Sunday, February 21, 2010

Making a plan

Today marks the beginning of week 30, which means that I'm starting to seriously think about what's going to happen when these babies are born, especially since it could be in as little as 5 or 6 weeks! I started drafting a birth plan ages ago, but hadn't really firmed it up or finalized it before now.

My goals for my plan were:
1) that it could fit on one side of one piece of paper, as I don't want anyone to have to search for ages to try to find my preferences for something;  
2) that each item could fit on one single line, using bullet points because I believe that simpler is better; and
3) that it should cover both a vaginal birth and a c-section, since I don't know at this stage which I'll be having - even if both babies behave themselves and we can start with a vaginal birth, there is still a chance that I may end up needing a c-section to get the second twin out.

I know that many readers will have their own opinions and preferences on some matters (such as pain relief or having the baby in the room with you all the time vs in the nursery part time), so please remember: this is my birth plan. I am not insisting that this is the only way to do things, since I believe that what may be right for one woman won't be for another. Now that's been said, here's the plan as it stands today:

Birth Plan for Bibliosaur (TWIN PREGNANCY)
Due Date    3 May 2008
Patient of    Dr H (XXXX Hospital) and Dr S (XXXX Medical Centre)

These preferences presume a normal pregnancy/birth; we may change our thinking as labor ensues.

Mr Bibliosaur (husband) present at all times.
No visitors or observers such as students or unnecessary staff at any stage.
Freedom to walk and change positions as needed/desired.
To stay hydrated by drinking water.

Pain Relief
If I request medication, I would like an epidural.

I would rather tear than have an episiotomy.
Please use local anaesthetic for any repairs.

I would like the freedom to push and deliver in any position I like.
Mr Bibliosaur would like to help catch the babies if possible.

Immediately Following Delivery

Mr Bibliosaur would like to cut the cords if possible.

Newborn Care
Please evaluate and bathe the babies at my bedside.
Mr Bibliosaur would like to accompany the babies should they need to go to the NICU, if possible.

Postpartum Care & Breastfeeding
If available, I would prefer a private room.
I would like the babies to room-in with me during the day and be in the nursery overnight (brought for breastfeeding during the night as necessary).
I will breastfeed/pump milk and would like to meet with a lactation consultant.

Cesarean Section Delivery
Mr Bibliosaur to be present during the surgery.
I would prefer an epidural rather than general anesthetic.
We would like the babies to be held by Mr Bibliosaur immediately and to be with me in recovery, if possible.
You may notice that there are a lot of "if possible" statements in there. That's because some of these things simply may not be possible with twins - for example, we may not have the option of holding them right away if they need to go to the NICU (and Mr Bibliosaur may not be able to accompany them there), and it may not be an option for Mr Bibliosaur to catch the babies - so we need to understand the potential limitations of our situation.

You also may notice that, compared to a lot of sample birth plans (like this one), it's short. This was both intentional - as I said, I wanted it to be able to fit on one side of a single sheet of paper - and because I don't have anything that I feel "it must be this way!" about. I simply don't care about many of the little things that are on some birth plans - for example, playing music or wearing my own clothes. Perhaps I should, but I don't.

Other things that are on some checklists - like stating that you don't want an enema upon admission - are outdated, since most hospitals don't normally do that these days anyway, so there's no point in bulking out your birth plan with things that won't happen or things that your hospital already does/allows as a matter of routine procedure. And there are yet more things - like wanting the lights dimmed - that I am confident I will verbalize (possibly rather loudly, haha!) at the time, and thus don't need written down.

I think that it's absolutely fine to have strong desires for your ideal birth plan, but that flexibility is important as well. My entire goal is to have a good outcome with healthy babies and a healthy mama, and I'm open to doing whatever I need to in order to accomplish that. If I go into labor and decide that I can do it drug-free, then that's great. If I go into labor and decide that I want drugs OMG NOW GIVE THEM TO ME NOWWWW, then that's great too. If we can do this vaginally, fantastic. If I need a c-section to get these babies out, then that's fantastic too.

If you don't know where to start with drafting a birth plan, there are a lot of websites out there that make it easy, like this birth plan creator from SheKnows - you just tick the boxes to indicate what you'd like, and the end result is your customized plan. This one from the Bump is fairly comprehensive, and I also like this simpler version from Bubhub, which is a bit less wordy than the SheKnows version.

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