Wednesday, June 4, 2014

Birth Plan

Now that it's June, I suppose that I should start thinking about planning my birth.  When I was pregnant with EG we were taking the Bradley class and had a dedicated time set aside each week to talk about, plan and think about our impending delivery.

Now, between trying to move around furniture, chase after EG and just sleep a little bit more, I haven't really given it much thought.  As you know, we hired a doula for this delivery, and what a G-d send she is too!  She's given us a few meetings before the birth, and having her come by has been the only real opportunity we've had to discuss the impending labor.  Working Dad came to my last doctor's appointment, and we sat outside afterwards telling ourselves that we would start to prepare.

So this is attempt #1.

If I could choose one idea or thought to have during my labor, I think it would be this one:
"You are braver than you believe, stronger than you seem, and smarter than you think." 

We are going to attempt a natural/drug-free delivery again this time.  Last time we made it about 17 hours before I needed to get an epidural because I was so exhausted.  This time I'm hoping to make it all the way.  I've had lasting pain in my back from the epidural, so I know it's not something I want a repeat of.

My personal philosophy has always been that we can endure just about anything, as long as there is an ending.  And I'm hoping that with this delivery that's the attitude I can take.  I can do anything, I can get through it.  One moment, one contraction at at time.

So, without further ado, here's our Birth Plan:

Elizabeth and Working Dad, with support from their doula Holly, would like to have a healthy mom and a healthy baby throughout the birth/labor process with the least amount of medical intervention possible.  As our supportive birth team we hope to have maximum flexibility, minimum medical intervention, and open communication to ensure informed consent.   

We acknowledge it’s impossible to lay out a comprehensive plan, but have our primary goal set as a healthy mother and a healthy baby and appreciate your assistance in this pursuit. 

As a laboring mother Elizabeth prefers that we focus on the positive, and aim to have a ‘negative-free zone.’  If needed, please feel free to pull Working Dad into the hallway so Elizabeth can focus on labor.  He can adequately communicate all needs to Elizabeth as necessary.

During Labor:
Elizabeth would prefer:
·         To be able to move as much as possible; utilizing the hallways, shower and other areas
·         External fetal monitoring only, every 4 hours or if a change of labor necessitates  it
·         Not to have an IV, but is comfortable having a saline lock if needed for antibiotics
·         To keep vaginal exams to only when a change in labor is apparent and not to have progress announced
·         For her bag of waters to break naturally
·         To ingest any desired food or liquid
Please do not make offers of pain medication
o   We know our options  and should something be needed we will ask for it
o   Please encourage us to take another walk around the floor, try another position, and use encouraging phrases- suggestions are appreciated

During Delivery:
Elizabeth would like:
·         To have a frank conversation regarding delivery of our child with the midwife or doctor who will be delivering the child, to ensure all members of the medical team are on the same page especially in the event of a shift change.
·         To have freedom of movement to be in whatever position suits her and the child best
·         Prefers not to push, but rather allow her body to naturally labor down until delivery is imminent
·         Should delivery occur during the daytime, we would prefer to deliver with the blinds open and as much natural light as possible
Please note that the sex of the baby is unknown, and we anxiously await to find out!

In the event of a C-Section:
·         Working Dad will stay with Elizabeth through the procedure
·         Elizabeth would like to have a curtain up, separating her from the surgery
·         We would prefer low lighting, positive interactions and to have Working Dad announce the sex
·         We would like to have immediate skin-to-skin contact with the baby, on the OR table if possible
Working Dad would like to cut the cord, if possible

After Birth:
Elizabeth experienced some trauma related to her placenta not being able to naturally deliver, and she bled out throughout the night following the birth of her first daughter.  It is our wish to allow the post process to happen as naturally as possible to help ensure that we do not have a repeat of our first delivery.

  •  Delay clamping of the cord until blood flow has ceased
  • We would like the placenta to deliver naturally, without Pitocin, cord pulling or other interventions
  •  If the baby must be taken to the NICU, Working Dad will go with the baby
  • We prefer to delay all newborn procedures for the first hour of life to bond with our new child. 
  • We prefer for all procedures and medications given to our child explained to us and done in our presence.
  • Elizabeth plans to breastfeed.  Please do not offer formula, sugar water or a pacifier.
  • We do not plan to circumcise in the hospital before our departure should we give birth to a boy.

In the event of a poor outcome:
Working Dad and Elizabeth would like the opportunity to take pictures, share with our child and take as much time as needed/possible to invite family to support us.

Of course, a birth plan isn't a substitute for good honest conversation, something I hope to have with the nurses and doctors that will be attending us during our delivery.  Since we'll be delivering at Kaiser we have no idea who will actually be the doctor/midwife attending us.  Which only makes a document like this all the more important.  Getting everyone on the same page is what a birth plan is all about.

While I advocate strongly writing a birth plan, I also advocate planning for your birth outside of this document.  I've seen too many people write things, or use automated birth plans (like this one) that don't really say much.  Or go the opposite and write things they have no idea about (I've been doing perinal massage to avoid an episiotomy).  If that's true, that's great, but when your birth plan is filled with things that aren't true, you'll only end up being ignored by the nurse.

Here's to B2's delivery!  Did you write a birth plan?  What did it say?  Any comments or suggestions?

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