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Tuesday, April 7, 2015

How to write a birth plan that won't make the nurses and doctors hate you on sight

(I had another post planned for today, but I got completely caught up and busy doing other things, so I'm pitching this softball instead. I hope you understand.)

I've shared the birth plan I wrote for Audrey's birth in a lot of different places, and I think it's time I actually shared it here on the blog so that I can link to it any time I want to share it again in the future. Think of it like my diary, but anyone can read it and make fun of me for it later.

I love birth plans. I like researching things before I do them, and giving birth is a hell of a thing to do. I can't imagine going into it blind, without at least trying to figure out how I intend to handle it. So I wrote a birth plan.

Here's the thing about birth plans, though: a lot of Labor & Delivery nurses and doctors don't like them. Why? Well, how would you feel if some a-hole customer off the street walked in with a 6-page 30-point plan for how exactly they felt that you should do your job? You'd probably get a little annoyed at them because hello, I do this all day every day, I think I know what the hell I'm doing.

But at the same time, giving birth isn't really like being a customer at the gas station. It's not like you're just getting on the roller coaster and you have no choice but to follow the rules on the wall or else you die. Giving birth is an activity that you are actually doing. You are an active participant in the process, so there's nothing wrong with having a say in how you want things to go! Most people wouldn't walk into the hair salon and just say "cut it however you think; long, short, curly, wavy, I have literally no opinion." So why would you treat childbirth like that?

You just want to make sure that in addition to advocating for yourself, you also respect the knowledge and experience of those who are there to help you.

That was my goal in writing this birth plan. I wanted the nurses to actually read it instead of rolling their eyes and chucking it in the trash ... but I also wanted them to still like me after they read it. I wanted them to know that I respected them and that I wasn't trying to be "that patient" (you know, "that patient", the one they all play rock-paper-scissors to avoid having to deal with), but that I also knew what I wanted and I hoped that they would be willing to respect me in that too.

And you know what? My amusing and self-deprecatory birth plan worked. The nurses passed my birth plan around; one asked if she could keep a copy to show to others. They not only read it, but they remembered what it said and reminded me of my own preferences when things started to go haywire and I couldn't even remember what I wanted anymore. It was awesome.

So, I offer this up to anyone who wants to either copy it, copy parts of it, copy the tone of it, or copy none of it but draw a big dickbutt right across the middle of it:

Patent's Patented Plan for a Natural, Intervention-Free Birth That Won't Make the Nurses Hate You
(and might even make them excited for you to come back and have another kid)

Hi! My name is [my name] and my husband is [his name]. [husband] works here at [hospital] – he’s the [his job]. Maybe you've seen him around the cafeteria! He tells me he eats salad a lot … is that true? Would he lie about that?! Would you tell me if he did? Whose side are you on, anyway?

Today, we’ll be working (I’ll be doing most of the work) on giving birth to a little girl named Audrey. And since I’m at least 80% insane, I will be doing my damndest to achieve a natural birth.

Attendants: My husband [name], my mother [her name], and my doula [her name] will be helping me out with this, assuming they don’t piss me off and get kicked out of the room (they might).

Labor Preferences: Because I am trying to labor naturally, I am going to be a bit of a pain in the arse. I apologize in advance for this. To facilitate my natural labor, I request that:
  • I do not receive continuous fetal monitoring unless it is deemed medically necessary. I know it’s just Velcro but it’s still going to make me rage out. Intermittent = better.
  • I do not receive IV fluids unless it is deemed medically necessary. I will be drinking water when I am thirsty, because I get thirsty a lot and you won’t like me when I’m thirsty.
  • I be allowed to move around freely, laboring on a birth ball, squat bar, shower, tub, hanging out the window by my feet, and doing the splits vertically on a wall for no reason.
  • I would like to wear my own gown for as long as possible, until it either becomes horribly soiled (which it will) or I need to be in a hospital gown for some unforeseen reason.
  • Pain management: We will be doing everything in our power to avoid any drugs. Even if I scream “GIVE ME AN EPIDURAL OR I WILL CUT OFF YOUR FACE,” do not give me an epidural. The safe word is “Baloney.” If I say “baloney,” call the anesthesiologist. Otherwise, just slap me hard and tell me to pipe down. I’m serious about the slapping.
  • No Pitocin unless we all agree that it is necessary. Even if labor is taking forrrrrr-everrrrr, as long as both the baby and I are doing well, we will keep on trucking the old-fashioned way.
  • If we could dim the lights and not be all shouty and stressed out, that’d be cool too.

Birth Preferences:
  • When it comes time to push, I would like to push instinctively. If it works for pooping, I figure it’ll work for baby-pooping too.
  • I do not want to lie on my back to push. I might be squatting, kneeling or sitting upright, depending how I feel, but please do not force me onto my back (that’s what she said!)
  • I would like to view the birth in a mirror, if I’m in a position to allow me to do that
  • I would like to touch my baby’s head as it crowns, reducing my likelihood of tearing my bits like a plastic grocery bag
  • Speaking of tearing my bits, no episiotomy unless it is an EMERGENCY. Oh god, my poor bits

Once the baby comes out:
  • Skin-to-skin contact immediately. Weighing/cleaning can wait until after the first hour. I wanna snuggle that slimy disgusting wriggling creature the second she clears the gates
  • I will attempt to breastfeed immediately, since there’s no time like right away to start feeling inadequate as a parent
  • Do not clamp the cord until it stops pulsing. We are a family of vampires and need blood.
  • No Pitocin after delivery unless I am actually hemorrhaging.
  • Newborn procedures all done in the room – if you take the baby out of the room I’ll scream “kidnappers!” and try to chase you and it’ll just be bad all around because I probably shouldn’t be running moments after giving birth.
  • Throw my placenta straight in the $*@%ing garbage. I don’t even want to see it. Ew.

Uh oh! C-Section Time!
  • My husband will be with me during the operation.
  • I don’t want to see anything. I’ll probably throw up and pass out like a billion times, so don’t let me see what’s happening and don’t even tell me what’s happening. That will just make me throw up and pass out more. I’m serious – I got an abscess lanced one time with local anesthesia and I threw up and passed out. I don’t handle surgery well.
  • Also, if general anesthesia is needed for some reason, please note my tendency to throw up at the drop of a hat. I would prefer not to aspirate and die.
  • Double-layer closure on the ol’ uterus, if you please. I want that sucker strong and durable.
  • My husband will go with the baby to do whatever it is babies do after being C-sectioned, and he will hold her right away while I continue to throw up/pass out in the O.R.
  • I would like to attempt to breastfeed as soon as possible, like an optimist/moron

Oops! It turns out it’s a boy after all! Who knew?!!?
  • Circumcise that little bugger and help me come up with some new names because crap.

Thanks for helping us achieve our super optimum birth experience! I bet everything is going perfectly according to plan even as you read this, because of course it is – it’s childbirth! The most predictable thing on earth!

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