What goes into a birth plan

How to Create a Birth Plan

Written by Kathleen Dailey

The day you give birth is one of the most important of your life. Creating a birth plan ahead of time helps you make decisions about how you want your labor and delivery to be, and lets others know your wishes. So when the big day arrives, you can focus on what's most important -- bringing your new baby into the world.

What Is a Birth Plan?

A birth plan is an outline of your preferences during your labor and delivery. For example, your birth plan may include who you want with you during labor, whether you want pain meds, or if you want the lights dimmed. You can include anything you think will make your labor and birth more comfortable for you.

Keep in mind, though, that a birth plan is not set in stone because you cannot predict everything that may occur that day. You or your doctors may need to make changes to the plan once your labor begins. So try to stay flexible if something unexpected happens.

What Should I Include in a Birth Plan?

Although it's tempting to include many details in a birth plan, try to keep it short so it's easy for everyone to read.

Here are some items your birth plan might cover:

The basics: List your name, your doctor's name and contact information, where you plan to give birth, and who you’re planning to have there with you.

Atmosphere: Think about what will help you feel most comfortable. Would you like the lights dimmed? Do you want your room as quiet as possible or would you prefer soft music? Would you like a support person to take photos or video of your labor or birth?

Labor preferences: Include any preferences you have for your labor. For example, do you want to walk around freely? Do you want to use a birthing stool, ball, or chair? Would you like to take a warm shower or bath?

Pain meds:Pain management during labor is an important consideration. You may not plan to have an epidural, but you could change your mind during labor. Or you may know that you definitely want to have an epidural if possible. As you're defining your birth plan, ask your doctor about your options for pain relief as well as any questions you have about them. These could include breathing or massage.

Delivery preferences: There are many options to consider for your baby's birth. If you're planning on a vaginal birth, would you prefer not to have an episiotomy unless it’s medically necessary? Do you want a mirror to see your baby's birth? Would you like your partner to cut the umbilical cord? Do you want your baby placed on your abdomen right after delivery?

If you need a C-section, who would you like with you in the delivery room?

Feeding and Care in the hospital: Once your baby's born, you’ll need to think about feeding and care. For example, do you want to breastfeed right after delivery? Or are you thinking about bottle feeding or combining bottle feeding with breastfeeding? Would you like your baby in the hospital room with you at all times, or would you prefer your baby stay in the nursery sometimes? Is it OK for the medical staff to offer your baby a pacifier or sugar water? If your baby is a boy, would you like them circumcised at the hospital? (Sugar water may be used at time of circumcision. )

Who Should Review My Birth Plan?

Review your birth plan with your partner and anyone else who will be with you in the delivery room, such as a labor coach or doula. Then ask your doctor to take a look at your birth plan, too. Your doctor, or the hospital or birth center, may have their own delivery policies. Reviewing your birth plan ahead of time gives you time to help resolve any potential conflicts.

Who Needs a Copy of My Birth Plan?

Once your birth plan is set, give a copy to your doctor to keep with your medical records, and take another copy to the hospital or birth center. You'll also want to give copies of your birth plan to anyone who will be with you during labor. It's a good idea to bring a few copies with you to the hospital or birth center when you go into labor, too. Another doctor may wind up delivering your baby if your regular doctor isn't available.

It is not necessary to have a birth plan as all of these preferences can be made while in the hospital, but it is certainly important to think about all the options and discuss them with your partner and doctor.

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8 Things To Include In Your Birth Plan

Writing a birth plan can help you feel more prepared and empowered as your due date approaches. A birth plan lays out your wishes for labor, delivery, postpartum, and newborn care. Even if you don’t end up sticking to the plan, it is a valuable tool for educating yourself and making informed decisions during labor and delivery.

General Tips for Writing a Birth Plan

There are many pre-made forms that you can fill out available from multiple websites, but you should write your own for the best results.
- Think about using the prewritten plans as a tool to use for writing your own plan.
Your birth plan should be brief, 1-2 pages is a good length.
Make instructions and requests clear and easy for doctors and other healthcare providers to read.
Bullet points are a good way to go to communicate clearly.
Use language that is firm but polite.
If you want to, include short explanations of your choices.
Make sure you are properly educated on your choices. There are many resources you can use to learn more about your different options. Ask your doctor about the best sources to use and think about taking a childbirth preparation course.
Discuss your birth plan with your obstetrician, midwife, or other relevant care providers before your due date.
Know that even if you make a plan, things may not go exactly as you pictured. The goal is for you and your baby to be healthy, and your healthcare providers will work to make sure that happens.

8 Things to Include When Writing a Birth Plan

1. The Key People Involved

When writing a birth plan, begin with listing the names and contact information for the key people involved in your delivery. This could include:

You
Your obstetrician or midwife
Your chosen pediatrician
Your partner or anyone else you expect to be present at the delivery

If there are people you don’t want to be involved in the delivery, you can identify them as well.

2. Relevant Information On Your Medical History

Include a section with important information on your medical history. List any medications you are taking, any conditions you are being treated for, and information on past pregnancies and deliveries.

3. What Type of Environment You Want

Put where you want to give birth in writing. If you are being seen by an obstetrician or certified nurse-midwife (CNM), that will most likely be at the hospital or birthing center they work with. But you should also put down in writing the type of atmosphere or environment you want to deliver your baby into. Note if you want certain music or guided meditations to be played. Or if you want the room to be as quiet as possible, make sure that’s clear.

4. Pain Management Preferences

Make sure you include your preferences for pain management. That means whether or not you want an epidural and any pain management techniques you want to use. If you have had trouble with pain management during previous deliveries, make sure you make a note of that.

5. Preferences for Birthing Positions

If you have discussed or explored different birthing positions with a care provider, note your preferences when writing your birth plan. Make sure you are educated on how to use these positions and any props you will be using. If you end up getting an epidural, you may need a contingency plan because you may not have the leg strength for squatting or sitting.

6. Other Wishes for Delivery

When writing a birth plan, you may also want to include:

Whether or not you want an episiotomy
What types of medications you want to avoid in the event of an emergency C-section
Requests for delayed cord clamping when possible
Choices for cord blood donation or cord blood banking

7. What Type of Postpartum Care You Want

In your birth plan, let healthcare providers know what kind of medications do and do not work for you. This includes pain medications, stool softeners, and laxatives.

8. Instructions for Newborn Care

Be clear about what kind of care you want your baby to receive. For instance, if you want to hold the baby skin-to-skin immediately after delivery, make a note of this. Include details on:

Your plans regarding breastfeeding
The use of antibiotic eye ointment
The use of vitamin K
When the baby will be bathed for the first time

Of course, you should find a pediatrician to discuss these things with before you deliver so you are prepared to make these decisions.

The physicians, nurses, and medical staff at Kernodle OB/GYN offer a comprehensive list of gynecological and obstetric services to the women in Burlington and Mebane, NC. If you have questions about how your hormones are affecting your health, call us at (336) 538-2367 to make an appointment.

Click here to read the Duke Health COVID-19 update for information on the steps we’re taking to keep you safe.

Birth plan

Soon you will have to draw up a detailed birth plan with your doctor.

Unfortunately, not always the expectant mother can participate in the planning of childbirth. As a rule, in most clinics, the sole decision is made by the obstetrician-gynecologist and all objections and wishes are rarely taken into account.

However, choosing the clinic where your baby will be born and the doctor who will help him to be born, you, of course, are already planning your ideal birth. It is our deep conviction that in order for the birth to go the way you want, even with the amendments and adjustments that life can make, first of all, we must hear the expectant mother and her wishes.

What do we mean by the birth plan and how it happens, - says the head of the EMC Perinatal Center prof. Natalia Kan.

What should be in the birth plan?

The first thing that the doctor evaluates is the possibility of having a baby through the natural birth canal. The size of the fetus, its location, the characteristics of the pelvis, and whether there are any aggravated factors in the form of somatic or obstetric pathology are taken into account. For us, the most important thing is the health of the mother and her unborn baby, even minimal risks must be taken into account. If a woman in labor has strict indications for a planned caesarean section, the doctor will discuss in detail all the risks that may be if you choose a different method, tell you why operative delivery is required. For example, with complete placenta previa, the doctor adds measures to prevent possible risks to the plan.

Most cases involve vaginal delivery or elective caesarean section. Then we provide all the possibilities for the imagination of future parents: do they want to be together in the birth unit, do they need to dim the lights, what music should be played, perhaps the woman wants to call her doula for childbirth or ease the contractions in the water, will the husband be present in the operating room and take the child first.

When drawing up a birth plan, the doctor and the patient discuss the possibility of inducing labor, the use of anesthesia, pain relief after cesarean, the ability to cut the umbilical cord and much more.

When is the best time to schedule a birth?

As a rule, at 36 weeks, so that the obstetrician-gynecologist has the most complete clinical picture based on the history of the course of pregnancy and the collected examination data.

What to do if things don't go according to plan?

Of course it could be. For example, during EP, situations may arise that cannot always be predicted in advance: acute fetal hypoxia, discoordination of labor, etc. In this case, the birth plan may change. In EMC, in such situations, the delivery room in a few seconds turns into an operating room with all the equipment necessary for the operation, but at the same time, all the wishes of the woman, which can be realized during operative delivery, will be taken into account.

We do our best to ensure that the birth of a woman takes place as calmly and safely as possible. Therefore, when drawing up a birth plan, we always take into account any wishes of a woman, if they do not contradict the safety of the mother and baby.

With us you will be calm and safe.

How I paid 113,500 ₽ for childbirth, but gave birth in the car myself

Anastasia Tikhomirova

will never forget the first birth

Two years ago I gave birth to a son — I prepared for a long time, but everything did not go according to plan.

When I found out that I was pregnant, I immediately thought about how childbirth goes, whether it is worth paying for them, how to choose a doctor and maternity hospital, whether to take my husband with me. There were a million questions, and the answers, like the stories of experienced girlfriends, varied and contradicted each other.

Around 10-12 weeks I began to prepare for childbirth: I read books, attended seminars, tried different practices - breathing exercises, aromatherapy, meditation, visualization. I even wrote and drew a message to myself in childbirth, traveled to maternity hospitals, got acquainted with doctors and their approaches. I also chose a doula for myself - this is an assistant who supports a woman during childbirth.

Then I could not even imagine that after choosing a doctor, a maternity hospital and a doula, agreeing on a birth plan and paying a decent amount for it, I would give birth in my own car in the back seat on the way to the maternity hospital.

I'll tell you how I prepared for the arrival of my first child and why everything went wrong.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

How I made a plan for childbirth and why I decided to give birth on a paid basis

Initially, I was set for the most natural childbirth - of course, with medical assistance, but with minimal interference in the process. According to modern recommendations, the environment in which a woman gives birth should be secluded and calm.

Caring for healthy women and babies during labor - recommendations from the UK National Institute for Health and Care Quality

It is also believed that a woman in labor will feel more comfortable if she is not distracted by strangers or their actions, is not nervous and gets what what she needs. Then childbirth is easier and the need for additional interventions is lower.

Birth care for a positive birth experience, WHOPDF, 2.99 MB

For this purpose, a partner or assistant is present at birth - someone who takes care of interacting with doctors and helping a woman, including psychological. In my case, I was also going to refuse epidural anesthesia, because I was afraid for my back, and I did not want labor to be accelerated by oxytocin.

The right of every woman to choose a partner during childbirth - WHO

Federal Law "On the fundamentals of protecting the health of citizens in the Russian Federation"

I made my birth plan. I went to the doctors with him, and we discussed with each one whether they were satisfied with this approach or not. A birth plan is a combination of the wishes of a woman in childbirth and the real possibilities of a doctor or hospital. With a paid delivery contract in some hospitals, it can be attached to the contract, which makes the plan legally binding.

Create a birth plan - American Pregnancy Association

Under CHI, you can also come to the maternity hospital and ask the doctors to follow the plan, but there must be a loyal doctor and a suitable maternity hospital. In any case, most of the points of the plan are subject to the right to refuse medical intervention, so there is a real chance that doctors will comply with it.

This is what my birth plan looked like

Clearly, with this approach, the best option for me was a birth contract. My budget was 100,000-120,000 R. This amount was enough to give birth in almost any maternity hospital in Moscow. Of course, with the exception of elite paid maternity hospitals and central clinical hospitals, where the price tag starts from 180,000 R - and this is with an on-duty team, and not a personal, pre-selected doctor.

Order of the Ministry of Health dated October 20, 2020 "On approval of the procedure for providing medical care in the field of Obstetrics and Gynecology"

Singleton births, spontaneous delivery in occiput presentation - clinical recommendations of the Ministry of Health of the Russian Federation

In fact, according to MHI, you can also give birth, taking into account all the wishes, but there is a lottery. It must be lucky that the doctor listens to the woman and that the views on childbirth coincide. The maternity hospital should allow partner births, this may not be available under compulsory medical insurance. In addition, the whole process will have to be aware of what is happening and insist on your own. Agree, this is difficult to do when exhausting contractions have been going on for several hours.

What is natural childbirth from the point of view of modern medicine

Anastasia Belova

obstetrician-gynecologist of the Fomina Clinic network, Moscow

Often, natural childbirth is understood as childbirth without intervention from doctors. This is not entirely true, since childbirth, by definition, cannot be unnatural. They can be induced, that is, caused, or by operative delivery, such as a caesarean section. But here we are not talking about the normal course of pregnancy and childbirth, this requires serious evidence from the mother or fetus.

In terms of the amount of medical intervention in normal childbirth, there has been a huge breakthrough in the last 3-5 years. Now they are trying to get away from the so-called obstetric aggression. All modern recommendations, including Russian ones, which are used both in private medicine and in the CHI system, regulate the position of non-intervention. That is, doctors try to simply observe the course of normal childbirth, intervene to a minimum - only when necessary.

Even the number of vaginal examinations is now limited - for example, the dynamics of the opening of the cervix, which is important to assess during childbirth, is checked much less often than it used to be.

In modern maternity hospitals, both according to compulsory medical insurance and paid, soft birth techniques are common: in the twilight, vertical birth, water birth, free behavior of the woman in labor in the process. There may be fitballs, exercise walls, special swings. Of course, a lot depends on the equipment of a particular maternity hospital, not everything can be available.

Also, according to MHI, a woman has the right to partner childbirth, however, in some maternity hospitals the situation may be such that this is impossible: for example, there are no individual maternity wards.

For the most part, a lot is being done now for the careful management of childbirth, they try to take into account the wishes of women everywhere, but all this is individual. That is why women still often choose paid contracts, a specific OB-GYN, doula, and so on, in order to increase the level of trust and communication.

Who is a doula and how to choose one

Who is a doula. A doula is a woman's partner in and before childbirth. She should provide psychological support during pregnancy and childbirth, help, distract with conversations from pain, create a peaceful and calm atmosphere in the maternity ward. It is important for a woman to try to relax and rest between contractions, but with the bright light, the "life-affirming" look of the maternity ward and the chaotic walking of the medical staff around the wards, this is difficult.

Why a doula is needed - Mayo Clinic

A birth companion to improve quality of care, WHOPDF, 208KB

Support for women during childbirth - Cochrane Database of Systematic Reviews

doctors and nurses - she will not make any decisions, but it is better to convey information to a woman during childbirth than a doctor, especially if it is a birth under compulsory medical insurance.

In principle, instead of a doula, anyone can be a birth partner - mother, grandmother, sister, husband, girlfriend - any close person who can handle it.

For me, my husband fell away immediately. Firstly, he is not a doctor or a psychologist. Secondly, it was not clear how he would help me in childbirth: his frightened face would most likely frighten me more than the process itself. But since I wanted my husband to participate, we decided that he would come after the birth and solemnly cut the umbilical cord.

I decided that girlfriends and mothers are, of course, good, but I need a specialist who has already been to childbirth, with experience and knowledge, so the choice fell on the help of a doula.

How to choose a doula. First of all, psychological education is important, preferably in a specialty close to perinatal psychology. The presence of a medical education for a doula is not important; there are doctors and midwives in the maternity hospital.

During childbirth, the doula has no right to interfere with the work of doctors and provide any medical assistance to the woman in labor. A doula provides exclusively psychological assistance, can advise, control something, talk about the pros and cons of any intervention, give a massage, create the right atmosphere. But she cannot make any decisions, especially medical ones.

You also need experience in childbirth. The Internet is full of announcements about doula training, there are both regular courses and professional retraining diplomas. Certificates and diplomas do not say how the assistant will behave during childbirth, what assistance tactics she will choose and whether she will suit you. The more births a doula has had, the more she has seen different birth patterns and is more likely to be prepared for a variety of situations. It is better to make sure that the selected doula has not just graduated from the courses, but has been working in this field for quite a long time.

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When choosing a doula, you need to focus on yourself. You need to understand that she will see you in a completely unpleasant and even somewhere terrible form - you should not be afraid or ashamed of her, you need to trust her and allow you to help. A doula should be endearing as a person, it’s good if you feel calm next to her, so it’s better to meet and chat several times before giving birth.

You can also read reviews. I didn’t really rely on reviews, but for my own peace of mind I read the birth stories on the doula pages and wrote to a couple of participants in these stories to tell their impressions.

Where to find a doula. You can search for a doula on the Internet or social networks, such as Instagram, and choose from the options provided, focusing on your preferences and wallet.

You can trust the hospital and, within the framework of the contract with it, choose a perinatal psychologist from among the psychologists of the hospital. But in this case, you need to conclude a contract with the hospital: you won’t be able to pay separately for the doula bypassing the maternity hospital. At least in the maternity hospitals where I was, this was not allowed.

For example, Instagram gives tens of thousands of entries using the hashtag #dula

How I found a doula. In my case, as funny as it may sound, my mother-in-law chose a doula for me. She just sent a link to her and said that she had been watching her for a long time and she liked her. I looked at the posts of this doula on the Internet, read a bunch of laudatory reviews, made sure that she was a perinatal psychologist with an education, phoned her, met - and realized that this is my person.

My doula had three pricing options:

The minimum tariff is 20,000 RUR. It included the birth itself and doula calls at any time of the day before the birth.
The optimal tariff is 25,000 R, these are calls, childbirth and postnatal care for a child.
The maximum rate is 30,000 R. These are calls, childbirth and postpartum swaddling for mom - a special procedure when you seem to be in a cocoon. It helps to recover after childbirth.

At the same time, 50% of the amount had to be paid immediately, another 50% - after the birth. I chose the second tariff and paid 12,500 R. I must say that now, two years later, the prices for doula services have increased by an average of 5,000-10,000 RUR.

Most doulas also offer their birth preparation courses, they cost an average of 5,000-10,000 R. I went to these at 32-33 weeks of pregnancy, it was useful. Most of all I liked live broadcasts with a doula and doctors and classes for pregnant women, which were also included in the courses.

10,000 R

the average cost of prenatal courses at a doula

At a meeting with a doula. Photo by Anna Larina

To attract clients, doulas also arrange meetings once a month or more often, where doctors, psychologists, newborn photographers and even aromatherapists are invited. All these meetings are free, I only paid for tea or parking.

During pregnancy, I attended 7-8 such meetings, and they were all different. At the last meeting at 38 weeks, we drew a drawing of childbirth with a psychologist, it was also free.

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These meetings gave me a lot, at least communication with the same pregnant women, understanding that we have the same fears. There was also communication with doctors and the realization that they are all on our side, and we also went through various breathing and meditation techniques at these meetings. And most importantly, you could get to know the doctors and ask them absolutely any questions in a relaxed atmosphere.

Childbirth drawing that I drew together with a psychologist

How I chose a maternity hospital and a doctor

The easiest way to choose a maternity hospital is by acquaintance. For example, everyone advised me the maternity hospital on Planernaya - I live in Khimki. Most of my friends gave birth there and were satisfied. But I wanted the most natural childbirth, so my ideal maternity hospital had to meet the following requirements:

Have the international status of WHO and UNICEF "Baby Friendly Hospital". This means that 10 principles of successful breastfeeding are observed there and conditions are created for the constant stay of a mother with a child. There were 11 such maternity hospitals in the capital in 2020. It was important for me that the maternity hospital was located in the north or north-west of Moscow - this reduced my list to four suitable ones.
There should be doctors in the maternity hospital who are familiar with the Auden technique of childbirth and are guided by it during childbirth. Michel Auden is a French obstetrician and gynecologist who practices labor according to the rule of three T: warm, dark, quiet. So the list was reduced to two maternity hospitals in Zelenograd and Bibirevo and three doctors.

List of maternity hospitals in Russia with WHO and UNICEF status - Gift of Sunshine Charitable Foundation

Promoting the development of baby-friendly hospitals - WHO

New Reasons and New Ways to Study the Physiology of Birth - Article by Michel Auden in the International Journal of Obstetrics and Gynecology

To make my final choice between two maternity hospitals, I started going to open houses. Usually they are held in maternity hospitals once a month. During the open day, they get acquainted with the hospital, wards, maternity boxes, show both paid and free wards and boxes. In the Zelenograd maternity hospital, we were even shown the department of pathology of newborns and premature babies. You can also meet doctors and ask any questions. For example, I asked if the spouse could bring champagne to the maternity ward and if it was possible to attach the birth plan to the contract.

The openness of maternity hospitals is aimed, oddly enough, not at increasing the number of contracts for paid births, but at attracting women in labor from all over Moscow and the region. So, in the Zelenograd maternity hospital, women in labor are accepted not only with a Moscow residence permit. They also lure the "golden hour" on the mother - this is when, immediately after the birth, the child is laid out on the mother's stomach and all examinations are done on her. And also the presence of a husband at childbirth and the "Moscow box of a newborn", in which 44 items for caring for a child. And all this according to OMS.

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This is how the box with gifts that is given out in Moscow maternity hospitals upon discharge looks like. Instead, you can get a payment of 20,000 R. Source: "Birth in Moscow"

It was a discovery for me that maternity hospitals are fighting for women in labor and are really ready to change to modern requirements. Maternity hospitals have pages on social networks, they broadcast live with doctors, arrange holidays, draws and do everything to get away from the picture of a typical maternity hospital from the memories of our mothers.

If you need paid childbirth, you can consult your chosen doctor for free, and in case of doubt, go to at least two or three. Each maternity hospital also has a school for pregnant women: it can be free for those who are observed at the consultation with her by registration, or paid - the lesson costs about 500 rubles.

/platnie-rodi/

Classes are held right in the hospital and can be completely different - from pain relief during childbirth to classes with babies. This is an ideal option for getting to know the maternity hospital.

Before giving birth, I managed to go to such classes twice: once for gymnastics, another time for relaxation in childbirth. Oddly enough, at 38 weeks I learned a lot. For example, I looked at childbirth through the eyes of doctors and understood how to relax on the Swedish wall during childbirth. The classes were conducted by doctors and perinatal psychologists of the maternity hospital.

What else did I pay attention to when choosing a maternity hospital

General impression. It is worth paying attention to the behavior of the staff, the hospital itself, the view from the windows and other details. For example, of the two maternity hospitals that I eventually studied, the one in Zelenograd was better.

The maternity hospital bribed me with good-natured staff, and the building itself, both outside and inside, does not look like a hospital at all. Nice colors everywhere, views of the forest. While walking here, there is absolutely no feeling that you are in a hospital.

In the maternity hospital in Bibirevo, I felt like in a hospital, the staff also did not look very responsive, although it seemed to be an open day. In general, the situation in the maternity hospital seemed to me not conducive to calmness and relaxation.

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Features of the approach to childbirth and medical care. Birth care in maternity hospitals may differ. In my case, in both cases, partner childbirth with one attendant was allowed, even under compulsory medical insurance, they are also immediately applied to the chest. At the same time, in the Zelenograd maternity hospital there is also a "golden hour" for mom.

Another advantage of the maternity hospital in Zelenograd is that it is a perinatal center, and not just a maternity ward in a general hospital. Accordingly, if something happens to a mother or child, they will be able to provide qualified assistance here, without having to call an ambulance and go to another hospital.

The main advantage of the maternity hospital in Bibirevo for me was that if you take a double or luxury ward, you can give birth right in it on a double bed - if there are no contraindications. Even in this maternity hospital, childbirth in the bath is welcomed, unlike the Zelenograd maternity hospital, where only the initial contractions can be waited out in the bath.

Maternity boxes. It was important for me that the maternity hospital had the following equipment:

Transforming chair for vertical delivery.
Vertical delivery chair.
Fitball for contractions.
Shower to water the coccyx during childbirth.

I also wanted a closed box, that is, without windows to the corridor. I didn’t want everyone and sundry to look at my torment.

Maternity hospitals in both maternity hospitals had everything you need, they are equipped approximately the same. Only there was no soul in some. Back in the maternity hospital in Bibirevo, there were only open boxes under compulsory medical insurance. In the Zelenograd maternity hospital, all maternity wards - both under compulsory medical insurance and under the contract - are closed, there are no windows to the corridor.

There were few differences in contracted maternity wards. In the Bibirev maternity hospital, the maternity ward is larger and there is a separate area for those who are waiting. In the Zelenograd maternity hospital, in addition to basic things like a fitball and a chair for vertical birth, a hammock and a wall bar for relaxation are added, there is also a shower, and not just a bath.

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Chambers. The main difference here is the number of beds. In the postpartum wards for compulsory medical insurance in Zelenograd, there is a ward for two, in Bibirevo - for four.

Single paid wards in Zelenograd with private bathroom. There are three categories of paid wards in Bibirevo, and they are very different from those according to the CHI, they are even located on different floors. Paid wards here are like hotel rooms with huge beds and the possibility of comfortable living with your husband. In the Zelenograd maternity hospital there is only one ward for double accommodation.

Postpartum ward for CHI at the Zelenograd maternity hospital Lux ward at the Bibirev maternity hospital

Contract value. Prices in different maternity hospitals differ, but on average they are about 100,000 R. There may be ready-made packages of services with a certain price or a standard price and surcharges for increased comfort or special conditions.

For example, in the Zelenograd maternity hospital there were two types of contract:

Large - 95,000 R, including a doctor, a maternity box and a paid ward for one person.
Small - 65,000 R for the services of a doctor and a maternity ward, and the ward is already an ordinary two-bed, as according to compulsory health insurance.

The Bibirev maternity hospital has a different pricing system. The contract for childbirth itself cost from 90,000-100,000 R, depending on whether the doctor has a degree. The cost of the contract also includes a maternity box. For a paid ward, it was necessary to add from 10,000 R to 20,000 R, depending on the level of comfort. For 20,000 R, this is practically an apartment with a kitchen, a bedroom and a bathroom. Promotions and discounts are often held in this maternity hospital, in 2019 my contract for a doctor - candidate of medical sciences, a ward and boxing cost 120,000 R.

120,000 R

cost my contract for childbirth

The choice of a doctor in a maternity hospital. The choice of a doctor was easy for me: I came to the appointment and announced my plan for childbirth. Since I initially chose doctors who were supporters of natural childbirth, they were not surprised by my birth picture. However, with one doctor from the Zelenograd maternity hospital, we agreed on everything, but with the other on the point "wait until the 42nd week" - no. Therefore, I chose the first doctor, he also had a strong liking for him. Paid 95,000 R, signed a contract and joyfully waited for X-day.

In Bibirevo, I liked the idea of giving birth right in the bed, but I didn’t like the maternity hospital itself and the attitude of the staff, besides, the prices were higher there. After personal meetings with doctors from Zelenograd, I finally decided that I would give birth there.

As a result, I planned a vertical natural birth without anesthesia and oxytocin with a doula, bath, shower, wall bars, and after the birth my husband was supposed to come and cut the umbilical cord.

How I ended up giving birth in a car

My mistake was that throughout my pregnancy I stubbornly believed that I was giving birth just like my mother. And she had a long labor, 14 hours each, large children and 42 weeks of pregnancy. I thought that I would not give birth on the planned date of birth, but would give birth later. As a result, I gave birth a day earlier, and the birth lasted not 14 hours, but five.

Signs of onset of labor - Mayo Clinic

I woke up at three in the morning from the traditional nocturnal discomfort of late pregnancy, looked like and fell asleep again. At six in the morning I woke up from a contraction, went for a walk and measured them. They were chaotic: sometimes once every ten minutes, sometimes once every five, sometimes every minute. I figured I was measuring wrong. I went to wake my husband, he began to resent why it was so early, and I told him: "I'm giving birth ..."

The sensations were already unpleasant: not hellish pain, of course, but hard. I thought, if these are only the initial contractions and a small opening, then what will happen at the end. While I was waking up my husband, my water broke, the sensations became even brighter. It became simply unrealistic to spin, however, I stubbornly believed that these were the initial contractions, the main one was still far ahead - and I began to admire women who gave birth several times.

At seven in the morning, we called the doctor and said that we were going to the maternity hospital. Our car was ten minutes walk from the house. My husband went after her, and when he returned, I was already moving with great difficulty. I was madly drawn to the ground, but miraculously I was able to make my bed and get dressed. I thought of putting on sweatpants with a drawstring, which later came in handy. As I was leaving, I remembered that I forgot the body butter, and I still have ten hours to give birth, I really need it. Then I also forgot the drawing in childbirth - I also had to return for it.

/rody-sovety/

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When we left the apartment, it turned out that only one elevator was working. People went to work, we stopped on a bunch of floors. As a result, they got to the car only at eight in the morning. I could no longer sit in it normally - I crawled in. And again I was covered, as I thought, by a fight. Although in fact it was probably already the third or fourth attempt.

Five or ten minutes later there was another contraction, it seemed to me as if the cork had come off - this is a small clot of mucus in the cervix, which comes out before the discharge of the water. But this couldn't be. I looked into my pants and realized that I had given birth. The child successfully got into wide trousers, like in a hammock. It's scary to imagine what would happen if I put on a dress or, even worse, jeans.

The husband remembers that his son immediately screamed. And the first thing I remember is how scared I was if all the legs and arms were in place, and began to count them. We could only think of wrapping the child in disposable diapers and pressing it against me, after which I was already afraid to move. And I still had to get to the phone to call the doctor. The back seat of the car looked like it might have been thought at the car wash that my husband was transporting a corpse.

Then it was a 40 minute drive to the maternity hospital, a stop along the way because we were afraid that the umbilical cord was tangled in the legs - mine and the child, a call to the doctor and doula who were in shock, and cutting the umbilical cord in the back seat. And also - the birth of the placenta in the emergency department, the furious looks of other fathers who at that time brought their wives, and the general commotion of all doctors.

What to do if labor starts unexpectedly

Anastasia Belova

obstetrician-gynecologist of the Fomina Clinic network, Moscow

It is impossible to prepare for sudden labor in advance, moreover, it cannot be stopped or slowed down in any way. If you are traveling by car and you understand that you will not have time to get to the medical facility, you should ask the driver to stop and immediately call an ambulance. On the plane, you can vacate several seats, spread something, take a comfortable position.

The main thing is to listen to the woman in labor, to pay attention to her well-being. Often, forcing a woman to go somewhere for medical help is much more dangerous than having a birth where it began.

The very process of birth is laid down by nature, childbirth can be swift - usually there is nothing to worry about. After 37 weeks of pregnancy, a woman can go into labor at any time - it is impossible to accurately predict their period. We must try to ensure that the chosen maternity hospital is close enough, not to take risks and not to go somewhere far away, for example, to the dacha.

How I was in the hospital and how much I ended up paying for childbirth

When we arrived at the hospital, they didn’t know that we were on contract and what happened, but they treated us well. Two nurses got into the car, helped to wrap up the child, examined him, and allowed her husband to cut the umbilical cord. As a result, they took the child away, and they took me inside on a gurney.

The problem was that after the baby, the placenta should be born, but this did not happen to me because I was sitting all these 40 minutes and was afraid to move. I lost a lot of blood and got tears, as a result, right in the emergency department, three doctors were already waiting for me, including mine.

The whole hospital came running to me, everyone asked how it happened, even the head doctor stopped by. And everyone was surprised when they heard that the birth was the first. The placenta was born right in the emergency department, then I was taken to the box, where they sewed up and treated the tears.

The doctor told similar stories from practice for a long time, which ended not so well. Then he said that he had a lot of patients, but he would remember me for a long time. To be honest, I enjoyed it. He awarded her husband the title of "obstetrician-gynecologist", which he is still proud of.

/patient-can/

What does the law say about doctors? All day alone and you won’t go anywhere, food is brought. I don’t even have anyone to talk to - doctors and nurses rarely come in, there are no neighbors, it’s somehow lonely. Considering that this is the first child and I did not understand well what to do, it was scary. These three days in the hospital, I envied the girls who were in the wards under compulsory medical insurance - with neighbors, a canteen and a view of the forest from the windows.

View from the window of the maternity hospital to the courtyard

The contract for childbirth stated that "the amount is returned if the birth took place urgently in another hospital." However, the placenta was born in the maternity hospital, they sewed me up there, and in the ward for the next three days I was also here - so the money was not returned to me even partially. These were probably the most expensive placental deliveries in history. It was a shame that they sewed me up in a regular ward under compulsory medical insurance, and I never used the Swedish wall of the paid ward.

Doula went to meet me, and I did not pay her the second part of the amount. Although her contract also states that if a woman in labor gives birth for reasons beyond the control of the doula without her, the money is not returned. This usually happens during emergency hospitalization or when a pregnant woman came for an examination, and the doctor began to insist on urgent delivery.

/rody-vychet/

How to get a tax deduction for a paid birth

The result is this: giving birth in a car cost me 113,500 R - services of a doula and her training courses, as well as the birth itself.

I spent on preparation and childbirth 113,500 Р

Contract with the maternity hospital	95 000 Р
Doula services, 50% prepayment	12 500 Р
Doula birth preparation course	5000 R
Two prenatal classes at the maternity hospital	1000 Р