Birth Plan for Emily Rose
Due July 3rd, 2000
Written by XX (mother) and XY (father)
We have written this birth plan for our daughter Emily,
who has been diagnosed with anencephaly. We have chosen the midwives
of [...] to deliver our daughter at [...] because of their reputation
as caring practitioners and their high level of medical expertise.
We hope this birth plan is of assistance in guiding the decisions
which must be made during the course of our daughter's birth.
We are not closed to ideas outside of this birth plan,
but these should serve as a guideline. We believe that the following
requests will help us make the most of our limited time with
Emily.
Labor and Delivery:
1) XX would like to freely change position during labor. She
requests suggestions regarding positions for laboring and later
for birth, in the hopes that a proper position can help to diminish
pain and make contractions more effective. If laboring in water
is possible, please show XX how to make best use of it.
2) Should pain medication become necessary, XX prefers to
start with a sedative rather than a narcotic. NO MORPHINE.
XX has terrible reactions to morphine. If a narcotic is administered,
please consider that Nubain worked well during her last labor.
If an epidural, please use an ultra low-dose epidural so XX can
assist with pushing.
Please keep in mind that our main objective is for XX to remain
as alert as possible.
3) Assuming they do not rupture on their own, please do not
rupture the amniotic membranes artificially. Other mothers of
anencephalics have found the membranes and fluid will help protect
the baby's head during labor and delivery. We feel this will
increase Emily's chances of being born alive.
4) XX would like to deliver in a squatting or semi-squatting
position if she is able. Please help if she can't figure out
the positioning on her own. Please take other measures to relax/stretch
the perinium before resorting to episiotomy. Please allow XX
to push at her own pace.
5) If delivery by cesarean, XY is to remain with XX at all
times.
If relatives are waiting or phone in, we request that a nurse
please give them updates as applicable.
After the Birth:
6) Because Emily may die immediately before or after birth, XY
will baptize her immediately. In the event that XY is unavailable
or unable to baptize her, one of the birth attendants should
dip her fingertips in water (any kind) and using that, make the
sign of the cross on Emily's forehead while saying the words
"I baptize you in the name of the Father, and of the Son,
and of the Holy Spirit. Amen." This is very important to
us.
7) If the diagnosis of anencephaly is correct, we request
only temporary assistance to initiate Emily's breathing. After
that, comfort measures only. Emily is not to be placed on artificial
life support without permission of either XX or XY. (Note:
if the diagnosis was incorrect, take whatever medical measures
are necessary, but please keep both parents completely informed.)
8) We request that Emily be immediately handed to her father
or mother, depending on the circumstances.
9) XY may or may not want to cut the cord. Please ask his
preference at the time.
10) Emily is to remain with her parents at all times.
Because we don't know how long Emily will survive, we want
to spend time with her immediately after delivery. Please delay
any procedures that can be put off until later. With routine
and necessary procedures, please perform as many as possible
with Emily in her parents' arms. For the rest, XY will accompany
Emily and return her to XX as soon as possible.
11) Emily is to receive some kind of nutrition. Our first
preference is breast milk. XX would like to try nursing Emily
immediately after birth. If this is not possible, XX would like
to express breast milk. We will bring our own Haberman feeder,
but we are open to suggestions of other feeding methods which
may be easier and more effective for our daughter.
12) We would like assistance in taking photographs. We may
have a video camera as well. Please help us with that also if
we require assistance.
13) If Emily dies during our hospital stay, please notify
staff members as applicable. Please allow us space to grieve
without abandoning us. We would like time alone to hold Emily
after her death to say our goodbyes.
Keepsakes Requested:
· bassinet card
· hats
· baby blanket
· any photographs taken at the hospital
· hospital ID bracelet
· hand and footprints
· molds of both hands and both feet (we have kits with
us)
· lock of hair
· we are open to other suggestions as well
Signed:
___________________________
XX
___________________________
XY
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