Thursday, July 7, 2011

Birth Plan and Why We're Having the Baby in a Hospital

Friday already! Love a short holiday week, though I am on a fairly permanent weekend schedule til the hummingbird arrives. Thought I'd share my birth plan today. I found it so helpful when I was writing mine to read other women's, and I definitely borrowed from them as well as got help from my midwife when I brought it to our appointment this week for her to read.

We are having a midwife, Debbie Frank attend the birth. Debbie has been a midwife for 30 years, has had, at different times in her practice, exclusively home or hospital births, and now she does both. She's the only one in LA that I could fine that does. I heard of her through my doula, Ilona, who I adore and completely recommend. Sky and I chose to work with Debbie when we couldn't decide on home or hospital birth. We loved her from the first meeting, and didn't need to give her a decision about home or hospital til 34 weeks. We decided long before that, though. I was very gung-ho for delivering at home, and Sky was too, for the most part, yet there was a little nagging part of him that kept saying "What if...." What IF we're the 1 in 1000 that has a crazy scary complication and we can't get to the hospital fast enough and.....too scary to keep thinking about. We talked a lot about it, and ultimately decided we would have this first baby at the hospital. I was incredibly resistant, because it's essential to me that birth me private, intimate, with no large crowds of hospital staff I've never met before. Space is really important to me, and the sterile impersonal room of a hospital felt like the antithesis of my birthing dream. Ultimately, what I decided however, is that it's most important to me that Sky be relaxed. If he were to be tense and scared I knew my labor would stall and I'd end up in the hospital anyway. Listening to him and how secure he felt being with Debbie and ultimately delivering at Cedars, I said OK.

I took a tour of Cedars, came back with a list of 25 questions for Debbie about procedures there, and was reassured that when you work with her there it's different. She'll come to our house first and be with us as I labor at home. When it's time to go to the hospital, she calls and says we're on our way, they get a room ready, and when we get there it's her, us, Ilona, and a nurse. That's it. As with any hospital, I can bring scents and pillows and music and photos and anything else I want to make the room feel more like mine. I don't get evaluated in their evaluation room, and Debbie and I have worked out ahead of time monitoring, IVs, etc. Once I had a day of mourning the letting-go of my home-birth vision, I started to visualize the hospital, how we'll make it personal, and to actually feel excited that for that first night of the baby's life someone is going to be checking on us repeatedly and letting us know everything is OK. Plus we're near Joan's on Third, which whoever comes to visit us in the hospital first has to bring us.

So that being said, here's my plan. There are certain things that I don't have on mine because Debbie will be with me and we know that. If I was in a practice where I didn't know who would be delivering the baby, or I was in a more traditional medical model, I might have chosen to include things like wanting to push in different positions, delaying cutting and clamping of the cord, skin-to-skin contact immediately, and that we're exclusively breast-feeding. What's on this plan is what Debbie and I agree it's helpful for the nurses to know specifically regarding labor and delivery.

Birth Plan for Melanie

photo from here and yes, I do need chalkboard paint so I can do this

Barring complications, Sky and I are planning for a natural labor and delivery with no medical interventions or augmentations. Thank you so much for your support and help.

*I understand the baby needs to be monitored. I prefer intermittent monitoring with the Doppler.

*I am not planning on taking any pain medication or having an epidural. Please help me to avoid them, and please do not offer them to me.

*Please do not ask me to "assign a number to my pain". (this is something nurses at Cedars are told to do: rate pain on a scale from 1-10. This is a cerebral exercise and birth is anything but. Asking to skip this lets the nurses off the hook and saves me from an intellectual exercise I have no interest in doing)

*I wish to move around freely; to eat lightly if I feel hungry, to drink if I feel thirsty.

*I do not want an IV or a hep lock. If, out of medical necessity, the need for one arises, please place a hep lock rather than an IV if I do not need continuous fluids or medication.

*I wish to deny active management of the third stage of labor, and would like that pitocin not be given to me to speed up the delivery of the placenta. (This is a state of California law that they offer pitocin to speed up placenta delivery. But you can deny it.)

*We are choosing to decline the erithromycin eye ointment, and I understand that I need to sign a waiver certifying this.

*We are choosing to decline the Vitamin K injection. (We're giving the baby oral Vitamin K which you can find at the Birth Sanctuary, as well as online)

*We do not wish to be separated from our baby. If the baby needs to be taken from me for medical intervention, Sky will accompany the baby at all times.

We understand that these are our wishes and not guarantees. Thank you again for your help!!!!

I'm going to bring a stash of mom's cookies for the nurses---I hear from every woman that bringing treats is a great way to win friends, as well as remembering their names.

With William and Kate here this weekend, and Carmageddon, ie the 405 closed next weekend, I am asking baby earnestly to please wait til near due date to arrive. Thanks, baby.


  1. That looks like a great plan. I hope the baby is listening to the due date request in earnest;)

  2. sounds fabulous melanie! i don't know if i ever told you that i am a birth doula but, i am and, i am so excited that you are working with debbie frank and with a doula. i love your decision to have your baby in a hospital! with much love, sharon

  3. @Desi: THANK YOU. so hoping so too! @Sharon: i had no idea! can't imagine going through this any other way than with those 2 gorgeous women:)

  4. I brought cookies for the nurses when i went in - and while i cant say for sure that's why, i did get the most experienced nurse on the ward (and one who had 7 children of her own with no pain meds...3 of them were induced...she told me this during my labor and became my instant personal hero...i wasn't in a place to question her choice to have so many!)
    xo belisa

  5. I think you have a great plan given your hopes and desires for your birth! I had 3 "natural" births all in a hospital, so I can tell you it can be done. :) Most of all, you have a team of support coming with you that can be your voice when you are busy laboring. Sending good labor and delivery vibes your way!!

  6. you all are awesome. thanks for the support!

  7. Congratulations on your pending baby! I found your blog through Lovely Morning whom I adore. I just linked my latest post to your blog. I figure there are girls out there that would like to hear of a positive pregnancy story.