Wednesday, August 31, 2011

Details, details, details!! (Of our hemo birth plan)

We put padding in our little hemo's clothes, use a helmet, and don't have a coffee table. We do these things to control our little hemo's surroundings to avoid bleeds in early life.  To the best of my ability, I need to control my baby's surroundings when it comes to birth.  Well, I am my baby's surroundings!  If I am tense, my muscles are tense and less flexible.  If I am lying on my back, my pelvis is up to 30% smaller, and my baby has to hit my tailbone and fight gravity to get out.  If I do not have freedom of movement in any way, I am compromising the ease of my baby's birth because I am not able to move with my baby's descent and delivery.  If I force pushing, I am potentially forcing my baby into the birth canal before he is ready and putting more pressure on his head.  If I am induced with Pitocin, my contractions are much more severe than natural contractions, making a lot more trauma for baby.  If I am drugged with an epidural, I am not as aware of my body throughout the birth and cannot respond to my body's cues (position, pushing, etc) In this light, we have designed a very careful birth plan with hemophilia in mind. 

Here's the details:

1.  I will be having a water birth.  Being in the warm water helps me fully relax and have full freedom of movement.  The warm water even helps me stretch more easily, preventing tearing.  It is also so pain relieving for me that it removes the need for an epidural (which usually leads to pitocin). 

2.  I will birth in an upright position: hands and knees, squatting, standing, or sitting on a birth stool.  The last two being out of the pool if I choose to get out.  The only exception would be laying on my side if for some reason I felt like laying down.  These positions let gravity help my baby and let my body open to the max!

3.  I will have intermittent monitoring as opposed to having a monitor strapped on my belly.  This also helps me have total freedom of movement.

4.  I have an IV available if needed, but I'm not planning on using it otherwise. This is also to help with freedom of movement.

5.  I will be eating and drinking through my labor, keeping my energy up and staying hydrated.

6.  I will not start pushing until my body starts pushing on its own.  If I get an undesirable urge to push before then, my midwife will check to make sure I am fully dilated. Ideally, I will try not to ever push to make sure the baby comes out as easy as possible.  This seems to be a small baby anyway.  So, there's a good chance he will be born without me pushing at all. 

7.  When Silas is born, we will not cut his cord.  We will allow him to receive all of his blood and stem cells.  We will wait until his cord is empty of blood, and his natural "Wharton's Jelly" has naturally sealed (clamped) his cord.  Then, we will cut the cord.  I believe that this approach will help him in many ways including reducing/eliminating bleeding from cord site if he has hemophilia.

8.  Our midwife will draw tubes of blood from the placenta to have his factor 8 level tested.  She has experience with this and I am confident that she knows what she is doing.  We have worked with her before and she is amazing!

9.  We are working with our HTC to arrange getting his blood tested right after his delivery.

10.  If Silas has any bruising or any sign of a bleed we will take him to the ER immediately to get him checked out. The hospital is less than a mile and a half away. Since we already have a hemophiliac, we do have factor on hand as well. 

11.  We've asked another hemo mom to attend the birth as our doula.  She is also a trained L&D nurse. 

12.  Also, I will be going to a chiropractor weekly until the birth to be sure my pelvis is in perfect alignment.  This will help the birth be easier on Silas as well.

Our approach is to do everything we can to give Silas the most gentle, non-traumatic birth possible to prevent a bleed in the first place.  We have hired a midwife who is highly skilled, and carries emergency equipment, drugs, and herbs.  I am pleased that we'll have another hemophilia mom attending the birth, and that she is a trained L&D nurse.  I am so excited and looking forward to an incredible birth!!

As always, I want to remind all my readers that I am sharing what we have decided for our family.  In no way do I think someone should use this as a blueprint for their own birth.  I only want to share what I've learned and spark thought.  If anything on this page interests you, look into it for yourself and discuss it with your doctor/s.  Thanks for reading!


  1. a wonderful birth plan in so many ways. I would love to link this on my website where i share birth plans :)

  2. Thanks so much! We have put a lot of care and thought into it. You are welcome to share it if you'd like!


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