Thursday, April 21, 2011

Creating a birth plan. More great resources from my doula friend.

  • To me a good birth plan isn't supposed to be a plan set in stone. It is really a plan of what to do in case this or that happens. I feel it is so important to educate yourself on everything that could happen during labor and decide how you would want to handle each circumstance should it arise. Having it all in writing helps your support team and you remember what you want when things are hectic and you are needing to focus. Your plan is also great for reminding you what your options are for coping with the pain. My plan will have a portion for my health care team and a section just for me and my support team full of options to help me get through when things get tough. Having gone through labor before, I am able to build on that experience to help me prepare for this one. I will especially focus on the parts of that labor that were hardest and find ways to cope this time. I think doing this will really help me get past my fears for the next labor.
    And as doulala says, 
It is a list of preferences.   
With rotating strangers attending the mom, it's nice not to have to re-remind to everyone.
The biggest reason to make one, imo, is the educational aspect.   In creating the BP, moms learn more about their options and rights.
Also in the end, it can be used to prove mom did express her preferences because they are not always honored and sometimes this goes poorly.  
  • How to write a Birth Plan

    Know your options

    The first step in writing a birth plan is to find out what your options are. Different doctors will give you different options for handling the same situation. Different hospitals will give you different options and have different policies. Differences in health between pregnancies can impact the options that are available.
    Your first job is to find out what options are available to you. If you are not sure yet what possible options might be, review the Birth Plan Checksheet. It is an exhaustive list of options you might have. It is a good tool for beginning conversations with your caregiver too. Read through the list and determine what options appeal to you, and what options you don't think you want. Use this to find out what options your caregiver feels comfortable with.
    Take the Birth Plan Checksheet on a hospital tour to find out how the policies may affect your options. If possible, make several copies and tour several hospitals. You may find that some hospitals appeal to you more based on the services they provide.

    Find out what you want

    Once you know what options are available to you, it is important to determine how you feel about the options. Some things will be very important, and others will seem small or unimportant. There is no right or wrong, it is simply a matter of understanding who you are and how you want things handled.
    You may find that there are several options that you feel very strongly about. In this case, it might be necessary to try to decide how the options rank in importance to you. The Ideal Birth Worksheet can help you work through your feelings about the options.

    Can you get what you want?

    After you have decided what you want, you need to take a hard look at the reality of your situation. Are the choices you have made realistic given your health? Does your caregiver and hospital support your decisions? Do your birth partners (doulas, spouse, friend, family) support your decisions?
    If you have made choices that are not possible you need to reevaluate your decisions. Do you need to change your plan, or do you need to change your care team. Can you increase the support for your choices by changing hospitals or midwives? Or would you prefer to change your decision about the options and stay with the practice, hospital and birth partners you've chosen. Only you can make that decision.

    Start the Dialog

    With your choices written out, talk with your doctor or midwife about what choices you have made and why. If your caregiver has concerns about an option, find out what they are and where he or she recommends you go to do further study.
    Be sure to be assertive, but not aggressive when discussing your options. Do not allow your caregiver to brush off your decisions or suggest that this is unimportant. At the same time, don't assume your caregiver will be hostile or uninterested in hearing what you have to say.
    Talk first about how you want to handle a normal, uncomplicated labor. Then move on to your decisions in case of a complication. Be sure to let your caregiver share thoughts and opinions about your decisions. Listen carefully to what is said. This will be your first real chance to determine if this is the doctor/midwife for you.

    Be Flexible

    Remember, you did not write the birth plan for the normal, uncomplicated labor. You wrote it so that those attending you understood your decisions about how to handle unexpected situations. When an unexpected situation arises, remind your caregivers to refer to your birth plan and work together through the plan you wrote.
    Some women get to do EVERYTHING on their birth plan. They get to try every position and pain relief technique and when complications arise, they get to have a cesarean done the way they wanted.
    Other women get to do very LITTLE from their birth pan. The nurse keeps the right atmosphere, but labor moves so quickly that you don't get a chance to try the tub and walk the halls.
    Regardless of the circumstances of your labor, use your birth plan to help you determine how you will react to labor.
  • What is a Birth Plan
    How to Write a Birth Plan
    Should I Write a Birth Plan?
    Hospital Planning
    Birth Plan Checklist
    Using a Birth Plan
    Informed Consent
    Abuse Survivors

Monday, April 11, 2011

18 weeks

I had my 2nd doctor appointment today. It was with a different doctor than I saw the first time. While we were in the waiting room Aimee had a blow out and stunk up the whole waiting room. I forgot the diaper bag so a complete stranger gave me a diaper. Thank God for such sweet people!
We were supposed to be doing belly pictures but I like this one better.

First things first the nurse checked my blood sugar. I was shaking so bad I could barely put my finger to the lancet. Turns out my blood sugar was 68. So they went and got me some apple juice. The doctor started by telling me they are going with my lmp for my due date. So it moved from September 14th to the 12th. So I am officially 18 weeks today. Wow that went by really fast. And oddly I am in no hurry. I am feeling completely patient. I'm really glad I've made it to this point where I get to find out the gender soon. And I look forward to just going through the rest of the pregnancy.

Anyway, so the doctor is sending me to a high risk diabetes educator so I can get a new meter and start testing 4 times a day. He wants me keep track of everything I eat as well and have me back in 2 weeks to see if we can figure anything out or if I need to be put on any other meds. I've been on metformin for the last 4 years but it just isn't doing the trick.

We got to hear the heartbeat again. It took a while for the doctor to find and I was starting to get pretty nervous since I haven't really felt baby move much yet. But he did find it and it was 150bpm. At my ultrasound it was 170. My uterus is just above my belly button so I am growing just on track. I still have not gained any weight and I hope to keep it that way. The doctor agreed that should be my goal for the whole pregnancy. I'm going to have to cut out the sugary snacks and eat even more healthy if I'm going to accomplish that without exercising.


17 weeks
I think I'm feeling movement. It is totally random and I seem to feel it most when I'm sitting up especially with the computer on my belly. With Aimee I felt it most lying flat on my back and it was very distinct flutters in my lower belly. These are more like twitches and I feel it most to the left of my belly button. So strange.