August 7, 2007

A labor nurse birth plan

I decided I'm working on a birth plan. Yes, it's early, but it doesn't hurt to be prepared. It seems that anytime a patient comes in with a birth plan, they end up with the things they don't want and their delivery culminates in a c-section. The more detailed, the greater the likelyhood things won't happen the way they plan and more likely they'll have a c-section. I don't know why that is. I think part of the problem in my area is people don't discuss their birth plan with their doctor. My worst experience with a failed birth plan was a couple years ago. This mom wanted no intervention, no pitocin, no internal monitors, no offers of pain meds, and absolutely no epidural. Seemed reasonable. But, her labor went on, and on and on and on for 2 days. She was ruptured and beta strep positive so she was admitted. She had changed her cervix a couple centimenters over the 2 days, so pitocin was started. She ended up direct fetal monitoring, an epidural and a c-section on day 4 after 6 hours being at 10 cm and after spiking a temperature. Baby also had a rough start and spend a day in the nursery on monitors, IV antibiotics and such. She obvioiusly did budge, but was very inflexible. I do think every pregnant woman should have a plan, know what they want and don't want, with each pregnancy. But, I'm sure there are other L&D nurses who will agree with me, you should be flexible. Anyway, back to my birth plan:

1. I want lots and lots of Magnesium Sulfate.
2. I'd like to have an emergency c-section without anesthesia due to a uterine rupture at my
old incison site. (yes, unfortunately, we have done c/s sans anesthesia, luckily not often)
3. If I dont get a emergency c/s and can VBAC, I'd like an episiotomy with a 4th degree
extension, please.
3. I also would like to be tethered to the bed for the duration of labor with internal monitoring.
4. I desire lots and lots of cervical checks
5. I also would like my baby taken from me straight away for at least an hour so it interrupts
with breastfeeding and bonding.

That's all I've got so far, but I think it hits the highlights. Maybe with this plan, I could have a nice, smooth vag delivery without complications.


AtYourCervix said...

You're so funny! Maybe the birth goddess with look in your favor, and grant you the opposite of everything you so desire.

My birth preferences were simply stated: intermittent auscultation after initial reactive NST, ambulation, no IV unless medically indicated, hydrotherapy and position changes, avoid pitocin before and after delivery, don't offer pain medication, non-separation of mother and baby, exclusive breastfeeding. *NOTE* Knowing what I know about L&D and how it can change very quickly, I am very flexible in these preferences.

Needless to say, everything went well, and my preferences were respected and were achieved. I also had midwives, and had them review my birth preferences beforehand. I also managed to arrive in L&D at 6cms :-)

Midwife with a Knife said...

I love the anti-birth plan! :)

Anonymous said...

Oh, and could you please give me too much fluid by opening the drip on the IV, I love shaking and having heart palpatations and just generally feeling anxious. Oh, and if you do decide to let me labor don't look while my meconium baby bounces on the bed. It's more fun that way...but for some reason I will go ahead and claim a doc's name for delivery on the birth certificate though I delivered the baby myself (sort of) on the hospital bed. Could you just give me that after birth pit, but still take my uterus? Tie both tubes before you do that! Please!