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Henci GoerFind out what other moms-to-be are asking.  Join in the discussion with Henci Goer, an expert in obstetric research. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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Reply To Topic Topic: Birth Plan advice
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Posted By Henci Goer, BA on 14 Nov 2008 12:34 AM

I think the best thing you can do is consult with your midwives. They will know the ropes in the hospital where you will be having your baby and will know how to minimize the chance of having problems with hospital staff. As you may already know, some medical staff do not welcome birth plans. They see them as adversarial on the woman's part, and certainly, and, to be fair, in some cases they are.  Here are some suggestions of mine, and if anyone else who reads this has recommendations, please chime in.

  • Help nursing staff to see you as a person. Introduce yourself briefly at the beginning. Adapting what you wrote in your post would be perfect. Then you can explain why certain things are important to you such as why you may be emotional and need extra reassurance and encouragement. 
  • Keep the birth plan short. You don't want the poor nurse to be paging through a manuscript. One way to do this is to find out the usual hospital policies and then don't bother to request anything they do anyway.
  • Resolve conflicts between what you want and usual policies ahead of time. Get agreement from your own care providers first, of course. Then they can tell you who to talk to on hospital staff. You may need to talk to the obstetrician(s) who back up or supervise your midwives and possibly the nurse manager of Labor & Delivery. 
  • Compromise where you can.  For example, hospital policy may mandate an IV, and you don't want one, but you can live with a heparin or saline lock. (They insert the IV catheter, but it is attached to a short bit of capped tubing instead of a long tube and an IV bag. You have mobility; they have a port should one be needed.)
  • Ask your midwife to initial or sign the completed plan, and, if possible, ask the back-up ob to do the same. The intent here is to show that your care providers have seen it and approve of it. This should help when dealing with nurses or a care provider you haven't met ahead of time. 
  • Ask that a copy be put into your records, but carry a copy with you as well. Have your doula or partner politely request that any new nurse review it.
  • Give positive reinforcement to nursing staff, i.e. "Thank you so much for helping us with this. This is so important to me (or her, if your doula or partner is saying this), and it means a lot."

Let us know how it goes.

-- Henci

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