Since we were talking about birth plans....

[WVUturtle514]

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!!

[LDRNMOMMY, BSN, RN]

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....

That's too bad. The place I used to work at was a lot like that. Family centered care....NOT! The only reason I would take baby to the warmer right away would be for respiratory distress or if mom requested that we dry the baby off first.

[SmilingBluEyes]

I think being in LDRP helps us. Mom and baby are not moved from their room and the same nurse continues to care for them as a couplet after labor. There is no good reason to separate parents and child unless health conditions make it necessary. But on units where LD and PP are separate, I have heard and seen this exact thing happening a lot. Seems the baby winds up in the nursery while mom is moved, having footprints, bath and weights done. It's a matter of routine on extremely busy units where time is critically short.

Give me a smallish community LDRP any day. I have done both. I just prefer this.

[SmilingBluEyes]

Also discuss your preferences with your health care provider. Sometimes, they will ask nursing staff to respect them, as well. Just as I said, be as non-confrontational and reasonable as you can. Most nurses want our patients happy and safe. And we really do want to make your birth experiences pleasant. Unit routines are tough for us sometimes, so we get "caught up". But you are not asking for anything earth-shattering and they should try to honor your requests.

[ILoveRatties]

If the baby is hypoglycemic, there are alternative ways to give formula than a bottle.

Nipple confusion is real. When it happens, it is a royal PIA. Best to prevent it.

[Neveranurseagain, RN]

You need to visit or call the hospital that you would be transferred to if needed and ask them your questions. And you do have the right to refuse things--just be assertive as heck if needed. The nurses tried to take my babe away "for a few hours of observation" but I refused, saying I would stay awake and watch her my self. I told them she was not to leave my room unless medically necessary. I had them bring in the scales to my room for wt and measuring. She was bathed by the nurses in my room too.

Sometimes, esp in busy units, nurses get caught up in routine and forget pt's are individuals and not everyone needs to be treated like cows moving thru a cattle squeeze (yeah!LOL I'm from a rural area!) So stick up for yourself and be expected to receive dirty looks and comments but just don't take them personally and thank God you don't work there!

[HeartsOpenWide, RN]

I would say, as long as there are no complications (i.e. doesn't need resuscitation) these are reasonable requests. (Or if the cord is too short...some times the cord is too short to be placed on mama's belly without cutting it first)

[cmonkey]

Why was the cord issue a problem?

They wanted to suction her for mec, so they cut it immediately. I'd argue the extra O2 via the cord is worth keeping, but it all happened so fast I didn't get a word out.

[kalley]

Given that it the birth isn't complicated I don't see how these requests would be too much. Call the hospital and see if your request would present any problems. Make sure you let your midwife know of your preference ahead of time too. She will most likely go to the hospital with you and will be a good advocate for you and has some sort of report with the staff if that is the hospital they generally transfer to in emergency situations. Best of luck with your upcoming birth. It will certainly be one of the most special events of your life!

[Pelham]

Just remember the important thing is to have a healthy baby. Everything you ask for is reasonable.The cord clamping and cutting is usually done so automatic that no one ever thinks about it. The major KEY is to have open communication with your nurse.As a LDRP nurse, if the patient is sweet and talks with me about why these things are important to her(not just read off the internet and sounds good) I try my best to do whatever makes her happy barring unsafe practice for her or baby.

Good Luck..

Let us know how it goes.:redbeathe

[SmilingBluEyes]

We use cup feeding if formula is needed to stabilize blood sugars. The only time we will use a bottle is if the child's sugars are hitting the basement and won't take the cup. It's either that or an IV, which most parents feel is worse than a bottle.

[dylansmama]

I also had these "requests" for my birth, but expect the unexpected!! I had a midwife, and a big 'plan' for natural, bla, bla, bla.... needless to say, it didn't work that way, and at the time YOU WILL NOT CARE! In my future pregnancies, I will have faith in the facility & God and just go with the flow. I understand where you're coming from, but I have never heard of a birth plan going as 'planned'.

[WVUturtle514]

I also had these "requests" for my birth, but expect the unexpected!! I had a midwife, and a big 'plan' for natural, bla, bla, bla.... needless to say, it didn't work that way, and at the time YOU WILL NOT CARE! In my future pregnancies, I will have faith in the facility & God and just go with the flow. I understand where you're coming from, but I have never heard of a birth plan going as 'planned'.

Well, I don't really consider this a birth plan. These are merely my preferences for after the birth, assuming of course there are no complications. And these requests will only matter to me IF I have to deliver at the hospital, which again, unless there is a complication I do not plan on doing. At the birth center going "natural" is my only option.....so unless a complication occurs and I would need to be transferred, then I will have no choice in the matter...