Due Date: April 16, 2009
Patient of Dr. ___________/ Hospital ________________
March 17, 2009
We're looking forward to sharing our birth experience with you. As you know, our baby was diagnosed with Anencephaly 18 weeks into our pregnancy. We have created this birth plan in order to outline some of our Wishes for his birth.
Seth has anencephaly, but I still want him treated like a "normal" baby.
After he is born I would like for a sterile head dressing to be placed on my baby to keep infection from setting.
Cesarean Section Delivery
-I would like My Husband to be present during the surgery.
-I would prefer epidural anesthesia, if possible, in order to remain conscious through the delivery.
-If conditions permit, I would like to be the first to hold Baby Seth after the delivery.
-I would like our plans outlined here for after the birth to be followed as closely as possible.
-My Husband would like the option to cut the cord.
-Please allow the umbilical cord to stop pulsating before it is cut.
-I have made arrangements for donation of the umbilical cord blood.
-I would like to hold Baby Seth through delivery of the placenta and any repair procedures.
-Please evaluate and bathe Baby Seth at my bedside.
-If Baby Seth must go to the nursery for evaluation or medical treatment, My Husband, or someone I designate, will accompany Baby Seth at all times.
-I would prefer to bathe Baby Seth myself, at my discretion.
I would like for my baby to get his sterile head dressing changed daily to help prevent and infection.
-If available, I would prefer a private room.
-I would like to have Baby Seth room-in with me at all times.
-I would My Husband to room-in with me.
-I would like my other children to have free visitation access.
-I plan to breastfeed and want to nurse immediately following the birth.
-Please do not give Baby Seth supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
-I would like to take still photographs during labor and the birth.
As of right now I do not plan to have my baby circumcised, unless a miracle happens and he is born without anencephaly.
Please take my wishes into consideration, as my only reason for this birth plan is so my baby has a bigger chance of being born alive.