Since we were talking about birth plans....

Specialties Ob/Gyn

Published

Specializes in Anesthesia.

So I thought I would post this here because I'd probably get the most honest feedback. My due date is this Saturday. My husband and I are really hoping for a natural, intervention-free birth, so we have decided to deliver at a birth center near our house. I really have no desire to deliver at the hospital and I'm going to try to do everything I can to avoid it. However, I know that there is the possibility that if I go extremely overdue and they need to induce me, that I will be required to deliver at the hospital. With that in the back of my mind, I have a few preferences that I wanted to run by you L&D nurses and see if they are acceptable or if I will be viewed as one of those PIA patients. All of my preferences are regarding AFTER the birth of the baby.

Barring any complications and/or medical indication that would prevent otherwise, my husband and I would prefer:

1. Baby be placed immediately on mom's chest after delivery

2. Newborn assessment be done with baby on mom's chest

3. Delayed clamping of cord until pulsation stops

4. Delayed weighing/measuring/shots of baby until mom is ready and/or mom has spent at least 20-30 minutes bonding with baby

5. Baby is to stay in room with mom at all times unless mom asks otherwise

6. No bottles or formula to be given to baby

Are any of these requests TOO far out there? I really don't want to be a "difficult" patient, but these are things that are very important to me and this is why I am opting to deliver at a birth center in the first place. How should I approach this subject with my nurse so that it doesn't seem like I am being pushy or confrontational? Any suggestions and comments are appreciated!!! Thanks in advance!!

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Specializes in student; help!.

If anyone tells you those requests are too out there, I'd find a different place to have your baby.

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Specializes in Anesthesia.
If anyone tells you those requests are too out there, I'd find a different place to have your baby.

Well, all of these things are standard at the birth center....so as long as I am able to deliver there, then I won't have to worry about anything. However, these are requests that I would have to make at the HOSPITAL if I have to deliver there.....that's what I'm worried about.

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Specializes in student; help!.

Except for the cord, I was able to have all that with my hospital birth. Not much help since you probably aren't going to fly up here for l&d, but our facilities are pretty conservative. So if I got to do it here...

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Except for the cord, I was able to have all that with my hospital birth. Not much help since you probably aren't going to fly up here for l&d, but our facilities are pretty conservative. So if I got to do it here...

Why was the cord issue a problem?

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Specializes in L & D; Postpartum.
Why was the cord issue a problem?

Sometimes there's a very short cord and if the mom wants the babe on her chest, cutting the cord would be necessary.

As to the other requests, at our hospital those would be honored if there were no problems.

Recently, we had a couple with a 3rd baby, big girl: 11 pounds +. Of course, she had 2 good sugar levels and then a bad one. I was the lucky nurse who got to go in and suggest a PC formula feed just to get the sugars up. The parents were very accepting of my explanation for why this was necessary. One of the Grannies, though, was not, and in a very derisive tone, said, "you're not really going to tell me that formula is better than breast, are you?" So I took an inaudible and invisible sigh to calm myself and said, "of course, breast is usually considered to be best, but in this case, if the sugar levels do not rise, that is a big problem for the baby, can lead to other kinds of problems later on, but would certainly lead to this baby being admitted to our NICU with an IV." That, took care of that!

And the parents, after all the visitors left, were very cool with it as well. The understood, and even apologized for the grannie's comment. Maybe Grannie will remember that and be smarter, just in case a friend's grandchild ever comes up against that same kind of problem.

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Your birth plan is exactly what our hospital does, except for the delayed clamping of the cord. Usually I take the baby to be weighed and measured when mom feels ready to get up and take a shower. That can take an hour or two.

Good luck with your delivery!!

steph

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Specializes in L&D,Wound Care, SNC.

Unless the baby is in respiratory distress everything you are requesting is standard practice where I work.

I hope all goes well with your labor and delivery!

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Specializes in Anesthesia.
Unless the baby is in respiratory distress everything you are requesting is standard practice where I work.

I hope all goes well with your labor and delivery!

Well, according to the lady who ran my birth classes, these things are NOT standard practice at the hospital where I will be delivering (if I have to go to the hospital). Apparently, after delivery they will hold the baby up to show you and then immediately take the baby to the warmer for all of the "standard procedures." Once all of that is done, they will let you have the baby until it is time to transfer you to the post-partum floor....then they take the baby to the nursery until you get settled into your post-partum room. She said that you usually only get to spend about 15 minutes with your baby during the first 3 hours......that's why I felt like I should write my preferences down and pray that the nurses will honor them....

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Nothing you ask for is unreasonable. I teach my clients to expect this unless they or their babies are sick. Our nurses tend to want to weigh and bathe babies early. It's hard to turn around, but I try. The dr's want to know weights for their dictation within about 15 to 20 min. I believe the darn bath can WAIT however. But we get busy and no one wants to have to bathe a baby later in their busy day.

One thing you should add: Skin to skin, baby and mom, after birth.I believe this is pretty critical to smooth transition, meaning, early neonate adjustment, blood sugar stability, bonding and early breastfeeding success. Let them wipe baby dry and place baby right on your naked breast, with nothing but a diaper on. It's really wonderful for both mom and baby.

I also teach my clients to ask the nurses to let dad either give the first bath, or participate. They learn this way, and get in on early bonding from the get-go. Yea, it slows things down a bit but the important thing to me is family bonding and learning how to care for the newborn, not my schedule. The dads LOVE this.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Well, according to the lady who ran my birth classes, these things are NOT standard practice at the hospital where I will be delivering (if I have to go to the hospital). Apparently, after delivery they will hold the baby up to show you and then immediately take the baby to the warmer for all of the "standard procedures." Once all of that is done, they will let you have the baby until it is time to transfer you to the post-partum floor....then they take the baby to the nursery until you get settled into your post-partum room. She said that you usually only get to spend about 15 minutes with your baby during the first 3 hours......that's why I felt like I should write my preferences down and pray that the nurses will honor them....

I would like to know more about what the birth classes taught you. Could you share via PM or here? I am a new birth instructor and learning. Also, remember, it's ok to challenge routines, as long as you are not confrontational or unreasonable. And the things you ask are far from unreasonable.

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Specializes in Community, OB, Nursery.

I don't think any of your requests are out there at all. 99% of people who want that at my place get it too, and we are a big teaching hospital. The 1% who don't get it, it's for reasons like the ones listed earlier...short cord, low blood sugars (which we only do under certain circumstances anyway), and we encourage rooming in. Nothing in there sounds unreasonable.

ETA - good luck to you, wish you a very happy, easy delivery! Keep us updated. :)

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