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Why Birth Plans DON?T Work
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Sarah McMoyler, RN posted:
Ask any labor and delivery nurse her opinion about these prenatal dissertations and she will tell you- do not waste your time. Having a plan for labor is like controlling the weather while flying to NYC- you can't! You can have a forecast, a sense of what to expect and then you need to remain flexible. If the weather changes and the captain comes over the PA with instructions on what passengers need to do- we do just that! The pilot knows more about flying the plane than we do. And so it goes in labor; formulate a picture of what you would like to have happen and be prepared to communicate that to your nurses. Then prepare to make decisions along the way, depending on "the weather." Maintaining flexibility in labor is key to having a positive experience. Trust the healthcare professionals to get you to "your destination," they know more about navigating through labor than you do. As with the pilot landing the plane safely on the tarmac- doctors and nurses are professionals, and are trained to get your healthy baby into your arms.

Does your hospital recommend that you prepare a birth plan? If you had one going into labor, did it serve you? I am interested to hear from the expectant parents as well as those of you who have had your babies about your experiences.

www.thebestbirth.com

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phoenix31674 responded:
I didn't have a formal one. I had a general plan in my head. Well, that got thrown out the window. I ended up with really bad back labor because she was face up. That wouldn't have been too bad, but her heart rate kept dropping and they had to go to constant monitoring, so I ended up getting an epidural - which I hadn't wanted. Basically, I ended up with the opposite of what I preferred - getting an emergency c-section. This time around, I have the plan in my mind, but we know we could end up with a c-section and I'm not going to have heartache over it.

But I realized this is a dynamic event and things won't always go like you want. Of course being in the military, I'm used the plan changing.
 
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Sarah McMoyler, RN replied to phoenix31674's response:
Good Morning and thank you for taking time to talk about the REALITY of giving birth. Interesting to note that you are in the military where you are accustomed to having a "plan." As you so aptly point out- plans change! When they do, it is most often with good cause. Granted, not without some angst or disappointment. In the end coming to terms with what the end goal was is critical.

I like your term a "dynamic" event - so true, in more ways than one! Best of luck to you with this next birth, Sarah R.N.
 
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phoenix31674 replied to Sarah McMoyler, RN's response:
In the military you learn to live your life with the statement 'No plan survives contact with the enemy', and that holds true no matter how many scenarios you have. Some changes are minor, but many aren't.

It would be interesting to hear from others and if they had been able to follow their plan.

Thanks for the wish of luck. Just need this one to hang in until his Daddy gets back from the exercise he's on now.
 
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Sarah McMoyler, RN replied to phoenix31674's response:
I agree; would love to hear from other parents, male or female about how their "plan" worked out. I can say for a fact that the vast majority of birth plans end up in the circular file - what seemed very important prenatally (usually controlling the process) becomes much less so as the labor unfolds.

When is your due date? I will absolutely hold a good thought for the baby to stay put until his Daddy is home- which is when?

Web MD community- your thoughts? Support for this second time mom?! Sarah RN
 
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phoenix31674 replied to Sarah McMoyler, RN's response:
I'm due Oct 4 with DH due home on the 28th. He'll probably be here since DD was not interested in meeting her due date and was 13 days late. Here in Germany they won't let you go past a week. I hope DS shows up before they either induce or decide to schedule a c-section since I've never asked if they do induction if you've had a past c-section, but they are okay with VBAC - thank goodness.
 
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Louise_WebMD_Staff responded:
I had a plan with all three children. None of them went according to plan. The first hospital was all about having a birth plan, but I was a first time mother and cobbled it together from the extensive reading I did and talking to other mothers.

The second, another hospital, this time they gave you a birth plan sheet to fill out. I think it mattered more that I had an amazing family practice doctor who delivered her. (Really amazing, he stayed all night with me and was just super) 8lb 13 oz baby, just a couple of stitches from a small tear.

Third child: I planned and planned and planned. She was the first child I had an ob/gyn for and he was in a large practice. She also was induced. (all my children were "late", the first one 3 weeks after dates, second one 10 days, third induced right at 2 weeks after dates) All my planning was for nothing because when I walked in with cookies to sweeten up the nurses, they offered an epidural right away and the nurse checking me in said a slur about those granola moms with their birth plans. Ooops. I quickly hid away the birth plan I had gone over with the doctor.

Then I was informed telemetry wasn't REALLY used at that hospital with inductions (even though I had been assured it was) and ended up pretty much tied down to the bed/chair for hours. I ended up getting an epidural that took forever for them to get, never worked right and kicked in fully when it was time to push. When I requested a mirror-the nurse yelled at us for not saying so sooner. When I wanted to touch the wee one's head as she was born, (as I had done accidentally during my first birth and it chilled me out, so did with the next two) I got yelled at that I was going to kill her and myself. (Yes, really)

The OB showed up for about 10 minutes to check me over and rupture membranes. Then showed up for another 10 minutes when she was almost delivered.

All three deliveries--it takes me forever to get to 5 cm. Once I hit 5 cm, it is less than an hour until delivery.

I agree on the flexibility thing though--both for labor and parenting. When I hear a mom-to-be or even someone thinking they want to have a baby say they "will never" (have an epidural, meds, c-section, pacifier, give a bottle, have a kid with a runny nose in public) I tell them that there are no nevers in pregnancy and childrearing.

Yes, I still dream of the "perfect birth" but since my youngest is now 12--I know that isn't going to happen. I content myself by reading birth stories and looking at my kids--none of their births were perfect, but does it matter in the end? Not really.
 
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Sarah McMoyler, RN replied to Louise_WebMD_Staff's response:
Dear Louise, Lot's of gold nuggets in what you have written- thank you. I have used traveling by plane as an analogy to giving birth- you can't control the weather and hence, sometimes turbulence. We've all had the flight attendant who should have retired; and yet more often, the crew does their best on our behalf. In both cases- giving birth and traveling by plane- the goals are the same- arrive safely!

I am sorry to hear that part of your memory of giving birth includes being yelled at- not appropriate, for sure. I applaud the fact that at the end of the day you are focusing on what you went to the hospital for: a healthy baby. It sounds like you are a great mom; thanks again for the thoughtful account of your births! Sarah RN
 
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Louise_WebMD_Staff replied to Sarah McMoyler, RN's response:
Ah well, giving birth and being a mom are two different things, but I am pretty passionate about pregnancy and parenting. I loved being pregnant. I loved labor (even the horrid parts). I love the results even more.
 
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Sarah McMoyler, RN replied to Louise_WebMD_Staff's response:
Wow! You loved labor? You are passionate! Not to paint a romantic picture of labor- it isn't. Although, I do think I know what you mean. When I am teaching expectant parents for labor, allot of the focus is on what partners can do to guide, reassure and remind her that they are THERE for her. She can feel safe and protected to do her work. Again, not to confuse this with a romantic dinner on the town- labor is intensely physical and emotional-which could be experienced as a passionate: raw and unleashed; allowing her to be in a state of abandon.

Are there women out there who have given birth who have a recall or memory of anything along these lines? So loved and cared for that it felt passionate? Sarah RN www.thebestbirth.com
 
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jmarsh81 replied to Sarah McMoyler, RN's response:
I can't say that I loved labor. But wanted to comment on the birth plan. With my 1st son, I wanted natural labor. That was the main plan for me, no meds. I would have loved to have a home birth or water birth, but where I live there were no centers nearby that offered these services. I woke up at around 8 am really crampy. Took a shower, went walking, then shopping. Arrived at the hospital around noon and my water broke walking in the hospital (so far so good). Went until around 4pm with nothing for pain, but then my progress stalled, and we kept losing the babies heart beat. I was stressing over that which caused me to stall even more. I finally gave in to demerol, which calmed me and allowed me to progess pretty quickly and the was born 6 hrs after entering the hospital. No epidural, but the demerol was awesome, lol.

With my 2nd son, I wanted the same thing. But my water broke at 34 wks, and I was in labor 36 hrs on pitocin. Very painful, and the dr wanted to do a c-section after 24 hrs. I was stubborn and wouldn't let him. Well after 36 hrs of labor, and finally progressing to 9 cm my little boy decided to stick his hand out first. So to keep from breaking any of his bones to deliver him, we done the c-section anyway. So much for a natural birth.

With my 3rd son, we were going with a VBAC. But at 37 wks we had a placental abruption, so another emergency c-section. Which turned out to be a good thing, because my uterus was fixing to rupture.

Now with this one, our first little girl. Forget any kind of birth plan. I know she is coming by c-section, we just don't know when. My body doesn't like to carry a baby once they reach 5 lbs. We were lucky to make it to 37 wks with the 3rd, and it almost killed both of us. The dr is very weary this time of letting me go past 36 wks with this one, which is 2 wks away. We go tomorrow to see if there is any progression, and what our next step is from here. I have learned to take it one day at a time, and make decisions when they are needed. Not to try to plan to much in advance, lol.

Sorry so long. I got on a rambling spree tonight.
Me, Jessi 29, DH, Mike 39, DSS, Michael 1991, DS1, Brandon 2000, DS2, Jeremy 2006, DS3, Tyler 2007, DD1, Katie Chyanne EDD 11/07/2010
 
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mama2ntk responded:
I never really had a birth plan written out but with my first (Oct. 97) I just knew I wanted a natural birth. I figured if women could do it back in the day without meds or intervention then so could I. On the day of his birth I was cramping and then my water broke at 9:45 a.m. so I got to the hospital and they had that pain moniter on me and the nurse was asking me questions. So she looks at the moniter and says "OMG your pain is that high and you're still talking to me?!" I guess I have a high tolerance for pain. He was born at 11:15 after the nurses were frantically calling for the doctor to come into the room.
With my first daughter my water broke at 11 p.m. so I went to the hospital and was basically contracting all night long. Finally as I was progressing as I was pushing the doctor says "keep pushing, I'll be right back" He must have thought I was gonna be a while but my daughter came out right away, it was only me, my dh, and the nurse in the room. She was born at 9:15 a.m.
With my second daughter my water broke close to midnight so I went in, even though the doc on duty told me it would probably be OK if I slept through the night and went in in the morning. I know better. When I got there I was dialated to 4 so they kept me in triage but then my contractions started getting a lot worse so my dh called the nurse into the room, she checked me and I was dilated to 9. They had to rush me up to the birthing room and the nurses were again, trying to call the doctor in and telling me "please don't push honey, we can deliver babies but we don't get paid to!" The doctor came just in time and she was born about 1:15 in the moring.
I know these were more birth stories vs my birth plan but mainly I wanted natural births which did happen and I wanted to nurse right away (with my second two after failing bf'ing with my first).
 
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Sarah McMoyler, RN replied to jmarsh81's response:
Dear Mother of ALMOST four! Congratulations on adjusting to reality each time it presented itself to you. You are a wonderful example to expectant parents who are digging in their heels as to how their birth will be, according to their PLAN! As you know, a hundred years ago, your births would not have had a positive outcome. It is medical science and technology that can and does make a difference in delivering healthy mom's and babies.

Please keep us posted with the decisions that are made for your daughters delivery. We'd love to know when she arrives.Congratulations to you and your growing family! Sarah RN www.thebestbirth.com
 
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Sarah McMoyler, RN replied to mama2ntk's response:
Dear mama2ntk,

Thank you for sharing your birth stories...I love the underlying messages "be prepared for the unexpected" and "listen to your intuition!" Having assisted thousands of women in some portion of their delivery I can tell you that both are essential when it comes to birth. Congratulations! Sarah RN www.thebestbirth.com
 
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BigRed331978 responded:
I did have a birthplan for my daughter which was basically "no epidural" and because of this the nurses were wonderful, supportive, and gave me great advice. My next one will be more thorough and included my choices for breastfeeding, birth positions, and my aversion to induction meds in MOST situations. I encourage friends to do a birth plan because a) I think it leads to parents researching and becoming more educated on choices, b) it encourages communication between them and their care providers, and c) it can alleviate some stress in just knowing that it's in writing and out in the open. Birthplans in my opinion are not about "what you want to specifically happen" during birth but how you would like things approached if contingencies DO arrive. If moms are anything like me in labor, they don't want to spend their time explaining stuff to everyone. I was deeply relaxed and introverted, so I was glad I was able to be left alone.


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