20-30 Weeks Birth Plan

Print Friendly

.
.

More Information:

Please, visit our birth planning page as well

which has additional birth education.

The Birth Plan:

 

This plan is specific to generally 20-30 week gestation birth, in which you may be required to stay overnight. 

You may not be required to stay overnight.  Ask your doctor for more information.

While D&C’s and D&E’s are performed during this timeframe of pregnancy loss, a birth plan specific to those birth methods is available under the category of “Early Hospital Birth Plan”.

 

What to Pack

__ camera, stillbirthday.com lists professional photographers at the “professionals/volunteers” page.

__photo of you and your husband to keep with baby
__Clinging Cross or something special to hold

__*additional special items: two teddy bears or blankets (one to leave with your baby, and one to take home), mold for baby’s hands or feet

__Music and player

__Favorite candle (in glass jar, for warmer)

__Personal fan

__Several wash cloths, for hot or cold compresses (optional-hospitals have plenty)

__Thermos of hot water

__Massage tools: rice packs, rolling pin, paint roller, oil

__Unscented and scented lotion

__Birth ball

__Pillows (1 or 2) and colored cases

__Change of clothes for labor partner

__Snacks for labor partner

__Gum or mints for labor partner!

__Husband’s cologne, aftershave, deodorant, or other smell preferred by the mother (he’ll wear it)

__Snacks for you: light snacking during birth, orange juice postpartum

__Suckers or other hard candy

__Lip balm

__Cell phone or calling card

__Loose change for phone or snacks

__Phone list for support people to join you for hospital visitation

__Ultrasound pictures, favorite scriptures

__*baby’s outfit (for visitation through to final farewell/burial)

__Toiletries: contact case, shampoo, toothbrush, deodorant, etc.

__Night gown or robe (might get soiled)

__Going home outfit for mom (2nd trimester clothes)

 

 

Have at Home:

__people ready to help!
__maxi pads (for lochia)

__nursing pads (and cabbage, sage tea, and decongestant for expedited weaning, or a hospital grade pump and storage bags/bottles for milk donation)  There is more in-depth information regarding post-loss lactation, and ways to help dry quickly or to pump for donation, at stillbirthday, available on the same page that you printed this birth plan.

 

About Birth:

 

NOTE: While it can be safe to deliver a very early miscarried baby at home, with precautions such as those listed in the at-home miscarriage birth plan, delivering a stillborn baby at home can come with some complications.  If you are adjusting this plan to deliver your stillborn baby at home, please first consult your local police department to make sure that you are in compliance with your state laws regarding at-home stillbirth.  Please make sure that you have a professional midwife to support you, particularly one with stillbirth experience.  Please know that there can be medical complications in a stillbirth delivery, just as in a “happy” birth.  Infection, postpartum hemorrhage, and other medical concerns should be prepared for.  You should not deliver your stillborn baby at home alone.  The remaining of this plan will pertain to hospital stillbirth delivery.

 

 

Natural Options/Information:

 

  • IV, with option of Heparin Lock instead
  • Blood pressure cuff
  • Possible electronic fetal monitoring
  • No food or drink
  • Possible limited natural induction/augmentation and positions, because of risk of placenta pulling from uterus and causing internal bleeding
  • Hands and knees on ball or on bed can be very helpful
  • Left Side Lying can be very helpful

 

Ways of creating a soothing environment for birthing include (but definitely not limited to):

__dimmed lights

__soft music

__massage (scalp, feet, legs, back, even brushing teeth)

__inspirational messages and scriptures written on index cards or spoken aloud

__letters written from extended family and friends who can’t attend the birth (read by husband)

__pictures drawn by older siblings posted in room (and left with baby)

__praying

__water therapy (bath until waters rupture, shower, misting spray)

__hot and cold therapy

__intimacy and bonding with husband

__emotional dystocia is likely – deep lunging, deep roaring, deep moaning all can help labor progress

 

 

Artificial Induction Options/Information:

  • Possible cervical ripening agents (Cytotec-tablet or Cervidil-similar to a tampon applicator)
  • Pitocin – in possibly very high amounts for this stage of pregnancy (possibly no water breaking)
  • Likelihood of Epidural or Narcotic (Stadol, Nubain are examples)

 

Pitocin Information:

+         Can start labor

+         Can speed up a slowed labor

+         Can increase intensity of contractions

+         Can stop a postpartum hemorrhage

+         Can be regulated and monitored closely

+         Can be turned off if necessary

–         Difficult to produce natural progression of contractions

–         Pain from Pitocin is often more difficult to deal with

–         Requires IV and constant monitoring

–         Mom small chance of hyptertensive episodes

–         Mom small chance of titanic contractions

–         Mom small chance of uterine spasm

–         Mom very small chance of coma

 

 

Epidural Info:

+         Catheter into epidural space in spinal column (1st space)

+         No need to repeatedly puncture: catheter can re administer or continue dosage

+         Given during Active labor (3-7cm)

+         Does not alter mom’s consciousness

+         Can relax mom

+         Can help lower blood pressure of a PIH patient with high enough blood platelets

–         Goal of 80% relief, not 100%

–         Completely immobilizes

–         Not administered promptly: same anesthesiologist for entire hospital

–         Chance of longer second stage/ More difficult to push

–         Mom chance of hypotension (drop in blood pressure)

–         Mom chance of itching in face, neck and throat

–         Mom chance of nausea, vomiting

–         Spinal headache healed by patching hole with mom’s blood

–         Postpartum headache/backache

–         Uncontrollable shivering

–         Uneven, incomplete or failed pain relief

–         Loss of perineal sensation: inability to push: increase cesarean chance

–         Mom need catheter

–         Mom chance of fever

Narcotic info:

+         Given IV in Active labor (3-7cm)

+         Increases pain tolerance (doesn’t eliminate pain, but takes “edge off”)

+         Can be given ASAP

–         Barbiturate derivative: anticonvulsive and hypnotic properties  (“I feel drunk or something.”)

–         Wears off/ ACCLIMATION, need for increased dosage

–         Can either increase or decrease labor (unpredictable),

–         Can cause mom vomiting

–         Can still feel highest peak of intensity, just not building up or let down

 

Crowning/Delivery:

__I would like the use of a mirror to see the baby’s head crowning

__I would like still photography

__I would like to be reminded and encouraged to touch baby’s head while crowning

__forceps, vacuum or episiotomy may assist in final delivery of baby

__Umbilical cord may be cut by doctor *Can be cut “long” so that dad may “trim” it later

__I would like my partner or doula to hold my baby until I am able

 

 

 

After the Birth

__*Have the photo you brought placed with your baby.

__*Ask if baby can be swaddled in the blankets you brought.

__*Ask how long your baby can remain with you.

__*Ask if you can give your baby a bath.

__*Ask if your labor room or your postpartum room can be in a quiet location on the floor, where you have less of a chance of hearing other babies, or if you can be transferred to a different floor in the hospital.  Transferring to a different floor means that you will not have maternity-specific care, however.

__*If your baby has hair, ask for scissors to cut a lock off.

__*Utilize all of the special plans you have, including saving mementos, holding your baby, capturing baby’s smell with a blanket you will take home with you, dressing your baby, naming your baby, taking photographs, and including a pastor and friends and family.  See the “Professionals/Volunteers” link at stillbirthday.com for additional services to consider.

__Have someone planning on spending the night with you. Perhaps consider having a friend spend the night with you, so that your husband can go home, prepare the house, and rest.

__You will still have lochia (the remaining blood from inside the uterus, which will be shed for the next 4-6 weeks).

__*You may have breastmilk come in immediately after the birth.  You can choose to pump and donate your milk, or go through the process of drying.  Drying your milk supply can be done more quickly by drinking sage tea, taking a decongestant, and/or applying frozen or chilled cabbage leaves in your bra (until the soften and warm, and then change out).  Expedited drying may take about a week to complete.  Some studies indicate that there may be a link between compounded postpartum depression and early drying.  There is more information regarding post-loss lactation at stillbirthday, from the same page that you printed this birth plan.  Here is our After the Birth resources section.

__*Mentally prepare for going home. The first few days at home can be very difficult.

__Watch for signs of postpartum depression (PPD) or secondary vaginitus.

__Be easy on yourself, your body, and on your recovery.

__Talk to your spiritual advisor, your husband, and trusted mentors and friends about all of your feelings.

__*Visit stillbirthday.com for “Farewell Celebrations” and for “Long Term Support” resources.

 

*are specific to stillbirth

 

Please click the links for more support:

before

during

after