Friday, 11 November 2011
Monday, 7 November 2011
Our Birth Preferences (to be applied to a hospital birth setting)
A lot had happened after this blog has been revived...so after this post there'll be many more to come to reflect on the progress (or lack of it) in the local homefront surrounding women's choices when it comes to birthing our babies...
It all started (the media frenzy, I mean) with this article:
DIY Mums: No doctors, please!
And subsequently of course it has opened the Pandora Box and this response letter was published by the same paper in the days following the 2-page spread:
Natural birth: Beware the danger
And recently there's another response:
DIY Mums:Someone qualified should be present
What they fail to realise is that we, the informed parents and adults, have preference to opt for home birth because we want to achieve a natural, gentle physiological birth without any unnecessary and risky medical interventions, that is prevalent in a normal hospital birth setting.
We want to avoid this from happening:
Gleaneagles Ampang obgyn was acquitted from a lawsuit that was throwned at him by a grieving husband whose wife had bled to death due to uninformed induction procedure
So if you were to understand how our body works and go back to the basics to make sure that we can have an optimal birthing experience that is both rewarding and beneficial for a lifetime, wouldn't you want to find a way to achieve it?
The question is, are the practising medical officers and the whole maternity care system willing to revamp their status quo and make way for the gentle,physiological births to happen in the hospital setting?
If they are willing to understand and cooperate with us, the paying customers with rights, than we are more than happy to deliver/receive our precious bundle of joy in the hospital but with so many negative stories surrounding hospital births, one would think twice to go down that path. Come to think of it, how many times have you heard of mothers recalling their hospital birth experience as something that they cherish and looked forward to experience again with their next child??? Share with me if you can find an obgyn and labor ward team that can agree to this birth preferences plan:
Sharing my BIRTH PREFERENCES SAMPLE for hospital birth (as a response to the latest media frenzy on the HB/UC movement):
(Primum non nocere is a Latin phrase that means "First, do no harm". Nonmaleficence, which derives from the maxim, is one of the principal precepts of medical ethics that all medical students are taught in medical school and is a fundamental principle for emergency medical services around the world. Another way to state it is that "given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good." It reminds the physician and other health care providers that they must consider the possible harm that any intervention might do. It is invoked when debating the use of an intervention that carries an obvious risk of harm but a less certain chance of benefit - taken from Wikipedia)
Dear Obgyn,
We (my birthing companion and I) trust your ability as a licensed medical practioner and have faith in your judgement in practising and applying your Hippocratic Oath of 'Primum non nocere' - First, do no harm, when it comes to assisting us in the birth of our baby.
We have chosen the HypnoBirthing method of gentle, unhindered physiological birth.
My birth shall entail the following (if at all,any special circumstances occur, that requires any medical interventions and a revise in this optimal birth preferences, then the benefits and risks involved in the procedure would have to be acknowledged by both my birth companion and I. We have the right to find any possible alternatives to the intervention/s proposed or to just hold it out and decide to wait until we can agree on the best way forward. If at all, there's any reason that you may not or would not be able to comply to this birth plan, then we have the right to find an alternative healthcare provider):
1st stage of labor
We would prefer that any hospital/medical staff involve in our birth shall maintain an atmosphere of calm and respect towards us (the family which includes my birth companion, myself and the baby).
We would appreciate if we were to be given the liberty of time and not to be rush through the labor and birth. We would not consent of any induction/augmentation of labor and birth, unless it is deemed necessary and the full risks and benefits of the procedure explained thoroughly.
We would prefer to be allowed to create an atmosphere that can promote the natural flow of the labor and birth hormone - Oxytocin. It is by making the room as private and comfortable as being in our own sanctuary with the lights dimmed, with soft background music of our choice, and we are allowed to wear our own clothing/apparel instead of the hospital gown. And to add on to that, we only allow named personnel to enter the birthing room to keep it private and unintrusive.
We would appreciate that no episiotomy is to be performed as we would rather risk a natural tear, if at all, rather than having to fix an episiotomy that would have to take a longer time to heal. We would apply the breathing techniques from the hypnobirthing course to breathe down the baby and allowing the natural expulsion reflex work in tandem with the uterine contractions to naturally expel the baby. We do not need any staff directed pushing.
We would appreciate to not have any artificial rupture of membrane and/or amniotomy procedure to be performed, unless deemed necessary, and our informed consent have to be seeked prior to it being performed. We would prefer to have a spontaneous rupture of membrane instead.
We would appreciate to not have any vaginal examination performed on me and not to be informed of the progress of the labor/birth (dilatation or time of contraction etc) as this will affect me psychologically and emotionally which might hinder the progress of my labor and birth.
We would appreciate to have freedom of movement and of changing the birth positions (sitting, squatting, walking about the labor ward etc) to allow optimal birth conditions and aid in the ease of the baby's descent through the birth canal. To allow this, we would prefer no fetal monitoring or IV drip to be strapped on me during the labor and birth. We would also prefer not to be lying on the back in supine position with the legs placed in stirrups as it will decrease the space in the birth canal and prolong the labor.
We would appreciate to be allowed to maintain a high energy level by eating, drinking and resting/relaxing throughout the labor and birth.
We would appreciate to not have painkiller suggested by the medical staff and no artificial substances to be administered during labor and birth, unless requested by either one of us. We would prefer to leverage on the body's natural hormone and neurochemical (Oxytocin, endorphin, prolactin etc) to achieve a comfortable and manageable labor.
2nd stage of labor
We would prefer that my birth companion is to receive the baby and announce the gender of the baby immediately after the baby's exit.
We would prefer to do a Lotus birth where we let the umbilical cord lay intact until it dries off by itself.
We would also want immediate skin-to-skin contact for mother, father and baby and no rub-down is required as we would want the baby's skin to absorb the vernix. Also, we would prefer not to have the baby's mouth and nose/airways to be suctioned by the suctioning bulb and no eye ointments to be applied to the eye region.
We would appreciate it if any test (i.e. Apgar) is to be conducted, then it must be with our informed consent and with either one of us present during the test/procedure.
3rd stage of labor
We would prefer the placenta to be birth spontaneously via nipple stimulation, visualisation etc and no cord traction or augmentation using artificial substances to be performed unless deemed necessary in the case of hemorrhaging.
After birth
We would prefer for baby to be roomed-in.
We would also appreciate to be given time to bond with the baby and establish breast feeding immediately after birth with breast crawl and direct latch method within the first 2 hours of birth. We would prefer not to have any formula milk to be given to the baby at any time without our informed consent.
We thank you in advance for your total understanding, cooperation and undivided support to our birth preferences. We welcome you to join us in our gentle, unhindered physiological birth.
The revised birth plan - feel free to copy this for your own use
Dear Obgyn,
We (my birthing companion and I) trust your ability as a licensed medical practioner and have faith in your judgement in practising and applying your Hippocratic Oath of 'Primum non nocere' - First, do no harm, when it comes to assisting us in the birth of our baby.
We have chosen the HypnoBirthing method of gentle, unhindered physiological birth.
My birth shall entail the following (if at all,any special circumstances occur, that requires any medical interventions and a revise in this optimal birth preferences, then the benefits and risks involved in the procedure would have to be acknowledged by both my birth companion and I. We have the right to find any possible alternatives to the intervention/s proposed or to just hold it out and decide to wait until we can agree on the best way forward. If at all, there's any reason that you may not or would not be able to comply to this birth plan, then we have the right to find an alternative healthcare provider):
1st stage of labor
We would prefer that any hospital/medical staff involve in our birth shall maintain an atmosphere of calm and respect towards us (the family which includes my birth companion, myself and the baby).
We would appreciate if we were to be given the liberty of time and not to be rush through the labor and birth. We would not consent of any induction/augmentation of labor and birth, unless it is deemed necessary and the full risks and benefits of the procedure explained thoroughly.
We would prefer to be allowed to create an atmosphere that can promote the natural flow of the labor and birth hormone - Oxytocin. It is by making the room as private and comfortable as being in our own sanctuary with the lights dimmed, with soft background music of our choice, and we are allowed to wear our own clothing/apparel instead of the hospital gown. And to add on to that, we only allow named personnel to enter the birthing room to keep it private and unintrusive.
We would appreciate that no episiotomy is to be performed as we would rather risk a natural tear, if at all, rather than having to fix an episiotomy that would have to take a longer time to heal. We would apply the breathing techniques from the hypnobirthing course to breathe down the baby and allowing the natural expulsion reflex work in tandem with the uterine contractions to naturally expel the baby. We do not need any staff directed pushing.
We would appreciate to not have any artificial rupture of membrane and/or amniotomy procedure to be performed, unless deemed necessary, and our informed consent have to be seeked prior to it being performed. We would prefer to have a spontaneous rupture of membrane instead.
We would appreciate to not have any vaginal examination performed on me and not to be informed of the progress of the labor/birth (dilatation or time of contraction etc) as this will affect me psychologically and emotionally which might hinder the progress of my labor and birth.
We would appreciate to have freedom of movement and of changing the birth positions (sitting, squatting, walking about the labor ward etc) to allow optimal birth conditions and aid in the ease of the baby's descent through the birth canal. To allow this, we would prefer no fetal monitoring or IV drip to be strapped on me during the labor and birth. We would also prefer not to be lying on the back in supine position with the legs placed in stirrups as it will decrease the space in the birth canal and prolong the labor.
We would appreciate to be allowed to maintain a high energy level by eating, drinking and resting/relaxing throughout the labor and birth.
We would appreciate to not have painkiller suggested by the medical staff and no artificial substances to be administered during labor and birth, unless requested by either one of us. We would prefer to leverage on the body's natural hormone and neurochemical (Oxytocin, endorphin, prolactin etc) to achieve a comfortable and manageable labor.
2nd stage of labor
We would prefer that my birth companion is to receive the baby and announce the gender of the baby immediately after the baby's exit.
We would prefer to do a Lotus birth where we let the umbilical cord lay intact until it dries off by itself.
We would also want immediate skin-to-skin contact for mother, father and baby and no rub-down is required as we would want the baby's skin to absorb the vernix. Also, we would prefer not to have the baby's mouth and nose/airways to be suctioned by the suctioning bulb and no eye ointments to be applied to the eye region.
We would appreciate it if any test (i.e. Apgar) is to be conducted, then it must be with our informed consent and with either one of us present during the test/procedure.
3rd stage of labor
We would prefer the placenta to be birth spontaneously via nipple stimulation, visualisation etc and no cord traction or augmentation using artificial substances to be performed unless deemed necessary in the case of hemorrhaging.
After birth
We would prefer for baby to be roomed-in.
We would also appreciate to be given time to bond with the baby and establish breast feeding immediately after birth with breast crawl and direct latch method within the first 2 hours of birth. We would prefer not to have any formula milk to be given to the baby at any time without our informed consent.
We thank you in advance for your total understanding, cooperation and undivided support to our birth preferences. We welcome you to join us in our gentle, unhindered physiological birth.
We (my birthing companion and I) trust your ability as a licensed medical practioner and have faith in your judgement in practising and applying your Hippocratic Oath of 'Primum non nocere' - First, do no harm, when it comes to assisting us in the birth of our baby.
We have chosen the HypnoBirthing method of gentle, unhindered physiological birth.
My birth shall entail the following (if at all,any special circumstances occur, that requires any medical interventions and a revise in this optimal birth preferences, then the benefits and risks involved in the procedure would have to be acknowledged by both my birth companion and I. We have the right to find any possible alternatives to the intervention/s proposed or to just hold it out and decide to wait until we can agree on the best way forward. If at all, there's any reason that you may not or would not be able to comply to this birth plan, then we have the right to find an alternative healthcare provider):
1st stage of labor
We would prefer that any hospital/medical staff involve in our birth shall maintain an atmosphere of calm and respect towards us (the family which includes my birth companion, myself and the baby).
We would appreciate if we were to be given the liberty of time and not to be rush through the labor and birth. We would not consent of any induction/augmentation of labor and birth, unless it is deemed necessary and the full risks and benefits of the procedure explained thoroughly.
We would prefer to be allowed to create an atmosphere that can promote the natural flow of the labor and birth hormone - Oxytocin. It is by making the room as private and comfortable as being in our own sanctuary with the lights dimmed, with soft background music of our choice, and we are allowed to wear our own clothing/apparel instead of the hospital gown. And to add on to that, we only allow named personnel to enter the birthing room to keep it private and unintrusive.
We would appreciate that no episiotomy is to be performed as we would rather risk a natural tear, if at all, rather than having to fix an episiotomy that would have to take a longer time to heal. We would apply the breathing techniques from the hypnobirthing course to breathe down the baby and allowing the natural expulsion reflex work in tandem with the uterine contractions to naturally expel the baby. We do not need any staff directed pushing.
We would appreciate to not have any artificial rupture of membrane and/or amniotomy procedure to be performed, unless deemed necessary, and our informed consent have to be seeked prior to it being performed. We would prefer to have a spontaneous rupture of membrane instead.
We would appreciate to not have any vaginal examination performed on me and not to be informed of the progress of the labor/birth (dilatation or time of contraction etc) as this will affect me psychologically and emotionally which might hinder the progress of my labor and birth.
We would appreciate to have freedom of movement and of changing the birth positions (sitting, squatting, walking about the labor ward etc) to allow optimal birth conditions and aid in the ease of the baby's descent through the birth canal. To allow this, we would prefer no fetal monitoring or IV drip to be strapped on me during the labor and birth. We would also prefer not to be lying on the back in supine position with the legs placed in stirrups as it will decrease the space in the birth canal and prolong the labor.
We would appreciate to be allowed to maintain a high energy level by eating, drinking and resting/relaxing throughout the labor and birth.
We would appreciate to not have painkiller suggested by the medical staff and no artificial substances to be administered during labor and birth, unless requested by either one of us. We would prefer to leverage on the body's natural hormone and neurochemical (Oxytocin, endorphin, prolactin etc) to achieve a comfortable and manageable labor.
2nd stage of labor
We would prefer that my birth companion is to receive the baby and announce the gender of the baby immediately after the baby's exit.
We would prefer to do a Lotus birth where we let the umbilical cord lay intact until it dries off by itself.
We would also want immediate skin-to-skin contact for mother, father and baby and no rub-down is required as we would want the baby's skin to absorb the vernix. Also, we would prefer not to have the baby's mouth and nose/airways to be suctioned by the suctioning bulb and no eye ointments to be applied to the eye region.
We would appreciate it if any test (i.e. Apgar) is to be conducted, then it must be with our informed consent and with either one of us present during the test/procedure.
3rd stage of labor
We would prefer the placenta to be birth spontaneously via nipple stimulation, visualisation etc and no cord traction or augmentation using artificial substances to be performed unless deemed necessary in the case of hemorrhaging.
After birth
We would prefer for baby to be roomed-in.
We would also appreciate to be given time to bond with the baby and establish breast feeding immediately after birth with breast crawl and direct latch method within the first 2 hours of birth. We would prefer not to have any formula milk to be given to the baby at any time without our informed consent.
We thank you in advance for your total understanding, cooperation and undivided support to our birth preferences. We welcome you to join us in our gentle, unhindered physiological birth.
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