At my last appointment I brought in the following draft birth plan. That was when the doctor told me about the likely early induction (due to gestational diabetes) and of course now my birth plan will need to change. But I wanted to share my original thoughts.
*If no medical complications arise, the following is my birth plan:
• Allow in delivery room: my spouse, doula, my mother
• Planned delivery: vaginal
• Stay hydrated with clear liquids and ice chips
• Eat and drink as approved by my doctor
• Intermittent fetal monitoring while I’m still mobile
• Heparin or saline lock rather than an IV
• Pain relief: Demerol at first and Epidural when requested and possible
• As few interruptions as possible
• As few vaginal exams as possible
• Hospital staff limited to my own doctor and nurses (no students/residents/interns)
• No labor augmentation
• Not be reclined
• Use foot pedals for support
• Continue Epidural
• Use a mirror to see baby crown
• No forceps usage or vacuum extraction
• No episiotomy
Immediately After delivery
• Cut umbilical cord only after it stops pulsating
• I would like to see the placenta before it is discarded
• Hold baby and attempt to breastfeed
• Keep baby in my room at all times
• Baby’s medical exam given in my presence and/or my spouse’s presence
• Please don’t give baby formula or a pacifier
• Breastfeed with the help of a lactation specialist
• Baby’s first bath given by myself or my spouse
• Circumcision performed by my doctor
If C-section is necessary
• Exhaust other options first
• My spouse to remain in the room the entire time
• Stay conscious, use epidural
• Explain the surgery as it happens
• Hands free so I can hold the baby immediately
• Breastfeed in the recovery room
I was expecting to go into labor naturally and labor at home for as long as I could stand the pain so I could eat and move around and be more comfortable. Being induced means I’ll be strapped to the bed the entire time with the IV full of medication and of course an epidural, cause there’s no way I’m doing pitocin contractions naturally. I was expecting to have the contractions start out bearable and gradually increase, and maybe have my own pain tolerance increase with them, but that won’t be the case with induction. Pitocin contractions come hard and fast, period.
The doctor said they don’t allow you to eat because your stomach needs to be empty should a C-section be necessary. I thought that was due to anesthesia but he said it was because there is a risk you might aspirate if you throw up. Ok, got it, no food. But he said I can have glucose and clear liquids, so Gatorade is going on the packing list.
On a lot of these medical intervention items – like forceps and episiotomy (where they cut you down there if you’re not stretching enough) he said that I gotta trust his judgement. I’d rather have a small tear than a large cut, but sure if that isn’t even possible then yes if necessary, cut. I guess I should add the word “routine” to some of these. Hopefully my doula will be able to help facilitate the conversation so that the doctors and nurses aren’t making decisions without my input.
I’m wanting most of the stuff done to the baby to be at least in my husband’s presence if I’m not able to participate. Hopefully the nurses will allow that. Doctor said I won’t want the baby in my room the entire time, but it is hard to feed on demand when the baby is kept away. I don’t want them to give him formula or a pacifier at least until breastfeeding is established. But I might change my mind as exhausted and out of it as I will be at that time.
I’m also told if I end up having a C-section, I might be in the hospital up to 5 days. That doesn’t sound fun, but again, I might feel differently. I need to check with my insurance and find out the coverage details in that situation.