This is such a touchy subject so I will try not to offend but instead just give my view and talk about what Taylor and I would like to happen....emphasis on the would like part.
Working in the NICU my job consists only of birth plans that have been broken. Noone PLANS for their baby to come early, noone PLANS for their baby to come out sick, noone PLANS for their baby to be immediately wisked away from them the second it is born. But what does happen sometimes is that a problem is detected when momma is pregnant and NICU is notified ahead of time and the plan soon becomes to get the baby out as safely as possible and do whatever it takes to keep the nugget alive and as healthy as possible. So we have plans, we plan which room the baby will go to, what nurse will admit the baby, what nurse practioner or neonatologist will be at the delivery, if we will need a respiratory therapist and respiratory support equipment, the type of bed baby will go into and if we need special things at mom or baby's bedside to help support it. That becomes our plan. We plan for the worst and hope for the best, but the PLAN is to keep everyone safe.
I learned very quickly working there that when women have birth plans, especially elaborate ones, and they are broken or things don't happen the exact way they planned, there is a huge amount of devastation and crushing blow that comes over the mom. Sometimes they will say "Wait, this isn't what we planned, this isn't how I wanted this to go!!" Well, I think of all the things to put on a birth plan, the most important should be "KEEP ME AND MY BABY ALIVE". (And usually that is written on there somewhere.) Because honestly sometimes it takes 20 people to complete that one task alone and it's sometimes very very hard to do. I know that is ultimately the goal of every pregnant momma but sometimes it is overshadowed by the fact that they had to get an IV in the end, or they had to have an emergency C-section, or they had to have NICU come and take baby for a few hours to watch it more closely to make sure baby is truly ok. If those things are not a part of the plan they become the focus, that it didn't go the way they wanted. It often gets overlooked that in the end both parties are alive. It seems priorities get scewed.
The bottom line of the entire topic is this..... GOD CONTROLS WHAT HAPPENS, not us.
We can pray and hope and wish for an easy, quick, manageable amount of pain, natural delivery with no complications at all and a perfectly healthy screaming, kicking, pink baby, DUH we all want that. BUT it's not ours to control. The two things you can't plan in life are birth and death, ironic really.
The doctors and nurses do everything in their power to make things go as smoothly as possible and we like to help make your wishes come true but there is a valid well researched rationale for every single thing we do in the Labor & Delivery and NICU world. We don't just say "eh, it's 2am, this is taking too long, I'm bored let's do a massive abdominal surgery and knock the mom out completely and make sure dad isn't in the room just so we can sit and chart and eat a cookie and not have to work the rest of our shift." It's more like "well this baby isn't tolerating labor at all, it's heartrate is crashing we have to get the baby out NOW or it will die." There is no time to get dad changed into scrubs to be in the OR too and sometimes it's really graphic (lots of dad's pass out when it's controlled and calm and scheduled let alone scary and fast). There also isn't time to put an epidural in, hence getting knocked out. I have literally seen a baby be born by C-section 5 minutes from the time they decide the baby (or mom) is in trouble, several times actually. That's pretty damn quick to move the mom into the OR, get her put under general anesthesia and cut a baby out. It's scary as shit when that happens but it happens so we can KEEP MOM AND BABY ALIVE! And it works. You don't realize how many moms or babies would die if we didn't do a c-section and when that scary moment happens and you don't have an IV because it wasn't part of your plan, you don't get drugs in time to start getting the baby out ASAP and we can't cut you open while you are awake and have no fluid or anesthesia on board. They put IVs in at the door as a precaution for the worst, not be annoying and poke you with something sharp. Sometimes it takes a while to find a vein and get it in and we can't risk waiting to save your baby while we try to get an IV in. We are nurses not magicians. They also make you NPO (nothing by mouth) when you come in because alot of women puke during labor either from pain, medications etc so it reduces that (who wants to puke when you have all that going on too). It also helps make sure your stomach is empty if you have to have a c-section, if your belly is full you can imagine what can happen when you get sick laying on your back in an OR with an open surgery in progress, you don't need to be choking when you are trying to have a baby cut out of you. No thanks. But see, reasons for it all, not attempts to be cruel. I guess I get a little defensive at some of the rude comments made to the L&D nurses (and even NICU nurses) from patients about their plans. Our job is to save and maintain life. The End.
Now onto some of the funny things we hear in our world. I can't even tell you all the things that come into the hospital on a birth plan. Some are literally 8-10 PAGES long with demanding requests that can't happen. Alot of time it is laughable the requests we get, some are just wild or impossible! Here are some of the funny things I've heard on plans. I put a few of them with my rational why it's kinda nuts in red.
No continuous fetal monitoring. 20 minutes on , 20 minutes off is fine.- 20 minutes is plenty of time for your kid to crash out, why have monitoring at all, it's a pain in the butt to put it on and take it off and we do it because it's important to make sure your baby is tolerating labor ok not to torture you. And who wants to be messed with every 20 minutes, just relax with the band on your belly and have the reassurance we can see if something bad starts to happen the second it happens.
No loud noises or push coaching- if you are first time mom, you may not know when to push or how often and loud noises will happen, it's a hospital not a church. The mom next door might like screaming through her contractions.
I would prefer not to spend any time lying flat on my back, including during pushing stage- cool go for it, we will see how you feel when you've been in unmedicated labor for 48 hours and if your baby tolerates your choice of position, sometimes babies say "uh no thanks, I don't like your right side mom."
I’d like to push in a sitting squat or whatever position I find comfortable.- If you can hold yourself up after laboring to squat go for it but your doctor can't see anything that is going on if you are like that, so what's the point of having a doctor or nurse.
No episiotomy- as one of my favorite doctor's says "If your kid gets stuck, you get cut", she gets them out, the end. Your body doesn't always tear if your baby gets stuck.
During the pushing stage, I would appreciate warm moist compresses and perineal massage to reduce risk of tearing.- I don't know if many nurses would do this for you, they have alot of other tasks to do, maybe a husband or doula?
No pulling on baby’s head. I would like to push her out myself. baby's sometimes need help, hence the doctors and nurses
We will provide blankets and will dry the baby ourselves- again, go for it, just a funny thing to worry about.
Noone will talk to me but my one nurse and my husband- that will not happen. Other nurses will answer your call light when your nurse is busy with her other patient, other nurses will help your nurse deliver you, there will be a nurse for your baby, your doctor will be there and usually an OB tech to hand him sterile equipment to keep you free of infection, they will all be talking to you and each other. They work as a team and have to communicate.
I will not have a c-section, IV, drugs for any reason including high blood pressure etc- well you might, end of story, if you signed consent for treatment in a hospital, it can happen.
No vital signs, blood pressures, or vaginal exams- not happening, this is what we do to keep you safe, if you don't like it stay at home.
We want our birthing pool set up in the room since there are no bath tubs in L&D- this is a hospital not a resort, we don't have space for a pool in the room and we don't do water births in our hospital.
Then we will talk about the large birth plan curse, most... MOST moms, not all, but most moms, with a large complicated crazy birth plan end up having it go nothing like they plan sometimes with an emergency c-section and a 2 week ticket to the NICU for their baby. I don't know why it happens but we talk about the birth plan curse. It's weird and sad, the last thing we want is someone to have an experience that is less than ideal for them but it's just creepy that it happens that way. Also alot of moms write something very elaborate, get into labor and decide they can't continue without an epidural etc. I found this funny meme about that.
So without further ado, this is our birth plan: and I am dead serious I am really doing this.
(a note attached to a freshly baked plate of cookies)
Lauren and Taylor's Birth Plan
1) Give me an IV and put through it whatever fluids and drugs you need to, to keep us healthy.
2) I want an epidural, they created it for a reason and I am not about testing my pain level, I won't get a medal in the end anyway so lets make this enjoyable for everyone.
3) I'd prefer not to have a C-section but do anything and everything you have to do to GET MY KID OUT ALIVE AND SAFE!!
4) Enjoy your cookies and have a great shift and thank you for what you do! , Love the Smith's
Now I will add that I want an attending (a real OB/GYN) delivering the baby, not a resident or student. I do not want a vaccum or forcep delivery but whatever has to happen, happens. and I don't want my family in there. That's it.
Birth plans are all a matter of opinion and there are a million variations and none are perfectly correct but try to educate yourself from a valuable source like a medical journal (not pinterest, blogs or facebook) before you start making ridiculous requests that are not possible or safe. Especially if you are a first time mom, if you are a seasoned pro, it's alot different. But still, you would never walk into a cancer center loaded with google information and tell the doctor how to treat your cancer to save your life, so why walk in to L&D like you own the place and demand that you know what's best in every situation regarding labor and delivery? Just focus on what is important, keeping mom and baby alive and understand that the people trying to help you have a baby do this for a living and are doing just that... helping you have a baby.
STEPS OFF SOAPBOX, thank you and goodnight.
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