The most ridiculous birth plans you've had the pleasure of reading

Specialties Ob/Gyn

Published

I don't know when I became so jaded- I had a birth plan with my son...every single thing went the opposite of what we had wanted (induction, ITN with subsequent pukefest and finally stat section for non reassuring heart rate and suspected chorio). But when I see that a patient has a birth plan I cringe! Maybe it's because every couple I've encountered with a birth plan have turned out to be the biggest PITA's I've had to deal with as patients- this last couple...sheesh, the dad interrogated my every action as though he thought I was going to hog tie his newborn daughter and assult her with formula and vaccines.

Their birth plan read as though it was copied out of a book...one of those ever popular "the medical industry and hospitals are EVIL and nurses are bullies and will bully you to do everything you don't want to do!!" Why are nurses and hospitals getting demonized so much? Do they really think we went into nursing because we like to harm babies and mothers and pi** off patients?

Ok, back to the birth plan thing: I've read plans that state "We require a private room" (good thing we have private rooms). "We demand immediate skin to skin and breastfeeding initiation" (gee, I was looking forward to poking your baby and letting him/her starve). "We do not want ANYONE in our room during labor except our accupuncturist and chiropractor".

I suppose these "requests" are not totally unreasonable, maybe it's just the way the plan is worded, and the defensive vibe I get from the patients who copy them from a book or author them themselves.

Specializes in Public Health, L&D, NICU.
I am not afraid, I'm cautious. There's a difference. If I'd had my son at home as I had planned, he would have died without a doubt, and I had a picture-perfect pregnancy and labor with no risk factors. The delivery is where things got very scary, very fast. I was thankful for the NICU team who resuscitated my son and saved his life. Yes he was sick and I had to leave the hospital without him but he's alive and well today because I listened to my gut and chose to play it safe and switched my care from a midwife to an OB/GYN and delivered at a hospital with an excellent NICU.

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I'm also a labor nurse who seriously considered homebirth. If we're so great, why did I consider it? Much as I love my coworkers, I was embarrassed about the idea of delivering in front of them. Also, due to some medical issues, I cannot have an epidural or spinal, and I thought a midwife could help me with natural childbirth. The vast majority of the patients where I worked had epidurals, so natural labor was a rarity. Not that it was pushed on them, on the contrary, this was the demand of the patients. I sought out a midwife who would assist me, but I changed my mind. Part of it was the iffy legalities, I live in a state where homebirth is a risky proposition legally speaking. When the midwife told me that if something went wrong she would, in her words, "dump you at the doors of the ER and never acknowledge that I knew you" I had some serious doubts. Don't get me wrong, I didn't have a problem with her attitude, because I knew if she attended me at home (or at a hotel, as was her usual practice) and it was found out, she could go to jail. So I stuck with my favorite OB at the hospital, and my birth was definitely a nightmare. He and my nurses did everything I asked of them. I was able to sit, walk, rock, get on a birthing ball, and reposition at will. But my baby had other ideas about my plans for a calm, natural, lady partsl delivery. My nurse had dimmed the lights, I had music, she massaged my back until I'm sure her arms were about to fall off. She fetched ice, she put cold cloths on my forehead, she encouraged me. My OB suggested a cesarean around 2am. I refused, and he said, "Ok, great, I'll be back in an hour and we'll see what's happening." By the time the hour was up, I was begging for a cesarean. I had that awful bone-on-bone pain of CPD. The baby was also having huge decels. My fears about being shy and embarrassed flew out the window. I'd have walked down the halls of the hospital naked if that was what it took to get that baby out of me. I was in agony. I hopped onto the OR table under my own power, while being gently scolded for not waiting on help. My precious child coded at delivery, and luckily, because I was at my hospital, he had a nurse practitioner, a nurse, and a respiratory therapist all to himself. Good thing, because I hemorrhaged due to uterine atony, so my nurse and OB were a bit busy dealing with me. My husband was brought into the OR even though I was under general (very unusual) because things were getting serious. We were both fine, thankfully.

I don't know how my delivery would have gone if I had chosen to do it outside the hospital. No one will ever know. But I feel like I got amazing care, and, though I sometimes feel like a failure for having a cesarean, I never blame my OB because he was happy to let me decide. I'm sure if the decels had gotten deeper and more persistent he would have urged me in that direction, but it didn't come to that. I'm just glad that I had the option of the section, and the team there for the both of us.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

@monkeybug I did my clinicals during the LVN program in L&D, I remember it was such a great place. Unfortunately the hospital only hires RNs. But I remember I had the most fun in L&D than any other place I had clinicals.

Specializes in Skilled Nursing/Rehab.

I just want to say that I have immensely enjoyed reading this thread! I am still in school and I have an interest in NICU/L&D nursing. I still have that wide-eyed notion that birth is a miracle and I want to be a part of it! Not sure I will actually end up working in this field, but this thread was very educational to me. It allowed me to see a wide range of ideas and beliefs held by L&D nurses.

There are 2 hospitals and no birthing centers in the town where I live, so hospital birth is pretty much the only (legal) option for mamas around here. Sadly, the hospital I do NOT work for is the one with a relationship with the CNW's in town, and they have a reputation for being more accepting of complimentary/alternative birthing practices. They have a whirlpool for women to labor in, I think they have birthing balls. Interestingly, I have done brief clinicals on the birthing units at both of the hospitals, and found that the nurses' attitudes were about the same at both... I wonder why the hospital policies seem to differ?

Anyway, thanks for sharing the lively debates and such... I haven't read any crazy birth plans, but I know my sister-in-law - who is a chiropractor and very wholistic and natural in her health practices - has had a natural childbirth with both of her babies. She declined all interventions for the babies, including Hep B vaccine, vit K and antibiotic eye ointment. She got a little upset when her baby was returned from the nursery with a band-aid after a heel stick. It was probably for the metabolic screen test, which I believe is mandatory in my state. I will have to ask her about that one...

Her babies are both healthy, and so is she, so I think she had a pretty good experience at the hospital!

Hate to tell you, but as a Caucasian woman and nurse who ended up with a very unpleasant AA OB, when I asked intelligent questions about my care or *gasp* refused certain treatments I knew were unnecessary at the time, I was treated like an idiot and given attitude too. So I don't know how much of it has to do with skin color and how much of it is just docs with God complexes.

Oh I am certainly not saying that all Caucasian patients are being treated great, but minorities tend to be treated worse (am I not saying all the time). Some of the shabby treatment I pointed out was actually done by black healthcare professionals!!! During my c-section, there was a Caucasian nurse that did such a wonderful job that I made sure the hospital and her supervisor knew just how great she was.

The only minor problem I have with continuous EFM is that it doesn't give you chance to go to the bathroom exactly when you need to. Sometimes when you are laboring, things happen too fast for a nurse to get there with a bedpan in time (and how comfortable can a laboring woman really get on a bedpan). This is bad enough when the nurses are understanding about it, but some of them are not and make a patient feel bad about what couldn't be helped. I think that is unacceptable.

It was a NST that helped save my youngest son's life, and I would rather have nurses ****** off that I crapped the bed than have a dead baby.

Specializes in Public Health, L&D, NICU.
The only minor problem I have with continuous EFM is that it doesn't give you chance to go to the bathroom exactly when you need to. Sometimes when you are laboring, things happen too fast for a nurse to get there with a bedpan in time (and how comfortable can a laboring woman really get on a bedpan). This is bad enough when the nurses are understanding about it, but some of them are not and make a patient feel bad about what couldn't be helped. I think that is unacceptable.

It was a NST that helped save my youngest son's life, and I would rather have nurses ****** off that I crapped the bed than have a dead baby.

One of the first things we did on our unit was to teach the laboring woman how to unplug her monitors and go to the bathroom without help. We were always happy to come assist with the IV pole, but if they needed to go immediately (as is often the case when pregnant) they were welcome to proceed without having to wait on us. Bedpan? No way, unless they were laboring without an epidural but with a fetal scalp electrode. We didn't want that yanked and pulled on accidentally.

And I seriously doubt anyone would get upset about a little poo in the bed. It's just part of L&D. The only time I ever got irritated about bathroom issues in bed was when I had a patient who could get up and go to the bathroom but chose not to. Instead she'd just pee all in the bed and then call us to come change the linen. And lest anyone think I'm unfairly assigning intentions to her that didn't exist, she told us what she was doing and why. She had few fans among the nursing staff. I've had some lazy moments in my life, but never to that point.

One of the first things we did on our unit was to teach the laboring woman how to unplug her monitors and go to the bathroom without help. We were always happy to come assist with the IV pole, but if they needed to go immediately (as is often the case when pregnant) they were welcome to proceed without having to wait on us. Bedpan? No way, unless they were laboring without an epidural but with a fetal scalp electrode. We didn't want that yanked and pulled on accidentally.

And I seriously doubt anyone would get upset about a little poo in the bed. It's just part of L&D. The only time I ever got irritated about bathroom issues in bed was when I had a patient who could get up and go to the bathroom but chose not to. Instead she'd just pee all in the bed and then call us to come change the linen. And lest anyone think I'm unfairly assigning intentions to her that didn't exist, she told us what she was doing and why. She had few fans among the nursing staff. I've had some lazy moments in my life, but never to that point.

I am glad you have that attitude. Some nurses do not. I think your hospital is more progessive than the local one in my area.

Specializes in Eventually Midwifery.

Ok, in my defense I love the Doulas in our area because of the wonderful support they provide to our patients and I'm not against birth plans at all...HOWEVER...I've heard some weirld things, especially recently, and have seen things taken to the point where it is downright dangerous. Some that I haven't quite understood lately have been...

don't put a hat on my baby during his hospital stay. This is a big one coming from our local doulas...some small paper that was not a very good controlled study said something about how no hats make the babies breast feed better and voila, it is doula law.

do not do fundal massage after I deliver to control my bleeding (Yes, she bled excessively. Yes, we did end up doing fundal massage, problem solved).

We've had some come in and refuse uterotonics during/right after 3rd stage and they do always bleed more, this is ok as long as they agree to take something if bleeding become excessive and nipple stim/breast feeding doesn't resolve it but we had one that ended up consenting to blood administration INSTEAD of pitocin, cytotec, methergine, or hemabate after delivery, was just dead set that she would not be receiving meds under any circumstance.

do no dry my baby after birth (Ok, I've heard don't bathe my baby, don't wipe of vernix and that is great, perfecly fine, but don't DRY my baby? that is NRP 101 right there).

I don't like refusals of antibiotics for GBS + because I've SEEN GBS sepsis and it's ugly but when you then are PROM >36hrs and running high temps with fetal tachycardia and foul smelling fluid and STILL refuse antibiotics I will sit at the desk and call you crazy (and yes then, right after delivery, code your limp, septic baby and wisk it off to the NICU where blood cultures are positive only a few hours after being drawn...).:no:

No fetal monitoring. And I mean none. No doppler, no intermittent monitoring, no basline FHR tracing, no fetoscope...nothing. To each their own but...why are you here?

imho lotus birth is gross and so NOT natural...that is rotting flesh you are keeping your baby attached to...even animal moms in nature know that you don't do that.

refusal of blood sugar checks on high risk newborns. I'm not talking that newborn that was cold once, or was a little jittery once I'm talking type 1 diabetics or even GDM with poor control, severe SGA babies...

I'm sure I can think of more if I sit long enough lol

Specializes in L&D.

When someone comes in with a birth plan, I usually get her. The odder the plan, the more likely I'll get the patient. "Nora, do we have a patient for you!" First, I go over it with the couple. The ones that include things like not doing a circumcision without consulting the parents are usually written by people who are afraid of the hospital and don't know their rights. It gives me a chance to do some education about their rights. I also explain my responsibilities to them, what I have to do to protect my license.

Remember that a patient in her sound mind can refuse anything and there isn't anything I or the hospital can do about it. I work in a small rural hospital, the next closest hospital is 3 hours away. We do not do TOLAC because we aren't staffed for it. But if the woman refuses a section and refuses to be transported a few hundred miles away to the nearest hospital that does do them, we have to do a TOLAC. I and her doctor must discuss with her the risk that she is taking (ruptured uterus, hemorrhage, fetal damage, hysterectomy, death of fetus, death of mother) and document that conversation with her. (I wish we had more conversations about the risks of elective inductions, but that's a topic for another thread) I've had patients refuse all sorts of things and as long as I believe they understand and accept the risks they are taking, I'm fine with it. It's their birth experience, not mine. I think it's stupid to refuse Vitamin K, or eye ointment, or immunizations, but it's not my call.

Every odd thing that comes up in OB is an opportunity for patient teaching, and I often learn something too. By the way, the oddest plan I've seen involved a Lotus Birth. Google it!

I came across a very interesting birth plan. My hospital is Baby Friendly and this particular patient had her baby at our hospital 3 years ago. She breast fed her first child through a mix of BF and supplementing. She wrote on her birth plan that she doesn't "drink the BFHI koolaid and wants a pacifier" and that "nipple confusion won't occur and the world will not end." She asked that "any La Leche League nurses be reassigned to another patient". She also specifically requested 2 rooms on our mother-baby unit that are our largest. How does she remember those things from years ago?? It was pretty hysterical to see the other spectrum.

I came across a very interesting birth plan. My hospital is Baby Friendly and this particular patient had her baby at our hospital 3 years ago. She breast fed her first child through a mix of BF and supplementing. She wrote on her birth plan that she doesn't "drink the BFHI koolaid and wants a pacifier" and that "nipple confusion won't occur and the world will not end." She asked that "any La Leche League nurses be reassigned to another patient". She also specifically requested 2 rooms on our mother-baby unit that are our largest. How does she remember those things from years ago?? It was pretty hysterical to see the other spectrum.

What an ignorant weirdo for sure.

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