As parents given the news of a terminal prenatal diagnosis, we know that you are faced with an overwhelming amount of information to process. We also know that you will be facing the daunting task of answering questions and making decisions that no parent should have to make. There is so much uncertainty and unknown when it comes to the duration of pregnancy, the labor and delivery experience, and the time you will have with your baby after delivery, and we know how overwhelming and devastating that can be.
Since there is so much about this experience that is out of your control, we want to help you feel informed and as in control as possible when it comes time to deliver your baby. To help you plan for the wide spectrum of experiences you could face, Carrying To Term created a comprehensive and interactive birth plan tool. This tool was created and designed by parents who know firsthand how difficult this process can be, and they used their experience to ensure that every parent facing a terminal prenatal diagnosis feels heard and confident in their decisions on delivery day.
It is perfectly understandable if the idea of creating a birth plan is overwhelming to you. This is not an easy process given the nature of why you are having to go through it. Even though this might be a painful and daunting task, it is incredibly important for you to create a birth plan because it outlines your wishes for you and your baby throughout the birth and the time that follows. This is your time to plan for the lifetime of parenting you hope to fit into a painfully short amount of time.
There is no doubt that you will come across questions that are difficult to process, but the act of addressing those questions now helps ensure that your needs and wishes are met. Our birth plan tool will prompt you and your significant other to consider all of your options, and by going through this process ahead of time, you have the chance to research and ask questions. It may seem impossible to make the right decision because nothing about what is happening is right. Your birth plan is about making the decisions that feel as right as anything is going to feel to you.
Taking the time to create a birth plan is one of the greatest gifts you can give to you and your significant other because it helps protect your time with your baby. There may be decisions that have to be made in the moment, and that's to be expected, but saving every decision for the delivery room only takes away focus and emotional energy from the time you have as a family. The heart behind the birth plan tool is to help you create the experience you want in the midst of circumstances you would change in an instant. We want to help you feel informed and confident in your decisions when you walk into the delivery room because these are memories that you will carry for a lifetime.
There is no birth plan in the world that can give you full control of what will happen on delivery day, but by creating a birth plan, you are getting a say in how it happens. It can be a powerful feeling to gain some sense of control in the midst of an out-of-your-control situation. Lean on the birth plan you have created to serve as an effective method for discussing important details with those who will be supporting you and providing you care during delivery and your time with your baby. Let this thorough and well-researched plan that you have created serve as your voice on the day when meeting your child is your sole focus and priority.
When you and your significant other sit down to begin this process, start by imaging your ideal delivery day. Though the circumstances you are in are gut-wrenching, unfair, and broken, there are so many moments of joy, peace, and love to be found on delivery day. Plan for that time like you would if you had never received the diagnosis because this is still your experience as a parent and your time with your child. What moments of parenthood do you want to be sure happen? Write them down and have them at-hand when you start your birth plan. From the foundation of your ideal day, the birth plan will help you voice those desires while also helping you create a sound and informed contingency plan.
When you are ready to utilize our birth plan tool, you can find it here. Once you click the button to begin your birth plan, you will notice that we ask you to create a login. We put the birth plan tool behind a login to protect your privacy and to allow you to save and change your birth plan as much as you want. The entirety of your birth plan is kept confidential. Only you and anyone you share your login with will have access to this plan. As you navigate through the tool, you always have the option to leave any field blank. You have complete control of what you fill out and how much information you provide. When you're ready, you can print as many copies as you choose to provide to your care team.
Once you create your login you, you will start by providing some introductory information. This section, step one, is where you provide your name, how you want your baby referred to in the birth plan tool, baby’s gender, if known, and the title of your birth plan. The information provided in this section will auto-populate throughout the remainder of the birth plan.
After completing step one, you will be directed to save and continue to step two. On this page, you will see the titles for the thirteen sections of your birth plan.
Each of these sections are collapsible so you are not going to be hit with an overwhelming amount of information when you navigate to this page. The tool was purposefully designed this way so that you can read the title of each section and expand each one as you are ready to address it. You can expand and collapse each section as many times as you need to.
Below you will find a brief overview of the thirteen sections in step two of the birth plan tool. These overviews are designed to help you know what to expect and to allow you the chance to emotionally prepare for each one.
About this Birth Plan
This section is where you will have the opportunity to write a brief introduction to your birth plan. Your words will appear at the top of your plan and serve as a way to set the tone, express the key content you want shared, and voice any specific comments or concerns you might have to your care team. This is a space for you to highlight specific needs as well as share anything you want that is not covered in the remaining categories.
To help you think through and create your introduction, we have provided a pre-populated description that you can use, customize, or completely rewrite as you see fit.
Our recommendation would be to start and end the birth planning process here. Start by adding to or rewriting the pre-populated response, address any initial thoughts or concerns, and then navigate your way through the remaining sections, taking notes as you go, if needed. Once you have reviewed and completed the other twelve sections, review your notes and come back to this first section. Reread what you have written here, and edit it as needed based on all that you learned and decided. You will likely have thought of more things to add to this introduction after familiarizing yourself with the rest of the plan.
The support section serves as a quick reference for you, your significant other, and your care team. In this section, you will have the option to list the names and contact information of your core team of support: your significant other, your doula or midwife, and your photographer, if applicable. This is where you will have the opportunity to document when you want your doula, midwife, or photographer contacted, what the scope of their involvement will be, and which members of your care team you want present during your labor and delivery.
At the bottom of this section and every remaining section, you will find a space to enter any additional comments or notes that you want to be sure are included. As with every field on this birth plan tool, you can always leave this section blank.
In the event that you elect for an induction or an induction is indicated at any point in time, this section outlines your wishes regarding methods of induction and labor progression.
We have provided a list of methods of induction for you to consider, research, and discuss with your care team, as needed, before making your decision.
In this section, you will be able to note your wishes regarding a variety of aspects involved in a vaginal birth or vaginal birth after cesarean (VBAC) such as:
- continuous fetal monitoring
- epidural use
- manual water breaking
- pushing or pulling interventions
In this section, you will be able to note your wishes regarding the need for an emergency C-section, medications used during a C-section, and which members of your support team you wish to be present during the C-section.
In the space provided for additional comments, you can note any special requests regarding the procedure like a clear drape allowing you to see the birth, skin-to-skin time as immediately as possible, or anything else that helps you feel more in-control and connected.
After Birth Care for Baby
In this very comprehensive section, you are able to specify your wishes regarding all aspects of your baby’s care in a variety of circumstances.
This section will address:
- routine care
- life-saving intervention
- holding the baby
- monitoring the baby's breathing and pulse
- feeding and nutrition
- bathing, diapering, clothing
- weights and measurements
- the moments leading up to death
- the time following death
You do not have to complete this section all at once. At any point in time, you can stop, save, and collapse this section. These decisions are ones that no parent should have to make so give yourself grace as you make them. Allow yourself the time to grieve and process any emotions they might stir up for you. None of these decisions are final. You can change your mind as many times as you want, even in the delivery room.
Breast Milk Care
The breast milk care section allows you to express all of your wishes regarding meeting with a lactation consultant, receiving materials about local milk donation banks, the process of pumping and donating your milk, and receiving information and resources regarding the process of comfortably ending lactation.
Funeral Home Preparations
Much like the support section, this section will serve as a quick reference for you, your significant other, and your care team. Here, you will have the option to list the name and contact information of the funeral home you have chosen. You can outline your wishes regarding hospital communication with the funeral home, how you wish to handle the transfer of your baby to the funeral home, and any items you wish to keep or have buried or cremated with your baby.
This portion of the birth plan tool may also serve as a helpful guide to know what questions to ask or topics think through when speaking with your funeral home.
Neonatal Organ Donation
In the event that you choose neonatal organ donation as an option for you family, this section is where you will have the opportunity to express your wishes. For more information on your options and the process of neonatal organ donation, please visit our page dedicated to this topic found here.
If you wish to meet with the hospital chaplain before the birth of you baby or if you wish to have your baby blessed or baptized, you can note that in this section.
Room Requests and Visitors
The room requests and visitors section allows you to have a say in your environment during labor, delivery, and the time following the birth. This section covers:
- laboring and recovering away from other newborns
- having a note placed in your chart notifying staff of your loss or impending loss
- having a sign put on your room door notifying staff of your loss or impending loss
- restrictions on non-essential staff being allowed in your room
- preferences regarding visitors
- preferences regarding photography
Lean on your nurses and care team to help ensure that these needs and wishes are met. If any member of your care team is incapable of or uncomfortable meeting these needs, you have the right to ask that they be excused from your care. We have even pre-populated text regarding that right.
Following the delivery of your baby, you may wish to have keepsakes made or keep anything used during the care of your baby. In this section, you can outline your wishes regarding:
- crib cards
- cord clamps
- handprints and footprints
- lock of hair
- all other new baby accessories
At the bottom of this section, there is space for you to provide any extra comments regarding your specific keepsake wishes.
Discharge And/Or Continuing Care
This section is your space to discuss your wishes surrounding leaving the hospital and how you want bereavement materials to be handled. In the event that your baby is still alive near the time of discharge, you may express your wishes regarding continued care for both you and your baby.
When you have completed and reviewed each section of the birth plan, you have the option to download and save your customized birth plan to your computer. You can then print copies to keep in your hospital bag and to give to your care team. Even after downloading the plan, you can still log back in and make as many changes as you need to.
It is our hope that this birth plan tool makes an impossible and heartbreaking process more manageable. It is our hope that this tool helps you feel confident and informed about your labor and delivery. If you have any questions, comments, or feedback regarding the birth plan tool, please don't hesitate to contact Sarah Garvey. You can contact her directly by filling out the form found here.