Friday, June 16, 2006

Birth Plan

(Originally posted on Friday, June 16, 2006 by Tim)

Sorry for the long hiatus on blog posts. I had a goal of one a week and I?ve somehow fallen off the wagon. One would assume that a wagon moving at a speed of one blog post per week would be pretty easy to catch up with. Somehow it hasn?t worked out that way for me. I think the subject would make a pretty good unit conversion problem for my Chemistry 101 class.

?You are on a wagon moving at a speed of one blog post per week. As a result of too many gin and tonics, you?ve fallen off the wagon. This is followed by a bad case of poison ivy and too many video games. This gives the wagon a two month lead on you. If you can type at a speed of 40 words per minute, how long will it take you to catch up with the wagon??

As you may know, Cat and I want a natural birth. It?s difficult to achieve this in many hospitals and we don?t have a lot of choices for health care here. We have decided that our best chance to have the birth experience we want is to have a home birth. We have a midwife we like and we?ve taken natural childbirth classes to prepare for the big day. However, there is still some chance that we could end up in the hospital. Cat could go into labor before Wednesday of next week. This would place Dalton at less than 37 weeks and our midwife would expect us to go to the hospital. We also could have some sort of emergency. To prepare for these possibilities, Cat and I have written up a birth plan to hand to the staff at the hospital.

A birth plan is a series of requests to the birth team, doctors and nurses, at the hospital. Ideally it is polite and aimed at convincing the team to respect our wishes during the birth. Here?s my first draft?

?Dear Medical Establishment Drone,

We wanted a home birth. The fact that you are reading this means that we are profoundly disappointed. We might have considered a hospital birth, but the poor quality and selection of medical care in this area obviated this as a rational choice. Obviously, since we are here, things are a bit messed up. Please review the series of guidelines below to help prevent your screwing things up further.

1. No pain killers. We don?t want any painkillers. These things disrupt the normal course of labor, they make it hard for the mother to push naturally, and they cause respiratory depression in the baby. In addition, when you turn the things off right before delivery, things are much more painful for the mother as she hasn?t had a chance to build up natural endorphins. Don?t offer us any painkillers. We don?t want to hear you say the words epidural, lidocaine, procaine, demoral, or morphine. We know that you hated organic chemistry and kept losing points for drawing carbon with more than four bonds. If you can?t explain the biochemical mechanism of action of a compound, you really shouldn?t be administering it. If we feel any of these compounds are necessary, we will let you know.

2. Intermittent listening as opposed to constant fetal monitoring. We know how much you love the machine that goes ping. In addition, it was very expensive and you need to keep billing the insurance company to pay it off. The problem is, you monkeys just can?t read the thing right. Multiple medical studies have shown no predictive power in the use of constant fetal monitoring. In fact, the literature supports that intermittent listening is just as good for preventing poor outcomes and that constant fetal monitoring increases the rate of cesarean and instrumental delivery. Look, your attention needs to be focused on the mother, not on a TV screen with fun graphs. We all know you couldn?t plot data correctly in college and that you?re no better reading it now.

3. Free access to food and drink during labor. For goodness sake, labor is 14 hours long for first time mothers. What on dog?s green earth makes you think that depriving the mother of food and drink is a sane course of action. Of course mothers get exhausted and you need to pump them full of chemicals and perform cesareans when you don?t let them eat.

4. No augmention of labor. We know that you want to deliver the baby so you can make your second golf game of the day. Look, you?re not good at golf. Your golf partner knows this, your wife knows this, we know this. If you type ?worse than the Three Stooges at golf? into Google, your home page comes up as the top hit. I?m not trying to hurt your feelings here, well not much, but it?s unreasonable to be so hair triggered on inducing labor. Medical studies have shown that there are no adverse effects associated with letting labor go as long as it needs provided there are no signs of distress in mother or baby. We?ve attached the studies in the appendix. Yes, we know reading is hard and, gasp, thinking while reading is even harder. The attached papers are devoid of graphs and structures of molecules so it shouldn?t be really scary. In addition, we?ve highlighted the relevant sections for you to make things easier. Please look them over. You can go in your office and close the door so as to not be embarrassed by the cleaning help catching you trying to follow the tables with a strained look on your face.?

I figure this ought to do the trick. How could they resist my persuasive intellect on the matter?

In the end, I?m really hoping we don?t end up in the hospital. After Wednesday, if we?re in the hospital, something will be fairly wrong. It?s unlikely that we will be able to reasonably avoid interventions as they will be necessary.

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