- Birth plan (see below)
- Comfort items for labor (warm socks, pillows, lotion, etc.)
- Clothes to wear home (taking into account your possibly different profile)
- Camera, film (if applicable), extra batteries
- List of people to call if you plan on doing so
- Items for the baby: gowns or pouches depending on gestation, stuffed animal, blankets, any special things you want to photograph the baby with
- Music and the means to play it (CD player, MP3 player, IPod, etc.)
- Snacks for the person going with you (you probably won’t be allowed to eat)
- Basket or other container to bring the baby home in (if you end up needing to put the baby in saline the hospital will probably be able to provide a container and saline)
- Cross, icons, other spiritual items
- Modes of distraction: book, crosswords, needlework, etc.
- Folder to keep paperwork in
- The number to call for NILMDTS (the hospital will probably have this but it doesn’t hurt to be prepared)
Birth plans are very individual things, but it’s handy to have somewhere to start and some examples. You won’t be graded on this; just put on it what you do and don’t want to have happen.
Here is a document that has been created that will cover all circumstances whether you are 12 weeks or 40 weeks. You can print this out. [NOTE: This link is no longer working. As soon as I find something to substitute for it I will include it here.]
As an example, this is the birth plan I took to the hospital with Andrew:
I would like my husband to be with me at all times unless he chooses to leave. I do not want any visitors in the room while I am in labor.
I would like to be able to play music quietly during my hospital stay.
I would like to remove the baby from the sac myself and cut the cord.
I do not wish to keep the placenta for any reason. We would like it tested for aneuploidy.
I do not want the baby removed from the room at any time. I would like the baby to be handled as little as possible.
I would like to take photographs after the baby is born.
I have brought a simple age-appropriate gown that I would like to dress the baby in when I am ready. I also have blankets I would like to use.
We do not wish the baby to go to the laboratory for any reason. We do not want any testing to be done on the baby, only the placenta.
We will be taking the baby home from the hospital when I am discharged.
The baby will be cared for in our home until the burial which will be in a private cemetery.
We knew we would probably be swimming against the tide when we asked to have our baby with us at all times and go home with us. Our first step was to talk to our doctor who was in complete agreement with us. Our second step was to write a birth plan (see above). The next step was navigating the hospital. If you have time I suggest you call ahead to whatever department you will be in and ask what the policies are. See if you can go ahead and do some of the work before you get there.
The system starts when you check in at admissions. Procedures vary but in our hospital we were asked to sign the basic consents to care when we checked in before we had even seen a nurse. Read these consents carefully. There will be one for you and one for your baby(ies). Look for sections that say things about allowing the hospital to dispose of all tissue, fluids, body parts, organs, etc., that may be removed. Look for sections that talk about testing. Cross out all of the items you do not want done. Write in the margin next to this a short explanation (i.e.- “The baby will not go to pathology or the morgue, will stay with the parents at all times, and will be released to home with the parents upon discharge.”) and your initials. Point this out to the clerk or nurse. These consents will be on your chart. Once everyone has signed them they are legally binding. Request a copy for yourself. Keep all of these papers in a single folder with your birth plan.
When you arrive on Labor and Delivery (or whatever department you will be staying in) point these things out to your nurse. Give her your birth plan, going over it and answering any questions. Make sure you are happy with the arrangements BEFORE you allow any procedures to start. It has also been suggested that you accomplish this while you still have your street clothes on. It is a lot harder to be imposing and strong in a hospital gown. Be prepared to leave the hospital if you cannot come to an agreement or compromise you are content with.
I will note that everything goes better if you are pleasant and assume that people will cooperate with you. If you are belligerent the staff will not want to work with you. Keep in mind that (with rare exceptions) the staff don’t want you to have a miserable time and they aren’t there simply to thwart your wishes. Having been a nurse myself I know that I would do anything within reason to keep my patients happy. I was a lot less enthusiastic about it if they came in looking for a fight however. If your nurse says something like, “No, that’s not our policy,” then ask to see the policy. Ask to speak to a nursing supervisor. Ask to speak to a patient advocate (every hospital has them now). BUT, as hard as it may be, try to remain pleasant even as you are being firm. And do be firm.
Very few hospital procedures and stays will go exactly as planned. The human body doesn’t always follow the rules and there is nothing exact about medical science anyway. When you are writing your birth plan keep this in mind. Think to yourself, what happens I start bleeding heavily and must have a D&C? What if decisions have to be made while I am unconscious? Make sure the person who will be with you at the hospital knows your wishes and discuss these eventualities with them. Even though your doctor and the staff may agree with you completely when it comes to your birth plan, emergencies happen and it is best to be prepared. I asked for additional ultrasound pictures to be printed before the induction started so that if I had to have a D&C I would still have some pictures of my baby. It is hard to predict every possible outcome, but spend a little time thinking about it. And if things don’t go as you planned, remember that you tried your best and be thankful for the things that did go well. Don’t blame yourself.
You will probably be very angry and upset if you are treated badly. This is to be expected. As much as I hate to admit it, there are places where patients are simply treated like items on a conveyor belt and not as human beings. If you wind up the victim of such circumstances, speak up. Write a letter to the hospital administration. Speak to the patient advocacy department. Speak to your doctor. At least try to do something so that another person may not have to suffer the same fate. Recovery from this kind of experience is difficult. Whatever you do, do not blame yourself for someone else treating you badly.
Again, write a letter to the hospital administration. Commend them for the positive things they did. Mention staff by name (this goes in their files). And be grateful you were with people who helped you through such a difficult time. [An example of such a letter – and a lovely response – can be found here.]