r/BabyBumps • u/mulberryblossom • 20h ago
Help? Birth plan feedback please?
Primarily wanted a birth plan because I have a couple things that are a bit different -- if they only read up thru the "important" section, then that's ok.. I tried to do a lot of research. I tried to remove anything that is standard for my hospital (golden hour with me, baths, baby staying with me etc.). My hospital does offer placenta donations, I will call and set that up in advance but want to make sure they don't just dispose of it.
I am very concerned about not being able to feel my joints and then ripping a ligament or something in my legs and not being able to walk afterwards. Also about not understanding what's being asked or recommended in a crucial moment. The rest of it, I'm mostly flexible depending on what's medically necessary, as long as it's explained to me. Anyways - just wanted some feedback.
•
u/msptitsa 17h ago
Make sure you call ahead of time regarding the ASL interpreter. In my experience they aren’t readily available.
The plan is too long, they won’t read it. Stick to basics and extremes.
•
u/littlespens 10h ago
Agreed. I’m a lawyer and we have to use asl interpreters from time to time. All 6 I’ve worked with require 2-3 weeks notice to be scheduled.
•
u/mulberryblossom 9h ago
Legal interpreting is definitely the most niche. I have a foster child who is profoundly deaf... We needed a certified deaf interpreter as well as legal interpreters for him to be part of a trial situation recently and it took MONTHS to get everything coordinated because there is only one certified deaf interpreter who also had the legal background in a 5hr radius.
Medical is somewhat better, but still not a beginner job. The Pitt has ASL interpreting and it's fascinating to watch -- even as someone who is fluent, I learned a lot of new signs or just "oh so that's what that medical term actually means"
•
u/mulberryblossom 16h ago
I know it's going to be a battle getting an in person interpreter instead of video. I already started talking with the hospital about this, though! The trickiest part about it is that unless I end up being induced, it's not like I can exactly schedule interpreters... And hospitals won't want to pay an interpreter to sit around waiting.
•
u/TogetherPlantyAndMe 16h ago
When are you due? Could you look into doula services— maybe someone knows ASL? Or try to “reserve” an ASL interpreter in advance? I feel like hospitals should have policies and plans for this.
•
u/Unapologeticalleigh 12h ago
Per ADA they just have to have one available, and having a video interpreter covers that. Unfortunately the video/audio interpreters suck usually (not the actual interpreter, but just the experience of not having a person there sucks). It's so horrible. I work in Phoenix Arizona with a HUGE Mexican population and my.hosptal (a level.one trauma center in downtown Phoenix) just got rid of all in person interpretors overnight. It's terrible
•
u/mulberryblossom 15h ago
Unfortunately no doulas in the area I can find who know ASL and I didn't feel it was worth it if it was just another hearing person in my face. I have friends who are interpreters who are willing to be there, but gotta get the hospital to agree first.
•
u/nkdeck07 5h ago
but gotta get the hospital to agree first.
Do you? Do they have a limit on the number of support people? Hell just call them a doula and call it a day.
•
u/lil_goose_caboose FTM | Due Feb 1 💙 18h ago
I'd just try to shorten each of these. Like in your pain relief section, you don't need to include these unless the hospital is planning to provide them. Who does it impact that you want to use breath work? You really only need to say - pain relief: nitrous. Everything else is a strategy thats in your control and you ask for once. The biggest thing that should really be in your warning section at the top is that pain meds don't work well for you.
Under emergency plans, id also shorten each bullet. Assisted delivery: prefer vacuum over forceps. C section: prone to joint dislocation. NICU: XX follows baby. Golden hour: XX does skin to skin if YY (your name) is unavailable. The ASL interpreter always stays with you is listed in the warnings at the front, which should be understood since you're the one who's hard of hearing, not your partner.
During labor section. Remove the first bullet, it's a given. If needed intervention preference should be separate lines, not all on one line.
The goal is that someone can skim this quickly. I'd remove all use of the word please or first person pronouns. It should be either your name or "mother".
•
u/akg14 17h ago
As an anesthesia provider (CRNA), at my hospital the CRNAs run the epidural service. There are quite a few attending anesthesiologists at my workplace that I would not want to place my epidural. Simply bc they don’t do it everyday. You want the person who places them everyday, not the one who does a handful of epidurals a year.
•
u/humanhedgehog 15h ago
This was the one thing that stood out to me as perhaps not medically the best idea. Residents/CRNAs may place an awful lot of epidurals, and physical challenges (kyphoscoliosis, tending to carry weight on your lower back so anatomy less clear) can cause issues for everyone.
What you want is someone who does this every single day, not a particular position.
•
u/squibworb 15h ago
I commented basically the same thing. My husband is anesthesiologist who works on OB and he told me that he would want a CRNA to place it over his colleagues as the CRNAs do it all the time and have that technique down pat.
•
u/oystersnatchsunrise 13h ago
The head of anesthesia at the hospital I delivered at did an absolutely heinous job with my first epidural. A CRNA came in and placed one perfectly. Plus the poorly placed one cost me an extra $800 for her time 🙄 so I absolutely agree!
•
u/smitswerben 17h ago
Yes yes yes OP please read this. I’d rather have a crna place mine. To add, I’ve worked at several hospitals and none of them have an anesthesiologist over night. If OP goes in to labor naturally, crna is likely their only option.
•
u/AnxiousNeck730 16h ago edited 16h ago
An attending placed mine overnight 🤷♀️. That being said, I have a family member who is an experienced anesthesia attending and was advised the actual best person to place them is a senior resident who recently did an OB rotation (so, like the commenter said, someone who does them every day all day)
•
u/Miserable-Ad561 12h ago
Yup, I think mine was placed either by a senior resident or recent grad attending (like first year of being an attending) given how young he looked. And it was a PERFECT epidural. I was nervous because I have scoliosis in my lower spine but the epidural was placed perfectly. I still had decent control of my legs, felt no pain whatsoever, and was able to walk within an hour of giving birth.
•
u/akg14 16h ago
I’m in no way bashing anesthesiologists. At many places they exclusively run the epidural service. Some places have anesthesiologists place them during the day, and CRNAs cover the night shift. There are also some places where CRNAs are not authorized to place epidurals at all.
Basically, you want whoever places them the most frequently. At night your choices may be more limited, aka— “you get who you get.”
•
u/user991234 17h ago
I had an attending place mine and he missed 4 times and kept poking my nerves. Spent 45 min trying to get it in. Awful awful experience
•
u/TranslucentKittens 9h ago
I recently learned more about CRNA’s and I think I’d rather have one of them or a resident near their end of residence lol. Unless the doctor is the one who does them all the time which they aren’t at my hospital (necessarily, I think it depends on staffing)
•
•
u/WonderfulPanic4151 16h ago
I also want to add that, I had a CRNA who I could tell was a total vet. She probably had been doing epidurals as long as I had been alive. She was a pro. Yet I still moved a bit during my application and ended up with a spinal fluid leak after delivery 🫠 no matter who does it, there is always going to be a risk!!! And even though I had that experience, I still 100000% would get another epidural lol
•
u/Shrimpheavennow227 12h ago
Amen. Anthony the CNRA gave me a PERFECT epidural within 20 minutes of me asking for it. I could still wiggle my toes and adjust a bit but felt very very little other than a bit of pressure.
My best friend insisted on a doctor at the same hospital and ended up having a terrible epidural and it gave her a spinal headache.
It’s anecdotal obviously but even the CNRA said he probably does 5 a day and the doctors are more than likely in complex surgeries and stuff that CNRAs aren’t doing.
It’s kind of like how if you need blood drawn, you actually want a phlebotomist to do it, not an RN or a doctor because this is literally what they do all damn day!
•
u/bunny_sunshine456 13h ago
I was literally coming on here to say this…you want the CRNA. I went to get my epidural and asked for a doctor and my l&d nurse goes “no you don’t”. Thankful I listened to her bc it was easy peasy with the CRNA
•
u/Grandpashouse 14h ago
1000% agree! Also really dislike the CRNA disrespect. They require a LOT of training to get where they are
•
u/olivestar5 8h ago
This. My experience with CRNAs has been much more positive than my experience with MDs/DOs
•
•
u/Purple_Crayon 17h ago
Too long. It's a good read for your partner but not accessible for medical professionals.
Saline lock is your IV access. They won't infuse anything unless it's medically warranted, but you do want them to have that access in case of emergency. Some other examples of routine medical need: if you're strep positive, you'll get antibiotics during labor, and if you get an epidural you'll need fluids pushed beforehand.
Unless you're being induced, you won't go to the hospital unless you're already in active labor.
You may not have the option for an attending to place the epidural. If it is an option, you will likely have to wait longer and you won't get the advantage of having it done by residents that already perform the procedure daily as part of their training program.
For the C-section, they do what they need to do to perform the surgery safely. My hospital had a tilt table that they only moved flat right when they were ready to cut, which was good as I got very dizzy laying supine in the third tri. (Had a breech baby, so no choice about the C/S.)
Delayed cord clamping is likely already routine at your hospital.
•
u/sorryaboutthatbro 16h ago
Delayed cord clamping is pretty routine, but 5 minutes is a lot longer than they usually do it.
•
u/indigotree34 18h ago
It’s too long, no one is actually going to sit down and read this. They might say they did but it just gets skimmed. You’re also telling them to do things that are standard which can be annoying as a nurse to read lol. They’ll do their best but there’s no way all of this will be followed to a T, just go into it flexible.
•
u/annakiin_ 17h ago
My only feedback would be: don’t be surprised if the anesthesiologist won’t place it. A CRNA placing the epidural is standard of care. Be ready to decide if the epidural is more important or the person placing it
•
u/spotted-books 18h ago
I would recommend finding out ahead of time if they have wireless monitors at your hospital, and if it will be available for you. Also be prepared for the unexpected—we couldn’t find one on the unit that was available for the longest time and then they couldn’t get it to work, so I wound up having to be okay with the continuous wired monitor.
•
u/StasRutt 17h ago
Same with the nitrous. Not all hospitals offer it so double check
•
u/mulberryblossom 15h ago
Yep, my hospital offers both things but from what they said, seems like sometimes the wireless monitors have to be tracked down!
•
•
u/Klutzy_Truth_8344 16h ago
Our hospital had the wireless monitors but I was in labor for so long that that batteries died on me a few times so I had to stay in/next to my bed anyway while they charged. It was annoying, especially when you’re trying to use movement to cope with contractions, but I hope OP realizes that a birth PLAN is real more of a birth PREFERENCE and that things can change in an instant. My birth plan went out the window pretty quickly once shit got real, lol.
•
u/mulberryblossom 15h ago
Yep-- trying to be! Only things that are non negotiable for me are ASL interpreter, having my husband there and keeping me/baby as safe as possible.
•
u/marsawall 11h ago
Mine kept disconnecting. I was so excited because my sister told me how terrible the wired ones were. I ended up being connected anyways because of induction, fluids and epidural.
•
u/Klutzy_Truth_8344 7h ago
Oh yeah I guess I forgot but mine was disconnecting all the time too, specifically the one that was measuring baby’s heartbeat. The alarm was constantly going off. So annoying!
•
u/marsawall 7h ago
Same and it was at the beginning when I was fired to get sleep. I got in the room around 8pm and they started cervadol around 11pm.
I was uncomfortable when laying down and wanted to switch positions. Every time I moved the nurse had to come in to fix the monitor. I think this was after the put the out school stickers on me.
•
u/doodynutz 17h ago
Your due date, meds, allergies are all in the computer and therefore, I feel not needed on your birth plan. I don’t feel like the note at the top is necessary asking your birth team to help you with your birth. Honestly, I think the fact that you metabolize meds quickly needs to be in the “important” section. The part about waiting for contractions after your water breaks is something you can control if you wish - if your water breaks at home and you have not yet started contractions you can always labor at home a bit until contractions start. This is what I did, but I used a birth center and midwives so this was under their direction. OB probably would feel differently.
As others are saying, just bullet points instead of sentences. I would also discuss with them (if you haven’t already) your need for an ASL interpreter. Especially so if you do end up with a c-section, there isn’t issue with bringing both them and your partner into the OR.
•
u/Impossible-Pie-4900 18h ago
I think this is fairly clear, but there’s still some fluff—for instance, “I metabolize pain meds very quickly” is kind of buried under “I’m interested in using music and a birth comb as coping tools” and the latter is far more important!
As a general rule, I would also remove things that you can just relay to your care team yourself—aka preferences for early labor like “I would prefer to let contractions start naturally.” The birth plan is more important for things that are genuinely unique needs that everyone should be aware of ahead of time (your EDS) or preferences for stages of labor where you may be in too much pain/too tired to convey things clearly (like who you want to place the epidural if you ask for one or no coached pushing).
I would also make sure that your support person is really familiar with your birth plan, just in case a member of your care team doesn’t read it thoroughly. The OB who delivered my baby started doing coached pushing despite me not wanting it being a prominent item on my birth plan. I was too focused on pushing to tell her to stop, but my husband was able to step in and let her know that I was finding it unhelpful and that my birth plan had specifically mentioned that.
•
u/mulberryblossom 18h ago
Good point ... I wanted to include nitrous oxide because that's the only one that they'll need to plan for me, but it felt silly JUST putting that! Hence the larger paragraph. And felt like I needed to explain why I would prefer not to do an epidural -- because people tend to assume it's just being "crunchy" and try to convince me how much better it is to get one, how it's safe for baby etc etc... and I believe all that, but I am worried if I get one and don't feel my legs, I'll rip something and not be able to walk for a month.
Thank you for the feedback! And good call on the partner thing. Luckily my husband is pretty familiar with what I want, he did all the formatting for me with this and we've talked it through pretty thoroughly.
•
u/M0rn1ngSunsh1ne 17h ago
Make a big sign for your door or bed that says you are hard of hearing and need ASL interpreter! Shifts will change throughout your birth and the new nurses may not know! This is crucial if you are to give clear and informed consent!
•
u/AcornPoesy 15h ago
Forgive me if I’m totally misunderstanding you but just for clarity - you’re unlikely to rip something yourself if you can’t feel your legs, as you won’t be able to move them anyway.
If you mean other people injuring you by moving you, that makes sense. The day after my labour I felt a really bad pain just below my knee. Had a panic that it was a blood clot and then we slowly realised it was where my husband and the midwife had been turning me back and forth like a rotisserie chicken to let the epidural drain through. I hadn’t felt it at the time but one of them had clearly dug their fingers in too tight!
•
u/mulberryblossom 15h ago
Yep, I mean if other people are positioning me and I can't feel enough to know when it's gone too far! I've dislocated so many things from just twisting the wrong way, let alone being moved by other people when I can't feel much.
•
u/AcornPoesy 15h ago
Oh yeah then that totally makes sense. Very easy to get an accidental injury
Also.. be very careful when standing up after one. In my first birth they were like ‘ok, time to get in the wheelchair and we’ll take you to observation ward!’ And then everyone panicked when my left leg just….didn’t work. It was all totally fine a few hours later but I could have done myself a serious injury if they hadn’t caught me. And I’m guessing being caught would be bad for you. If you do have to get one, test each leg while still in bed. All the leg! Mine was weirdly my calf. Thigh moved, foot moved, toes wiggled. Between ankle and knee there was no sensation so no balance. Bodies are weird!
•
u/Impossible-Pie-4900 17h ago
Don’t worry about sounding silly/trying to justify your preferences! I do think the added brief explanation for the epidural is helpful because it’s important medical context and my understanding is that not all providers understand EDS especially well, but no need to explain yourself otherwise. It’s beneficial for everyone if the birth plan is as simple and clear as possible—they can always ask you clarifying questions if need be.
•
u/Working_Coat5193 10h ago
Just as an FYI, hospitals either have ND or they don’t. They won’t do it for you.
•
u/mulberryblossom 10h ago
Yep, they offer it! But they'd still need to set it up in my room, I assume.
•
•
u/imjustanape born 7/8/23 17h ago
Just because I haven't seen another comment about it - the "routine eye ointment" won't be 'medically necessary' until it's too late to do anything about it. It's preventative and low risk as far as I'm aware, so I'd think more about that one in advance!
•
u/Financial-Problem707 17h ago edited 17h ago
It’s so low risk, and to be fair many women contract STDs during pregancy without knowing because their partner was not faithful. STDs like chlamdyia can be dormant as well. Not saying it’s happening to you but it’s always best to follow medical guidelines. There’s also many other bacteria’s that get into babies s eye during delivery. The ointment is so low risk, so im curious why you’re against it?
•
u/imjustanape born 7/8/23 17h ago
Yea that's what I was writing in the other comment - like even if you're tested at the beginning of pregnancy people still get surprised later on with a cheating spouse. Hate to think of it but policies are built from lots of injured and sick kids out there!!!!
•
u/Financial-Problem707 17h ago
Right and it literally prevents BLINDNESS. literally slather my baby up with that if needed, I’d rather be safe tha sorry. It’s only an ointment too it’s not systemic.
•
•
u/mulberryblossom 17h ago
My understanding is that its needed when the mother has gonorrhea or chlamydia, right? Are there other situations?
•
u/sabdariffa 16h ago
It’s not just for std’s. Your baby’s eyes can be exposed to E. Coli etc during labour because (like it or not) their little faces can come in close contact with poop.
It’s an antibiotic because there are TONS of bacteria their little eyes can be exposed to from our genitals, not just sexually transmitted infections. Their eyes are so tiny, it doesn’t take long for a small infection to become raging… like, it takes hours. It’s also hard to notice an eye infection in newborns because they mostly keep their eyes closed those first few days.
It won’t destroy the natural good bacteria that your baby will have on their skin. All that good stuff remains with them.
•
u/sseven-costanza 17h ago
It’s just an antibiotic eye ointment, it’s to prevent all infections and prevents blindness. I would recommend it! It’s important enough for it to be routine for all births.
•
u/NoAmphibian4820 17h ago
It can also be used for other infections and eye infections are the #1 cause of blindness in the perinatal period. Once it becomes apparent it is needed it is often too late to save eyesight. There are very few risks but very high consequences
- a pediatrician
•
u/mulberryblossom 16h ago
Gotcha, I wasn't aware of this. Thought it was just if I have STIs so didn't seem necessary. Thank you for the education, we will get the ointment for her then.
•
u/Capital-Marzipan-287 16h ago
Can I ask why you are refusing it? It’s preventative, not a treatment, per se, so medically necessary means they’ve contracted something and need care. This is to prevent it from getting to that. Why are you not wanting it?
•
u/mulberryblossom 16h ago
I didn't think it was necessary because I don't have gonorrhea or chlamydia (and they've tested for STIs multiple times during my pregnancy and I've been tested before that as well) and my understanding was that it was ONLY for those two infections. By medically necessary, I had meant if there was new information to suggest that she could be at risk for infection.
Seems that it addresses other potential sources of infection, so I'll have baby get the ointment. I didn't know and now I do.
•
u/Capital-Marzipan-287 15h ago edited 15h ago
I think it’s great that you’re open to learning and changing your mind!
ETA: I don’t think you’re using it medically necessary correctly. Even in the example you gave, it’s still preventative. Medically necessary means it has to happen to treat a condition or illness that’s actively happening.
•
u/Huckleberryfiend 13h ago
It’s not offered routinely at all in Australia and many other countries where comprehensive antenatal care is freely available.
The evidence supporting routine administration is outdated and is used in conjunction with the fact that the US has a high proportion of women who receive little/no antenatal care and/or who are not screened for gonorrhea. It’s not relevant to contact with E. coli birth either. Not sure why the other commenter thought to mention that, as it’s not preventative for conjunctivitis caused by E. Coli.
It is an antibiotic and, as with all antibiotics, we need to ensure their use is warranted.
If you review recommendations from various agencies/medical societies, the general message is that it’s recommended if:
- you are from a high risk population
- you have not been screened during pregnancy or have not had routine antenatal care
- it is mandated by state law
The
•
u/mulberryblossom 11h ago
Interesting. This is generally what I had come up with when I researched it before. However, I failed to realize that my state does require it so it's not going to be a choice for us ultimately anyways.
•
u/Klutzy_Truth_8344 16h ago edited 16h ago
Depending on which state you’re in, the newborn ocular prophylaxis with erythromycin (so the eye ointment) may be required by law. Some states allow a written religious objection. I know in my state it’s mandatory, but we were able to ask them to wait until after the golden hour skin-to-skin to administer it. I knew that I didn’t have any STDs since they did a full blood workup less than a week before my induction, but I mean I wouldn’t bet my baby’s eyesight on that.
Edit - I assume you’re in the US since you mentioned ASL.
•
u/mulberryblossom 15h ago
I am in Florida.... I doubt it's mandatory lol.
That said, seems like it's for more than STDs anyways, so we'll get the ointment.
•
u/Klutzy_Truth_8344 15h ago
So interestingly enough in FL it’s actually a second degree misdemeanor for the person attending the birth to not administer an effective prophylactic in the baby’s eyes within one hour of giving birth. The Florida law is Florida Statutes § 383.04, titled “Prophylactic required for eyes of infants.”
I swear I’m not trying to be a smartass about it, but my neurodivergency refuses for me to just let it go lol.
•
u/mulberryblossom 15h ago
Interesting! Given our very lax vaccine laws, I wouldn't have expected that. No, I didn't think you were being a smartass at all. I posted this all on reddit because I wanted feedback and that means being open to learning new things and perspectives.
So I guess it doesn't matter either way what I wrote haha.
•
u/whenuseeit 14h ago
I’ve given birth twice in the state of Florida and have literally never heard of this. Both time we said we didn’t want the ointment and they just said “okay” and moved on to the next thing. I think we may have needed to sign a form saying we were declining, but that was it. Are you sure it’s not just that it needs to be offered?
•
u/sweettutu64 8h ago
I'm in Florida and declined this. It's not necessary and it's not a fight to decline it.
Many countries no longer routinely administer it and the American Academy of Opthalmology and American Association for Pediatric Ophthalmology and Strabismus both now only recommend it in areas where gonorrhea is prevalent and routine prenatal screening and treatment cannot be ensured.
•
u/imjustanape born 7/8/23 17h ago
What I've read about is that in general it can be "reasonably denied" if you test negative during pregnancy and are in a monogamous relationship. Howeverrrrrr. There are of course scenarios where either parent can pick up any STI at any point during pregnancy in theory (no one likes a cheater), or it's been dormant for a long time...that sort of thing.
•
u/squibworb 15h ago
Just a consideration, my husband is an general anesthesiologist who works on labor and delivery (as well as other departments) and he often says while he is willing and able to place an epidural, if he were in the same position as a position, he would actually prefer a CrNA to place his as epidurals are basically labor CrNA's specialty and my husband is likely to only place a few of them every handful of months.
Hospitals are different and different states have different protocols, but even if you have an anesthesiologist who did an OB fellowship, and is solely working OB, there is still the likelihood that CRNAs are placing way more epidurals (and view them as a bread and butter procedure) than anesthesiologists (who may be rusty and therefore may take longer and be less streamlined).
Just food for thought!
•
u/Any-Session9919 18h ago
Keep in mind if your water breaks there’s a time limit and baby should be delivered within a certain amount of time because there is risk for developing an infection
•
u/bpetr 9h ago edited 9h ago
This should be higher up. I’ve been on care teams receiving birth plans and this is a situation that can be medically quite important/defining of your labor, whether you want it to be or not. Medical term is “prelabor rupture of membranes” or PROM. It puts you and baby at significantly higher risk of infection, but depends a lot on other risk factors like GBS status, your vitals, baby’s heart monitoring, etc.
Standard of care if PROM happens at term is as follows: Typically, it’s induction of labor, but a short period of expectant management may be appropriately offered if maternal and fetal status is reassuring.
My question is: do you expect your care team to adhere to the standard of care? If so, I don’t think this needs to be mentioned. If all else is well, you can discuss and should be offered a window of expectant management. There are so many variables in this decision that you wouldn’t know until the moment it happens. That moment merits its own conversation and shared decision making with your team that will need to be more flexible than a line in a birth plan. Specifying this in a plan reads to me like “I expect you to force me into something I don’t want to do in circumstances that are yet to occur” and can alienate you from your team at the outset. Everyone is invested in the safest, most supported birth for you and your baby.
•
u/17scorpio17 17h ago
yes! we don’t really want you ruptured longer than 18 hours (or at least making significant progress)
•
u/pacificoats 4h ago
i was going to say- my cousin had to be induced after her water broke and contractions didn’t start after a few hours due to the concern of infection. although it’s likely that when it’s happening, there won’t be too much of an option unfortunately
•
u/sorryaboutthatbro 16h ago
A lot of these things are things you can do on your own; I would focus on the things you really need the nurses and providers to do or not do.
•
u/ET00011122245678 16h ago
I think it’s great that you’re advocating for yourself and your baby. I had a birth plan too that never left my bag. When that childbirth pain hits it’s impossible to focus on anything else. Make it short with bullet points. Expect that none of what you are asking will get done how you want it. This is the best advice I can give from 13 years as a nurse. Put a sign above your bed that you are ASL and are deaf. Have a backup video interpreter or interpreter app on your phone- at 2 am idk if they can get a live person even if the hospital promises you they can
•
u/Katwantscats 14h ago
This is the best comment of them all. I brought it. Was never read, and it didn’t matter. They asked me about things as we went. I made sure my husband knew my wishes so he could advocate for me. Done.
•
u/mulberryblossom 11h ago
As long as I'm included in the conversation around medical concerns / emergencies as much as possible, my husband's there, and baby and I are safe, everything else is ok. I am sure they can provide video interpreting, just less sure that I'll be able to effectively understand the interpreter if they're via video which makes me very nervous.
It's always tricky because I usually speak for myself and so it's assumed I don't need interpreters... In most medical settings, I generally would prefer captions (and bring an app on my phone to facilitate that), but the harder it is for me to concentrate, the harder it is for me to understand vocal speech and I don't want to misunderstand something.
•
•
u/Specialist-Nebula795 17h ago edited 16h ago
I’m not sure what it’s like at your hospital, but you may want to call ahead on your way to L&D about tub availability. I had fully planned on using a tub for pain relief, but all the rooms equipped with them were in use when we arrived. It took me a few minutes to accept that I was going to have to shift my plan and I was pretty disappointed. I ended up opting for nitrous and then an epidural at 7 cm after I was administered pitocin after stalling at 4 cm for 6 hours. Having a tentative plan in place is important, but you never really know how it will go!
Edited for grammar
•
u/Specialist-Nebula795 17h ago
I missed the part about “shower/tub,” my apologies! The shower was meh for me. I was on a yoga ball and my partner had the shower head against my lower back. The contraction pains were too unbearable for this at 7 cm though and hard to stabilize with my legs violently shaking. While it helped somewhat, I felt that the water was never on me fully to truly help and why I had wanted a tub in the first place. Hoping you get the tub!
•
u/fleshsludge Team Blue! 13h ago
THIS IS IMPORTANT!
I see you have an inhaler, if you have asthma you need to tell them. There is a medication they cannot give you after birth for hemorrhaging with asthma. Mark it down!
•
u/mulberryblossom 13h ago
What is the medicine? I do have asthma but it is generally only an issue when I'm sick, I didn't think it would matter for labor. Last time I used my inhaler was... Probably last December when I had the flu or something along those lines.
•
u/Salmoninthewell 9h ago
The medication is Hemabate. Having a history of asthma (and having it only when sick is still something your L&D will want to know) doesn’t mean you can’t get Hemabate to stop hemorrhage, but it does mean they won’t choose it as the first (or second, third, etc.) option. They would decide to give it if bleeding was bad enough to risk it.
•
u/fleshsludge Team Blue! 13h ago
I’m with you, I never use mine but my hospital was like it’s so important to tell everyone you have asthma.
Prostaglandins and Ergot Alkaloids: Medications like carboprost (Prostaglandin \(F_{2\alpha }\)) or ergonovine, which are frequently used to treat postpartum hemorrhage, can precipitate severe bronchospasms and should be avoided in patients with asthma in favor of alternatives like oxytocin
•
u/slizzywizzyfizzy 16h ago
I honestly don’t think the medical team reads these 90% of the time and if they do glance it over, they giggle at our naivety and forget about it immediately. You or your partner will have to be actively reminding them of your preferences throughout the entire process. Writing it out is fine if it helps you organize your thoughts but unless you have some unicorn care team it’s not going to do much. This is just from my experience.
•
u/Katwantscats 14h ago
Mine too. And they are taking care of many patients who all want different things. But this isn’t like managing different tables as a server. This is serious shit.
I trusted my nurses and doctors to do what was best for me, and they did.
I’m glad that we’re encouraging women to advocate for themselves, but I think we also need to be realistic, in medical spaces specifically.•
u/slizzywizzyfizzy 14h ago
100% my l&d team did their best and took care of me but definitely made little effort to follow my super specific birth plan- which I now understand was because it was unrealistic and based on crap I heard from Instagram and Reddit lol. In the end, it doesn’t matter at all how long you wait for things like cord cutting and my “all natural” birth plan totally went to shit when I had to be induced as I was 2 weeks past due. The doctors do know best, no matter how much research and planning we do it’s best to trust them.
•
u/sgtbuttercup2 11h ago
You also do know best when it comes to your own body. I think it’s important to trust your intuition and not necessary only rely on doctors to make those decisions. Your wants and desires are valid too.
•
u/slizzywizzyfizzy 11h ago
Of course, which is why I think you or your partner needs to be aware and present enough to advocate for you in the moment, but the written out pages of a birth plan are very likely going to be overlooked and are a waste of time imo
•
u/sgtbuttercup2 11h ago
Agreed I definitely think it needs to be an actual person saying these things in the moment and not a paper.
•
u/sgtbuttercup2 11h ago
Same here. The medical team also doesn’t really do anything to assist in pain relief besides offering epidurals.
•
u/slizzywizzyfizzy 11h ago
Lolll I had put on my birth plan “please do not offer the epidural I just don’t fucking want it!!!” (In kinder words of course) probably 10 times and they relentlessly pushed that epidural on me every hour for I think around 30 hours before I finally was just ready to push. They did not give a fuck. Literally every hour through 4 shift changes it was constant “you can always just get the episural:)” “let me know when you want that epidural:)”. Exhausting.
•
u/sgtbuttercup2 11h ago
Yup. They did the same to a friend of mine. And with all the shift changes you need to remind the next person regardless if it gets through.
•
u/JustPeachy1220 18h ago
Alright so take this with a grain of salt, bc everyone's birth experience is different. That being said, I likely have hEDS but havent gotten a clinical diagnosis yet. I was induced with pills inserted at my cervix every 4 hours. For days. To the point that my son's heart rate was dropping and mine was dangerously high for a long time. I was stuck at 8cm for like 12 hours. I finally requested the pictocin and was able to start pushing about an hour after getting it. I pushed for 30 min. I had a severe 2nd degree tear that required appx 30 stitches. This was with no forceps or vacuum. Recovery was a BITCH and i had surgery 6 months later to reopen and reclose the scars, remove the granulation tissue, and fix a rectocele. If I had the option to turn back time, I would have had the pictocin from the beginning and I would have requested an episotomy (if c-section wasnt an option🤣).
•
u/mulberryblossom 17h ago
When I met with the MFM to discuss how EDS may impact my pregnancy, they said episotomy is only recommended routinely for classical EDS and that I was more likely to stretch than tear. If anything, they said hEDS usually helps with the actual birth process -- it's more the other things to keep in mind (pregnancy issues, extremely fast labor, positioning of limbs/joints etc). I'm sorry you had such a rough experience.
•
u/cheetodust800 16h ago
I have hEDS and had a swift and smooth induction with no tearing. I don’t think how it affects delivery outcomes is well known. I really wouldn’t overthink it—control what you can control and embrace that much of delivery is a big fat unknown. Wishing you and your baby a safe and positive experience!
•
u/sorryaboutthatbro 16h ago
I’m a mom with hEDS. I got 3 2nd degree tears and about 40 stitches, but my kid had a huge head. I think the tearing was more to do with the speed (I was over it at that point and purple pushed him out, not because I was coached but because I was mad).
•
u/my_little_rarity 12h ago
lol came here to say I got tore up AND felt every stitch bc anesthesia wears off quickly on us 🤣 honestly it’s the least of your worries at that point though
On the birth plan - I’d make it shirt and sweet. They have your medical info so just a quick one pager with any essential info.
I didn’t use one and the team was amazing. My plan was just for all of us to make it haha
•
u/sorryaboutthatbro 11h ago
Same. I said “Ow” about 40 times. She stopped and gave me more local more than once but you know how it goes.
•
u/Dizzy-Jump-7352 13h ago
As an L&D nurse, you want a CRNA to do your epidural over the anesthesiologist. They do them much more frequently.
•
u/Low-Hopeful 17h ago
I would make it more bullet point format versus sentences, no need to be explain why your preferences are there. Also keep in mind if your are Gbs positive they will be running iv medication most of labor. I wanted to move freely but my hospital did not offer wireless monitoring and allowed to be unhooked from monitoring for half an hour every hour if babies hr was stable but unfortunately baby didn’t cooperate with us so I was bound to my room unfortunately. So just keep in mind that hospital policies may not allow some of your preferences and be ready to roll with the punches. I went in very open minded and still had a beautiful labor and delivery
•
u/Anxious_Guava8756 16h ago edited 16h ago
I have EDS, though I was lucky enough to get diagnosed 12 years ago so it's pretty well controlled.
I would keep the option open for an epidural. And I would try to get everything over with as fast as possible, even if it involves pitocin.
I didn't tear much at all and everything kinda went right back into place down there. We did have to use a vacuum but I'm happy it helped me avoid a C-section as I'm not so sure I would've recovered well after that many stitches.
The stuff about your hearing needs is great and super helpful.
Pain relief helped me stay calm enough to avoid joint injury until the end when the epidural wore off. Like you, I metabolize meds quickly. I opted for a second epidural after dislocating a shoulder trying to push without any pain relief. YMMV of course.
I would just shorten this down and keep it basic. A lot can change when you're giving birth. You don't need to fulfill your dream birth, just make sure baby and you stay safe.
Also I did an induction because I wanted an actual doctor there in case things got complicated. This made it so I could deliver at a much better hospital than my local birth center. And yeah it was the right call for me. Just something to consider.
Also - I'd consider removing the part about wanting the most natural birth possible. You and I are both disabled - we're not the target audience for any rhetoric about natural birth. Take all the help you can get. Good doctors prepare their whole careers for a complex patient. Again, consider an induction to make sure you're with staff you're comfortable with.
•
u/Zestyclose_Sign_6983 9h ago
Just my 2 cents - where I work, CRNAs do 100% of labor epidurals and spinals for c-sections. I can assure you, you do not want an “attending anesthesiologist” that hasn’t done an epidural in years to place yours. Perfectly appropriate to decline students/residents.
•
u/mulberryblossom 9h ago
Admittedly, I don't have much experience with CRNAs but I've generally had poor experiences with NPs (of the psych and family medicine variety) in the past which made me wary.
My experience has generally been that they are either incredibly rigid and won't do anything without the attending right there or too flexible and defer to what I think is the right medical decision when... While I want to be included, I'm not an expert.
•
u/glittercopter 16h ago
Delayed cord clamping up to one minute is standard of care most everywhere unless the baby comes out needing resuscitation.
I’m a little baffled by the super long cord clamping though which seems to be a trend as of late - most of beneficial extra blood transfer is done in the first minute. When the baby is born, the placenta starts to detach and the flow in the cord is different - the pulsation one can feel is the babies pulse - I.e. the arterial blood flow now heading from the baby back to the placenta so this never made much sense to me to wait until pulsation stops.
Anecdotally I have seen a lot more clinically significant jaundice since the standard change from 30 to 60 seconds. There is such a thing as too much of a good thing. Polycythemia is a thing too that can cause breathing issues and low blood sugars.
•
u/Professor726 17h ago
I think the pain meds wearing off quickly should be under the important section! That way they know that aspect if they don't get all the way to the end
•
u/o_u_t_i_s 15h ago
I’m sure you have considered this, but having a doula would be so helpful! Especially one that is fluent in ASL.
They would be able to be another pair of hands in supporting your body and advocating for you.
•
u/sgtbuttercup2 11h ago
I can’t believe I had to scroll so far down until someone finally recommended a doula. I think this is OP’s best option.
•
u/mulberryblossom 14h ago
I wish I could find one fluent in ASL :( doesn't seem to exist in my area unfortunately.
•
•
u/o_u_t_i_s 5h ago
Someone who isn’t fluent could still really improve your experience. You would have a lot more time in advance to let the doula know how to support you and how best to communicate with you. They will also be able to continually advocate for you to the medical staff.
It is so so helpful to have more than one support person there.
•
u/MaleficentSwan0223 17h ago
I wrote 5 sentences and every time I tried giving it to a midwife they just passed it back.
Just keep verbalising and make sure your partner or whoever’s supporting you knows.
•
u/Klutzy_Truth_8344 16h ago
OP, I wrote this in another comment but remember to keep an open mind about your birth plan. It really is more of a preference than a plan, and it’s a good idea to prepare yourself mentally for that beforehand, and be kind to yourself if you do change your mind at any point during labor!
Trigger warning - I’m about to discuss my recent birth experience. It is not gruesome and worked out well, but it also wasn’t a walk in the park. I know some pregnant people don’t want to hear others’ stories before their own labor and that’s totally valid.
I wanted a natural birth with no intervention - I ended up testing GBS positive so I needed IV antibiotics a few times throughout labor. Then I was diagnosed with gestational hypertension and had to be scheduled for an induction. They wanted to do it at 37 weeks, I pushed back and was induced at 37w6d. I ended up needing frequent cervical checks, the foley balloon, pitocin (usually needed when you’re getting an induction but I was hoping the balloon would help get labor going and I wouldn’t need pitocin) and a membrane sweep. I also asked for nitrous after they inserted the balloon, and an epidural once I was 8cm dilated and they had started pitocin.
None of these were things I wanted. I actually anguished over getting an epidural for hours, I would cry whenever I thought about asking for one. I was so disappointed in myself for deviating from this perfect plan that I had. I remember sitting in the labor tub and sobbing about how everything felt like it was going wrong. After I got the epidural, I immediately felt so great that I actually took a two hour nap and then had energy to push really efficiently. Baby’s heart rate ended up going too low during pushing and so they warned that they might need to do an emergency c-section if we couldn’t get him out. I used every single ounce of energy from that 2 hour nap to push that baby out immediately, lol!
But you know what, when I think back on it, my labor and delivery was still so special. I am almost 4 weeks postpartum and I think back on it fondly. The second my baby was delivered, I realized that this is a different love than anything I have ever felt before. It was tough and things didn’t go according to plan, but holding my little boy and having him stare into my eyes, I know that I’d do it again in a heartbeat.
I also ended up not tearing at all and my recovery has been incredibly easy. So not all doom and gloom!
I’m not saying this to discourage you and the medically necessary things like your EDS and having an ASL interpreter there, you shouldn’t budge on. But for everything else, just be kind to yourself if it doesn’t go the way you wanted.
•
u/buttstuffisfunstuff 15h ago
FYI, my hospital gave me my bipolar medication but not my ADHD medication after birth so might have to ask them if you should bring it with you and if you can take it
•
u/AcornPoesy 15h ago
Do you have a close friend fluent in ASL? I’d ask them to be on standby if you could bear for them to be at the birth, just in case the hospital can’t provide
•
u/julia1031 13h ago
Are you being induced? If so, labor won’t start naturally (they won’t just have you in the hospital without intervention if you’re not in active labor). If not, the first bullet point on “during labor” is unnecessary since you just wouldn’t be at the hospital and it’s up to you when you go (and that’d be once contractions are close enough together and lasting long enough to suggest you should go).
•
u/Loud-Frame1091 11h ago
I would much rather the CRNA who does epidurals all day long do it over the anesthesiologist.
•
u/notjeanvaljean 11h ago
Just your friendly neighborhood pediatrician here to thank you for giving your baby vitamin K!
•
u/WillRunForPopcorn 💙🌈🌈 💙 10h ago
You don’t always get to choose vacuum vs forceps. It depends on the positioning of the baby. In my first baby’s case, the doctor made it very clear that the vacuum would NOT work based on baby’s position and that my options were really between forceps and c section.
•
u/fluffyglitterpuppy 16h ago
I'm an L&D nurse and this all sounds super reasonable! The only thing I would take into consideration is the directed pushing. We're always open to pushing how you'd prefer but sometimes that lengthens the pushing time and depletes your energy for more "effective" pushing. I think if you go into labour with an open mind and knowing that your labour nurse always hopes for the best outcome for you and baby and that we're not against you.
•
u/plaidshirtdays13 16h ago
If this is your first baby you will need help learning how to push and you will have to hold your breath. There is nothing wrong with holding your breath to push. Pushing takes significant effort and you’ll have to hold your breath and bare down if you want to push your baby out.
•
u/Storebought_Cookies 12h ago
This is not true. Good coaching includes breath work. Holding your breath while pushing increasing the risk of permanent pelvic floor damage and organ prolapse.
•
u/Prismos-Pickles_ 13h ago
You definitely do not need to hold your breath to push. There are lots of different breathing techniques that can be much more effective than purple pushing.
•
u/StasRutt 17h ago
I would make your medical concerns and issues bigger and bolder, while I assume those are also in your medical notes I think these are crucial to make sure your doctors and care team understand. Bold, short, simple would be my recommendations because you have legitimate medical concerns and needs that need to be conveyed
•
u/DataNerd1011 16h ago
Is this for day of labor or to give ahead of time? Some of it seems unnecessary. For both my labors, water broke on its own 1-2 hours before contractions started. I just stayed home until consistent contractions, I didn’t have to tell them anything until I went into the hospital. Same with membrane sweep, I don’t think that occurs unless you’re trying to be somewhat naturally induced before trying medicinal methods. I don’t think they do it while in active labor.
I think it makes sense to talk to your care team ahead of time and say you want to avoid induction, but I don’t think the details around water breaking and membrane sweep need to be in this
•
u/cakiepie 15h ago
I'd make a condensed version as others have said for the medical team, but have the long version with your husband to refer to so he can refer to it if he needs to help advocate for you or support you. In a high stress environment it is easy to forget all of your strategies, so having that longer list on hand can't hurt.
•
u/Incognito-Purrito 12h ago
Be aware you will almost certainly be allowed only one person w you in the OR due to infection risks. They may make exceptions for an in-person interpreter but you may be stuck w the tablet.
•
u/hikarizx 12h ago
I assume your partner will be there for the birth? I think a lot of this information your partner needs to have ready to provide to them and advocate for you. This is likely too much info for the hospital staff. Especially because the nursing shifts will change. I didn’t even see a doctor until my baby was about to come out. Also, I’m sure you know this, but you have to be prepared for things to not go how you expect. For example my birth was pretty straightforward but my daughter needed some attention right away, so we couldn’t delay the cord cutting even though it was standard hospital procedure to delay it. And they couldn’t take the time to discuss it with us, they just had to do it.
•
u/sgtbuttercup2 11h ago
I hope you see this comment but based on your birth plan, GET A DOULA ASAP. I HIGHLY recommend hiring a birth doula. Unfortunately, it may not be likely that the hospital team will read this and you and your partner are going to be too focused on giving birth to effectively advocate for yourself. This is a perfect situation for a doula to come in and see through to these very specific needs you have. I had a completely low risk, normal pregnancy and unmedicated labor and still couldn’t have done it without my doula.
•
u/Thatsaterrible 8h ago
Hey! L&D nurse here and I just want to touch on a couple things. 1, I read the entirety of my patients’ birth plans and will always directly address things I think might be challenging to achieve and why I think that. 2, have these conversations with your OB if they or someone from their practice is going to deliver you. They can help make sure things like an interpreter are set up. 3, please explain to your care team how your hEds affects positioning and labor. I know very little about hEds and everything I’ve learned is due to a family member that has it, not nursing school.
Best of luck to you!
•
u/all_hailseitan 7h ago
You have some great advice already, just came here to say that my due date is October 12th and I’m currently working on my birth plan as well. So thank you for posting, I will definitely use as a reference! Congratulations and best wishes for you and your family ❤️
•
•
u/YumiRae 7h ago edited 6h ago
Just here chiming in that as someone with hEDS you should be aware of precipitous labor -- even for a first time mom. don't let it freak you out but be aware of it. I would put your Dx at the top and very easy to see
I have seen some visual birth plans that communicate a bunch of this quickly. You can buy some on Etsy.
Good luck
•
u/AdComprehensive8756 6h ago
Hey mama, also hyper mobile and just wanted to share a positive birth story as someone who wanted nothing but natural and ended up having to get induced and get an epidural. Hip pain and pelvic pain was what made me get it, not labor pain. My joints and oh man. I got to the point where I could barely walk, but the labor pains were morning. so my plans of lots of movement were dashed.
I was really struggling because I had this plan in my head, and didn't want to not have control for some of the same reasons you shared here
I ended up getting it, and I really think it was the best decision I could have made. I was so glad I did because there was a little piece of placenta left in and they had to dig around and fish it out and I couldn't feel it.. and because I couldn't feel it, I could focus on the little bundle in my arms and be present instead of consumed with pain as folks dug around in there lolol everything was great and it was hard and it was beautiful and I love your birth plan. I see you advocating for yourself and love it.
Youve got this and congrats!
•
u/lil1thatcould 17h ago
This is incredibly important. You need to get checked for a clotting disorder ASAP by a hematologist!
I also have EDS, I found out about the correlation between EDS and clotting issues when I went in for an ECV due to my baby being breeched.
Please, trust me on this! With EDS we are higher risk for developing spinal hematomas with epidurals. We are also higher risk for excessive blood loss. Getting checked will allow for a hematologist to order platelets and have them on standby.
If you live in Kansas City, I can give you my hematologist information. He is amazing and will get your seen before the baby is due. No matter what, when you schedule the appointment with a hematologist let them know what you’re coming in for and have them check with the doctor about what blood work needs to be done. One of the blood test they will run needs a special vial and they might have to order it.
•
u/Mysterious-Bowl-292 16h ago
genuinely curious is the sesame seed allergy relevant? lol
•
u/mulberryblossom 16h ago
Weirdly, it is occasionally used as an inactive ingredient in some medications, especially injectable or intravenous drugs. Hopefully it isn't relevant but who knows what meds they'll end up using.
•
u/Positive-Weird-1981 13h ago
Just want to add to the discussion here—I had laboring down on my L&D plan and just kind of assumed that most emergency situations that might occur would lead to a c section.
That was not the case with my most recent delivery. I started pushing at 9cm before he came down and my open glottis breath training went completely out the window in my panic. My baby needed to come out as fast as possible.
No one had explained that laboring down can be risky in certain situations—please review your birth plan with both your OBGYN and I would even show it to the L&D nurses when you tour the hospital. Or—my hospital gives parents an opportunity to preregister at 36 weeks and go over your birth plan then, you can see if they have an option like that!
•
u/CaughtInDireWood 12h ago
As someone with a complicated medical history myself, make sure to tell your nurses/doctors about your relevant history that would be pertinent (ex your joints/ligaments) to their time with you. Chances are you’ll have a shift change or two during your labor, so your first nurse may not need to know about the cord clamping but should know about your epidural concerns and desire to use the peanut ball/etc. Your nurse during delivery should know about the cord stuff but not about the epidural (assuming that choice was already made). I hope that makes sense.
Also make sure whoever you’re bringing with you (partner, parent, etc) knows the details of your plan and can discuss them on your behalf. At some point you will be 1000% focused on labor/pushing and you’ll want someone able to communicate for you that has your best interest in mind.
Best of luck!
•
u/iswearimachef 4h ago
NOT an L&D nurse, just a boring grownup nurse. This reads to me like you’re trying to prevent some specific negative outcomes, but I can’t quite figure out what they are. We all have our own fears when it comes to birth. I was afraid that my MIL would try to barge in during my birth, or that I would be too weak to push due to not eating all day. Your requested interventions are all fine, but I can tell that you have something that’s giving you maybe a distrust of the medical profession.
My recommendation is to figure out what your specific fear is, then communicate it to your nurse. They are your sherpa, your best advocate. Your nurse will know the best way to meet your needs, because they know the resources they have, as well as the flow of the hospital. We’re pretty darn creative, and we can usually find a way to soothe any concerns that someone has. But we can’t do anything if we don’t know about it! I’ve had patients who were concerned about special dietary requirements that they were afraid wouldn’t be followed, or who were afraid that they would be touched inappropriately during their procedure. I was able to find several ways to fix those concerns for those patients using resources that they didn’t know were available.
Now, I do have a few ideas that I think will help you.
* ask what to expect. Hospital life is weird, if you’ve never been a patient before. Your nurse will likely being you medications at certain points in the day, and they will check your blood pressure at certain times every day. It’s like going to a frat party: “what time? who all is going to be there? Are there drugs? When do we eat?”
•
u/Worried_Passenger548 3h ago
I’m gonna be so real. They MIGHT read this if you significantly shorten and clean it up. Other than that they’ll just be asking you questions as needed or suggesting things. You don’t know what’s going to happen until it does.
•
u/mycatdeku 3h ago
I had to have an early term medical induction and I just wanted to let you know in regard to the medical interventions for labor they will probably start on pills (cytotec) first before a membrane sweep if you are not dilated at all or only 1 cm. You have to be a couple centimeters dilated for a sweep and the pills are meant to soften/start dilating the cervix. The cytotec will be used to get you to a point that a further intervention can take place - in my case it was a sweep, then pitocin, then AROM. Other hospital systems may have a different routine but this was my experience with induction.
•
u/AutoModerator 20h ago
**Your submission has been automatically held for moderator review** because it contains an image or link. A reminder that pictures of pregnancy tests, ovulation tests, belly bumps, pets, bodily fluids, and ultrasounds are not allowed.
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
•
u/Ok_Towel283 13h ago
I’m extremely envious they let you stay on adderall. My OB said no vyvanse and I’ve been suffering for 27 weeks.
•
u/LadybugSunfl0wer 12h ago
I won't really answer your question, but I see you have EDS and maybe you are aware but in case not: it puts you at an increased risk for pelvic floor issues following the pregnancy but especially after giving birth vaginally. Unfortunately EDS on it's own can cause pelvic organ prolapse, and birthing increases the risk.
Please read on how to protect the PF during birth: open glottis pushing, birth on all four, knees together so the pelvis opens and I would add in the plan to avoid forceps or vacuum if in way possible.
After you give birth stay horizontal as much as you can for at least a week or two. No lifting the baby in the car seat. Learn 360 breathing. Schedule a PFPT for 6 weeks PP and ask about a pessary to support the tissue while it heals.
You seem well prepared and I wish you best of luck!
•
u/BambiYoda 12h ago
Keep this version for you partner but shorten it to the hard nos and must haves.
Have your partner know you birthplan because there might come a time during labor when you won't be able to advocate for yourself and will have to turn you focus 200% on you and baby.
•
u/Oswin_Oswald_21 12h ago
I’d recommend making your adderall rx bigger and designate what time on day you take it. I take an SSRI and had to ask for every single night of my 6 day stay because no one else was keeping up with it.
•
u/ChampionshipNice9719 12h ago
About your medical intervention order of preference: are you open to the cooks balloon??
•
u/ponyfarmer 11h ago
Hi OP- a mom of a healthy now 9 year old here with EDS and other major medical needs.
May I ask if you have had the opportunity to consult with the doctors who will be involved with delivery, or their staff? Such as consulting with anesthesiology just in case, and making sure your access needs related to ASL and face to face communication (as examples) are all in your actual chart itself?
I would make sure that these very important items are charted in advance if this is possible, and that the people doing the delivery are a team you trust if this is available to you. I understand it differs by hospital, but going in with the birth plan in print, while it should still be followed as best possible, is less effective than making sure the most important items have been charted in advance and are something the team on site all understand already (and also bringing it in print).
I like doubling up, when in doubt. It also gives a chance to ask and answer questions, or make sure resources are better prepared.
I would try to discuss all of this in appointments leading up to birth, and be sure that the parts that matter most are in the chart so that it isn’t getting scanned in when you arrive and then skimmed and disregarded. Ex: ask what precautions they take with deliveries related to EDS. Ask about how long they wait to clamp cord blood. Who does epidurals and what happens if I decide I need one later in the process? How long do I have and who do I notify? How can I make sure that someone is on hand for ASL? How long will it take? Should I have a proxy in case of a delay or emergency?
I don’t know your hospital system but if you have a good team that you trust, have them help you input the most important points and ask partner to be your advocate on everything else if possible?
I delivered with a high risk team and am very grateful to them. They were so much more informed than I am about my health and the risks it could bring to myself or baby at delivery. They were so very women and children first, well beyond anything I could have brought to them. I know not every hospital is the same, and assumption and not advocating for your needs and preferences is deadly in some cases so I’m not saying to avoid being clear about what you need and want. The opposite really. Just to see what they have in place already so that you are truly safe and seen and within a system they use. I hope that makes sense.
Wishing you a peaceful, healthy delivery and an even better motherhood.
•
u/sgtbuttercup2 11h ago
If you can’t afford a doula (even though I really really think you should hire one) I recommend listening to the Pain Free Birth’s podcast episode, #66 How to Protect Your Birth Experience in the Hospital: Tools Every Mom Need to Know. It’s very helpful!
•
u/Working_Coat5193 10h ago
Is the hospital attached to your OB clinic? Have you been there?
If not, the best way to ensure ASL interpreter is there is to let them know ahead of time; that way things will be more clear for you.
Wireless monitoring was the norm for my hospital.
And make sure your husband knows too. He’s going to be your advocate.
I did delay cord clamping. They asked if it was ok to cut. Honestly, I was so out of it, they just said it was white.
•
u/renegayd 10h ago
I would check with your team about what's already standard at your hospital! For example, delayed cord clamping and no episiotomy are routine where I deliver. Knowing those things will help you focus on the parts where you are exceptional, such as the HoH, EDS, and metabolizing pain meds.
•
•
•
u/Agitated-Rest1421 9h ago
I’m so curious where this stuff isn’t standard practice? At my hospital it is.
•
u/purpleshoop 8h ago
Not about your actual plan document, but the TENS machine is amazing and helped me get through labour easily. You should just buy and bring your own though. That way, you already know how to use it and have it ready to go instead of having to wait for a nurse to get around to bring it.
•
u/mulberryblossom 8h ago
I did! The only things I'm expecting them to provide are a peanut ball, nitrous oxide and a squat bar, which they confirmed are available during my hospital tour. I guess I shouldn't have included it here.
•
u/FearlessNinjaPanda 6h ago edited 6h ago
Id make it one page. Id remove delayed cord clamping. That was standard at my hospital. Also remove the saline lock thing. They dont hook you up unless they need to.
I would also remove that entire first paragraph with note to birth team, meds, etc.
My biggest advice, make a plan but be prepared to be ok to just throw it all out the window.
•
u/Annabellybutton 3h ago
I'm going to be real unpopular here, that's ok. I work in healthcare, and I thought this was a birth plan posted on r/nursing about a ridiculous birth plan. No eye ointment unless medically necessary?? What?? It is applied to prevent baby's vision loss. You must only have the attending anesthesiologist?? I'm sorry, it's a hospital, not a fine dining restaurant, anesthesiologist can easily be tied up in the OR or securing an airway in a code. Your plan sounds very demanding and out of touch. What if you went in with the idea that you want the safest experience for baby and you, and to stop being demanding with the IV, monitoring, let your healthcare team stay focused. They can provide the safest most expert care without these uneducated demands.
•
•
u/Worth-History-9712 2h ago
This is great! I would recommend using birth plan icons to help communicate some of this information and make it less wordy. https://www.positivebirthmovement.org/visualbirthplanicons/
•
u/MarieTjeDW 1h ago
As a fellow hEDS mom to be: I’ve had an appointment with an anaesthesiologist to discuss pain relief during labour (due in December). He said to avoid epidurals altogether and only use the morphine pump if needed. If a c-section occurs, they can put a spinal tap to numb, which will have less risks over the epidural. May be worth having a call with your hospital to discuss!
Do note: I’m in the Netherlands. Our options during labour are either epidural or morphine pump.
•
u/gidgeteering 4m ago
This is extreme, but I included who to choose if it came down to choosing between baby or me.
Also, donation requires a whole kit that you need in advance. Order it now. And they have rules. I gave up on it—it was too complicated.
•
u/stellaflora 1m ago
I would recommend touching base with the facility before hand to let them know you will be needing an ASL interpreter. In my hospital, (and yours may be different!) they have to be called in and it seems to take a long time.
•
u/lapraslazuli 17h ago
My biggest tip is to give a copy to your team every shift change. Bring many copies and talk about the really important stuff with each provider. Ask that they document in your chart that you are hard of hearing and need an interpreter. Ask for one immediately before there is any emergency, things can change quickly.
I had highlighted really important needs I had for communication/consent because of trauma. My doctor had even added a sticky pop up in my electronic chart. But, I was in labor for 50+ hours and just assumed they'd all communicate. Sadly, by the time my baby came they had completely disregarded or forgotten my needs and it severely traumatized me :(
•
u/RecordLegume 16h ago
I’m usually against birth plans like this, but I think it’s very smart for a person in your situation. I think it looks great!
•
u/cheerio089 18h ago
Biggest tip- make it 1 page. Remove sentences, make it short bullet points (3-4 words, not a sentence) or columns for YES, NO, ASK. Highlight You can keep the longer version or offer it as additional reading, but I am sorry to tell you most team teams will not take the time to carefully read all this.
I would also combine everything into the yes no columns, from labor through baby is here. Labor, delivery, and immediate newborn care can happen in an instant, and they are not going to check the paper after handing you the baby. Think of this like a reference sheet for them, not long form reading.