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Choosing a Birth Plan That is Right for You

Erin Neu discusses her role as an OB nurse navigator and shares her insight on choosing a birth plan that is right for you.
Choosing a Birth Plan That is Right for You
Featuring:
Erin Neu, RN
Erin has unique qualifications, in addition to being a Nurse Navigator who has worked in OB for over 23 years in our Family Birth Center, Erin, her husband, their 10 children and 5 grandchildren were all born at Franciscan Health. She is well versed when it comes to pregnancy, childbirth, motherhood and especially delivering at Franciscan Health-you could say it is her passion.
Transcription:

Scott Webb Host: Whether you are thinking about having your first baby or are a seasoned veteran, like my guest today, navigating the process of having a baby can be a little daunting and OB Nurse Navigators are available to help guide us through this amazing journey. And my guest today is Erin Neu. She's a mother and grandmother and an OB Nurse Navigator at the Franciscan Health Center for Women and Children.

This is the Franciscan Health Doc Pod. I'm Scott Webb. So Erin, thanks so much for joining me today. Let's start with perhaps the easiest one for you today. What does an OB Nurse Navigator do? What do you do on a daily?

Erin Neu, RN (Guest): My day takes on its own path, but just as my job description says, I'm a navigator. So, I work with our expectant families who are having a baby either soon or in a few weeks or in a few months. And sometimes with families pre-pregnant, to help start planning their family and to grow their family. So, we work with them in different ways. I do face-to-face appointments of course, but my biggest job in the beginning is just to get them familiar with our hospital system, our birthing center, and to get them ready and prepared for the next few weeks of their pregnancy and helping them just feel more prepared for delivery more than anything.

Finding an OB GYN is usually the first thing we do. So, if they've not already gotten established in an office, we find the perfect fit for them. And that's based on lots of different reasons. So, that first contact with an expectant family, a lot of it is just some questions that I ask them so I can help them find the perfect doctor. And then once they get to that first appointment, it's keeping in contact with them throughout the rest of their pregnancy, helping them navigate the OB GYN office, helping them navigate the hospital system, getting preregistered and lots of things. So, I'm really like that support person, your doula, your friend, your mom, big sister, more importantly, just that connection between your doctor, your hospital and you. So, I think OB Nurse Navigator is a perfect term for what I do every day.

Host: Yeah, it really does sound like you help moms and dads-to be navigate all of this, which, especially if this is their first baby, can probably be a bit overwhelming. So, let's talk about that initial free face-to-face visit. What's covered in that visit as you help moms and dads-to be start this amazing journey.

Erin: First of all, I get, just a little brief, health history. So, if they don't have an OB GYN, it's important to get that done and get that selected and based on their health history, if they maybe have some significant chronic health issues, we want to get them into an OB GYN that specializes in that. So, initially, it's just that quick little health history, talk a little bit about how they're feeling, talk a bit about diet and nutrition, the importance of taking prenatal vitamins right away, getting that first appointment set up, of course. And how and why it's so important to keep those prenatal visits.

The first few months of pregnancy, you see your OB GYN monthly, and as you get closer to your due date, you start to see them more frequently, with the last four visits being in the last four weeks of pregnancy. So, those appointments are super important and sometimes they feel like they're not, but I want moms and dads and support people and families to know that it is important to keep those appointments and to go to all of them. Early prenatal care is the best way to ensure a healthy outcome, both for mom and baby. So, the earlier the better.

We talk about some of just the routine labs and tests that'll be done at those appointments. We talk a bit about some other tests that they may need if they're in a high-risk health situation and then of course we get them starting to feel familiar with the hospital and the resources and services we offer here. So, things like prenatal, childbirth, breastfeeding classes. We do have a free car seat safety clinic. So, we get connected with that. We talk about the hospital of course, and what they can expect when they're here.

And as they go through their pregnancy, at certain points in their pregnancy, they'll have times where there's special screening and tests and things that are done. And we can elaborate a little bit more on that and plan for that. And then as they get closer to delivery, I bring them into the hospital and do a private tour with families so that they can see what door they're going to use on delivery day. Support people are always a little anxious about where do I take her? Where do we check in? How do we check in? So, that process. So from the beginning, until the end, I'm here to just help them prepare and get ready for the big day, which is usually delivery day in their hospital stay.

Host: I know that one of the things that people do now, parents-to be do, is they put together a birthing wish list. So what is that exactly. And what types of things might be on someone's list?

Erin: Yeah. So, a birth wish list, I like to use wish list rather than birth plan. Birth plans are great, but they can be a little intimidating to families. So, a birth wish list could be, I want to come to the hospital and deliver my baby. And you tell me everything that I need to do or need to know. It could be very comprehensive. A birth plan could be, I come into the hospital, I want no medications for my delivery. I want just my support person present for delivery. It can be very specific to what their wishes are.

But what's nice with a birth plan or a birth wish list, is that if moms and support people can sit down together and come up with what their thoughts or what their feelings are and what they hope to happen for their delivery, and then things maybe go a different path, they sometimes are a bit more prepared for that. So, having some answers, if, for instances, the decision is made while they're in labor that mom needs now to have a Cesarean delivery or a C-section delivery. Is dad gonna be in the room with her during that? That's something that you don't want to answer in the moment. That's something that you maybe want to have talked about before you arrive at the hospital.

And it's always funny too, because support people at times will have different ideas. I thought for certain, you would want an epidural because you don't handle pain very well when the expectant mom is no, I want to do this natural. So, it brings about conversations sometimes before you're here in the moment at the hospital.

And then of course, if there's maybe some special circumstances that perhaps this is going to be an early delivery, and mom and dad can plan for that ahead of time, they'll know what the policies and what they need to prepare for a baby in our NICU, here at the hospital is. So, I think birth wish lists are great. I highly recommend them. The nurses here at the hospital, we love them. They can be printed out on a really nice, pretty piece of paper, or they can just be scribbled on a napkin. We don't care. It doesn't have to be anything fancy. We just want to know what your wishes and what your hopes are for your delivery and your stay with us so that we can make that happen.

And there's times that there are things that people think we can't do that we absolutely can do. So, those conversations, again, with me prenatally, before delivery, we can help get some things set up and arranged for them here in the hospital if we need.

Host: When it comes to hospitals, in terms of, where we should have our babies or have the babies delivered, do moms and dads-to be necessarily really care which hospital? And if they do, how do they choose the right one?

Erin: One of the things that I always recommend is, to visit. If you're able to visit the hospital that you're either considering to deliver at, or you're asked to deliver at because insurance is directing that, to call the local hospitals and to try to make a visit if you can. If they don't have an OB Nurse Navigator like myself, it's likely that the Childbirth Educator that leads the classes and things could give you some direction on how processes and policies and things work in that specific hospital or birth center. I also think it's very important to be in a center that has a high level NICU, which we do, because of course, we don't plan on our babies going to NICU, but if your baby does require some intensive care or special care following delivery for a complication or something that was unexpected, our moms want to be and our families, want to be in the same center that their baby's going to be in. So, if you're delivering in a hospital that maybe does not have a higher level NICU, it's likely that if your baby requires higher needs, it would be transferred to another facility which could mean that mom and baby is separated for a bit, and that's not what we want.

Finding a hospital that has a high level NICU, has an OB staff that is trained in emergencies and maybe unexpected delivery situations. We have a high-risk OB Center here as well. So, having that in our hospital, we can care for women who have very complicated pregnancies, very easy, what I call boring pregnancies, where there's not a lot going on, if we can say that about pregnancy. But delivering it as in a family focused center that has the backing of an entire hospital to care for mom and baby should the need arise. Of course, we don't ever want that to happen, but having that here I think is very comforting to our families. They know that if their baby does require some special care in our NICU, they can be with their baby in a private room setting.

So, making that visit to the hospital and learning all you can about the hospital, definitely can help you make a choice. And oftentimes insurance does say, this is one of the choices that you have, but there's a good amount of times that insurance will give you a couple of options of hospitals that you can deliver at. So, if you feel as though, perhaps you're limited to one, maybe ask the questions of your insurance company is there an alternative hospital that I could deliver at? And of course, explore the cost of that too, because there's always, sometimes there's those tiering systems where one facility's not as expensive as another.

Host: And Erin, what concerns, if any, should parents have about having a baby during the pandemic? And you mentioned support people. And so in the past, it could have been maybe the whole family that was there, after the baby was born. But now we're just talking about mom and a support person, right

Erin: Yes, we are. Our hospital, as well as many others, are only allowing the one support person to be with the laboring mom. Often when we have a baby, we have this big dream of grandma and grandpa or big brothers and sisters coming in to see their new baby brother or sister, after delivery and extended family and friends coming and things, and that is not what's happening right now. So, it's been very hard for some of our moms and dads and support people and expectant families. Some of those dreams that they had or thoughts that they had of what was going to be, is not happening. And it's unfortunate, but it's actually a little bit of a blessing too. When you're in labor and you're waiting for a baby and you've got a whole room full of people out in the waiting area, you feel like you're the show a little bit, like you're the one that's got to get this entertainment happening and going, so, these people can see this baby and go home. And there's a little bit of silent stress, I think for families sometimes when there's a lot of people in the hospital. And it's not that they don't want to share that experience with their family, but I think having just that one support person with you, it's very calming. You don't feel as rushed. You're able to breathe and take the time to enjoy the experience. And it's a very special time and you are going to get to share that baby with your family and your extended family and friends for a long time.

So, cherish the time that you have, the quietness that you have in the hospital right now. After you have your baby, I think our nurses and it's a bit selfishness of us, I know, but we love spending time teaching new moms and dads and parents, how to care for their baby and how to feed their baby. And when we're coordinating with visitors coming in and out, that sometimes takes away from our time with new parents and then going home is a little bit more of an adjustment. So, having all the time that we need with new families here in the hospital has been a huge blessing to us. We feel like our moms and parents are going home, feeling better prepared to care for a baby and rested.

They're having time to spend and bond and enjoy their baby without having to worry about looking all perfect and pretty, and having baby fed and ready for grandma when she walks in the door. COVID is very scary right now, especially for our expectant moms. Appointments in the office are different. Most likely support people are not able to go. It's just the expectant mom going for her appointments. So, those prenatal visits are looking a lot different. Having dad here in the or the support person here in the hospital with mom is super important to us. So, we do everything we can to keep the support people in the room during COVID. There's some precautions that we have to take, of course, as everyone is, but our ultimate goal is for the family unit to stay together here in the hospital, to go home and be healthy and to be ready for family when it's a good time to visit. We definitely recommend follow the recommendations of the pediatrician on when it's a good time to maybe have visitors or people to the house, to meet their new family member.

So, definitely reach out to your pediatrician or your doctor and ask those thoughts of what they have. They'll have the latest and greatest updated information and what the best plans and actions are at that time.

Host: Yeah, they definitely will. And Erin, so great having you on. You're just so upbeat and positive. It's such a great conversation and you've really covered all the bases. Anything else though, that we want to tell moms and dads to be, as they think about and begin this amazing journey.

Erin: I think one thing I would like to add is prenatal classes and we talked about that a little bit. They're so important. They're so helpful. They can seem a little overwhelming in the moment, but there's a lot of things that. You hear great birth stories from your grandma and your aunts and your friends, but being in the classroom, especially those that are taught by the hospital that you're going to be delivering at, can be specific to the plan or the care that you're going to receive at that facility. So, taking those classes really helps you prepare for more than I need to know how to have a baby. It really helps you understand what you might need to bring to the hospital, what you might want to bring. And again, it opens up those conversations with your support person about plans for delivery day.

So, classes are super important. All of our classes right now are virtual. Many hospitals are offering that. So, please reach out to your birthing center or ask your OB GYN if you're not sure how to connect with the people, that are offering classes at your facility, of course, we will give classes to anyone.

So, if you're not delivering here with us at Franciscan Health, we'd be happy for you to join us for our virtual classes. And, we can give you some basic knowledge, some general knowledge on babies and things, and really just to enjoy the journey of pregnancy. Those normal discomforts of pregnancy can be pretty darn uncomfortable, but they go away. After you have that baby and you meet that baby for the first time, all of those discomforts and those worries and those scares are gone.

So, enjoy that pregnancy. Don't focus too much on the news and what's happening out there. And if you have questions or you're worried about something or scared or not sure what to expect, reach out to your OB GYN, call the nurse practitioner in your office. Call me. Let us answer some questions and put those worries to rest.

Host: Yeah. That covers it. And a great way to finish. I think we covered everything today. I hope this helps moms and dads-to be. It's such an exciting time, even during COVID. And as you say, just focus on having your baby, focus on loving your baby and your family and all of that and leave the news to everybody else.

Thank you so much for your time and you stay well.

Erin: Oh, thank you.

Host: To schedule your free OB Nurse Navigator appointment, email guiding you@franciscanalliance.org or call (317) 528-5224. And we hope you found this podcast to be helpful and informative. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well.