Friday, July 16, 2010

The Birth Plan

I've been reading up on my impending BIG EVENT ... which will take place in about 6 weeks from now. It's a BIG EVENT because my status in life is gonna change forever and we're gonna be PARENTS. Which is naturally a BIG THING. Heehee.

So anyway, being inspired by the Lamaze method and all thing natural, I've decided to write a BIRTH PLAN. I know it seems like I'm being so dramatic, those who know me well enough and has seen my 30-page typed, printed and bound wedding manual would consider my 2-page birth plan a breeze by my standards!
 
I don't really know what to expect other than what I've heard and read, so I'd like to be prepared for contingencies and not lose control to a series of medical routines that may not be absolutely necessary but performed merely for the sake of comfort and convenience. I strongly believe that our bodies are designed to give birth naturally and we should aim for a birth experience as natural as God has intended it to be. Of course sometimes emergencies arise and that's where the ob-gyn works his magic with modern medical technology. My objective here is not to take medical intervention as my FIRST option nor as an easy way out. Of course, we don't deny that in many cases clever medical intervention can save lives and I'm definitely opting for that in the case of an emergency.

My research has led me to this and yet I'm not sure how accepted are pre-written birth plans in Malaysian hospitals. One main reason for having this is because  I'm quite paranoid that I'll be in too much  pain and distraction to respond with correct decisions in the throes of labor. The last thing is I want is the medical team doing a bunch of routines on me while I'm not in the sound state of mind to protest!

I'm sharing my birth plan here as it may be of some help to others and as I'm also so new  to this, I'm open to advice and feedback from the more experienced of you lot. Also, to give credit where due, this birth plan is a result of extensive research online but most of my final draft here is adapted from Childbirth.org and Birthplan.com

This birth plan is intended to express the preference and desires we have for the birth of our baby. We fully realize that situations may arise such that our plan cannot and should not be followed. However, we hope that barring any extenuating circumstances, you will be able to keep us informed and aware of our options. Our aim is to have a completely NATURAL vaginal birth as much as possible, hence we wish to be consulted on all necessary medical interventions and be clearly informed of all consequences of each medical procedure. Thank you.

Privacy
• Only allow husband and my mother in labor and birth
• Would prefer not to have students, residents etc and any unnecessary staff
• Keeps doors closed at all times

First Stage (Labor):
• Standby my asthma medication e.g. ventolin inhaler
• Music of our choice via iphone / notebook
• I need my own bedding e.g. pillows and blankets
• Prefer option of wearing my own clothing
• Keep invasive / vaginal exams to a minimum.
• Maintain mobility throughout labor; sit up, walk, sleep, shower etc
• Eat and drink to comfort
• No IV drip, no Heparin / Saline lock at this stage
• Relaxation techniques (music, breathing, aromatherapy)

Baby Monitoring
• Only intermittent monitoring using hand-held devices e.g. Doppler, fetoscope
• Avoid (electronic fetal monitoring) EFM unless absolutely medically warranted

Induction / Augmentation:
• If my pregnancy progresses past 40 weeks, I would prefer to base the decision to induce on the results of the baby's biophysical profiles, not on my own personal discomfort or impatience.
• Please do not rupture my membranes artificially unless the baby is in distress
• Use natural methods to induce labor
• As much as possible, no IV induction e.g. Pitocin, use Prostaglandin Gel to ripen the cervix

Pain Management:
• Heat or cold packs
• Massage
• Use analgesic pain relief if I ask for it e.g. Gas / Pethidine
• No drugs that may cause side effects to baby
• No spinal epidural unless a C-section is warranted

Second Stage (Birth):
• No supine birth; prefer as upright as possible or whatever feels right at the time
• As long as baby and I are fine, allow the pushing stage to progress free of stringent time limits
• Prefer no episiotomy, but please use compresses & massage, unless risk of tearing.
• Please administer local anesthesia when repairing any episiotomy
• No urinary catheterization
• If all is fine and I’m not in severe distress, let me cut the umbilical cord

Baby Care:
• As long as baby is healthy and normal, delay all routine assessment after bonding and breastfeeding.
• Let baby bond on my chest skin to skin ASAP, even if cord is intact
• Breast feeding only; please help baby latch on if necessary
• No pacifiers, formula or glucose water
• All assessment of baby must be done in the same room as me, in front of me or the father if I’m unconscious
• We will save the cord for cord blood banking
• No circumcision on my baby

Cesarean Birth:
• Spinal / epidural anesthesia, no GA (take not e of ASTHMA)
• My husband and mother may be present
• Final stages; lower the screen so I can see the baby emerging
• Keep baby close to me during recovery and begin breastfeeding as soon as possible

Sick / Premature Baby:
• Breast feeding as soon as possible
• Keep baby close to me as much as possible

Just for the record, this is one of my main reading reference:




Some other online resources I find really helpful are:
  1. American Pregnancy
  2. Lamaze
  3. Baby Center Malaysia
  4. The Bump

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