Birth plans

[Anonymous]

Because of some prior issues with PTSD, my first birth was rather traumatic. It never occurred to me that past feelings would coming back to haunt when I was in labor. I did not have a birth plan nor did I share my issues with the doctor, which was a HUGE mistake. I've been in therapy for almost a year now, but I think it would be naive to believe that I will be cured of flashbacks between now and December. It is unlikely that I will be able to meet with the doc prior to this delivery, I will get whomever is on call. For some rather complicated reasons, I have been receiving prenatal care in Virginia but need to deliver in Maryland.

I am trying to get a birth plan together. I really don't need something elaborate. I am very concerned that it will not be taken seriously by the hospital staff and/or doc. Should I just write something that says "I have issues, please don't do A B or C"? Is there a nice way to say that I have issues in a sentence or two? The thought of explaining what happened to a bunch of strangers while I am in labor is kind of horrifying.

[Anonymous]

Can you be a little more specific with u so that we might help?

[Anonymous]

I think you could do that, or you may want to seriously consider the idea of hiring a doula, who will act as your advocate in the delivery suite. If not, perhaps your partner could be your advocate here?

[Anonymous]

PP here: sorry, I forgot to mention that I work with PTSD on a daily basis and as you know it's nothing to mess around with. If you think birth is going to trigger a panic attack and flashbacks, this is something your medical team should definitely be aware of. In the event that you get a medical team that is unresponsive to your needs though (and it does happen) you should really designate your partner or a doula to advocate strongly for you.

good luck!

[Anonymous]

7:56 - Are you asking specifically what I need to avoid?

The things that really freaked me out last time were being stuck on my back, people barking orders at me, the doc putting her hands in me without warning and the sensations of actually giving birth. It was not just an annoyance, these things caused flashbacks and a kind fear that someone without PTSD would find hard to understand.

I would like to push when I feel the need, not be on my back, have some warning before someone touches me and to be touched only when it is absolutely necessary. There is not much that can be done about the sensations, but I can try to prepare for what is unavoidable.

I have already hired a doula and she is aware of the needs I have. She has loaned me a book and recommended the birth plan. I just need to figure out what to put in the plan that will increase the likelihood it will be taken seriously.

[Anonymous]

How far along are you? Is it too late to switch care providers? Having someone in the room with you that you know and that understands your needs would be enormously helpful. It seems that if you're worried about this now, your worry will only intensify as the day approaches with you wondering who's going to be in the room and how they'll treat you. I think a strong doula will go a long way in helping you.

[Anonymous]

I'm wondering if a note/mini-plan from your therepist would be taken more seriously.

[Anonymous]

Anonymous wrote:7:56 - Are you asking specifically what I need to avoid?

The things that really freaked me out last time were being stuck on my back, people barking orders at me, the doc putting her hands in me without warning and the sensations of actually giving birth. It was not just an annoyance, these things caused flashbacks and a kind fear that someone without PTSD would find hard to understand.

I would like to push when I feel the need, not be on my back, have some warning before someone touches me and to be touched only when it is absolutely necessary. There is not much that can be done about the sensations, but I can try to prepare for what is unavoidable.

I have already hired a doula and she is aware of the needs I have. She has loaned me a book and recommended the birth plan. I just need to figure out what to put in the plan that will increase the likelihood it will be taken seriously.

Yes, thanks for the additional info.

[Anonymous]

I would strongly recommend using a doula. The doula can be an advocate for you and make sure the doctors and nurses respect your wishes.

If you are giving birth at Holy Cross, you might want to consider the Holy Cross doula program. I used it and found the doula most helpful in getting my questions asked and making sure my birth plan was followed. They are also familiar with the entire staff at the hospital and are very welcomed.

Either way, I would strongly urge you to use a doula.

[Anonymous]

I agree with a PP that potentially switching to a solo provider (or a practice where you can know in advance for sure who will attend & assist in your delivery) might be the way to go. I was with a large practice for #1 and ended up with a doc who would not let patients deliver in positions other than on your back. I did not have an epidural (so I could have moved around) and I did not want to be in bed on my back, but the nurse told me the doc (who she had worked with many times before) would not deliver in any other position. I was strep B+, so was hooked up to an IV for the antibiotics, and also had an internal fetal monitor & a BP cuff (I had high BP) so it would have been tough to be too mobile anyway, but I would have preferred to be using a birth bar or something else. Anyway, long story, but next time I will pick a provider (probably midwife) who will let me choose what position i want to be in. Agree that a doula will help if she can advocate for you - but make sure your provider is open to a doula. Also, a simple birth plan is a great idea. I think the nurses & doc took mine seriously.

Good luck.

[Anonymous]

Is there any way you can switch to a midwifery practice? I can't remember if this is an option for delivering in Maryland or not. I think the doula will be a good thing--is she familiar with the hospital where you're delivering and their staff? We talked to a doula when I was pregnant and she had some great recommendations for doctors and hospitals where our decisions would be respected more than others.

Will you tour the hospital where you plan to deliver? You may want to see if you can talk to the nurse in charge at that time and see what kind of reaction you get.

You may want to check out some of the resources at birthnetwork.org.

Best wishes.

[Anonymous]

This is the OP. Having a midwife was my original plan, but I have found out that my plan with Kaiser does not cover midwives or even solo practices, only their staff docs. I am 24 weeks, so switching insurance is not very practical at this stage. Paying cash for a midwife's services is not feasible for me.

My anxieties over not being listened to may get better between now and the birth. I suddenly got much more worried about all of this around the anniversary of the original trauma.

I have an appt tomorrow and will bring up my concerns with the doc.

Thanks for the advice everyone. I will talk to my doc and therapist about them writing something to take to the hospital. That is a good idea.