Birth Plan #3!

I sat down to write my birth plan for this baby and laughed when I looked over my previous plans.  I deleted the parts about "no pain medication" and "no interventions".  I think those could've been realistic had I not been attempting my first VBAC and if they hadn't hooked me up to pitocin as soon as I arrived.  Anyway... this one is a bit more flexible since I'm attempting a repeat VBAC and there are a lot more ifs involved.  Here it is for anyone who might be interested :).

Birth Plan:

The person present for the birth will be Alexis’s husband, Jason Snooks.  My ultimate goal is to successfully achieve a repeat VBAC.  I understand that compromises may need to be made, however the following are my preferences.

Labor

• I want only Kaiser Permanente doctors, nurses, and midwives to attend to me.
• I would like to be out of bed as much as possible during labor (walking, etc.).
• I would like to be able to drink clear liquids as well as a protein supplement, if possible.
• If continuous fetal monitoring is required, I wish to be upright and mobile while connected to the monitor.
• In the past, I have progressed very slowly.  Please be patient with me! 😊
• Due to having severe acid reflux, I will need a dose of Zantac every 12 hours.

Delivery

• I would like the option to be in a position other than lying on my back when I give birth (squatting, lying on my side, etc.).
• As long as the baby and I are healthy, I prefer to push instinctively and to have no time limits on pushing.
• I am fine with an episiotomy.  If needed, please perform.

 After Delivery

• I would like my baby placed immediately skin-to-skin after delivery.
• The umbilical cord shall not be clamped or cut until the baby is breathing and pink, and until all pulsation in the cord has ceased.
• If the baby must be taken from me to receive medical treatment, Jason will accompany her.
• I would like to breastfeed as soon as possible (within the first hour)
• I would like to meet with a Lactation Consultant as soon as possible after delivery.
• I want all procedures that are done and all medications that are given to my baby explained to me before they are carried out by the medical staff.  If I disagree with the administration of an immunization or medication, I am willing to sign a formal waiver.
• I would like to have the baby evaluated and bathed in my presence.
• Prior to our discharge, I wish for my baby to be placed on pulse oximetry to rule out any obvious heart conditions present at that time.

Cesarean

• FYI, I have had 2 hernia surgeries with mesh and 1 previous C-Section.
• Please ensure all medications administered are suitable for breastfeeding.
• I would like to have warm blankets during the surgery.
• Please inform my husband when the baby is being delivered.
• In the event that a cesarean is necessary, we would still like to delay the cord clamping until pulsation has ceased.
• I would like to have skin-to-skin contact with the baby as soon as it is possible in the delivery room.
• I would like to nurse the baby as soon as possible after surgery (within the first hour).
• If the baby is doing well medically, please bring her to me as soon as she is suctioned, weighed, and measured. Please do not worry about cleaning her up much before bringing her to me.
• I do not wish to be separated from the baby after her delivery.  I would like for her to remain with me and my husband, even while I am in recovery.
• I do not want any medications following surgery that will make me drowsy or that may interfere with my ability to remain aware and conscious.
• I would like to be weaned off of the spinal/epidural as soon as possible after surgery and given an alternate form of pain relief (Percocet, etc.).
• I would like to have my catheter and IV removed ASAP after my recovery period.

I would like to eat and be free to stand up and walk around as soon as possible after surgery.

34 Weeks

I just read my 34 Week post from when I was pregnant with Logan and had to smile... that week was when I received my job offer for the company I'm still working for.  I still can't believe how that all happened but am so thankful that God blessed me with a great job, even when I was 8.5 months pregnant :).  Some interesting things have been happening at work this week, some that I won't go into detail about but I will talk about my benefits briefly.  When we completed our open enrollment for insurance last year, I could swear I elected to receive short term disability coverage, just on the small chance that I would get pregnant ;).  This week I started getting my paperwork together to file for it and was told that I'm not currently covered.  Oh, the thoughts that ran through my head ;).  And what makes it even more difficult is that the HR Manager resigned his position and moved out of state a couple weeks ago.  The interim HR Manager has been trying to help me but can't find my original signed copy of benefit elections anywhere (what are the chances?).  So, I've been trying not to stress about what's going to happen when the baby gets here.  I'm just praying that something will work out so that we don't have to rely solely on Jason's salary.  Everything will be fine, though...

I had my 34 week checkup this afternoon and it went fairly well.  I told the doctor about my slip last weekend, which is still causing me a LOT of pain and he sympathized but said it's going to hurt because of where the muscle/ligament strain is and where the baby is positioned.  I imagine it will take a while to heal so I'm just trying to manage as best I can.  The doctor seemed completely unaware that I was sent to Labor & Delivery on Monday so I had to explain things to him, including the part about the nurse saying the baby was either breech or transverse (sideways).  He decided to do an impromptu ultrasound (with the same prehistoric u/s machine he used to confirm my pregnancy).  He said the baby is head-down but slightly transverse, so kinda diagonal, I guess?  He's not concerned about it at this point but wants to check again at my next appointment too.

The doctor read over my birth plan and said everything looks fine, yay!  I've read a few articles/blogs this week that have touched on birth plans and they seem to be very anti-BP, which is fine but I just want to comment quickly on that.  I know that labor and delivery can be a very unpredictable experience and many different things can happen, however.... that's why I titled mine "birth preferences".  It's a plan but as I experienced with Logan, it can change very quickly.  There are some things that I'm pretty adamant about (skin-to-skin contact, breastfeeding, delayed cord clamping, etc.) and I have good reason to want those things.  For example, when Logan was born, I got to see him briefly but then he was whisked away to the NICU and I was taken to my room.  I wasn't able to get out of bed for 12 hours, which meant I couldn't see him, hold him, feed him, talk to him for 12 hours.  It was a very difficult day for me filled with a lot of longing, guilt, anger, etc.  If I can avoid that from happening again, I will make every effort to, including drafting up an 'annoying' birth plan ;).  I'm not knocking anyone who chooses not to have one... that's fine and dandy, but I want to have one in place.  If anything, it will be something that Jason and I can look at throughout the labor & delivery process to help keep me focused.  That's my little spiel ;).

My blood pressure is still 120/80 (normal) but I have gained a total of 27 lbs, ack!  I'm guessing the fact that I haven't been able to walk this week has played a part in that gain but the doctor didn't seem concerned about it. 

I started getting a sore throat last night and it has been even worse today along with some ear pain and pressure.  I had the doctor check it for an ear infection but he said it isn't infected at this point.  I'm taking some Sudafed to clear up the small amount of fluid that was in my ear and hoping the pain will go away quickly.

Ok, here is the weekly summary:

Contractions: Haven't really noticed any this week.
Cravings: Nothing this week.
Weight:  My total is up to 27 lbs
Swelling:  The swelling is back with a vengeance.  I'll blame it on the 70+ degree weather that returned this week ;).
Things to do: Still need to buy furniture and other items from my registry (Target), pre-make meals, pack the hospital bag, pack a small bag for Logan, reinstall the infant car seat, etc....
Heartburn:  It is under control but only because of my friend Zantac.
Stretching: Stretching and more stretching.  I take it as a sign that she's growing :).

Baby's current size is about 18" long and 5.5 lbs, whew!  Only 6-ish weeks to go :).

Birth Plan

Since I'm 34 weeks along and this pregnancy has been anything but dull, I've decided to revamp the birth plan I had when I was pregnant with Logan.  I have taken a lot of the same pieces from that plan but edited it based on my experience with him.  The main difference is the addition of the Cesarean "section" (hehe, get it?).  With Logan, there were a lot of things that I wish I could've changed concerning his delivery and the care that followed (for both of us).  I plan on taking this to my doctor on Friday to go over it with him.  I'll report back with any concerns or objections he may have.

Without further ado, here ya go:

*************************************

The person present for the birth will be Alexis’s husband, Jason Snooks.  My ultimate goal is to successfully achieve a VBAC.  I understand that compromises may need to be made, however the following are my preferences.

Labor

• Please do not offer pain medication – I plan on using alternative pain relief options.  I will ask for pain medication if I need it.
• In the event that I do request pain relief, I would like information about any medication before receiving it, including the purpose, potential side effects on me and/or the baby, and options on timing.
• I would like to be out of bed as much as possible during labor (walking, etc.).
• I would like to be able to drink clear liquids as well as a protein supplement, if possible.
• If continuous fetal monitoring is required, I wish to be upright and mobile while connected to the monitor.

Delivery

• I would like the option to be in a position other than lying on my back when I give birth (squatting, lying on my side, etc.).
• I prefer to tear rather than having an episiotomy. If an episiotomy becomes necessary, please discuss with me beforehand.
• As long as the baby and I are healthy, I prefer to push instinctively and to have no time limits on pushing.

 After Delivery

• I would like my baby placed immediately skin-to-skin after delivery.
• The umbilical cord shall not be clamped or cut until the baby is breathing and pink, and until all pulsation in the cord has ceased.

• If the baby must be taken from me to receive medical treatment, Jason will accompany her.
• I would like to breastfeed as soon as possible (within the first hour)
• I would like to meet with a Lactation Consultant as soon as possible after delivery.
• I want all procedures that are done and all medications that are given to my baby explained to me before they are carried out by the medical staff.  If I disagree with the administration of an immunization or medication, I am willing to sign a formal waiver.
• I would like to have the baby evaluated and bathed in my presence.
• Prior to our discharge, I wish for my baby to be placed on pulse oximetry to rule out any obvious heart conditions present at that time.

Cesarean

·         Please ensure all medications administered are suitable for breastfeeding.

·         I would like to have warm blankets during the surgery.

·         Please inform my husband when the baby is being delivered.

·         In the event that a cesarean is necessary, we would still like to delay the cord clamping until pulsation has ceased.

·         I would like to have skin-to-skin contact with the baby as soon as it is possible in the delivery room.

·         I would like to nurse the baby as soon as possible after surgery (within the first hour).

·         If the baby is doing well medically, please bring her to me as soon as she is suctioned, weighed, and measured. Please do not worry about cleaning her up much before bringing her to me.

·         I do not wish to be separated from the baby after her delivery.  I would like for her to remain with me and my husband, even while I am in recovery.

·         I do not want any medications following surgery that will make me drowsy or that may interfere with my ability to remain aware and conscious.

·         I would like to be weaned off of the spinal/epidural as soon as possible after surgery and given an alternate form of pain relief (Percocet, etc.).

·         I would like to have my catheter and IV removed ASAP after my recovery period.

·         I would like to eat and be free to stand up and walk around as soon as possible after surgery.

      Sorry for the formatting at the end... it doesn't seem to be copying it correctly from Word.  Anyway, as with the plan I posted for Logan, advice and suggestions are welcome as long as they are given in love ;).