Monday, 17 October 2011

My Birth Plan

My first birth was great albeit with extra pain brought about by early artificial rupture of amniotic membrane (which happened without my consent), I believe it could be greatly improved.  After countless hours of research and 12.5 hours worth of hypno-birthing classes, I am now more prepared mentally and physically to give natural birth the second time around.  Now that I know better, I want to do better. 

Having a birth plan is not so straightforward.  Firstly, some doctors are not so keen on it because it deviates from their routine procedure.  But that is exactly the point, every mom gives birth differently so one mold does not fit all.  Secondly, the care providers and hospital policies are, if not oblivious, unreceptive to such requests.  Third, keeping the birth plan short is a challenge.  The more you know, the more you realize that much of the processes and procedures greatly affect the quality of birthing and most importantly the baby’s first experience earthbound. 

I will be absolutely thrilled if all goes to plan. My husband and I, however, have discussed on how we would handle the unexpected, when it does happen.   Thanks to our hypno-birthing class, we come prepared and have an acronym for it - BRAND.  Remembering what the acronym stands for is very helpful when medical intervention becomes an option: to ask 1) the BENEFITS of the solution being offered, 2) what are the RISKS of the provided solution, 3) are there any other ALTERNATIVE solutions, 4) what happens if we do NOTHING and stick with the birth plan and 5) how much time do we have to make a DECISION.

At the end of the day, it is about making an informed decision.  I am of course not against medical intervention.  In fact, we are very fortunate to live in a time when such interventions are readily available in order to save a mother or baby’s life.  What we don’t want is treating an otherwise normal physiological event into a medical procedure, when labor inducement is introduced even when mom and baby are doing great or caesarean is automatically performed because of breech position without even exploring options - when everything is done so routinely. 

This is the purpose of the birth plan – to give mothers the “voice”.  It is a conviction that giving gentle births to our babies is a step towards a more compassionate world. 


ADMISSION STAGE

  • To be assigned a nurse who is partial to natural birthing.
  • To self-hydrate and decline routine IV prep upon admission.
  • To have intermittent monitoring (EFM) of FHR after the mandatory twenty-minute strip at admission.
  • To be provided a labor room equipped with water tub.


DURING FIRST STAGE LABOR

  • The patience and understanding of care providers to support our wish for natural birth as much as possible.
  • To continue with intermittent monitoring (as agreed with doctor every 30minutes to 1 hour) only.
  • To be allowed to walk around or move during labor.
  • To be allowed to eat and drink, without the use of IV drip unless medically necessary.
  • To be fully consulted before any medical procedure is to be done (e.g. amniotomy, augmentation, membrane stripping).


DURING BIRTHING

  • To be allowed freedom of labor positions of choice (as discussed with my doctor, my pain tolerance and stamina is higher when I am on all fours).
  • To be allowed the use of HypnoBirth breathing techniques.  Mother-directed pushing.
  • Episiotomy only if necessary and only after discussion.
  • To allow the gentle descent of the baby – no pulling.  If possible, dim the bright lights temporarily at moment of birth and until baby is moved to mother’s chest.


FOLLOWING BIRTHING

  • To refrain from suctioning baby’s nose unless medically necessary.
  • Immediate skin-to-skin contact, with baby placed on mom’s lower chest.  Dad joins in this bonding by placing hand on baby’s back under warming blanket.
  • To be allowed mom-baby bonding as long as possible and delay measurements of weight, height, etc… and other procedures.
  • Delayed cord cutting.  Dad will only cut cord after it stops pulsating.
  • To allow vernix to be absorbed into baby’s skin; delay “cleaning”.
  • To refrain giving the baby glucose water.  Mom to breastfeed exclusively.
  • In the event of C-section, the Dad to be allowed to remain with mom in the operating and recovery room.
  • Dad will hold the baby after C-section and bring baby to Mom for viewing and eye contact.  In the absence of urgency, Dad continues to hold baby for bonding.




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