Do you guys read birth plans?

[dawngloves]

I'm putting together a birth plan to give my OB in a couple of weeks. I had one for my first, but I never had a chance to give it to my OB when I PROMed @ 36 weeks.

So I'm wondering, would I be wasting my time and paper? I do want to have things explicitly known by the nursing staff, like no e-mycin gtts, no bottles, ect.

I know I read living wills on charts, but that's a differnet slice of cake.

Thanks for any feedback!

[mother/babyRN, RN]

YOU are also a man and whether you like it or not (or should I say, whether WE like it or not, a man, controlling or otherwise, is going to relate to another man and his issues, if he has any)..I have read earlier that you and your wife enjoyed a good experience and that is totally wonderful. Believe it or not, no one here as far as I can determine, has said that every experience that has to do with a birth plan, is negative BUT you seem just a teensy bit defensive about it...HUMANS fear loss of control. Lets not limit it just to nurses AND one can still be judgemental and still be caring. One just has to work on the judgemental part. Reading between the lines of your last post makes me feel that you are at least a little judgemental with those of us who may disagree with your point of view on birth plans. Don't make the mistake of assuming that just because we may dread them (and men DO attempt to control female nurses in ways they usually do NOT attempt to control male nurses), we treat birth plans with less respect than not...We are allowed to talk about the experiences that don't go so well, because not all can go well. In a year with say, 30 birthplan couples, roughly half go mostly as they would like. The vast majority do not result in disaster, but when they do, they do it in a big way...I don't know that I was actually offended by your last post, but it did imply to read between the lines..I am really grateful that you are one of the only nurses in OB that I am aware of that has a great success with birth plans in general, however, losing control has nothing to do with my personal opinion of birthplans when it comes to eroneous or unreasonable ones, as when the dad speaks for the mom, or refuses to allow her to be given pain medicine. SHE is in charge of the labor and delivery deal even though he may be the dad, he is NOT going through the process anyway NEAR the same level as she is....May you forever have successful experiences with birthplans which come your way...When there is a controlling partner to the degree described in my (and others which followed), that is not a partner to a reasonable and workable care plan-that is a partner to an abusive relationship. Fortunately, those sorts of types are few and far between....(Thank God )....

[mark_LD_RN]

to mother baby rn you sound very biased(as related to gender), being a man has nothing to do with it and i highly resent that statement. a couple where the man is controlling everything would not like me, i have had some and they do not like to confront me. they usually request another nurse because i let the women have the last word during birth. I have never once refered to a man controlling the birth for the couple, it is a joint effort .you have surely seemed to forget that! I have great experience with couples and their birth plans. nurses who fear bbirth plans or go into it with the thought of failure is the problem, admittedly not all of the problem.

i really would like you to explain how you could possible get any gender issue out of my reply! Remeber females are not always open minded or correct either.

It is a shame many nurses feel birth plans are a joke and are unreasonable. i speak from personal experience many of the nurses i work with feel the same way. that is why i voluntarily take the couples with birth plans when possible.

if you treat the couple with respect and gain their trust instead of prejudging them and dooming them to failure,I have found that they all will allow interventions if it would prevent harm to mother or baby. lets be a little more open minded . by the way I have had ones go bad and never had a couple refuse intervention when absolutely needed, i inform them and let them retain some feeling of control.

I know some feel i dont have a right to speak on this because i am male ,but they are wrong. It is the hardest thing i ever had to do in my life, to help my wife with 4 pregnany for 9 months and then to watch her go through birth. you do not know what is like to watch someone you love more than life itself go through pregnancy and birth and know it is your child she is carring and birthing for you.

our birth plan was written by her and it was her wishes, (she is by the way an rn also). at one point during the last birth i begged her to take a little something for the pain to which she refused,so i honored her wishes.

birth plans can be a wonderful thing i just ask they be treated with respect and not laughed at, the couples mean well and do the best they can. the medical profession is not always right, america has the highest technology and interventions for birth but we still rank near the bottom in outcomes,maybe it is time to rethink some of our stratergies.

All of what i said here is from personal experience from nurses i work with it is not to be infered to be against anyone here.

i like birth plans in general and that is just my opinion,thanks,mark

[shay]

Mark, grab a big sack of granola and pull up a bean bag, honey, 'cause the church of the painful truth is now in session.

You need to get a grip and get a clue, and please, for the sake of all of us involved here, put the incense down, extract your head from your rectum, and walk with me into the plane we all know as reality.

While I'm sure that in happy-happy-land or wherever it is that you practice nursing, birth plans are always reasonable and natural childbirth always succeeds. I am so happy for you that you have neeeeeeever had the experience of caring for a couple so focused on 'the plan' that they couldn't see the forest for the trees. I am so happy that you have never encountered a couple who willfully and deliberately went against medical advice because to do so would deviate from 'the plan.' I am thrilled that you have the magical powers to cure such controllable things as thick meconium and cord prolapses simply with your open mind and positive thoughts. Too bad poor mother/babyrn 'doomed' her couple by thinking her evil, negative thoughts and caused that cord to prolapse and that baby to release its' bowels in such a forceful manner. It seems she is not blessed with your gift. I am so happy that you have never seen a baby get sick, injured, or die because of their parents' unwillingness to deviate from 'the plan,' like so many of us have seen. You are truly fortunate.

However, on my planet, and on the planet of just about everyone else here, things go wrong, even with the best laid plans and the most supportive nurse. Things go wrong, without warning, without reason, without cause. Babies get into distress. Babies die. Mothers die. And no amount of positive thinking, open-mindedness, meditation, incense, granola, or what have you could stop it. That, my dear, is how things work in the real world. While we love when natural childbirth works well, what we don't love is when 'natural' childbirth is either forced on a woman by her husband or significant other, despite her crying and pleading for help, or when a baby is dying on the vine but you cannot do anything to save it because its' parents are so focused on sticking to their precious plan. What we don't love is when the couples we are trying to help approach us and labor as if it was war....mommy and daddy versus the evil nurses and doctors. What we don't love is when people speak to us as if we are stupid, like we actually enjoy having to use major interventions and technologies simply for the sake of using them.. not because they are necessary to sustain life.

And finally....mother/babyrn came here to vent her frustrations, to talk with her peers. If her opinions of the couple she cared for offended your delicate sensibilities, that's just too da**ed bad. Suck it up and BACK OFF. She has the right to voice her opinion, and she has the right to think and feel and say whatever she wants here. It doesn't make her judgemental, it makes her human. Maybe one day we can achieve your divine level of perfection, but until then we will all have to just hope that one day we are as fabulously blessed as you.

Church is now dismissed.

[Hardknox]

And furthermore, Mark, the day a man expells a baby from his body I will agree that birth is a joint effort for the couple --as you so inaptly put it.

[shay]

Originally posted by Hardknox

And furthermore, Mark, the day a man expells a baby from his body I will agree that birth is a joint effort for the couple --as you so inaptly put it.

HIGH FIVE, SISTER GIRL!!! ROCK ON!!

[mark_LD_RN]

to shay and hard knox you both sound very defensive, even hateful, could it be you are so upset because i am male? My head is not in my rectum shay but your old head most definitly is. You obviously have got something out of your rectum into your ears.I am not in a dream world AND NOT ONCE DID I SAY THINGS NEVER GO WRONG. I said that once you earn their trust and respect they are more likely to do what you ask.

Shay I never meant to offend anyone just my opinion just like you and mother baby rn did. I only said i was offended by her referal to the male (gender issue) she said it was because i am male. In real life a husband that is as controlling as she said would not want me around, they avoid conflict and cant control me, i also annoy them because when i see one like that i always take the mothers side.

hard knox I do not have to expell a baby from my body to know about birth. You do not know what it is like to be the husband of a women you love more than anything in the world in birth, to spend 9 months helping and worring about her, or to watch her be in pain etc. For all of your information it was my wife who gave birth and it was her that decided not to take pain meds. at one point I had begged her to take something but she did not want to so i did as she wished. by the way she is an rn also not just some hippy as you seem to like to think.

if i offended mother baby rn I am sorry it was never meant to be. CAN YOU SHAY AND HARD KNOX BE AS GROWN UP AND APPOLOGIZE FOR BEING FAR MORE UGLY AND INSULTING THAN I EVER COULDBE!

[shay]

Ahhhhh...I see your delicate sensibilities WERE bothered. Well, Mark, if you think that defending mother/babyrn and her right to vent is unproffesional, so be it. You also think her feeling the way she does is 'judgemental.' Into thought crimes much?

And you most certainly DID imply that nothing ever goes wrong with your precious birth plan couples. Instead of saying something like, 'I'm sorry that happened to you, mother/babyrn. I on the other hand really enjoy taking care of birth plan couples. It's horrible that you had such an awful experience,' you condemn her for having a 'negative attitude.' Puleeze.

So no, I don't owe you any apology. And in the future, don't pm me nastygrams. Just say what you've got to say here, in the public forum, or don't say it at all. When one of our own needs support, she's going to get it as far as I'm concerned. You can stay in your ivory tower with your perfect nursing model, but for me, I'm going to support my co-workers and validate their frustrations instead of condemning them.

[mark_LD_RN]

Shay , you are a very twisted hateful biased individual. and closed minded at that. I defend her right to an opinion just like anyone else. I am in no ivory tower and did not say non of my birth plan cuples go bad.i support al my coworkers weather or not we agree. YOU are a very ugly person to take and say such ugly untrue things about someone you dont even know. i did not condeem her for her negative attitude ,I simply stated what i have seen in several hospitals i work at. if mother baby has a problem she can let me know we are adults and should be able to discuss things as professsionals. unlike you whoo has to explode and belittle and insult one with a different view and one which never meant to insult anyone. I simply stated that my birth plan couples do better than most and feel a possitive attitude and a trusting relation ship go further with the couples. they deserve to be treated with respect.

the only part of my delicate sensibilities that were offended is you insinuating i dont know what i am talking about because i am male, and that i had my had stuck up my ass. the only one here with their head stuck up their ass is you the great and mighty nurse shay,.goddess and defender of all females.

you need to learn to behave like a professional and treat others with such. and again to mother baby rn, i meant no offense to you, and am sorry if you took it that way.

i see shay is not big enough to apollogize for her inappropriate outburst. she has obviously said it with malice. maybe you just been a nurse to long or something.

[Hardknox]

I merely stated a fact. The woman goes through the pain of labor. The man does not. There is not a gender issue---it is a biological fact. Do you mean to tell me when my husband had a brain tumor removed it was a joint effort at his surgery just because I supported him , encouraged him, and took care of him post op? I think not. There is no need to get nasty and play the gender card.

And, like Shay, I do not want anymore pm nastygrams.:kiss

[canoehead, BSN, RN]

When I get a couple with a birth plan I try to conciously relax when I go in the room and make a point of discussing their wishes on the first meeting. I bring up any concerns I might have and ask if they have talked to their MD about that part of the plan. Then I say something like if "thus and such" happens then we will do this because....how does that sound to you?

They usually are OK when they know that we will deviate only if there is a threat to the baby or mom. And I make a point of going through parts that I think are great, like showing them the squat bar, or explaining how we will tackle the monitering issue. I go in with the idea that we talk about what they want...and if they refuse to talk I need to explain that I am part of the team and need to know the plan if something happens that is not included in the written birth plan, so I can follow their wishes. I've never had an issue that couldn't be resolved, although I may be just lucky.

I know nurses that go in and explain "it is policy that..." have less success because they don't tell them the "why" for the policy.

And couples are almost always disappointed and angry when things happen against their wishes, but I make sure to talk with them after the crisis and say it's too bad things didn't go their way, do they understand why we deviated from what we had agreed on?

I think alot of the more inflexible plans are the product of an inflexible system at the last birth. So if I show we will work together things get alot easier on both sides.

[Jolie, BSN]

I absolutely do not have a problem with "birth plan couples". I have assisted with and witnessed many beautiful births by well-prepared mothers and their partners.

My issue was that a father threatened me because I refused to follow HIS, not his wife's wishes, and refused to provide sub-standard nursing care (denying REQUESTED pain medication).

I have seen too many parents get so caught up in their birth plan that they can't see the forest for the trees, and forget that the ultimate goal of the exercise is a healthy mother and baby. I've had parents refuse a transfer to a tertiary care center because they didn't want to give up the Jacuzzi and entertainment center, for God's sake!

[mark_LD_RN]

well hardknox a brain tumor and birthing a baby are quite different things and situation. and according to jcaho we are to care for the family as well as the patient. but with birth it is a joint effort for most couples.sorry you do not see it that way. but i guess you can not see from the other half of the couples side. admitted not all couples are like this.but with a normal couple you dont know what the man feels and as usual you could probably care less about him( to quote an earlier post "because this is the one area women still control").

I only took offense to the gender issue and bring it up because you did. I do not see it as a prequalification to have an opinion. and definitely do not like to be made fun off or insulted tag team style as you and shay have choosen to do. as for the pm if you don,t like them dont read them,was not trying to be ugly just trying to clarify my point to be sure you read it.

this is supposed to be an open forum not an insult the other or lets gang up on the different person area. lets keep an open mind and be professional. as hard as that my be for some.