drafting our birth plan

Birth Plan for Maleen Mayuga-Cruz

ESTIMATED Due Date: 26 February 2007
Patient of Dr. Nicholas Dikio
Scheduled to deliver at Los Alamitos Medical Center
Drafted on 27 January 2007

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Dear ________________

Following is a statement of our birth plan and childbirth choices. We have educated ourselves prior to making these decisions and hope to carry them out, but we realize that complications do arise and in such instances trust our caretakers to make necessary decisions on our behalf.
Thank you for taking the time to read this and helping us realize our birth plan.

Sincerely,
Alejandro & Maleen Cruz
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Labor
I prefer to go through the first stage of labor at home.
I would like to be free to walk around during labor.
I would like to use a birthing ball if possible.
I wish to be able to move around and change position at will throughout labor.
I would like to be able to have fluids by mouth throughout the first stage of labor.
I will be bringing my own music to play during labor.
I would like the environment to be kept as quiet as possible.
I would like the lights in the room to be kept low during my labor.
I would prefer to keep the number of vaginal exams to a minimum.
I do not want an IV unless I become dehydrated.
I would like to wear contact lenses or glasses at all times when conscious.

Monitoring
I wish to have continuous, external fetal monitoring that would keep me mobile.
I do not want an internal monitor unless my baby has shown some sign of distress.

Labor Augmentation/Induction
I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.

Anesthesia/Pain Medication
I realize that many pain medications exist I'll ask for them if I need them.
I would like to have a standard epidural offered to & be made available to me.

Caesarean
Unless absolutely necessary, I would like to avoid a Cesarean.
If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.
I wish to have an epidural for anesthesia.
If my baby is not in distress, my baby should be given to my husband, Ale, immediately after birth.

Episiotomy
I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch.
I would like a local anesthetic to repair a tear or an episiotomy.

Delivery
I would like to be allowed to choose the position in which I give birth, including squatting.
I would like my husband and/or nurses to support me and my legs as necessary during the pushing stage.
I would like to try to deliver in a squatting position, using my husband or a squatting bar for support.
I would appreciate having the room lights turned low for the actual delivery.
I would like to have my baby placed on my stomach/chest immediately after delivery.

Immediately After Delivery
I would like to have my husband cut the cord.
I would like to hold my baby while I deliver the placenta and any tissue repairs are made.
If my baby must be taken from me to receive medical treatment, my husband and my mom will accompany my baby at all times.
I would like to see the placenta after it is delivered.
I would like my baby to be handed over to my husband and my parents as soon as possible.
I would like my intimate area to be thoroughly cleaned after I deliver.

Postpartum
I would like to have my baby 'room in' after I have had some time to recover.

Breastfeeding
I plan to breastfeed my baby and would like to begin nursing very shortly after birth.
Unless medically necessary, NO bottles should given to my baby (including glucose water or plain water).
I DO NOT want my baby to be given a pacifier.
I would like to meet with a Lactation Consultant.

Circumcision
I would like my baby to be circumcised before we check out of the hospital.

Photo/Video
I would like to take still photographs during labor and the birth but not from a graphic angle.
I would like to make a video-recording of labor and/or the birth but not from a graphic angle.

Other
I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.
I would prefer to check out of the hospital as soon as possible.

Prepping for childbirth

I never thought that I could ever attend a childbirth class especially since I am getting very close to popping. I inquired with several childbirth/lamaze/Bradley method teachers back in Manila but I couldn't afford any of them -- financially and schedule-wise. I was not willing to shell out Php 4,000 and give up six consecutive Saturdays for it! SO finding and finally attending a one-day class here in the U.S. at no cost was truly an unexpected blessing! :)

I took the class ("Super Saturday Childbirth Preparation") last Saturday, January 27th at Cypress College from 9:00 am to 4:30 pm. My teacher was a very nice lady named Kathy Miller, a certified childbirth educator, registered nurse and mother of four. There were about 7 couples in the class plus single me! Boohoohoohoo. I was the only one without a husband-coach in tow which turned out great for the class because the teacher used me as a "demo" for most of the exercises. She became my coach & told me to take note of the important stuff I needed to cascade to my husband (who I said was on a "business trip").

The course, sponsored by Pampers through its Pamper Parenting Institute (see http://www.pampers.com/en_US/aboutPPI/page/default.do;jsessionid=LQXKGC41104ZNQFIAJ0X0NY and click on "programs), covered the following:

• Anatomy of Pregnancy & its Discomforts


• Overview of Labor


• Stages of Labor


• Coping


• Contraction Patterns


• Breathing Exercises


• Position Changes


• Coaching Skills


• What to Pack for the Hospital


• Medical Procedures & Options


• Medications & Anaesthesia


• Drafting a birth plan (will blog mine soon)


• Recovery & Post Partum

We were given handouts and we watched several videos of different types of labor and delivery. I guess I won't really know what I will be getting myself into until I am there but at least I already know what to expect. :) Moms-to-be out there, a generic class like this may just be worth the investment -- in time, at least. There is a free on-line childbirth class on www.about.com that can be taken in five weeks (or a marathon of a couple of days) that. I went through it and the scope is essentially what the course I took covered.

Since Ale was not there, my dad and I decided to hire a Lamaze teacher to come over and give Ale & I lessons next week. It will be a 2-night private class for only $50. :) I guess this one will be different because we will be having more exercises and not really lectures. :) Funny lang that I already warned forewarned the instructor that "I believe in pain-free birth -- with an epidural!" Hahahaha!

We'll tell you about it in the next update...God bless...

Re-taking my glucose screening test

I just came back from my 35th week check up and we are doing just fine. Thank God!

However, my initial glucose screening test indicates that I may have a gestational diabetes (see: http://www.babycenter.com/refcap/pregnancy/pregcomplications/2058.html.) This is not final yet until I take the 2nd screening which will require me to fast AGAIN and then take the test in 3 hours. LET US ALL PRAY that I pass last one otherwise I will need to be put on a diet and I may be required monitor my blood sugar levels until I give birth. Huwag naman po sana! Ask Annie nalang to expalin more when you see her. Hehehehe.

I was asked to take the test because we have a history so it makes me a very likely candidate for it.

Thank you so much.

God bless!

And the next...

The past 2 weeks have been slow and relaxing so I can afford to exercise more frequently! I've been walking at Liberty Park here (they have a rubberized walking track) or doing my pre-natal salsa dance plus yoga everyday. :) Exercising does two things: keep me warm and energized! I also hope doing this will help Teo descend more quickly. Kaya dun sa mga hindi nage-exercise sa inyo: MAHIYA NAMAN KAYO SA AKIN!!! Bwehehehehe. :p

Last week, I took a Glucose Screening Test which is not a standard pre-natal test back home but is here (especially because our family has a history of diabetes). It required me to fast for 12 hours. Then, we I got to the lab, they had me drink this really icky sugary substance and I had to wait for another hour before they drew blood! Diyosme! By the end of it, gutom na gutom na ako na nag brunch na kami ng dad ko sa I-Hop! :P I do not know what the results are yet. I just hope curbing on sweets as much as I could in the past months helped keep gestational diabetes at bay!!! I am due to see my OB again on Friday afternoon.

I spent the last weekend again with my mom's side of the family. Eh anu pa ba ang gagawin dito kung hindi mag-malling??? :P So yun. I went around with Mommy Dele (my mom's sister), my cousin Dale and Ma (our lola who most of you have probably met). Thank Jesus I can't shop! I ended up buying stuff for my sister and for Chum (pero pera niya hahahahaha). I was also able to watch two movies: Pursuit of HappYness and Night at the Museum with my two little cousins.

I was also able to register at a local parish (San Lorenzo Ruiz in Walnut) and inquired about upcoming bapstimal dates. Teo will be baptized here and then again back there so he will have two sets of godparents. Ale and I have already asked a pair to be the primaries who are required to attend a seminar and eventually be certified at their respective parishes.

I have been looking for a crash course in childbirth prep since Monday and was getting frustrated that we didn't have one in the area. So, I prayed about it and found suddenly several options recommended by teachers in lamaze.org and icea.org . Unfortunately, none of the ones I found fit my requirements at first i.e., too late in Feb, too early that Ale won't be here yet or too pricey. :) I patiently called several other hospitals until I finally called MY hospital and they recommended that I try Cypress College and see if they have an upcoming birth class. Guess what? They do. FOR FREE.. So I went there today and registered at the School of Continuing Education for the class this Saturday from 900-430 (see http://schedule.sce.cc.ca.us/course.php/200625/PAR/3CC/HLTH/400 ). I was even issued a permanent student's I.D. and I can enroll in any of the free and low-priced short courses that they offer!!! Simultaneously, one of the certified Lamaze teachers near where I stay emailed to say that she can set up a rush private class for Ale and I sometime week of Feb5th at a price that I can afford (fyi, Lamaze classes in Manila are at php4,000 for about 6 sessions so if I can get this private one for $50 solve na ako). God is great talaga! :)

The weather this past week has been a lot friendlier. Sa gabi lang malamig. Buti nalang!!! And, I am now allowed to drink Vitamin C. Yehey!

That's it, pansit (for now). My dad and I are looking forward to having Mom, Ale and Nanay here next week!!!

First Week

It has been a week since my dad and I left Manila and so far, so good…except for the super cold weather! California is beset by an abnormally cold condition. It reminds me of the winter I spent living in Rhode Island and working in NY which I don’t want to re-live. It’s so cold that the fountain outside my uncle’s home would freeze & become popsicles!!! Hahahahaha! The only good thing about it is that I can wear a nice coat and scarves (sabi nga ni Ale ako ang pinakamaarteng buntis in the world).

We were able to get thru immigration without a hitch. In fact, the people who checked-in my dad and I at the PAL counter forgot to hand over my expectant mother’s information sheet and OB’s medical certificate and not even the personnel on the plane noticed that I had a bump. I guess it helped that I wore jeans and I tied my belt low on my hips (mala ‘80s style) and I held my huge coat in front of me the whole time. Also, it is a blessing that Ale and I didn’t change my passport yet to my married name so my dad and I were interviewed together.

I already have a Filipino doctor here who I saw last Monday, Dr. Nicholas Dikio. He is very nice so he will waive all my pre-natal consultation and test fees – otherwise I have to spend $100 or so per visit which will pile up because at 34 weeks I need to see the doctor every week already. Doc says Teo and my belly are just the right size for 34 weeks! God is good.

My dad and I have also pre-registered at and gave a deposit to the hospital where I am due to give birth. That means, when the big day comes, papasok nalang ako. It’s LOS ALAMITOS MEDICAL CENTER – a 10-minute drive from where we stay. Since we will be paying in cash, they gave us a discounted package rate that covers either normal or caesarean delivery. It’s a nice private hospital that even gives tours – Ale and I will take the tour when he gets here so we know the procedure for OB-admitting. Again, God is good.

And it gets better. Last week, my aunties and cousins handed over to me a whole balikbayan box filled with barely used clothes and shoes from newborn to 2 years old. So that plus the stuff that you guys gave me and we’re solved!!! You see, I have 7 nephews here (and only one niece – malakas ang lahi ng lalaki sa amin) and the youngest are only about 3-5 years old. God is amaaaaazing.

As for me, well, I’ve been eating healthy and try to walk around as much as I can. I feel stronger when I exercise and keep active most of the day. As expected, at 8 months, I have difficulty sleeping because Teo keeps moving which makes me go to the bathroom a lot!!! During the day, he kicks like crazy and I love it!!! Manang-mana talaga!!!

Do continue to pray for us. Especially now that I have a cold -- my fourth bout since getting preggers -- no thanks to this brutally cold weather.

That’s my update so far. God is truly wonderful!

You are in my prayers!