Birthplan and Awful Hospital Experiences

[highlander]

I'm booked in for Caeserian birth 2 weeks today. After much research, I compiled a birth plan and I asked my OB (I'm in Vancouver at the mo') if she would like to see it. In the same breath I said I wasn't sure if she was the person I should show it to as most of it was post-natal care, getting rapid acess to the baby etc and that I didn't think any of it impacted on her. She replied 'I hope not', which at the time I thought was a bit of an odd reply so I haven't shown it to anyone.

I'm very anxious that if I turn up at my pre-admission appt (next week) with a birth plan then they'll just mark me down as a stroppy patient and be mean to me. The stuff I'm worried about is asking for the 5 min APGAR to be done when sprog is with me or DH. I've also asked for him not to be weighed or washed until we ask, preferably after I have attempted to BF. If he gets cold I've asked for him DH to be taked to the recovery area and allowed to have skin to skin and for them not at all to be separated (ie worried the nurses might try a sneaky weigh). I've also written that I'm a modest person and that I do not wish for my pelvis to be left undraped at any time, except for insertion of the catheter. It makes my blood boil when people casually say 'you leave your dignity at the door during childbirth'.

Anyway, I'm worried if I don't show anyone a birthplan then I may end up with a really horrible experience, after all the hospital staff aren't mindreaders! I haven't enjoyed pregnancy one bit and I'm worried that if I don't get to see the baby straight away or be in control of what happens to him, then I may reject him. The OB isn't really interested in this sort of stuff. My experience so far is that they do not welcome my input into decisions about my care.

Sorry, very long.

Of course you should show your midwives your birth plan! And the consultant, if she's involved. How will they know about all this stuff otherwise? You have a right to be treated with dignity and to have your views considered I think. I don't know what it's like in Canada but ime in the UK they do take some notice of birthplans (although things may not always go according to plan of course). Is this your first?

highlander, I have no experience of Canadian healthcare, but would imagine that they should at least listen to your requests; they don't sound at all unreasonable!(Though not sure why you're so against weighing- it doesn't take long!). Maybe the midwife/ nurse you see when you check in would be the best person to discuss it with- she should be able to pass on your concerns re the APGAR etc to the paeds who will do the baby check as soon as he is born. (At least it was a paed here).

Don't worry too much about rejecting your baby- that is highly unlikely to happen- I didn't enjoy pregnancy at all, but didn't have a plan for the Caesarean (didn't think it would be an option, tbh), and just let it all happen. Dd was taken out, sucked out, APGAR'd, wrapped up and given to dh and I whilst I was being sewn up. We didn't have skin to skin till I was in recovery, when we had a quick bf, then they bathed and dressed her for me. Whatever happens, enjoy your baby!

highlander, I didn't have a birthplan, but it sounds like yours is good. The OBs don't do postnatal care in the US (I'm not sure if it's the same in Canada), so her response isn't tactful, but she won't have much to do with the baby after finishing with you.

I would have a chat to the nurses on staff during the pre-admission appointment about how to approach giving the on-call staff a birth plan. Stay open and calm. My time in the US hospital with my first was wonderful. My husband never left my son's side and the nurses were great. We had a couple of minor complications, but he was always with him. My husband went for everything -- yours should remember that he has a right to be there. I think the nurses will think your husband is charming for wanting to do that and easily accomodate him. As for the modesty, talk to your nurse when she comes in and explain. I've found nurses are great about that sort of thing.

We were in a small community hospital that was a teaching hospital's outpost. It was nothing posh. Most of my friends and relatives have had the same experience in the "it all went like it should have" sense.

Don't be aggressive and remember that you do have the last say in your and your child's care (well, not to an extreme degree, obv!). I think that the modesty bit might be something they overlook (if they overlook anything), so be willing to coach them, ie, "Could you please cover me up?".

Hope it goes well for you.

another big worry is that DH will not be a very good advocate for me and our son. He is a doctor, and past experience with his dad has demonstrated that his first instinct is to go with what is in the best interests with the hospital staff, and not his relative, IYSWIM.

I'm really worried that if they refuse, for no clinical reason, to hand over the baby after the 1min APGAR, that DH will just sit there and go 'OK'. He's already mentioned in the past that he hates relatives who question every aspect of their spouse's care. When I showed him the birthplan he said that lots of what I'd written wasn't necessary, like indicating my enthusiasm to BF and thus stating that the baby musn't be given formula - he said 'oh, the unit will know this'. Yeah.....

Oh, I'll stop.

I have had both an emergency and an elective caesarean, and both experiences differed in many ways. The first time I felt completely out of control of everything and had little support or help from the midwives and felt too much like they know best and what do I know? The second time (elective) I felt more confident and spoke up and the response I got was fantastic. I discussed my fears, my hopes and everything went smoothly. I wish the same for you - just speak up, calmly if possible and ask for whatever you need and if you encounter a negative response, ask someone else. I could kick myself for being so frightened to speak up the first time. Good luck to you.

You definitely do need to speak up about your wishes, but if they're reasonable it's my experience that the medical personnel will accomodate them if possible. Of course the best interests of the baby (and you) come first.

Just wondering, why are you so against the baby being weighed? It's not a big deal.

highlander, i have experience only of the U.K but they followed my birthplan exactly.
When they needed to do something different, (quite a few things on the day), they explained why and always let me know.
I too was very worried about being on full view for everyone and wanted a sheet over me.(Obviously different as you're talking about a caeserian but i too am modest and was very worried aout this). I remember being in agony and my mam trying desperately to cover me up

Hope it all goes well and you get the birth you are hoping for++++++++++++++++++++++

I'm not against the baby being weighed at all. I want our separation time to be minimised to give me the best chance to bond. After all, it's hardly an urgent clinical need.

I've altered the start of the plan with a sentance saying as a first-timer I'm obviously terrified and over-anxious. I've also asked that they bear in mind that what is routine for medical staff is new & terrifying for me and as such I would like to to participate in evey aspect of my care, except in emergencies where I realise I have to trust staff to make decisions for me. I've also written that I acknowledge that no birth can go 'to plan'.

(obviously it'sd better written in the plan, I'm rushing a bit here).

I think maybe that sets the tone a bit better, doesn't make me sound like such a stroppy control freak - which I am, but they don't need to know that

Feel a lot happier now. Will probably feel a whole lot happier when these blasted pregnancy hormones disappear!

Highlander - I think it is very important that you discuss your wishes with the staff beforehand. I think it is perfectly reasonable for the 5 min Apgar to be done when baby is with you. It obviously depends on what the 1 minute Apgar is and you can tell staff that you appreciate that. In my experience I have found that C/S babies are often still with the paediatrician at 5 minutes because they want to ensure that they do not have rapid respirations. Baby could have an Apgar of 9 but show signs of indrawing of the chest after that time which is a sign of respiratory problems. Paediatricians are keen to ensure that baby does not develop problems which pretty common. How many weeks will you be at C/S?

Having said that, in someways it is better to get that out of the way so that you can then get your baby with you undisturbed.

We offer parents the choice of having the baby weighed in theatre. I don't know anyone who has refused and again it means that there is less chance of being disturbed. Baby is placed skin-to-skin when being transferred from theatre and is kept there as long as mum wants. It is a sad fact that there is a mountain of paperwork to be done after delivery and the weight is needed for the notification of birth (legal paperwork). However, paperwork can wait because you will be in recovery for a while. However, I must admit I like to get the 'crap' done so I can leave mum and baby undisturbed when they are together.

As I said before, I think you should discuss your plan with the staff. It is YOUR birth experience and it should be tailored to your needs.

I'm going to be 38+5 on the day. I had the option of 38 but I'd heard it was better to be as close to 39 as poss to avoid wet lung.

Didn't appreciate those points you mentioned mears. Maybe I should delete the bit about the 5 min APGAR and weighing?

I'm just so worried I'll reject the baby - I hated being pregnant, although with only 2 weeks to go I feel a bit better.

Bought the post-CS comedy 'big pants' at the w/e. Don't understand why anyone would want to wear them other than to protect an abdomical incision though! They are just the biggest things I've ever seen Of course I made DH go to the check-out and pay for them; it's impt he shares the indignity of it all

A doula can be your advocate in the delivery room. In the scenario of staff having not read your birth plan or your dh becoming wrapped up in the emotional intensity of the birth, a doula could really help you and your dh through this, plus keep the staff right as to your wishes.

Have a look at here

doula out of the Q, I'm afraid. DH has taken a 50% pay cut to work here and I'm not working so we're living on a shoestring!

highlander, please don't worry about rejecting the baby!

I had 4 sections. 1 epidural (at about 41 weeks) in US where I saw the baby briefly before she was whipped away, and I didn't see her again for ages; 1 GA in this country (at about 40 weeks) where I didn't see her between about 9pm and 6am, or not consciously; and 2 epidurals in this country, 38 weeks and 37 weeks, where I had the baby reasonably soon but have no idea now how long all the bumf took. I felt the same attachment to all of them, honestly.

janh speaking a lot of sense. I had emergency cesearean for first time with 4th dd, and, although my mother was first to hold her, feel I have bonded more with her in many ways. Was just grateful that she (and I) survived and were both healthy. Dont depend too much on your birth plan. So many things can change at the last minute. Whatever happens between the time that you deliver your baby and when you actually hold him/her, nothing will break that bond. Just enjoy the end result - nothing can be better than that moment.

I want to agree with Jan and MIAM. You will bond with your baby. In a perfect world it would happen immediately following birth. My 2nd delivery went perfectly and I was able to hold and nurse my baby immediately. The first delivery was a nightmare. She was born at 36 weeks and was immediately rushed to the NICU. I was able to hold her for a few seconds before she was taken away, but not again until the following day, and my husband didn't hold her at all till the following day.

Also, my first child was unable to breastfeed, whereas my 2nd spent her entire first year attached to my breast. I am equally attached to both of them.

Good luck, and try to relax and not fret over every detail.

Absolutely give them the birth plan - do not assume that they know everything or indeed anything. Being weighed is not an urgent clinical need, I bled quite a lot after ds was born so while they were sorting that out was a good time to weigh ds as it totally took my attention from what they were doing to me. I didn't even know they were worried until I read my notes a few weeks later, my dh still doesn't know. I suppose that story demonstrates that if your staff understand the basic idea of your birth plan they can tailor your post birth care to be as close as possible.

I made it perfectly clear to my dh that he was not to be separated from ds if I had to go to theatre, I had this irrational fear of a retained placenta. I'm not entirely sure how fiercely he would have defended this though. I'd put the bit about no formula in capital letters, so they know you are very serious. It won't do any harm for them to be a little bit scared of you suing them.

Highlander - you are just getting a rush of aprehension that all mums get. I truly believe that babies do not need to be with their mother immediately to 'bond'. I have seen it many times where babies have needed to be separated. My third baby did not get a cuddle until he was a week old because he was ventilated. We had no problem bonding. I don't think that women who have C/S deliveries can really get to see and hold their baby properly until they are in recovery. The theatre table is too narrow for a start. You will be absolutely fine and you are going to be so amazed with this little person that you have produced. I can remember the awe of looking at my new baby thinking how amazing it was that this little baby had been inside me. Aim for whatever birth experience you want, accepting that hings do not always go to plan. The professionals looking after you do not want to deny you the experience you want. All women are different, so let them know what you are thinking. I am sure they will try to accommodate you if they can. Can't believe you are so close to delivery

mears, you are so right about the apprehension. I feel like I've been pretty casual about everything up until this week. All of a sudden I'm paranoid about EVERYTHING. Did I use enough bleach when washing the cot, am I using the right washing powder, are my post-birth knickers big enough, do I know enough about breast feeding, am I a bad mother already? - the list goes on.....

Here's hoping I can look back and laugh

highlander you will.
I discussed my options with midwives before my c-section, and had similar requests to you. They did explain that skin-to-skin with me could be awkward on the table, so I settled for having dh hold a wrapped ds by my head. 1 and 5 min apgar were done in theatre, but after 5 minutes they decided ds was getting cold so had to take him from theatre. It was our choice that dh go with ds rather than stay with me. They went to recovery and ds was weighed (dh put him in the scales and took him out), and dh put a nappy and sleepsuit on him and had him waiting for me when I came out of theatre. I was bf 2 minutes later.

But however it happens in the end, you will bond with this baby. I had such a terrible pregnancy that I considered ending it- even though it was planned. But I loved ds as soon as I saw him, and in a way I think I found it easier than people who enjoyed their pregnancies - the relief that I was no longer pregnant helped me to cope with the first few weeks of bleeding, leaky boobs and sleepless nights. Every time I felt bad I just reminded myself how much better I was feeling than prior to the birth.