Monday, December 8, 2008

Birth Plan

Parent's wishes for the birth of Owen Thomas _

Owen is a miracle and gift from God. His birth is an occasion for rejoicing. Please treat it as such, even if he is still born or dies soon afterward. Please refer to him as Owen and share our joy and sorrow with us. Our wish is that if he dies, dad or mom are holding him. As a result, we ask that all possible procedures be done in our presence or delayed until his condition is assessed to see if he is stable. Our intent is to provide Owen an opportunity to ‘stay with us’ on primarily comfort care with minimal intervention. We truly appreciate your help and support, and ask that you understand if we seem indecisive at times. We also appreciate and find great comfort in your expressions of grief, be it through tears or humor.

Delivery (Possible vaginal birth or c-section):

Mom would like an epidural and pain relief. We also want the baby to be monitored as well as mom. Mom wants to be aware, alert and present for the delivery and afterward. Should Owen become distressed during a vaginal birth, then mom wants a c-section.

We desire to have a third person (in addition to dad and mom) in the delivery room/OR to take photographs and/or video. We do not wish to have any unnecessary hospital staff in our room at any time (ie students, interns, etc). Only hospital staff that are performing medically necessary exams or procedures are to examine our son in life or death.

We desire no circumcision, inoculations/vaccinations, and no eye ointment at any time. Please delay vitamin K, footprints, weighing & measuring until after both parents have held Owen. Immediately after birth, perform standard suctioning, rubbing, and vigorous drying to aid in his respiratory and cardiac efforts. We desire that the following guidelines be observed:

1) Assess Owen's respiratory effort after drying, rubbing, and suctioning. Keep in mind that due to his lung mass, Owen may need oxygen.

a) If he breaths well and has a heart rate above 100 bpm, weigh & measure; then, give him to mom or dad.

b) You may follow standard newborn resuscitation procedures (up to and including PPV (either bag & mask and/or CPAP), chest compressions and administration of medications (ie epinephrine, morphine, etc.) and oxygen). An umbilical catheter or IV are okay. We probably do not desire for Owen to have a tracheal tube inserted, nor mechanical ventilation. If you come to this point in resuscitation efforts, please discuss with dad and/or mom. We will probably just want to hold, comfort and love him – but we want to be given the information in case we change our mind.

c) Any tests should be discussed with parents and done with parents’ permission only.

2) We do not wish to participate in the Washington or Oregon Newborn Screening Program and want no part in any testing, donation or research of any kind (genetic or otherwise, irregardless of whether it’s coded, anonymous, identified or de-identified).

3) We desire that mom or dad be holding him at all possible times.

4) We desire that no procedure be done without parents' presence. Dad is to be with Owen at all times. As soon as is practical, please have Owen join mom in the recovery room.

5) We desire full rooming in (no NICU, transition nursery) for at least first several hours. We understand that hospital policy may not allow for this with some of the minimal interventions/monitoring that we are requesting.

6) We desire that dad and mom bathe Owen themselves if possible. If not possible, please bathe him in the same room with the parents.

7) We desire that our child and other relatives be allowed in to see Owen ASAP for as long as we wish.

8) We desire that mom try to nurse Owen. Request that the lactation consultant visit as soon as possible for assistance (mom has nursed one previous child). If Owen is unable to nurse, mom will express breastmilk using a pump and this should be given to Owen via a feeding tube. If mom is not producing enough breastmilk/colostrom (or Owen’s blood sugar is too low), formula and/or IV fluids are okay. If Owen’s esophagus isn’t connected to his stomach, then no further attempts at introducing nutrition are to be made.

9) If Owen stabilizes, we desire to take him home ASAP on comfort care.

In case of death:

If Owen dies during our stay, please notify staff members as soon as appropriate. Mom will be recovering and will probably be best cared for on the maternity floor, but the staff should be sensitive to the situation when possible.

In Owen’s death, please respect our wishes in point 2) above. We do not wish to have an autopsy.

If he dies before being bathed, we desire to bathe and dress him ourselves.

After he dies, we desire that Owen be with us as long as we desire. We also desire that our child and relatives be allowed to be with us during that time. We request Owen stay with us until the funeral home arrives.

Owen's name, Owen Thomas _, must be on the death or still birth certificate.


Heidi K said...

Shannon, I like your birth plan so much, I want to adopt it as ours as well. I also love the music you have on your blog. Do you have a list of titles ?? Have you ever heard the song, " Held" by Natalie Grant ?
You've done a great service, offering this example. I hope others in our circumstance find it as helpful as I did. I know I've been a little lost in the last month or so.
Thanks, and God bless


Shannon said...

Heidi, I'm soooo glad you like our plan! After we had found out about Owen's condition, I scoured the internet for birth plans, formulated one based upon several others I had found - then discussed it with a neonatologist before it became this end product...

The songs on my Playlist are:

01. I will carry you — Selah
02. Smallest Wingless — Craig Cardiff
03. Glory Baby — Watermark
04. With Hope — Steven Curtis Chapman
05. Held — Natalie Grant
06. Heaven — Craig Cardiff
07. Angel — Sarah Mclachlan
08. Awake — Josh Groban
09. Lullaby — Dixie Chicks
10. Hold Him In Heaven — Barbara Fairchild
11. Angels In Waiting — Tammy Cochran
12. Tears In Heaven — Eric Clapton
13. Lullabye (Goodnight, My Angel) — Billy Joel
14. Another Day — Natalie Grant