Thursday, 21 November 2013

A Completely Hands Off Birth Plan for the 121 (American military hospital in Yongsan, Korea)

Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both. This link and this link have more info.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators. Below you can find A Completely Hands Off (for the 121) Birth Plan. I also have more sample birth plans on my birthing plans for Korea post. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.

A Completely Hands Off Birth Plan for the 121 (American military hospital at Yongsan)
This was taken from Facebook.

Guess Date:

Pre Labor: 
• Attendants will be: husband, doulas, and children.
• Please, no vaginal checks. (This is to decrease risk of infection, premature rupture of waters and unconsented membrane stripping.)

 Labor Stage 1
• Attendants will be present with mother at all times, through all stages of labor.
• My goal is to labor outside of the hospital as long as possible and request to be sent home if labor is not progressing quickly.
• Please allow me to use my birthing ball and I would request showers for pain relief.
• No IV or Hep Lock will be consented too.
• Please, no internal monitoring at all. o If you feel fetal heart monitoring is necessary please use a Doppler. (External monitoring will be allowed intermittently and if medically necessary.)
• No vaginal exams, for the reasons stated above.
• No pitocin or otherlabor inducing drugs.
• No epidural.
• Please do no try to restrict my food or drink intake.
• No premature breaking of waters, or membrane stripping. This will not be consented too, and may be considered assault.
• Please, no movement limitations. I change positions very often in labor.
• No stir-ups will be needed.
• No hospital gowns, please. I will bring my own.
• Lights off or dimmed. Please allow me to have a quiet, dark environment for my birth.
• Please no extra staff.
• Please allow me to decide when to push. Please do not yell at me or count while I am pushing. And please do not put time restrictions on pushing.

Labor 2nd Stage 
• No episiotomy will be consented to. (Massage with oil brought from home and a warm wash cloth will be fine.)
• Please do not use forceps.
• If you can see that it is a nuchal cord I request that you leave him or if you are well versed in the somersault technique you may try that, you may not pull, tug or try to unwrap the cord.
• If he is born with a nuchal cord, this is not a cause to cut the cord, so please do not.
• Please do not put a time limit on my delivery.

After Birth 
• No pitocin, uterine massage, or cord pulling to deliver placenta
• Please place baby immediately on my chest. o This is for skin to skin contact and it's known benefits as well as to help initiate breast feeding.
• Do not cut the cord, we will be leaving the cord intact until it stops pulsating. We feel this is the easiest and healthiest way to help our baby transition into the world and request you respect our decision.
• Do not bathe our baby, do not wipe the baby down, do not towel off the baby. We would like to leave the vernix on the baby. This is to help with temperature regulation, to protect against infection and to help the baby regulate his skin PH. Thank you for respecting our decision.
• If tearing happens and stitching is needed, please use a local anesthetic.
• Our baby will stay with parents at all times. No nursery visits.
• We request that you delay all routine exams for a minimum of 1 hour to allow for family bonding.
• Please perform all exams in the room with parents present.
• Do not give our baby any shots. We choose not to vaccinate and therefore do not consent to the Hep B shot, Vit. K shot or antibiotic ointment eye jelly.
• We will be exclusively breast feeding. Please do not give baby, bottles, pacifiers, artificial nipples, formula or water. Please do not suggest nipple shields.
• Please expedite our discharge as soon as possible. As long as there are no complications we would like to leave within 24 hours. This will help us start to settle quickly and will help you by providing more room.

I understand this plan may be inconvenient for you and your staff. Please be assured that we have researched everything in great detail. Know that I have birthed two other healthy babies and am very familiar and comfortable with my own birth process. Please respect our wishes, even if they are against your hospital policies, these are the decisions we have made, and we know our Patients Bill of Rights. Please know that we will be forced to consider any unconsented interventions an assault on mother and baby. Thank you for taking the time to read our wishes, and for respecting our decisions as parents.

Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.

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