Amelia's Birth Plan

Were not sure if this is our "final draft" but I know it helped us to see what other peoples birth plans looked like when we first received Amelia's diagnosis, so I thought I would put ours out there as well...

Amelia Grace is due to enter the world on Aug 2nd, 2010. She has been diagnosed with Anencephaly. Knowing that our time with her will be short, it is important to us that as many of our needs be met as possible. My husband, Tim, is to remain with us at all times. Dr. Daniel Kirsch will be delivering her. We have chosen to have a c-section (during the week of July 26-30) in hopes of improving the chances of a live birth and insure Amelia is under the least amount of stress possible. We would like to record the birth in the OR, since this may be the only chance to record her while alive. We have requested that a professional photographer (Steve Kowalski of a Better Exposure) be admitted in the OR to photograph the birth. We have discussed this with Dr. Kirsch.

I would like to have the least amount of medications as possible. I do not wish to have any narcotics or sedatives prior to the birth. I do not anticipate having anything in surgery, other than an epidural. Unless a life-threatening situation arises, I do not wish to be knocked out during the c-section. When it is time for Dr. Kirsch to take Amelia out, we would like the screen to be lowered so we can see her.

We do want the usual suctioning, drying off, etc. done, but would like it to done on my chest or within my reach by Angee Fuoss, RN. We intend to baptize her immediately after birth and would like water and a cloth available for that purpose. If our pastor (Rev. Roland Jank, Jr.) cannot make it to the delivery, Tim & I will baptize her. We want to be told right away if she is breathing or if she has a pulse. We DO NOT want any chest compressions, intubation, or IV’s done on Amelia. If she is not breathing, we would like efforts made to help initiate her breathing only. We would also like her given supplemental oxygen if needed. If she is doing poorly, we ask that she be given to us to hold. If she is to die right away, we want it to be in a parent’s arms. We anticipate that Amelia will be born with a large opening to her occipital area and neural tissue will be exposed. If she is holding her own, we would like a dressing placed to any open area. We would prefer it be dressed with Saline or Vaseline gauze, and then an outer layer of gauze, whatever works best. We would like for staff to keep our family updated during this time so they will know if Amelia was born alive or not.

It is very important to us that Amelia be in the room with us at all times, preferably held by us. While I am being moved out of the recovery room, I would like to carry Amelia with me on the stretcher back to my room. If she has died shortly after birth, my husband and I will probably wish to spend some time alone with her, but would like staff to tell our families that she has passed. We will, however, want our son (Noah who is 2 yrs old) with us right away. We will have someone with our family designated to bring him back to us. We would like assistance from staff in bathing/dressing Amelia. If Amelia has passed, we do not want our time with her to be limited. We may want to keep her with us for several hours, and will let staff know when we want our funeral home (John A. Gentleman – Tony Allmon) contacted. Again, we request that our photographer (Steve Kowalski of a Better Exposure) be admitted to photograph our family and baby girl.

If our time with her allows, we would like to bottle feed Amelia. If she lives long enough to require nutrition, but is unable to take a bottle, we may want a feeding tube inserted. For however long we may have with her, we want her in the room with us. We do not want her taken to the nursery for any reason. I also want my husband to stay with me during my hospital stay. If the time for my discharge is nearing and Amelia is still with us, I want her pediatrician Dr. Michael Moore to come and assess her. I have already spoken with him directly and requested his services specifically. We request assistance in involving hospice for Amelia and home oxygen if necessary.

We have given consent to Nebraska Organ Recovery for the donation of Amelia’s heart valve and aortic arch after her death. A family member or a representative from our funeral home will come to the hospital to transport her to their off site OR within 12 hours of her death. Our NOR coordinator (Todd Jackson) should be contacted when she has passed.

We have known our time with Amelia, if any, would be short since her diagnosis in March. Please feel free to laugh and cry with us. We welcome the open expression of emotion from staff and family. Per your normal practice, please feel free to indicate our situation for staff and visitors. It is only in light of her condition that we have chosen to provide a birth plan. I know you are a competent, compassionate group of people. We thank you in advance for sharing in this experience with us and helping us to make as many memories as possible with our daughter while in your care.

Tim and Melissa Lorang