Wednesday, December 22, 2010

birth plan

The Maternal Fetal Medicine (MFM) midwife and I discussed detail plans for delivery. I really don't have a choice about anything at all which but it is good to write down the plan to clarify everyone's understanding. According to my doctor some people write an essay for a birth plan so he is happy with my little flow chart and dot points that I put in my file!

I get asked frequently about what the plan is because the excess aminotic fluid carries risks for delivery. Babies tend to float around instead of settling into a firm head down position. When the waters break the cord can get caught and squished cutting of the babies oxygen supply. However, vaginal births are usually best for Mom and baby if possible.

So here is the expanded version of the plan if we make it to 37 weeks:

1. if the baby is head down - planned induction of labour during business hours. They may do an aminoreduction first to get rid of some of the fluid. I will be given an epidural and the doctors physically will hold the baby’s head in position while they break my waters. Hopefully a vaginal delivery will follow. If not, I have an epidural ready to go for a c-section. The midwife thought I may get a cuddle while the umbilical cord was still attached but my doctor said he would rather hand the baby right over to the pediatric I wrote that I would like a cuddle if the pediatric team thinks it is ok.

2. if the baby is not head down - C-section with an epidural so I am conscious.

In both situations the baby will be given to the paediatric team right away and intubated and ventilated right there in the operating theatre. They set up the room so I can see what is going on with the baby the whole time. There will be up to about 14 people present during the birth plus any medical, nursing, or midwifery students in the room. The MFM midwife told me just to focus on the midwife and my husband and ignore everyone else.

Neil will be with me in both scenarios and go with the baby to the NICU until I can join them.

If I go into labour early:

depending on the situation, I may still have the options of 1 or 2 but a 'code green' is also a possibility...code green is what the hospital calls over the PA when an emergency c-section is needed and all the necessary staff rush together. I have to be unconscious for the c-section in this scenario...hopefully we won't be in this situation because it means there is something going on that is dangerous for the baby and very traumatic for me to have to wake up not knowing the condition of the baby and possibly being quite sick from the anesthetic.

The MFM midwife has also arranged for my aftercare to be in the Antenatal and Gyne ward where I am currently staying in 1. because I know the staff and they know me 2. so I don't have to be in the postnatal ward with all the Moms and babies everywhere. She also arranged for Neil to be allowed to stay over with me, which normally isn't allowed after the baby is actually born.

Feeding plans

I try to express breastmilk to be stored and fed to the baby through a feeding tube until he is ready to try the boob. 95% of babies with CDH have feeding issues, so not sure if we will actually get to the breastfeeding stage but will at least be able to give him all the benefits of breastmilk regardless of how it gets to his belly.

So...all sorted


  1. Good plan - try to stay away from the colour plans - here's voting for a vaginal - less intervention the better. Keep the hug in the plan. Hope it can stay there.

  2. Push it out and steal a hug!!! That's what I'm hoping for you. Do the best you can and that hug is super important you as well as Baby Ross. Here's hoping it happens. And WOW, it sounds as though you are getting really good care. I'm impressed.

  3. I'm happy to hear it sounds like you are getting great medical service.