Posts Tagged ‘Birth plan’

F.E.A.R.

Thursday, August 30th, 2012

I have been thinking on the F.E.A.R. (False Evidence Appearing Real) acronym.  What else can it mean? Fear itself can be a positive or a negative. Fear can be a stumbling block or a motivator.

I enjoy coming up with affirmations and words that alter the view especially as it relates to pregnancy, childbirth and postpartum. I have been and know so many who have fear thrust upon them by friends, provider, family, strangers or have deep fear from previous experiences or from the unknown lurking ahead.

Take my words, come up with others and make your own acronyms to work with the FEAR surrounding you, inside you and take away its power.

 

F                      E                     A                     R

Feeling, Freedom, Fix, Fire, Fierce, Forge, Find, Fortitude, Frame, Fight, Force, Free, Forever, Forgive, Feel, Fearless

Everything, Exist, Eradicate, Excite, Envelop, Empowered, Encourage, Enhance, Expectation, Effort, Exquisite, Endearing, Encourage, Enhance, Effort, Expectation, Exquisite, Equal, Excel, Expert, Ease, Engage

Admit, And, Am, Advocate, Amplify, Armed, Above, Answer, Awareness, Act, Assist, Attitude, Ally, Appear, Admire, Ask, Alter, Apprehension, Action, Alive

Rest, Respect, Rise, Release, Rage, Rights, Ready, Resonate, Relief, Repair, Rely, Resist, Rejoice, Roar, Risk, Release, Re-frame, Rephrase, Remain

 

Please share additional words you come up with!

Writing Your Own Birth “Plan”

Sunday, October 16th, 2011

A birth plan has more than one purpose. It begins as a value clarification exercise, then becomes a communication tool with your care provider and ultimately a guide of needs and desires during labor, delivery and postpartum. Even if your birth location does not ask for birth plans, it is a good idea to write one for your own benefit.

Step 1

Clarifying your needs, wants and desires. Here are the  Birth Menu of Options and Assessing Your Feelings we use in class  to begin the value clarification process.  The birth menu is most helpful when you begin by crossing out what you are not interested in, highlighting the items you know you want and circling what you need to research. The AYF worksheet is for you and your husband/partner/non-doula labor support person to go over together to ensure you are on the same page and open up conversation. Doing this prior to 35 weeks of pregnancy gives you more time to coordinate with your care provider or birth location. If you have a doula or are taking a childbirth class, she/he can help you in this part of the process as well.

Step 2

Write down in order of labor, delivery, immediate postpartum and in case of cesarean needs and desires. Your plan really needs to be within one typed page for easy reading and digesting by care provider and staff. The only items that must be listed are care options that are outside of usual practices, protocols or standing orders. Here is the Sample Low Intervention Birth Plan we use to help you see a finished format and types of pertinent information that may be necessary to list.

Step 3

Take your written plan into your care provider. This is a conversation starter, a beginning, a partnering tool. As I encouraged above, early to mid 3rd trimester gives you more flexibility in communicating with your provider and setting your plan in motion. It also gives you opportunity to change providers or birth location if you cannot reach a comfortable agreement.

Step 4

Make any changes.Finalize.  Print out final copy.  Give one to care provider, have one in your bag for labor and birth, give one to doula (if you hired one). Though this is not a binding or legal agreement it can go a long way toward the type of care and birth you want.

Step 5

Gestate peacefully until labor begins!

Birth Plan Sample

Monday, February 28th, 2011

A birth plan is designed to facilitate communication between you and your provider, especially necessary if you are  birthing outside the home environment.  Secondly, it is to offer information on the individualized care you as the mother would like during labor, birth and immediately postpartum for you and your baby.

It should be brief (no more than one page) and only have the bullet point information that is specific to individualized care and desires not usually within your care provider’s standing orders or usual protocols of the birth location.

It is important to take a written birth plan to a prenatal visit at least a month prior to your given estimated due date in order to have a clear understanding of expectation and agreement. If it becomes apparent that you and your provider are not on the same page, this gives can give time to seek out another provider that fits you and you fit with. Remember it is not a legal document that your location of delivery or care provider must adhere to.

 =======================================================

Birth Needs and Desires for: _______________________. 

Care Provider:_________________.

Estimated Due Date: _________________.

 

Labor

I am planning on a no to low-intervention natural birth.  I plan on being mobile, lightly snacking, drinking orally, and having ___________ present.   I understand that intermittent monitoring of me and my baby will be necessary.  I want to be fully consented for any procedure that may come up and fully participate in the medical care for myself and my baby.  I understand that there is pain management available to me, I will ask for it if I so desire.

  • I plan on wearing my own clothing. I will ask for a gown if I change my mind.
  • I would like a saline lock in lieu of a running IV.
  • Limited vaginal exams after initial assessment.
  • In the event an induction and/or augmentation is medically necessitated-
    • Ripening – Foley Catheter instead of Cytotec (misoprostol), Cervadil or Prepadil
    • Pitocin – A very gentle and slowly administered dosage increase.
    • AROM – will only consent to if an internal fetal monitor is a must.
  • Spontaneous pushing and delivery in any position I am most comfortable with.
  • No cord traction or aggressive placental detachment, including deep uterine massage.
  • Delayed cord clamping for at least 10 minutes or until my placenta spontaneously detaches (baby can receive oxygen or other assistance while still attached to me).

Postpartum and Baby Care

  • Request that my baby is on my belly or chest for assessments and warmth (even oxygen can be given on me)
  • Delayed bathing
  • Delaying vaccinations including eye ointment and vitamin k.
  • Exclusive breastfeeding, no pacifiers, sugar water, or formula. I will hand express if necessary.
  • No separation from me unless absolutely medically necessary not just protocol.

Cesarean: In the event a cesarean becomes necessary and is not a true emergency requiring general anesthesia.  I would like to keep the spirit of my plan A to plan C so the delivery can be as family centered and intimate as possible.

  • Only essential conversation related to the surgery and delivery
  • Lower sterile drape or have a mirror present so I may see my baby emerge
  • Only one arm strapped down so I may touch my baby
  • Pictures
  • Aromatherapy as I desire for comfort, abate nausea and to mask surgical odors
  • Baby to stay with me continuously in OR and recovery
  • If baby must leave OR for treatment, my partner/spouse goes with baby and I would like my ____________ to stay with me so I am never alone.
  • Breastfeed in OR and/or recovery
  • Delayed immunizations
  • Delayed washing and dressing of baby
  • No separation from me except what is absolutely medically necessary

This “plan” may be copied, pasted and edited  for use by others.

A Birth Plan By Any Other Name…..

Saturday, May 1st, 2010

With the majority of women heading to the hospital to birth their babies, planning for the impending birth has become an important aspect of preparation in the United States (though the percentage of out of hospital births is rising).  Standardized, highly medicalized, non-individualized perinatal and postpartum care has really led the way to this being a need. Sadly for most women, attaining evidence-based and individualized patient care going into the hospital environment is not often simple or accessible even with a well thought out, communicated, and researched plan.

In light of the care women are likely to come across for themselves and their babies, below is a list of the common information that needs to be addressed during pregnancy for labor and birth  (for a comprehensive pdf, please email me at desirre@prepforbirth.com):

  • What level of care is needed – low-risk (the most common) or high risk
  • Eating and Drinking Orally
  • Saline-Lock, running IV or Neither
  • Fetal Monitoring – continuous or intermittent
  • Pain Management Options
  • In the event of Labor Induction
  • In the event of Labor Augmentation
  • Pushing and Delivery Options
  • Cord Clamping Options
  • Immediate Postpartum Baby Care, Assessments, Interventions & Treatments
  • Immediate Postpartum Mother Care, Assessments, Interventions & Treatments
  • In the event of a Cesarean
  • Infant Feeding Options
  • In the event of Mother/Baby Separation or NICU Stay

Once the information is gathered women are often urged to write it all down in document format.  The most recognizable term is Birth Plan. The very word plan though can be a stumbling block for both mothers and staffers alike.  It can come across hard line and lacking flexibility. Unfortunately, this can be construed by a staffer or care provider that a woman is telling them how to do their jobs or that she has very set even unrealistic expectations. Don’t kill the messenger here, that is really how it can be looked at and thought of by the medical professionals receiving it. I am not saying it is the “right” thinking.

The idea that the term “Birth Plan” may very well be outdated is intriguing to me.  Upon research, I have indeed found so many other ways to name this document.  I highly encourage a pregnant woman to try many different titles on for size to see what best suits her communication style and personality.

A birth plan by any other name list (please send me any other titles to add that are missing):

  • Birth Preferences
  • Birth Map
  • Birth Dreams
  • Birth Vision
  • Birth Wishes
  • Birth Needs
  • Birth Desires
  • Birth Wants

Be aware that whatever the document is called, it should be no more than a single page that speaks to the current practice culture in any given area. For example, if Cytotec (misoprostol) is never used for ripening, then saying it isn’t to be used is moot and can negate the other portions of the document to the reader because the reader may think the writer is out of touch with what goes on. Do the research on the birth location practices and protocols along with the care providers standing orders so the details are up-to-date.

By no means though should cookie-cutter care be what defines a woman’s options, desires or needs for her written “Birth Plan”.  Always discuss with care provider ahead of time. If a provider uses responses like, “You can try that but…”, “Just get the epidural because….”, “Why would you want to do that?”, “Having a natural birth doesn’t make you a hero.”, or anything similar, these are giant red flags. This could be the first insight that a woman and her provider do not share the same philosophy or idea of expected care. Red flag responses may very well be leading to a serious compromise to the provider’s desires no matter what is agreed to. Well crafted and designed lip service is how I see it. Please listen intently to the answers to questions.

Writing a “Birth Plan” is a valuable and pretty necessary undertaking when birthing in the hospital in my opinion and experience.

As a last thought, a “Birth Plan” document is not legal, but rather a communication tool and values clarification vehicle for a woman, her provider and the staff she will come in contact with.



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