I was reading around, and saw quite a few posters who seem to think kinda badly of birth plans, and just curious as to why? Is it because the patient made one, or because some/all of the requests were unsafe or just plain stupid? I made a birthplan for my daughter, but all it really said was:
*NO ONE was to take her anywhere without either my husband or myself.
*If complications arose that I wanted her safety to take priority over mine.
*No forceps (I saw horrible pictures of babies who had these types of deliveries, and it terrified me!), but vacuum was ok if nessisary.
*NO ONE was to ASK me I wanted pain meds- I wanted to do drug free, and thought that if I had someone ask me, that it might have been too easy to accept.
i really love birth plans.. esp from people from diffrent cultures.. i just don't like birth plans today .. but i bet i will love them again tommrow.. i just really love babies ..
Birth plans are fine--to a point. Being realistic helps. So does having a fair understanding of actual L&D conditions. Or in the absence of that, being willing to learn and discuss things rationally can go a long way. But the biggest plus is being able to accept that plans are only that--plans. Reality sometimes rears its ugly head and plans get set aside.
Trust is another factor. If you come into the hospital with a birth plan that says you view staff as the enemy and any intervention as a weapon to rob you of your "birth experience," that could be a problem.
Free-standing birth centers or, under certain conditions, a home birth might be a better option for someone who wants to have every detail approved in advance.
Granted, there are docs, nurses, and facilities that are too aggressive with interventions, but that is something that should be determined long before it's time for the actual birth. If you feel you can't trust your practitioners, keep shopping until you find someone your feel more comfortable with. It's easier to switch docs than get locked into some kind of power struggle.
It's difficult to work with parents who are so focused on the journey that they sometimes lose sight of the destination. A plan should be a list of desires, not an edict of demands. Soemtimes the goal can be met by a different method. Flexibility is a virtue and a necessity when birth is the subject.
I think her plan is perfectly fine. She wants a healthy baby, she doesn't want anyone stealing it, she doesn't want forceps marring it, she wants to be au naturel.
I guess it should be told to the pregnant among us that their wishes will be honored if at all possible but that safety must come first.
I still resent that not a single one of my desires was honored. I had a C Section with my last and didn't want him to get those stinging eye drops and had it in writing. He didn't pass through the birth canal, couldn't pick up germs I didn't have anyway, and I had refused the drops. They instilled them anyway. Don't tell me about state law, either. Parents can refuse them for their children.
I was refused my placenta. I should have raised a ruckus but was tired and afraid and nauseated and acquiesced. I still resent it. It was mine and I had a right to it.
My PP nurses were, I'm convinced, skimming my pain med and/or my #$@^ doctor didn't order enough or the right stuff. I think he had me on Toradol, for God's sake, after surgery - with a real knife and real incision and real pain. I had thought it was Demerol but doubt it. I felt much better when we switched to Percocet on POD 3 and I was finally getting the narcotic analgesic I needed. I told the doc and he looked at me like I had 2 heads.
My PP nurse wanted to rip my IV out right away and not give me the remainder of the IV fluid I needed to replace the CSF I'd lost during the spinal but I refused to let her do it and she got mad, no one would help me to the bathroom the first time I needed to get up and I felt very faint (I should have just peed the bed but they'd probably have left me lying in it for hours), the night nurse slammed into my room in the middle of the night to shove some empty Isolettes into the unused portion of my room for storage, I let them talk me into a circ and have regretted it ever since, they wanted me to sign the circ permit while doped up on my pain Rx, I developed a killer spinal headache and my idiot nurse refused to call the doc - I wound up calling the DON's office and the doc's office myself, as I was in agony. My father got angry that I asked him to go out so I could nurse, my husband decided to freak out over becoming a father while I was in labor and he was unwilling/unable to "be there" for me, my friend from work didn't want to leave the room while they did pelvics on me and I was embarrassed, the midwife was mad when I opted for a CS in lieu of continuing to try to be induced, and I was required to pick up my baby myself when I had been sliced open and was fresh post-op, as I had no one to stay with me and the nursing staff apparently were all deaf and could not hear my baby screaming his head off. When I decided to keep him in bed with me in order to avoid the lifting, the nurse told me I couldn't do that because "the doctor doesn't want you to". I told her the doctor could just jolly well stay with me to hand him back and forth. She shut up and left.
A lot of what I have related is not apropos to a birth plan question but it does show how seemingly little things can add up to a very hard and trying experience. Add hormones to the mix and learning to nurse or an episiotomy or other troubles and you can have a real mess.
Oh - at the time, Dr. LeBoyer's method was in vogue and I had written down that I wanted this approach. Ha. The delivery room was as dark as high noon in the desert. It was as quiet as a locomotive and as peaceful as a tsunami.
I think birthplans should be looked ay like maps. there are more than one way to get to the goal,, but we want to take the same route as the parenys want.
I think however policies and protocols get in the way. Jacho standards require us to assess pain, try to get rid of it, do interventions. granted we can state patient preferes not to be asked about pain, or offered pain meds. patients have had very intensive birthplans and the doctor has kept to their plan giving them risks and benefits if something bad happens they can still sue. Bad things can happen real quick. even with an IV you can bleed out in minutes (usually doesn't happen but could.
i read my post and realized how horrible it sounded. i have 6 kids w/ one set of twins that are 2 now.. i understand completely how she feels. i did not have a birth plan because i honestly never thought of it. i deliver very fast and i'm out in 24 hours.
Anyone else have the "birth plan phenomena??" Gosh, more times than not, when a mom presents with a birth plan (no matter how reasonable or ridiculous)...THIS mom will have everything happen to them and then some and end up with exactly what they didn't want. I will admit, I have become jaded over so much time that when I see a birth plan, I automatically put a c/s chart in the front pocket to ward off evil spirits.
Some people just have outrageous expectations, and really just read what sounds fabulous from assorted websites and think...this is what I want, with no regard to reality. I don't get up and go to work with the plan to not give my patients a great birth experience. I DO, however, want my patients (both mom and baby) to be well....regardless of what is written on many sheets of paper and considered law.
We just had a birth plan mom (a very extensive birth plan. as a matter of fact) that ended up breech and was scheduled for surgery. Her birth plan dictated that she not have a foley, that the drape be lowered so she can see the baby come out of her abdomen, and so the baby could be put on her breast so she could breastfeed. She didn't want the cord cut right away..the list went on and on. I had to read it again, because I swore she was talking about a vag delivery...but no, this was her birth plan for her c/s. In my institution, c/s are done in the main OR (we don't have OR on our L/D), and cases are totally packed in and there was nothing on that list that could've remotely been accomodated.
I guess I just don't get why most things have to be in a "plan". The plan isn't a binding contract anyway so why not just tell the nurse what your wishes are. If your list is so long that you need to write it, chances are the staff are going to forget some of it anyway. INMHO. Babies aren't predictable beings anyway so the rigid planning down to the minutia is kind of ridiculous anyway. (I am not talking about those who don't have mile long ridiculous demands).
I just dislike the adversarial ones that make me sound like some evil servant ("the nurse WILL NOT do this... the nurse WILL NOT do that" half of the time talking about things we never do anyways). I've always responded much better to polite requests.
Any birth plan that is polite and reasonable is fine with me.
Elvish, BSN, DNP, RN, NP
4 Articles; 5,259 Posts
We all have those nights, kizzy. We have all had those patients too.