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Calling for Birth Plan Thoughts!



 
 
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  #1  
Old April 17th 05, 02:24 PM
Chookie
external usenet poster
 
Posts: n/a
Default Calling for Birth Plan Thoughts!

I'm heading in to my delivery hospital to discuss labour management this
Friday. I'm particularly interested to hear from people who had
pre-eclampsia, ITP or a similar condition on what practices suited them or
annoyed them etc, but all comments are welcome.

I want a relaxed normal delivery with as few interventions as possible during
labour, and to delay cord clamping until after pulsation ceases. DH would
like to cut the cord and say a prayer. I want to put the baby to the breast
immediately. My idea of a Bad Time is arguing with an intervention-happy
obstetrician between contractions, and I'm planning to enlist the aid of the
midwives to prevent this (they run the show unless something goes wrong).

So far, my enquiries include:

I expect to need more emotional support than the average second-timer,
particularly if I develop symptoms.

I think staff should have a look at the relevant section of my labour notes
from DS's birth, so they know what went wrong last time and how fast.

Do you want me to come in fairly early in labour for blood tests or other
baseline measurements? (ASSHP suggest a repeat full blood count, serum uric
acid, creatinine and liver function tests, together with assessment of urinary
protein at 33-36 weeks gestation in symptomatic PE.)

Under what circumstances would induction/augmentation be considered? Or
Caesarean?

My obstetrician suggested an IV be put in "just in case". How about we hold
off on that until I develop symptoms? I don't want to labour with a needle
stuck in my hand.

I want CFM only at the onset of serious symptoms (ie, inability to control
blood pressure despite adequate hypertensive therapy; deteriorating liver
function; deteriorating renal function; progressive thrombocytopenia or
neurological complications or imminent eclampsia) or heavy-duty medication.

Do you use magnesium sulphate for convulsion prophylaxis?

What cutoff should we use for BP? (ASSHP suggest 170 systolic and/or 110
diastolic, but I am not sure my numbers got that high until I actually
seized). What would you do if my BP did get too high?

Frequency of BP monitoring -- half-hourly and at delivery of placenta if
symptomatic -- how often will it be done beforehand?

Is there any point to anaesthetic assessment prior to labour if I am
asymptomatic?

Platelet count prior to epidural -- how long does it take and how much could
my platelets fall in the intervening period?

No ergometrine/syntometrine for third stage -- use oxytocin (they probably do
this anyway).

My ob suggested 4-hourly BP monitoring for 24 hours post-partum. I would like
6-hourly BP monitoring for the succeeding 24 hours as well.

"Careful clinical monitoring should detect premonitory signs of convulsions
(eclampsia) such as hyperreflexia with clonus, retinal vasospasm, visual
obscurations and persistent headaches." How do we do this in labour?

"All of the features of pre-eclampsia will resolve postpartum but clinicians
should remain alert for new maternal complications for at least a week after
delivery." What will this involve?

"Eclampsia is a well recognised complication of the puerperium, especially
when the guard of regular observations has been dropped. Some
abnormalities, particularly thrombocytopenia and platelet function defects,
will often get worse during the first 2-3 days after delivery" -- how will
this possibility be handled?

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.
  #2  
Old April 17th 05, 03:14 PM
Anne Rogers
external usenet poster
 
Posts: n/a
Default

you seem to have sensible questions, though I don't know enough to comment
at all

about the needle, firstly they should be able to insert one fast and the
need to insert one would unlikely to be without any warning, but if they
really want you to be already set up, see if they can get a vein on the back
of your arm, I would also hate to have one in my hand, but I've never had a
problem with one in my arm, even when it's been there for days.

Anne


  #3  
Old April 17th 05, 03:24 PM
Todd Gastaldo
external usenet poster
 
Posts: n/a
Default

"Do I have to go through a formal process to organise a FAQ...or do I just
do a Todd?"
--Ellen/Chookie, 2002
http://groups-beta.google.com/group/
misc.kids.pregnancy/msg/a45192dfb785c7ed

Ellen/Chookie,

You didn't mention birth position so - for the benefit of new readers - I
will risk doing a Todd. : )

1. Most women understandably do not wish to say to the OB or midwife:

"Your standard delivery positions - semisitting and dorsal - close the birth
canal up to 30%."

Instead, women usually say diplomatically: "I want to push in positions
which allow the birth canal to open maximally" - or words to that effect.

2. Most women also understandably do not wish to say to the OB:

"Your standard procedure is to keep the birth canal closed the "extra" up to
30% - keep women semisitting or dorsal when babies get stuck - I don't want
you to do that."

Instead, women usually say diplomatically: "If you have to pull with hands,
forceps or vacuum, please make sure I am in a position that allows my birth
canal to open maximally."

Point #2 in this Todd is rather new - I think it was inspired by Rivka.

Todd

PS One more note below######

"Chookie" wrote in message
...
I'm heading in to my delivery hospital to discuss labour management this
Friday. I'm particularly interested to hear from people who had
pre-eclampsia, ITP or a similar condition on what practices suited them or
annoyed them etc, but all comments are welcome.

I want a relaxed normal delivery with as few interventions as possible
during
labour, and to delay cord clamping until after pulsation ceases.


##### New readers. Immediate cord clamping temporarily asphyxiates the baby
and robs him/her of up to 50% of his/her blood volume. It is wise not to
explicitly call the OB or midwife's attention to this fact - but all women
should know it. Saying "delay cord clamping until after pulsation ceases"
is much more diplomatic.

DH would
like to cut the cord and say a prayer. I want to put the baby to the
breast
immediately. My idea of a Bad Time is arguing with an intervention-happy
obstetrician between contractions, and I'm planning to enlist the aid of
the
midwives to prevent this (they run the show unless something goes wrong).

So far, my enquiries include:

I expect to need more emotional support than the average second-timer,
particularly if I develop symptoms.

I think staff should have a look at the relevant section of my labour
notes
from DS's birth, so they know what went wrong last time and how fast.

Do you want me to come in fairly early in labour for blood tests or other
baseline measurements? (ASSHP suggest a repeat full blood count, serum
uric
acid, creatinine and liver function tests, together with assessment of
urinary
protein at 33-36 weeks gestation in symptomatic PE.)

Under what circumstances would induction/augmentation be considered? Or
Caesarean?

My obstetrician suggested an IV be put in "just in case". How about we
hold
off on that until I develop symptoms? I don't want to labour with a
needle
stuck in my hand.

I want CFM only at the onset of serious symptoms (ie, inability to control
blood pressure despite adequate hypertensive therapy; deteriorating liver
function; deteriorating renal function; progressive thrombocytopenia or
neurological complications or imminent eclampsia) or heavy-duty
medication.

Do you use magnesium sulphate for convulsion prophylaxis?

What cutoff should we use for BP? (ASSHP suggest 170 systolic and/or 110
diastolic, but I am not sure my numbers got that high until I actually
seized). What would you do if my BP did get too high?

Frequency of BP monitoring -- half-hourly and at delivery of placenta if
symptomatic -- how often will it be done beforehand?

Is there any point to anaesthetic assessment prior to labour if I am
asymptomatic?

Platelet count prior to epidural -- how long does it take and how much
could
my platelets fall in the intervening period?

No ergometrine/syntometrine for third stage -- use oxytocin (they probably
do
this anyway).

My ob suggested 4-hourly BP monitoring for 24 hours post-partum. I would
like
6-hourly BP monitoring for the succeeding 24 hours as well.

"Careful clinical monitoring should detect premonitory signs of
convulsions
(eclampsia) such as hyperreflexia with clonus, retinal vasospasm, visual
obscurations and persistent headaches." How do we do this in labour?

"All of the features of pre-eclampsia will resolve postpartum but
clinicians
should remain alert for new maternal complications for at least a week
after
delivery." What will this involve?

"Eclampsia is a well recognised complication of the puerperium, especially
when the guard of regular observations has been dropped. Some
abnormalities, particularly thrombocytopenia and platelet function
defects,
will often get worse during the first 2-3 days after delivery" -- how will
this possibility be handled?

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.



  #4  
Old April 17th 05, 06:29 PM
sharalyns
external usenet poster
 
Posts: n/a
Default


Chookie wrote:
I'm heading in to my delivery hospital to discuss labour management

this
Friday. I'm particularly interested to hear from people who had
pre-eclampsia, ITP or a similar condition on what practices suited

them or
annoyed them etc, but all comments are welcome.


Ok--I had pre-eclampsia. Ended up with an OB for labor and delivery.
The most annoying thing was that we had planned to do the birth plan
that weekend (while taking our first labor class), but he arrived on
Friday. So I didn't know the OB, she didn't know me, and our wishes
weren't written down. So I was in the middle of labor and telling
people what I did and didn't want.....

I expect to need more emotional support than the average

second-timer,
particularly if I develop symptoms.


I expect this next time around too.

My obstetrician suggested an IV be put in "just in case". How about

we hold
off on that until I develop symptoms? I don't want to labour with a

needle
stuck in my hand.


FYI--an IV isn't a needle stuck in your hand and left there. The needle
is used to gain access to the vein, a catheter inserted and left there,
while the needle is then removed. I found that the forearm is a great
place for a non-intrusive IV. The hand tend to be sensitive, and the
anticube is positional if they have to administer fluids. I too would
like to labor next time without an IV in place, but I would not be
seriously opposed to a forearm saline lock for quick access.

My ob suggested 4-hourly BP monitoring for 24 hours post-partum. I

would like
6-hourly BP monitoring for the succeeding 24 hours as well.


FYI-The usual for after a 4 hour BP monitoring, is every 8 hours while
remaining in hospital (once per shift if shift change is q8 hours).
That would mean 3 checks in the second day versus 4 checks.

"All of the features of pre-eclampsia will resolve postpartum but

clinicians
should remain alert for new maternal complications for at least a

week after
delivery." What will this involve?


FYI--mine meant that twice a week I went in to have my BP measured
until resolved (2 weeks post). Of course I was at the hospital all the
time because my son was still admitted.


Also--you could ask *how* they would plan to induce (I may have missed
this question). The way my labor was started, I would *highly*
recommend. They took a foley catheter and inserted it up past my cervix
into the uterus without breaking my waters, and then inflating the
balloon. With nothing more than mild cramping once in a while, I was
4-5 centimeters in 8 hours. It was when they started pitocin and
performed AROM (without my permission) that things got ugly.

I think the rest of your questions are excellent!

Sharalyn
mom to Alexander James (9/21/01)

  #5  
Old April 17th 05, 08:33 PM
external usenet poster
 
Posts: n/a
Default

For me there is a difference in how I would want to be treated with and
without an epidural. Without an epidural, I cannot tolerate being
strapped down, so that means no constant monitoring (and me preferring
an internal monitor to an external monitor so I don't have to stay
still for it to work) and no IV. If I get an epidural, I can't do
anything except lay there, so then I don't really care if I have an IV
or monitors strapped on. Just thought you might want to consider that.

I have ITP, but my platelets have never been an issue to anything
except getting an epidural. Two hospitals I went to would allow an
epidural with a good bleeding time test, but my current hospital has
simply said no epidural if platelets are under 100K, so you should look
into the rules of your hospital. I personally came to the hospital
late in my second labor knowing it would make it impossible for me to
get an epidural, but preferring to labor without harassment in the
earlier parts of labor. With this time an epidural being off the table
for sure, I plan to again arrive in late labor.


Good luck in not getting pre-e this time! Have you shown any symptoms
of it yet?

KC

  #6  
Old April 18th 05, 05:04 AM
alath
external usenet poster
 
Posts: n/a
Default

I'm trying to read between the lines here to clarify what some of your
concerns are.

I want CFM only at the onset of serious symptoms (ie, inability to

control
blood pressure despite adequate hypertensive therapy; deteriorating

liver
function; deteriorating renal function; progressive thrombocytopenia

or
neurological complications or imminent eclampsia) or heavy-duty

medication.

You seem to be saying here that you don't want fetal monitoring unless
you have severe pre-eclampsia. Am I getting that right? Of course all
these decisions are up to you, but I personally would want my wife to
have fetal monitoring if she had any pre-eclampsia (including mild).
Fetal compromise is one of the criteria that defines severe disease -
if you aren't looking for that, you won't know.

The clinical findings you list above are part of the definition of
severe pre-eclampsia. Once you get to this point - and I hope you don't
- fetal monitoring isn't really an issue any more because if you get
this sick, you need an expedited delivery (hopefully vaginal if you are
far enough along in labor, c-section if you are not). The additional
finding of fetal distress really wouldn't add much to the decision. In
other words, if you get this sick, you need to be delivered quickly no
matter what the fetal monitor says.

Do you use magnesium sulphate for convulsion prophylaxis?


What are your concerns here? Perhaps a better question would be, "under
what circumstances would you use mgso4 for seizure prophylaxis?"

What cutoff should we use for BP? (ASSHP suggest 170 systolic and/or

110
diastolic, but I am not sure my numbers got that high until I

actually
seized). What would you do if my BP did get too high?


Cut off for what? For the diagnosis of severe disease? For needing
antihypertensive medication?

"Eclampsia is a well recognised complication of the puerperium,

especially
when the guard of regular observations has been dropped. Some
abnormalities, particularly thrombocytopenia and platelet function

defects,
will often get worse during the first 2-3 days after delivery" -- how

will
this possibility be handled?


If you develop critical thrombocytopenia, you may be advised to have a
platelet transfusion.

  #7  
Old April 19th 05, 12:41 AM
Chookie
external usenet poster
 
Posts: n/a
Default

In article .com,
"alath" wrote:

You seem to be saying here that you don't want fetal monitoring unless
you have severe pre-eclampsia. Am I getting that right? Of course all
these decisions are up to you, but I personally would want my wife to
have fetal monitoring if she had any pre-eclampsia (including mild).
Fetal compromise is one of the criteria that defines severe disease -
if you aren't looking for that, you won't know.


Last time, I had severe disease without any fetal problems. I am one of the
44% of eclamptics who suffer it post-partum. DS was delivered at 41 wks and
weighed 8 lb 5 oz. This baby isn't showing any signs of trouble either -- in
fact, it's more active than DS was -- so I'm treating myself as a time bomb
and not worrying too much about the baby. My symptoms were high BP --
seizure, haemolysis, the standard liver & kidney problems, and
thrombocytopenia/DIC. The only symptom in labour was severe headache, and the
seizure occurred about 5 minutes pp.

The clinical findings you list above are part of the definition of
severe pre-eclampsia. Once you get to this point - and I hope you don't
- fetal monitoring isn't really an issue any more because if you get
this sick, you need an expedited delivery (hopefully vaginal if you are
far enough along in labor, c-section if you are not). The additional
finding of fetal distress really wouldn't add much to the decision. In
other words, if you get this sick, you need to be delivered quickly no
matter what the fetal monitor says.


I don't want CFM *unless* augmentation of labour is indicated.

Do you use magnesium sulphate for convulsion prophylaxis?


What are your concerns here? Perhaps a better question would be, "under
what circumstances would you use mgso4 for seizure prophylaxis?"


I heard that a large-scale trial of MgSO4 was taking place to see if it was
useful for preventing seizures in the first place -- it's definitely the drug
of choice for preventing *further* seizures. If anyone knows anythign about
this trial, I'm keen to hear about it -- couldn't spot it yet on Pubmed.

What cutoff should we use for BP? (ASSHP suggest 170 systolic and/or
110 diastolic, but I am not sure my numbers got that high until I
actually seized). What would you do if my BP did get too high?


Cut off for what? For the diagnosis of severe disease? For needing
antihypertensive medication?


Either.

"Eclampsia is a well recognised complication of the puerperium,
especially when the guard of regular observations has been dropped. Some
abnormalities, particularly thrombocytopenia and platelet function
defects, will often get worse during the first 2-3 days after delivery"
-- how will this possibility be handled?


If you develop critical thrombocytopenia, you may be advised to have a
platelet transfusion.


Fortunately, my platelet function normalised rapidly last time, but I'd like
to see it monitored because of the rule of thumb about PE occurring later in
subsequent pregnancies.

IIRC, I had 2 units of *PRBCs* transfused, and as it still took 18 months for
my haemoglobin to return to normal, I assume the haemolysis was severe (I only
lost about 850 ml of blood).

Thanks for helping me clarify my thoughts!

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.
  #8  
Old April 19th 05, 09:45 AM
Larry McMahan
external usenet poster
 
Posts: n/a
Default


Chookie,

I don't know how much hlep this is going to be, but here is a copy of
Monika's birth plan. since it is written "bullet" style, maybe you
will find silver one among them. :-)


I am Monkia Finkenstaedt McMahan, and this is the birth plan
for the delivery of my child. This plan should govern my
medical treatment if I am transferred to a hospital for
labor and/or delivery.

I expect each item on which hospital policy differs from my
stated wishes to be discussed with me and my husband, and
explicit consent be obtained from me before undertaking any
action that is contrary to the wishes stated in this birth
plan.


General Procedures and Procedures Specific to the Mother
--------------------------------------------------------

I do not want to be shaved.

I do not want to have an enema.

I want to labor in my own clothing.

I want the option to give birth nude.

I do not want to have my membranes stripped.

I do not want to have my waters broken without my prior
consent.

I want to eat light food and drink juices or water of my
choice at any time during the labor.

I do not want to be placed in the lathroscopic position (on
my back) for exams or at any other time during labor or
delivery.

I want remain ambulatory and labor in any position of my
choice. I want to give birth in the position of my choice,
including, but not limited to standing, squatting, or
all-fours.

I do not want an episiotomy. I would rather risk a natural
tear.

I want my husband Larry N. McMahan and my midwife H
P to be with me during the entire labor and delivery.

If I am incapacitated so that I am not able to give medical
consent, I want medical concent to be obtained from my
husband, Larry N McMahan before undertaking any medical
procedure.

I do not consent to EFM (electronic fetel monitoring) at any
time during labor and delivery, except for cause and with
consent. All routine monitoring should be done with
fetoscope or doptone.

I do now want to have routine vaginal exams to monitor
progress. Exams will be for cause and with consent only.

I do not want to be prepped for IV (heparin lock inserted)
unless there is a medical necessity. This will be done for
cause and with consent only.

Pain relief medication will be administered with consent
only. If I want any I will ask. Please don't suggest it to
me.

Absent other medical indications failure to progress will
not be considered a cause to induce labor. Induction will
be done for cause and with consent only.

I do not want forceps or vacuum extraction to be used for
delivery unless there is a medical necessity. If necessary,
then consent must be obtained at the time.

I do not wish for cord traction to be used for removal of
the placenta. I also do not wish to have any drugs
administered without my permission in order to deliver the
placenta. I wish to use nipple stiumlation, primarily by
breastfeeding to encourage the placenta to detach and
spontaneously deliver. Any change to this point must be
done only for cause and with consent must be obtained at the
time.




If a Complication Requires a C-Section
--------------------------------------

I want my husband, Larry N. McMahan, and midwife H
P to remain with me in the operating and recovery room
before, during and after the procedure.

I want the procedure to be done using a local anesthetic
only, no general anesthetic.

I do not want to have a screen placed so I cannot see the
birth.

I want to hold the baby, and if possible attempt to
breastfeed the baby immediatly after the birth.

I want the baby to be seperated from me the minimum time
possible.

Procedures Regarding the Baby -----------------------------


I want either myself, my husband, or the midwife to remain
with the baby at all times after the birth.

Absent medical complications, I want my baby to be examined
and his Apgar evaluated while he lies on my stomach.

Absent medical complications, I do not want my baby placed
in an isolette or on a warming table. I want my baby to be
held by myself or a family member at all times.

If my baby is a boy I do not want him circumsized.

I do not want the baby to be fed formula, glucose water, or
to be given a pacifier at any time after the birth.

I do not want my baby to receive a vitamin K injection. It
may be given orally.

I do not want my baby to receive silver nitrate eyedrops.
Erithromycin ointment may be given, but only after the first
two hours.

I do not wish to have my baby's airway routinely suctioned.
It will be done for cause and with consent only.

I do not want the baby's cord to be clamped before it has
stopped pulsating. Absent medical necessity, I do not want
the cord clamped or cut until after the placenta delivers.

If complications require the baby's hospitalization, I want
to breastfeed or express breastmilk to feed the baby. I do
not want supplemental feeding without consent.

If complications require the baby's hospitalization, I want
to visit or stay with the baby at any time.

If complications require the baby's hospitilization, I do not
want the baby to be fed by bottle. The baby may be fed by
gavage, cup, or syringe.
  #10  
Old April 20th 05, 04:52 PM
Alicia Norm
external usenet poster
 
Posts: n/a
Default

Larry McMahan wrote in news:4264c525
@usenet01.boi.hp.com:


Chookie,

I don't know how much hlep this is going to be, but here is a copy of
Monika's birth plan. since it is written "bullet" style, maybe you
will find silver one among them. :-)


I am Monkia Finkenstaedt McMahan, and this is the birth plan
for the delivery of my child. This plan should govern my
medical treatment if I am transferred to a hospital for
labor and/or delivery.

I expect each item on which hospital policy differs from my
stated wishes to be discussed with me and my husband, and
explicit consent be obtained from me before undertaking any
action that is contrary to the wishes stated in this birth
plan.


General Procedures and Procedures Specific to the Mother
--------------------------------------------------------

I do not want to be shaved.

I do not want to have an enema.

I want to labor in my own clothing.

I want the option to give birth nude.

I do not want to have my membranes stripped.

I do not want to have my waters broken without my prior
consent.

I want to eat light food and drink juices or water of my
choice at any time during the labor.

I do not want to be placed in the lathroscopic position (on
my back) for exams or at any other time during labor or
delivery.

I want remain ambulatory and labor in any position of my
choice. I want to give birth in the position of my choice,
including, but not limited to standing, squatting, or
all-fours.

I do not want an episiotomy. I would rather risk a natural
tear.

I want my husband Larry N. McMahan and my midwife H
P to be with me during the entire labor and delivery.

If I am incapacitated so that I am not able to give medical
consent, I want medical concent to be obtained from my
husband, Larry N McMahan before undertaking any medical
procedure.

I do not consent to EFM (electronic fetel monitoring) at any
time during labor and delivery, except for cause and with
consent. All routine monitoring should be done with
fetoscope or doptone.

I do now want to have routine vaginal exams to monitor
progress. Exams will be for cause and with consent only.

I do not want to be prepped for IV (heparin lock inserted)
unless there is a medical necessity. This will be done for
cause and with consent only.

Pain relief medication will be administered with consent
only. If I want any I will ask. Please don't suggest it to
me.

Absent other medical indications failure to progress will
not be considered a cause to induce labor. Induction will
be done for cause and with consent only.

I do not want forceps or vacuum extraction to be used for
delivery unless there is a medical necessity. If necessary,
then consent must be obtained at the time.

I do not wish for cord traction to be used for removal of
the placenta. I also do not wish to have any drugs
administered without my permission in order to deliver the
placenta. I wish to use nipple stiumlation, primarily by
breastfeeding to encourage the placenta to detach and
spontaneously deliver. Any change to this point must be
done only for cause and with consent must be obtained at the
time.




If a Complication Requires a C-Section
--------------------------------------

I want my husband, Larry N. McMahan, and midwife H
P to remain with me in the operating and recovery room
before, during and after the procedure.

I want the procedure to be done using a local anesthetic
only, no general anesthetic.

I do not want to have a screen placed so I cannot see the
birth.

I want to hold the baby, and if possible attempt to
breastfeed the baby immediatly after the birth.

I want the baby to be seperated from me the minimum time
possible.

Procedures Regarding the Baby -----------------------------


I want either myself, my husband, or the midwife to remain
with the baby at all times after the birth.

Absent medical complications, I want my baby to be examined
and his Apgar evaluated while he lies on my stomach.

Absent medical complications, I do not want my baby placed
in an isolette or on a warming table. I want my baby to be
held by myself or a family member at all times.

If my baby is a boy I do not want him circumsized.

I do not want the baby to be fed formula, glucose water, or
to be given a pacifier at any time after the birth.

I do not want my baby to receive a vitamin K injection. It
may be given orally.

I do not want my baby to receive silver nitrate eyedrops.
Erithromycin ointment may be given, but only after the first
two hours.

I do not wish to have my baby's airway routinely suctioned.
It will be done for cause and with consent only.

I do not want the baby's cord to be clamped before it has
stopped pulsating. Absent medical necessity, I do not want
the cord clamped or cut until after the placenta delivers.

If complications require the baby's hospitalization, I want
to breastfeed or express breastmilk to feed the baby. I do
not want supplemental feeding without consent.

If complications require the baby's hospitalization, I want
to visit or stay with the baby at any time.

If complications require the baby's hospitilization, I do not
want the baby to be fed by bottle. The baby may be fed by
gavage, cup, or syringe.


Wow... Talk about being prepared.. ;-)


--
http://www.BirthClubForums.com
The online community for new and expected parents.
$50 Contest going on NOW!
 




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