Regarding labor and birth - Patricia (Trish) McKenzie
Due Date: 10/18/2011
Patient of Dr.’s Hall & Morales
Scheduled to deliver at Capital Regional Medical Center
Dear Dr.’s Hall & Morales
I'm having a baby and these are my wishes for before, during and post delivery. I understand that these wishes may not pertain to any unplanned circumstances, but I would like to stick as close as possible to this plan. Please direct any questions to my sister, Barbie. Thank you.
- I wish to be able to move around and change position at will throughout labor.
- I would prefer to have a saline lock rather than a routine IV.
- I wish to be able to bathe/shower, as long as my membranes are still intact.
- I would like to be able to have fluids by mouth and eat lightly throughout the beginning stages of labor.
- I would prefer to keep the number of vaginal exams to a minimum.Monitoring
- I do not wish to have continuous fetal monitoring unless it is required by the condition of my daughter.Labor Augmentation/Induction
- I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.
- I would prefer to be allowed to try changing position and nipple stimulation before Pitocin is administered.
- I do not want any kind of anesthesia offered to me during labor, though I would like it available if I specifically request it.
- If my primary care provider determines that a Cesarean delivery is indicated, I would like to obtain a second opinion from another physician if time allows.
- I would like my husband present at all times if my daughter requires a Cesarean delivery.
- I wish to have an epidural for anesthesia.
- If my daughter is not in distress, my daughter should be given to my husband, Wade, immediately after birth.
- I would like to breastfeed immediately after delivery. Episiotomy
- I would prefer not to have an episiotomy unless absolutely required for the baby's safety.
- I would prefer warm compresses and massage to reduce the risk of tearing. Delivery
- I would like my husband and/or sister to support me and my legs as necessary during the pushing stage.
- I would like a mirror available so I can see my daughter's head when it crowns.
- Even if I am fully dilated, and assuming my daughter is not in distress, I would like to try to wait until I feel the urge to push before beginning the pushing phase.
- I would like to have my daughter placed on my stomach/chest immediately after delivery.
- I would like to decline Pitocin to deliver placenta, unless medically necessary for excessive bleeding.
- I would like to postpone clamping/cutting the cord until it stops pulsating.
- I would like my husband to cut the cord.
- I would like to attempt to breastfeed immediately after delivery.
- I would like to have my daughter examined in my presence, and would like to delay this for 1-2 hours.
- I would like to delay bathing baby until going home.
- If my daughter must be taken from me to receive medical treatment, my husband or my sister will accompany my daughter at all times.
- I would like to decline the Hep B shot and Vitamin K shot being administered to my daughter. I will give her an oral dose of Vitamin K.
- Unless medically necessary, I do not wish to have any bottles given to my daughter (including glucose water or plain water).
- I don’t mind my daughter being given a pacifier.
- I would like my daughter to room in with me throughout the duration of our hospital stay. Photos
- I would like photos/videorecording of labor and/or the birth permitted. Other
- My support people are my husband, Wade, my sister, Barbie, and my doula, Kris. I would like them to be present during labor and/or delivery.
Emery Rae’s Birth Story
Barbie (my sister) and the fam came over for supper, and decided to leave to get a good night of rest. Wade and I were tired, and decided to hit the sack early. While Wade went to shut the gate, I stood up from my birth ball to start shutting off lights, etc. and felt a gush of water. I thought to myself “but I didn’t even feel like I had to pee” and walked to the bathroom. I sat down, and knew that what I was feeling wasn’t pee. Wade came back in the house, and as he passed the bathroom I calmly said “Baby, I think my water broke.” He said, “ok, well what do we need to do? I’ll call Barbie and catch her before they get too far away.” I attempted to clean myself up, and Barbie came back to the house. We took our time getting things together, and Wade took the time to sharpen his granddaddy’s knife for “cord cutting.”
We left for the hospital around 10:15 p.m. and arrived in the ER. My contractions began not long after my water broke, but were tolerable and fairly consistent at about 6-7 minutes apart. As everyone was shuffling for a wheelchair, I told them I was fine to walk, and walked in to check myself in. In triage, I was checked (by a mean, nasty nurse) and was still only 2cm. They were trying to figure out a way to prove that my water was broken so I could be admitted, and my version of the events wasn’t quite good enough. Kris, my doula, arrived shortly after we did, and after an hour or so, I was finally admitted.
I got into a L&D room around midnight. Dr. Hall was called, and threatened that if nothing happened by 5:30 a.m., he wanted Pitocin started. In my mind, I had a goal, and my goal included no Pitocin. The mean nurse kept teasing me that I didn’t want any of the “happy juice” and she was very rude. I was so glad when she got off. My contractions were starting to intensify, and all I wanted to do was to get up out of bed and walk around, but they wouldn’t let me until they could get an iv in. I was doing really well, breathing through the contractions, and was so relieved when I was finally able to get up and move. I thought I would use my birthing ball a lot in labor, and I actually only used it once as an alternative to lying in bed while the nurse tried to get a reading on the baby’s heartbeat.
After the iv port was in, I headed straight for the shower. I switched back and forth between standing in the shower with my head on the tile in the corner, water hitting my lower back, and sitting in the shower chair with water hitting my belly. The pain was intensifying, but with each contraction, I went in to my own world to work through them. Wade, Barbie, and Kris all did so great with encouraging me and being there for me. At some point (probably around 3:30 or 4 in the morning) I don’t really remember any breaks in contractions, and I was so exhausted. I wanted to lie down on my side for few minutes.
Once I got in the bed and on my side, I was feeling like I was coming to the end of my abilities to continue on. I kept visualizing my safe word in my head, “mistletoe”, but I also knew that I was too far along to get an epidural. I didn’t know how I was going to keep going. I really was not responding much to outside stimulation, but I was moaning and making deep, primitive sounds that seemed to keep me focused on the process. The nurse checked me and I was 8cm, but I was having such a strong urge to push.
Since Baby Girl was still sunny-side up, I got on my knees to see if that would help her kind of flip over. I couldn’t fight the urge to push, and I kept telling them I couldn’t wait any longer. The nurse started working on me to get me stretched enough to call me a “10”, and I kept having the urge to push. I was so exhausted and I had no idea how this baby was going to get out of me. I felt like I was pushing with everything I had, and it wasn’t enough to make her come out. It felt like she wasn’t even moving very much.
I remember Dr. Hall coming in around 5:30 or so and saying he was proud of me for not having an epidural, and that now it was time to get her out. I just couldn’t push with enough force to be productive. Dr. Hall used the vacuum to help get her out, and I felt myself ripping apart. I think I pushed for about an hour.
When she was finally out and she cried, it was the most beautiful sound I’d ever heard before. I wanted her on my belly and in my arms, and I was so afraid that someone would clamp her cord too soon. I wanted to delay that for as long as possible.
When I finally got to touch her, she was so beautiful. She looked just like Wade, with the exception of the big lump on her head from the vacuum. Wade came over and was crying with me, as we looked at her. He got to cut her cord, and Dr. Hall let him use his granddaddy’s knife. She started nursing like a champ almost immediately.
Because of the vacuum and because Baby Girl was transverse, I tore pretty significantly, 2nd and 3rd degree tears. This required some pretty extensive repair and my recovery was way tougher than I anticipated for a vaginal delivery. I wasn’t able to get out of bed and walk for 3 days.
When looking back at my birth plan and the expectations I had versus the reputations of both my doctors and the hospital I delivered at, I am so please at how my birth experience went. (My doctors and the hospital both have extremely high epidural rates, and even higher ceasarean rates.) For the most part, I achieved my goals and birthed a beautiful, healthy baby girl, without using drugs.
Emery Rae McKenzie
October 20, 2011
7lbs 15oz, 21”
Jen Starks, Owner