Saturday, September 28, 2013

A Foxy Birth Plan

We brought 10 copies of the Birth Plan - and separate copies of the 'in the event of a section Birth' plan . Because we'd originally planned a homebirth I did not have an OB in advance of arriving at the hospital. I did however have a chance to review it with him before we started the induction. He was very kind and explained what he might have a problem with and what he would be fine with. It was helpful for me to share my desires, but also to know what might not be possible. The nurses were also very kind and willing to listen to my wishes and explained what they might have a problem with. 
From the very beginning I was very clear about my right to refuse to do anything I was not comfortable with. I let them put the hospital bracelet on me, but then I took it off. I brought my own clothes (nightgown and robe and slippers) to wear. I brought my own blanket for the bed. We put up a sarong covering over the light and clock. We set up battery operated candles and brought our own music.  We claimed the space as our own. 

There are 4 full pages of nurses notes documenting every time the "patient refused" monitoring or iv port, or some other procedure. We kindly acknowledged that it was her job to ask, but never forgot that it was my right to decline. I think that part of what made my birth experience so positive was that I remained in control of what happened to my body.  

I understand that not all facilities are as accommodating. We were very respectful of the nurses and doctor, but also very clear about our anxiety being in the hospital and our desire for as natural a birth experience as necessary. I've also had feedback from others (in the medical community) that my birth plan asks for WAY too much, but it worked well for us and our situation. 

Without further ado... I share with you:

A Foxy Birth Plan 

It is our goal that that the entire birth process be treated as the joyful, celebratory, respectful event. We ask that the staff respect that for us this individual birth is neither common nor routine, but rather is a very special and long awaited event. After experiencing years of infertility treatment this child was conceived in love with the help of IVF. This birth represents the long awaited dream of starting our family. 
I strongly desire for my husband and doula to be with me AT ALL TIMES. I do not consent to being left alone without my husband and/or doula at ANY time for ANY reason during my hospital stay. 
I love and respect my husband. I trust him and give him full authority to make decisions on my behalf.
Please take the time to slowly explain things to me and my husband, listen to our questions, and obtain our consent prior to taking any action. We are apprehensive about being in the hospital and appreciate your patience to ensure that we understand why procedures are being suggested.
Pain Management:Please do not ask me what my pain level is or offer me pain medication. I am aware that it is available  and will ask for it if I need it. 
Delivery:I do not consent to an episiotomy. Please use perineal massage (with olive oil I have provided) and coaching for slow birth of baby’s head as well as varied positions for pushing to help avoid tearing. 
I strongly wish that the father be the person to announce the baby’s gender after birth.
I strongly wish that the father be the person to cut the umbilical cord after it has stopped pulsing. 
I would like to see and keep my placenta. My doula will take possession of my placenta after it is delivered.
Newborn Care:
I strongly desire for the baby to be placed STILL WET on my bare chest immediately following the birth. Please cover us both with with warm blankets as necessary and perform any essential newborn assessments while the baby is on my chest.  
If for any reason the baby cannot be placed on my chest, I strongly desire for the baby to be placed on the bare chest of its father. 
Bulb suctioning only unless baby shows signs of problems.  Any deep suctioning to be performed with a mobile unit while I hold baby or at my immediate side.
I do not consent to weighing, foot printing, PKU testing, Vitamin K injection, or other routine non-medically necessary tasks for the first five hours after birth. 
I do not consent to hospital staff bathing or cleaning the baby at all.
I plan to breastfeed. I do not consent to the use of any artificial nipples, formula, or sugar water for the baby.
I do not consent to the administration of eye ointment or hepatitis b vaccination.
I do not consent to the baby being removed from my presence at any time. If the baby must go to the NICU or nursery for necessary medical treatment, the father must accompany the baby at all times.
Recovery and Postpartum Care:
I would like to be able to eat real food following the delivery so that I have the strength to nurse & care for my new baby.
I would like access to the baby’s & my medical chart.
Please limit the number of times staff enter our room and please respect our desire to decline certain standard procedures. We will sign any necessary disclaimers.
We would like to be discharged as soon as possible. 
Thank You for helping us welcome the arrival of our baby!
We realize that cesareans and other surgeries are a common event at hospitals. However we ask that the staff respect that for us this invidividual surgery is neither common nor routine, but rather is a very special and long awaited even that will have effects lasting a lifetime.
I request that everyone in the OR be introduced to my partner and I and that we are explained what their role is.
Please place the IV in my left hand/arm.
I do not consent to tying my arms down unless I am unable to control them. I strongly wish to have at least one hand free to be able to touch the baby once the baby is delivered. If needed, release my right arm after the baby is delivered.
I prefer epidural anesthesia.
I do not consent to tranquilizers, sedatives or amnesiac drugs being administered. My husband or I will ask for these drugs if we feel they are necessary.

During the Cesarean:
I would prefer a low transverse incision.
Conversation between staff kept to a minimum (no casual chatter unrelated to the birth) with focus being on making my partner and I feel as at ease as possible and kept informed as to what is taking place.
I strongly wish that the father be the person to announce the baby’s gender after birth.
I strongly wish that the father be the person to cut the umbilical cord.
I strongly wish to see the baby being born either by lowering of the drape or providing a mirror.
I do not consent to a single layer suture to close my uterus.  A double layer closer with dissolvable stitches must be used.
I do not consent to staples to close my skin layer and instead want sutures.
I do not consent to my husband being separated from me even in the case of general anesthesia. It is important that the birth of our child be witnessed by a family member even if I am not in need of support at that time.
I do not consent to any students, interns, or unnecessary staff watching or treating me at any time.
I strongly desire for the baby to remain on my chest or in my arms throughout suturing, recovery, etc.
We intend to keep my placenta.  Please keep it clean and refrigerated.

Why do i blog?

I started blogging,,, hmm, when did I start blogging? It was mothers day, 2010. We were in the deep dark depths of our infertility journey. I was in a desperate place. I was afraid of the internet, a little, of the publicness, the permanentness, of the internet, but had signed up for an amazing internet class. It was beyond incredible. I started writing, and I found myself finding words for feelings that were consuming me... In the words that I wrote I found new ways to express the pain and grief and fear that I felt. And then in reading the words that other had written, I found that I wasn't alone. I recognized the things that others were writing and found myself in their words. It was powerful. Shortly thereafter I took the leap and started my first blog. It was kindof like a diary, but one that quickly started talking back to me. The feedback from others was encouragement for me to keep writing, not the reason that I wrote, but something that keep me coming back. I quickly found others who had our same rare diagnosis, who were a few steps ahead of us into the hard decisions that were waiting for mr fox and I. The relationships that grew from that blog are ones that I will treasure always. The women who walked that harrowing journey with me, even though we've never met in person, know me better than almost anyone. They supported me in ways that my IRL supporter just couldn't. In some ways it was because I felt free to share my innermost thoughts and feelings on my blog. There were so many things that I was afraid to say, afraid that my words would somehow be used against me later, but for whatever reason was able to write and share with totally random strangers. I went to great lengths to keep my blog anonymous. It was a big part of what made it such a safe place. But over time, let my closest friends and family know about it, and invited them to read it. It felt like the right thing to do, and was a powerful tool to 'let them in', to help them understand how deeply I was affected by our experience, but also led me to think twice about what I wrote, made me start censoring my words, and ultimately hesitate to write anymore. There was also something strange about transitioning what had been exclusively an infertility blog to something else. I feel like there are so many other things I'd love to write about, but it didn't feel right to write about them in that space. That blog holds the story of my deepest darkest times in life. That time has passed, and yet I feel the need to honor it by protecting the space that captured it. And yet, I miss writing. I miss the chance to sit and expand my thoughts, to see them laid out on the page. To have them translated from random bits of information flying around my head to cohesive articulated ones. It feels validating. It feels meaningful. So here I am, starting a new blog, a new space to write. So much has changed since I started. I am making a commitment to myself that I will carve out the time I need to take better care of myself. Time to exercise. Time to write. Time to just be me.

Politics of Birth

I'm sitting here typing as my little Fox naps with his head resting on my leg. Gotta love naptime!

A photo of little Fox and I were recently included in an article by Rebecca Dekker on her blog Evidence Based Birth. There is so much great information compiled here, and in such an easy to understand format. I recommend her site to all of my pregnant friends.

After our highly medical conception, Mr Fox and I decided we plan a home birth. We switched from our OB to a Licensed Midwife at 20 weeks, but as we approached 43 weeks decided to switch back to an OB for a hospital induction.  I consider myself very educated about pregnancy and birth - if only through osmosis as I grew up watching my mom in her work as a childbirth educator, doula, lactation consultant, and parent educator. Regardless, it has been an interesting process for me to look back at our birth and review all of the decisions that we made along the way.

The more I learn and reflect on my own experience, the more I realize just how political birth is. There is very little respect for 'informed consent' and much more talk about what a doctor will 'let' a pregnant woman do or not do. It makes me angry, and it makes me feel like I have a responsibility to change things.

I honestly don't care how or where a women births her children, but I absolutely believe that women should be fully informed about and empowered to make their own choices. I also firmly believe that if a women wants to defer to her doctor for those decisions that she should be confident that her doctor is providing her with the evidence-based care that is best for her and her baby.

I find myself wanting to be more involved in organizations that are working to influence change at the political level, but seeing that there are many more organizations who are working to educate women one-at-a-time so that they can demand change. California Families for Access to Midwives is doing political work that I want to be a part of. Until I am in a place to make a more formal commitment of time I find myself working around the edges, trying to support the work that is being done, but unable to take on the bigger projects that are so necessary to really make a difference.

Maintaining limits that I've set for myself is critical to my sanity. But someday in the future, I will do more. I will.

Wednesday, September 25, 2013

So We Begin

I miss writing. I miss having a place of my own to chronicle my thoughts. I miss the community that I found online, but need a fresh start,Granted I have less time to write since the little Fox joined me, but it's time that I will find. So many posts fill my head - posts about the politics of parenting, reviews about all of the spas that I am determined to visit, struggles to balance being a wife, mom, employee, volunteer, and individual, and so much more.