What the Heck Goes into a Birth Plan!?

So depending on where you are in your pregnancy, you may be getting ready to write your birth plan, but even if you're not ready to start writing it's always a good idea to start doing research as early as possible.  Nowadays, there are so many different theories and options for what kind of birth you are going to have.  Will it be 100% natural and "crunchy", will it be 100% medicated and "sterile", or a combination of both. Vitamin K shot, or not? Bath immediately after or not? There are so many options and choices you need to make (yep, parenting decisions start before birth) that it only makes sense to do as much research as you possibly can to make the decisions to give you the type of birth you really want.  But, it is important to understand that birth plans are NOT written in stone, they are a depiction of your ideal birth, and give the hospital or birthing center staff an outline of what you are trying to accomplish, but be aware that things may change.

For my birth plans I always put that unless it is a medical emergency where either my life or the life of my child is in immediate danger, ALL medical decisions must be discussed with me and my husband and that we be allowed to discuss our options in private before a decision is made.  I didn't have any issues with my birth plan not being followed at my first birth, which was a hospital birth, and I don't foresee an issue with this birth since it's at the same hospital.  It is very important to tour the hospital or birth center you are planning on delivering at, for two reasons. First it will give you an idea of what you need to bring when you pack your hospital bag, and second it will give you insight on what practices your hospital has for delivery, what options they give you (birthing tub) and if they are open to more natural birthing methods.  All of this information will help you to make your birth plan, and if your hospital is completely against the birth you want (most hospitals are moving towards becoming more accepting of natural births) you will then need to decide if you want to stay with the hospital or find a different option.

 I suggest working on your plan for several weeks; do your research, type it up, come back to it a week later and make any changes, discuss it with your doctor and make any changes you want after that. You should shoot for your birth plan that is 1-2 pages long, anything longer than that may be too detailed and micromanaged.  If you do this you are more likely to become disappointed with your birth, and nothing is guaranteed.  If you have micromanaged your birth plan down to the detail you are setting yourself up for failure.  You want your birth plan to express your overall goals for your delivery and list any important features that are key to your birth.  Once you plan has been written you need to print out about 4-5 copies and put them in your hospital bag. You want enough copies to give to your OB, the midwife/doula if one is present, and any nurses that will be present (keep in mind that you might not have the same nurse throughout labor and delivery due to shift changes) so you want to make sure you have enough copies for anyone that will be at the birth.

What should be in your birth plan?

You first want to list any allergies, or medical issues you have as they may become pertinent during your birth.

LABOR:

• Who should be allowed in the room during labor
• How do you want changes of your birth plan to be handled
• If you're unable to make decisions who should do it for you
• Do you want an epidural or not
• Is it okay for staff to ask you if you are in pain, can they use the 1-10 scale
• Can staff offer you pain medication or not.
• If there is a birth tub do you want to use it, how soon after arrival.
• Do you want freedom of movement during birth
• what does that mean to you
• walking around
• changing positions in bed
• What kind of fetal monitoring is okay with you
• Continuous
• Intermittent
• What would you like to happen if your labor stalls?
• wait to see if it starts up again naturally or get intervention
• Do you want to drink and eat during labor or not

DELIVERY:

• Do you want freedom of movement during delivery
• what does that mean to you? Any specific positions you want?
• Is it okay to push based on counting (the doctor counts 1-10 while you push and you push throughout the entire time) or do you want to push based on your feelings (no counting)
• Are you okay if your perineum is cut if needed, or would you prefer to tear.
• Do you want to pull your baby out?
• Are you okay with the use of forceps, vacuums, etc?

CONTINGENCIES:

• What do you want to happen in the case you have to have a c-section.
• Who should be with you
• how soon do you want to hold your child after the c-section.

POST DELIVERY:

• Is it okay if the cord is clamped immediately or do you want it to stop pulsating first?
• Who is going to cut the cord
• What is the minimum amount of time you want skin-to-skin contact before measurements are taken of you child.
• Do you want your placenta to be delivered naturally or removed?
• Can your baby receive a bath shortly after delivery or would you like to wait
• if you want to wait, how long
• Who will go with your baby, if anyone, during the bath?
• Do you want your child to receive the vitamin K and Hep B shots?
• Do you want your child to receive the antibacterial eye cream?
• Are you planning on breastfeeding? Can the hospital staff provide formula bottles while at the hospital?
• Will the baby sleep in the room with you or in the nursery.
• If you're having a boy, will he be circumcised or not?
• Are you cloth diapering? If so, are you doing so in the hospital or can staff put your baby in disposables?

Those are the main points that should be discussed within your birth plan.  Remember to be as succinct as possible, bullet points usually help with this.  I also like to bold the important parts like the "do's" and the "do not's" so the hospital staff's eyes are immediately drawn to those areas.  Remember that your birth plan is a guideline and there is not guarantee that your birth will go exactly as you want. The birth plan, will help to guide your medical staff so that they can work to try to make sure you get your dream birth.  A great way to help insure your birth plan is realistic is to talk to your doctor/midwife and tour the hospital/birthing center so you know what the policies are so you don't go into your birth with a birth plan that doesn't apply to the rules of the hospital/birth center. I hope this helps all of you and is a good guide to get you started.  If you have any trouble or questions feel free to ask!

What's in your bag?

As delivery approaches us mommies to be are constantly told to "have our bags packed and in the car." We are told this so much that it often becomes a daunting task, because it's OBVIOUSLY supper important (why would they be telling us all the time if it wasn't) but this is a totally new experience so we have NO IDEA what to bring.  If you are like me, and most first time moms you will probably pack WAY to much because girl code states: when in doubt, bring everything! So with this in mind I wanted to give everyone out there some advice on what to bring and not to bring.  Granted this is based on my personal experience so take it with a grain of salt, but I think that hearing various experiences helps you make more informed decisions. Now, before we even start packing you need to do some homework first.  The first thing you need to do is take a tour of the hospital or birth center you will be delivering at.  The reason I suggest this is because the tour guide will usually tell you an "extras" that the hospital/center gives and doesn't give so you know what will be waiting for you.  If the guide does not do this, feel free to ask questions like: "are there any necessities the hospital provides?" or "What are some items I need to bring for my stay here."  Bring a notebook and paper so you can take notes and remember what will be provided to you so your baby brain won't kick in while packing.  For instance I delivered at Good Samaritan Hospital in LA and I was provided with a fleece robe (so soft) fleece socks/booties with no-slip grips, diapers, large sanitary napkins, squirt bottle for after care (the doctor will explain what this is for), and out choice of a stroller or car seat...pretty cool. With this in mind I new there was a lot of "recommended stuff" I didn't need to bring because it would be provided for me. So here are my suggestions of what you NEED for your hospital stay when you deliver.

1) Baby book: Put this in there ASAP! I forgot to put mine in and the nurses offered to put my little's hand and foot prints in and I was (and still am) devastated I didn't get them.

2) The good camera and video camera: Even if you're not planning on doing a birthing video it's nice to have the option to take video once baby arrives, and yes, smartphones do take good pictures but I like the quality of a DSLR better.

3) Nursing bras and bra pads: You may already be in them depending on how big your boobs have grown, but make sure you pack at least two sets because you may leak while you are getting use to the whole breastfeeding thing.

Just because they're "granny panties' doesn't mean they can't be cute

4) Granny panties: You will NOT feel like getting into anything remotely sexy right after delivery, and besides you're going to be using those sanitary pads for a few weeks so you need something with a lot of coverage to hold them.

5) Pajamas and baggy pants/yoga pants: You will not be back to your pre-baby tummy right away no matter what. I was "all baby" and it still took a couple weeks for my uterus to go down enough to put on old pants. Besides, after all the work you're going to be doing, yoga pants will be WAY more comfortable.

6) Maternity clothes: Yeah, you will still need to be in maternity clothes for a little bit due to your uterus size (see #5) and while you may be able to squeeze into pre-pregnancy clothes, you'll be wanting to go with comfort at this point.

7) Hair brush, tooth brush, toothpaste: I would suggest buying travel sized items and just throwing them in so you don't accidentally forget to grab them on your way to the hospital, and don't forget a toothbrush and hair brush for daddy too!

8) Clothes for dad: Remember, he's going to be there just as long as you are so pack something for him too.

This is WAY over the top obviously, simple granola will do, he doesn't need a luxury meal.

9) Snacks for dad: Now my hubby didn't need these because I had a very short labor, but I would advise packing some little snacks just in case you guys are there for the long haul...just make sure he knows not to eat them in front of you.

10) Swaddling blankets and receiving blankets: Bring a few of these because while you're getting the hang of feeding, burping, and diaper changing yucky stuff WILL get on EVERYTHING. So pack a few of each.  With my first I think I packed three for each day (so six of each) and that was perfect. This also depends on the season you're delivering in, my daughter was born in December so I packed a lot more blankets.

11) Hospital and going home outfit for baby: The hospital outfits don't need to be anything too pretty (your bundle will probably be swaddled most of the time) but make sure you pack  cute going home outfit because you will be taking A LOT of pictures of it. I also suggest speaking with the grandparents and seeing if there are any cultural traditions regarding the going home outfit they want to provide.  My mom, always provides the going home outfit for all of her grandkids because she wants to follow the Colombian tradition of an all yellow outfit.

12) Birthing aids: This depends on what you are planning to use, if you are using a doula see if she will bring items such as birthing ball, heating pads, ice pads, etc.  These are all very specific to the type of labor you are planning to have and the pain management you are planning to use.

13) Boppy pillow: This was really helpful for when I wanted to put Isabella down but still wanted her close to me.  I would put the pillow on the bed in between my legs and be able to still have her close but have my hands free.

So those are my recommendations for what to pack in your hospital bag, also be sure to leave some room because people will be bringing you things while you're in the hospital.  I remember when we were leaving the hospital with Isabella it took at least an hour to go because my poor hubby had to take about a ten trips from our room to the car because of all the stuff we had.  I know some lists say to bring books, iPads, computers, etc but I found I didn't use any of those.  Mainly because we were too busy with our newborn (she slept in the hospital room with us) to use any of those things.  And when she was asleep we had visitors so we weren't using any of that stuff.  This is also where the hospital tour comes in handy, because we saw that the hospital had satellite TV so we knew we didn't need anything else.  Like I said, you're list is going to be very personalized based on where you are delivering, how you plan to handle pain, where the baby will be sleeping, etc.  There is not cookie cutter list for packing a hospital bag.  But it is important to realize that a lot of the items in other lists, or that you may think you need, you actually don't.  This is why I suggest the first step in packing your bag is to tour the hospital and ASK QUESTIONS!  I hope this list helped you guys!

My Birth Story

Every woman's birth story is completely different, like the kids we bring into this world.  I was one of those women that everyone hates, my pregnancy was ridiculously easy.  I didn't even know I was pregnant until I was almost eight weeks along. I never got morning sickness,  or backaches, or growing pains...if it weren't for my growing belly and the occasional headache and heartburn, I really wouldn't have even known I was pregnant.  My birth story is pretty much the same, completely different than your "typical" (if there is such a thing) birth story. I had Braxton Hicks contractions on and off from 22 weeks on.  We lived over an hour away from the hospital at the time and my doctor was concerned that my labor would go very quickly due to all the practice my body was having. So a week before I delivered my daughter, my husband and I were sent to the hospital's hotel where I spent my days while my husband was at work.  Exactly one week after we checked in to the hotel I went with my mom to a regular doctors visit, it was still three weeks before my due date so I told my husband to go to work because nothing was going to happen.  I met my mom and sister (who had literally just arrived from New York) at my doctor's office.  We went in and she started my regular exam, however within a few minutes she stepped back and said "Pam do you know you're in labor?" I looked at her shocked and said "No!" She then told me that I was 3 1/2 cm dilated and that I needed to go to the hospital NOW.

I wasn't feeling any contractions or anything, so I convinced my mom and sister to let me walk the two blocks to the hospital (I know I'm crazy).  We went to the L&D ward and I was checked in. Once we got settled into the LD&R room I was at 4 1/2 cm. At that time my doctor broke my water and the contractions REALLY started!  I labored for about an hour and half naturally because I really wanted to have a completely natural birth.  However, I wasn't able to walk around because my blood pressure rose and I have a heart condition. Since I wasn't able to move as much as I wanted (even though the hospital was VERY occomidating) I eventually asked for an epidural. It took an half hour or so for the anesthesiologist to arrive and give me the epidural.  After that everything was nice and calm. I was talking to my mom and husband (who had made the hour drive in less than 45 minutes), when the nurse told me to let her know if I felt any pressure.  I told her that I had been feeling pressure for over an hour. She and another nurse examined me, their eyes grew to half the size of their heads and they said, "the baby's almost here don't push we're going to get the doctor." They ran off and a couple minutes later the doctor came in and told me that I was ready to go!

I began pushing and everything was going great. The doctor even asked my husband to hold my leg...he tried but then looked like he was about to pass out so my mom did it (got to love moms). I pushed for about an hour and a half and then my beautiful baby girl came into this world, after an overall quick labor of 6 1/2 hours! It was the most magical and amazing day of my life and I still remember every detail of it, with so much joy.  For my next posts on this blog, I will be going over pregnancy week by week and give you all the details of THIS very different pregnancy!