops might be quite annoying after a while.
- If I need to have an IV, I would prefer to have a saline lock (a plug for your IV needle): This would also allow mobility should I choose to move around.
- I would prefer that the amniotic membranes ("bag of waters") rupture naturally: Brandon and I get mad at a show on the Discovery channel that shows a maternity ward where it seems like the fist thing they want to do is break the bag of waters. The problem is that you basically have 24 hours from that moment. If contractions don't start soon, they'll administer pitocin to intensify contractions. Ultimately, if you haven't delivered within 24 hours, they'll push a C-Section because of the risk of infection. I hope this is not the case at Kaiser, but we'll have to see when we get there.
- I would like to meet the pediatric provider on duty if possible: Just in case there is a reason that she'll need some attention from the pediatrician after birth.
Pain Management
- I am considering having an epidural or using pain medication, but will decide when I am actually in labor: This topic tends to rate the strongest opinions from folks. I have no idea how intense the pain will be, nor how well I'll handle it. I would hope to be able to go all the way unmedicated, but I'm sure everyone would if it were easy. That's why I want to keep an open mind and make the decision when the time comes.
Delivery
- I would like the option to be in a position other than lying on my back when I give birth if possible (such as semi-sitting, squatting, lying on my side, or on my hands and knees): Trust me, I'm really not even remotely considering giving birth on my hands and knees, but should the mood strike, I guess I want to keep my options open.
- I would prefer that the baby be "lightly" dried off before being brought to me: We discussed this one a lot, but ultimately decided that having her toweled off for 15 seconds wouldn't ruin the mother-child bond that is supposed to be formed quickly with skin-to-skin contact immediately after birth. I'm sure I wouldn't mind the slimy bundle of joy thrust upon my chest, but why not have a slightly less slimy bundle instead.
- I would like to have Brandon Stepp cut the cord, if possible: If he is still conscious and in a vertical position.
Postpartum
- I want all procedures that are done and all medications that are given to my baby explained to me before they are carried out by the medical staff: I don't want to be a bother to the medical staff, but it seems like it would be nice to know these things.
- I would like to have the baby evaluated and bathed in my presence: Sure, why not.
- If the baby must be taken from me to receive medical treatment, I would like Brandon Stepp to accompany the baby: Reference above statement regarding his state of lucidity and directional disposition.
- I plan to exclusively breastfeed my baby while in the hospital: I suppose that will tide her over until the mommy milk machine gins up.
- I would like additional information and support to help me learn to breastfeed effectively: This is a no brainer. I have no clue what I'm doing in this department, so I'll take all the advice I can get.
- I would like to be consulted before my baby is given water, formula, sugar water, or a pacifier: I don't guess any of these things will hurt her, but I'd like to stick to the breast only plan if possible.
I will give our midwife a copy of the birth plan at our next appointment on April 15th. I am really glad Kaiser offers the plan to their patients and hope other hospitals do the same. It's not an all inclusive plan but it is a good start to get patients thinking about how they'd like their birthing experience to play out.