"Donna Metler" wrote in message ...
I'm looking at writing a birth plan and getting it on file. The thing is
that this delivery WILL be a c-section, since my last delivery ended up
having to be a classical C, so I can't VBAC, and most of the examples I've
found don't deal with that. I would like to breastfeed/pump if at all
possible, but unless someone else is staying with me, I don't know about
having the baby room in for the first 24 hours or so because of recovery
pain (I've had abdominal surgery twice now-I have a good idea of how much
pain I'll be in right afterwards).

My DH was able to stay in the room with me, and my mom came when he
wasn't able to be there. Of course, right after the section I was in
recovery for some time, and he spent that time in the NICU with DS.
Does your hospital not allow you to have someone else in the room with
you overnight?

In addition, I have a 50% probability that this will end up being another
premature delivery. Therefore, I assume the birth plan will have to be
changed in that instance, and I don't know what is reasonable. If it's
another premature birth, I will probably be on pretty heavy medication
(since that would imply a recurrance of the HELLP), and I don't know if
breastfeeding would be reasonable or not.

I breastfed a premature baby after an emergent c-section at 34 weeks
for severe pre-eclampsia, and no one said anything at all about
breastfeeding being contraindicated because of it. They assumed I
would be breastfeeding and gave me meds compatible with it. I was on
the mag, blood pressure meds, and painkillers, fwiw.

Is the HELLP likely to recurr, or is it just (just!) that you're at
very high risk for PE? I thought HELLP had about a 5% recurrence rate
but made it more likely that you'd get severe PE -- that's why I'm
asking.

The sucking reflex kicks in at right around 34 weeks, so if your baby
is earlier than his or her sucking reflex you will have to pump. Be
prepared for the NICU to tell you that they do not believe in nipple
confusion -- heck, be prepared for the IBCLC to tell you that she does
not believe in it and to give the preemie a pacifier. There is
actually a new study saying pacifiers don't interfere with preemie
breastfeeding and they will want to provide what comfort they can and
you will not be able to be in NICU all of the time if they want you on
your left side with an IV. However, you can teach a nipple-confused
baby how to latch.

My 34 weeker was in NICU for a week. I found pumping very difficult
but you do not have to get very much at all at the very beginning
because they are so very small and do not eat much. There's also some
speculation that the milk comes in later for PE moms and some
confirmation that the milk comes in later for c-section moms. My
hospital provided Medela Lactinas to all women with babies in the NICU
while in the hospital and rented them to us at a nominal rate when we
were discharged, so you might find out if a protocol like that is
already in place.

It took several days to teach DS how to nurse as his suck reflex
developed and as he worked through the nipple confusion. Once he
learned how we all got way, way more sleep. If you have any questions
*at all* when your baby is born please email me or post and I will see
if I can be of any help!

Does anyone know of any examples online or have suggestions for birth plans
when you already know it isn't going to be a "perfect" delivery? There's so
much that I really can't control that I want to make sure that in areas
where I can make a choice, I get to do so.

I have seen some -- I'll poke around in my books and see what I turn
up.

Also, I have a scenario to bounce off of you. I've been asked to take
a strings position at the local middle school, which I am reluctant to
do because I will be moving in a year. It would set those students up
to have four teachers in four years. *But* they are having a great
deal of difficulty finding someone string-certified and it sounds like
if I *don't* take it, they're going to plug in a choir person with
nominal at best string experience. On top of that, it's a part time
position with a tour in April and three competitions, i.e. full-time
work, part-time pay. I wouldn't really be gaining experience I need
on a resume and I would have to juggle care for DS among three
different care providers (relatives) and school starts in a little
over a week. So I am leaning towards not taking it, and feeling
guilty because the students are going to be disappointed and set back.

--
C, mama to twenty-one month old nursling