תכנית הלידה שלי (ילדתי בארה"ב) סליחה על האורך.
Wednesday 22 March 2000
To: medical stuff and nurses
Birth care pavilion
West Boca Medical Center
Dear medical stuff,
Re: Birth plan - Tamar
The nurses who attend a birth are important at least as the physician, if not more. Therefore, I'd like to communicate to you my wishes concerning my birth at your facility in the form of the following birth plan. The birth plan has been read and approved by Dr. Beil, my obstetrician. I believe that your awareness of my wishes, combined with your professionalism and compassion, will enable you to do your best to give me, my baby and my family a pleasant and healthy experience during my stay at the hospital.
Generally speaking, I wish to have the least intervention possible during the birth and after it, unless absolutely needed otherwise. I also wish that I and my husband Raz would be as actively involved in the process as we can, and be consulted with on everything. I'd like a LeBoyer birth, with quiet and friendly environment for my baby. Betsy Schwartz, my doula, will also be there to help in any way she can.
My birth plan is as follows:
BIRTHPLAN - TAMAR
DURING BIRTH
As mentioned before, my husband and I would like as little intervention as possible, and as much involvement and independent decision-making as possible; this means that for every procedure we should give our immediate and specific consent. Since there is a possibility that I'm not going to be able to make decisions, my husband's specific consent is needed at all times and he speaks for me.
Details...
- I'd like to wear my own clothes.
- Presence of others: I wish that my husband, my sister and my doula to be present. Others' presence will be at my discretion.
- The onset of labor should be spontaneous, without induction. If enhancement is needed, labor should be speeded by natural means: walk, change positions, nipple stimulation, but not with pitocin.
- Labor and birth environment - I want a "LeBoyer" birth: dimmed lights, whispering - no talking aloud and no shouting during labor and delivery, and warm room.
- Position for labor and birth: I wish to be free to change positions and walk around during labor, and give birth in any position I find comfortable - not necessarily in bed (can be the floor, or a chair!). Unless I feel uncomfortable, I prefer spending the whole labor and birth in the bathtub (water birth). Therefore, I don't want to be confined to bed by monitoring and IV; I ask that monitoring the fetal heart rate will be done from time to time with Doppler that will allow me the freedom to change positions.
- I'd like to eat and drink as desired during labor. If I need to empty my bladder, I'd prefer to walk to toilet.
- Pain relief: I'd like to give birth naturally without any medication, and I ask not to be offered any medication or discouraged from this decision (unless medically needed). Nevertheless, I would like to be given an epidural if I specifically ask for it, and the progress of labor still allows it.
- During the active labor and birth stage, I wish to push naturally when I feel the urge and as much as I feel needed, and not to be directed when to push, for how long, etc.
- To speed up labor, I prefer to use gravity-enhancing positions and wish to avoid the use of forceps or vacuum.
- I ask not to perform an episiotomy; I'd like to try for intact perineum with massage, support, hot compresses, controlled pushing, and positions to promote perineal stretching.
AFTER BIRTH
In general, I wish not to be separated from my baby after birth, but to be with him in my bed. If separation is necessary due to medical problems, it should be done only with both my husband's and my specific and immediate consent and with one of us present at all times, and if possible, touching the baby.
Details...
- I ask that the baby's airways will be suctioned only if the baby does not expel his own mucus.
- I'd like my husband to catch the baby and put him directly on my belly, skin to skin. Please, do not dry the baby - just cover both of us with a blanket to keep warm, if needed. If the baby is born in the water, I ask that my husband and I will dry him when we take him out of the water, and not the medical staff.
- I ask that my husband will cut the cord, and do it only after it stops pulsing.
- Delivery of placenta should be spontaneous and encouraged only by breast stimulation and baby breastfeeding. Please, no medication or manual extraction.
- Visitation: at my discretion.
- Discharge of me and my baby from the hospital - when desired (possibly less than 24 hours).
- I wish that any immediate care or observation necessary would be done when the baby is in my arms, or my husband's. We'd prefer to wait a couple of hours for any other routine procedures, i.e. foot-printing, vitamin K, putting on the scale.
- I wish that either my husband or I will put the baby on the scale and will touch him all this time.
- I ask that that vitamin K shot would be given to the baby when he is in my arms. (טעות!!!!!)
- I ask that no eye drops will be applied into the baby's eyes.
- I'd like to breastfeed my baby within the first hour after birth.
- We are not planning to circumcise the baby.
UNEXPECTED EVENTS
In general, it is crucial that absolutely no procedure will be done to the baby or me without at least my husband's specific, explicit and immediate consent.
Cesarean birth
- Anesthesia: regional anesthesia with little or no pre-medication
- Participation: screen lowered at time baby is delivered.
- Presence of partner/others: more than one supportive person present (husband + doula).
- I wish to hold my baby in my arms immediately after delivery, to breastfeed him as soon as possible, and not to be separated from him unless absolutely necessary. If the baby has to be sent to intensive care, I ask that my husband will be present with the baby at all times and touch him whenever possible.
- Everything else as mentioned before in the after birth section.
Jaundice:
Preferred: sun photo-therapy in mother's arms, allowing breastfeeding and avoiding giving him water as much as possible, to prevent problems with breastfeeding.
Thank you very much for you cooperation!
Sincerely,
Tami
הערות:
- חודש לפני התאריך ישבתי עם האחות הראשית בבית החולים והצוות ועברנו על התוכנית סעיף סעיף. התוכנית נכנסה לתיק, הרופאה קיבלה העתק, והבאתי כמה ללידה.
- הלידה עברה נפלא - היו כמה חריקות מצד הצוות הרפואי (שנוכחותו הייתה מינימלית), אבל בעזרת רז ובטסי הדולה התגברנו עליהן.
- הלידה הבאה בבית, אני מקווה.
. לקחתי שני עותקים, אחד לחדר לידה והשני לחדר ילודים.
הצלחות
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