Thursday, January 08, 2009

Our Birth Plan

Yeah, it may seem a little early to have a birth plan, but you know me..... I am posting it here because when other parents posted theirs it really helped me to develop mine. I looked at quite a few of them and took ideas from many. Some instances I changed the wording to best fit us and other times I left the wording the same because it was perfect. I'm hoping my birth plan can help someone else who may be in a similar situation.

Birth Plan
At 21 weeks into our pregnancy we were devastated to learn that our daughter, Carleigh McKenna, has anencephaly. We realize that Carleigh will look different physically and will have facial anomalies. We hope that everyone can see her for what she is, our beautiful little baby. We may only have seconds or minutes with her, but we may also be blessed with hours or days. As Carleigh’s parents, it is our greatest wish to be able to cherish every moment we have with our baby, in a loving and caring environment. We have compiled this list of requests and wishes regarding her care in order to make this experience as easy as possible for all involved. Please do not hesitate to ask us for clarification if it is needed. Please don’t mind if we change our wishes at any time. Our wishes all revolve around our need to spend as much precious time with Carleigh as possible and to prevent her from suffering during that time. Our wishes are as follows:

1. We ask that our daughter be referred to as Carleigh.
2. We wish to have a sign placed on our door that designates what type of situation Carleigh’s birth is. We prefer not to have extraneous staff entering our room without speaking to our nurse first (i.e. housekeeping, dietary).
3. If possible, we request nurses specifically trained in bereavement.
4. We are planning on a vaginal delivery. We prefer not to have continuous fetal monitoring during labor and delivery unless we request it. Periodic monitoring of heart tones is preferred. In the event that Carleigh’s heart tones are undetectable or decreased we do not want an emergency cesarean section. However, we do realize that if one is necessary to protect Holly, we would like Anthony to stay with her at all times.
5. Holly would like to freely change position during labor. Suggestions regarding positions for laboring and later for birth are welcome, in the hopes that a proper position can help to diminish pain and make contractions more effective.
6. Assuming they do not rupture on their own, please do not rupture the amniotic membranes artificially. The membranes and fluid will help protect Carleigh's head during labor and delivery. We feel this will increase Carleigh's chances of being born alive.
7. As long as it is safe for Holly, we want her to be able to hold Carleigh immediately following delivery. If Holly is unable to hold Carleigh, we would like Carleigh to be handed to Anthony. We wish to cherish all the time we have with her. Every second counts.
8. We would like mechanical assistance to be used only temporarily to initiate Carleigh's breathing. We do not want any extraordinary measures taken to maintain breathing or to initiate her heartbeat.
9. Since Carleigh is going to be with us for such a short amount of time we want every second possible with her in our arms, beginning from the moment of her birth. Please delay (or even prevent if possible) any procedures that can be put off until later. If any procedures must be done we ask that they be done while Carleigh is in our arms.
10. We would like Carleigh to be kept warm with the use of kangaroo skin-to-skin care, warm blankets, hats, or the radiant warmer if needed.
11. We do not want to have any routine admission medications given, such as erythromycin ointment, or Vitamin K, nor do we want her blood sugar monitored.
12. We ask that you give us privacy, without abandoning us. Encourage us to do whatever feels right.
13. We do not want Carleigh to be taken from the delivery room at any time, by any person, for any reason.
14. If Carleigh lives long enough we would like to feed her. Our first preference is breast milk. If Carleigh is unable to nurse, Holly would like assistance in expressing colostrum/breast milk to give to her either by spoon or bottle. If this doesn’t work we want her to be tube fed.
15. In the event that Carleigh does not die immediately, or soon after birth, we may consider having an IV inserted for the administration of pain medication. We wish to make Carleigh’s time on earth as pain-free and comfortable as possible.
16. In the event that Carleigh is experiencing severe seizures and seems uncomfortable or in pain, we may consider the administration of anti-seizure medication.
17. We want to have Carleigh baptized or dedicated to the Lord at our request. Pastor Mark B----- will be present to assist us with this.
18. We want the nursing staff to weigh and measure Carleigh when we request it. Should we forget to request it, please do it prior to her leaving the hospital.
19. We would like the opportunity to give Carleigh her first bath.
20. We have brought clothing for Carleigh, which we would like to dress her in. We do not want these clothes to be removed at any point or by any other person than her parents. Carleigh is to be wearing these clothes when she leaves the hospital.
21. We anticipate that Carleigh will die during our time in the hospital. When this happens we want her to be with her and holding her in our arms. When she has passed please notify staff members who will come in contact with us. Please do not take her away from us after she dies. We will let you know when we are ready. If we are blessed with the opportunity to take Carleigh home with us please give us advice on how to feed her and care for her head (with dressings etc.).
22. Please do not allow anyone in our room without talking to us first. We would like to have the option to bring our family and children to the hospital to meet Carleigh and spend time with her. We ask your assistance in keeping them updated as we request it. We might need your help with phone calls and getting visitors in when we are ready. Carleigh has family that is very eager to meet her. If possible, we want them to be able to spend time with Carleigh while she is still alive. Time is of the essence for us and we do not want any avoidable regrets or missed opportunities.
23. Any keepsakes that we leave with Carleigh, such as blankets, loveys, and jewelry, are to remain with her at all times, even when she is taken from us. These items are to be placed in the casket with her.
24. We do not want Carleigh to go to the morgue at any time. We request that the hospital contact Fisher & Edgington Funeral Home directly when we are ready to say goodbye to Carleigh. We wish for her to be picked up directly from us or the nursing staff and be taken by a staff person from Fisher & Edgington Funeral Home. We have made prior arrangements for this. Fisher & Edgington Funeral Home can be contacted at (937) 382-xxxx.
25. We have contacted Kim L--, who is affiliated with Now I Lay Me Down to Sleep, a bereavement organization, and have arranged for her to come to the hospital and take professional pictures of us and our baby. We ask that you accommodate her in anyway that is helpful. Her number is (937) 382-xxxx. Other family members will or may be present to take additional pictures and video.
26. If any caregiver has a suggestion or an idea that you think may be helpful, please share it with us, as there are many things we haven’t thought of.
27. If any nurse, doctor, or other caregiver on our team is uncomfortable with any of this, please excuse yourself from our care if possible.
28. We would like to have as many keepsakes and mementos as possible. Please save the following items for us to take home:

-the bassinet card


-baby blanket

-any photographs taken by the hospital

-hospital ID bracelet and cord clamp

-hand and footprints (we also wish to have footprints put in books we have brought with us)

-mold of hands and feet (we have kits with us)

-lock of hair if possible

-clothing Carleigh may have worn

-heart rate/contraction strips from any monitoring

-and any other things you think we may wish to have

This is a very difficult time for all of us. We truly appreciate your help and support, and ask that you understand the varied range of emotions we may experience. We also appreciate and find comfort in your expressions of grief, so please do not hesitate to show your emotions in front of us. We have tried our best to prepare for our short time with our little Carleigh. Saying “Hello” and “Goodbye” in such a short period of time will not be easy. With your help and support we hope to make this time as meaningful as possible.


HP_Twilight_Freeek said...

I think that is an excellent plan. If it's the right one for you, then it's perfect.

A few things you should Ohio law, you have legal rights to take her hair, any "keepsakes", dress and bathe her (health permitting), and hold her at any time, even after death. If you wish her to be brought to you from the morgue (sorry to be morbid!!) to see her before you leave, it is your legal right. A lot of these things I didn't get to do with my own daughter, because I didn't know ahead of time what was acceptable. Videos, pictures, etc. cannot be taken from you, nor can the doctors tell you that you're not allowed. The only things you may not be entitled to, or may be up to the discretion of the hospital are heart/fetal monitorings and things of that nature. NILMDTS works with a lot of hospitals, and if you go over this plan with your OB at the next appointment, I'm sure every effort to comply will be made.
Again, if there are any organizations I can get you folks in touch with, I will be more than happy to!

Betty "Jackson" said...

I have never in all my life seen such a detailed birthing plan. I never thought hospitals really followed them. When I had Luke it was pretty fly by the seat of your pants type of deal, but I can really see why you have typed this all up after having read it. Makes me wish I would have had one for Luke too.

jen said...

I will pray that everything goes exactly how you want it to. You'e put a lot of thought and work into this!

Alissa said...

You are so organized! I think your birth plan is wounderfully planed. I love how you have thought out EVERY detail. I hope her birth turns out a happy moment no matter the out come. (((hugs))) Holly & Carleigh!

Emily James said...

Holly, I love your plan. It definitely sounds like you know exactly what you want and that's great. I pray that you, Anthony, and Kyndra are able to bring Carleigh home.

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