Our Birth Plan

I share our birth plan to assist other families who might be in the same or a similar situation as ours in writing a birth plan of their own. Writing this was very difficult for me. To come up with direction for different situations required Roy and I to sit down and think through all of the possibilities of what might happen, from best to worst case scenario. Not only that, but we then had to think of what we wanted to happen in each of those situations. This was not an easy process and not something we could get motivated to do. In addition, because Keagan is our first baby, we were not even sure what to expect with the labor and delivery. What I ended up doing was looking through the birth plans of several other families and literally just copying and pasting what I liked. Then eventually, literally two days before we went to the hospital, I knew I couldn't wait anymore, so I sat down and made the birth plan our own. Decisions we made are not right for everyone and in fact some of the decisions we had outlined in our birth plan were not what we went through with when situations actually presented themselves. However, it was very helpful to have these hopes set-up in advance so that the hospital staff did not have to frequently ask us our desires and overwhelm us.
This is the birth plan that we established:

Our baby, Keagan David, has been diagnosed with anencephaly, in the 18^th week of his life. Knowing that our time with him may be short, it is important to us that as many of our needs and requests be met as possible. Our decisions are based on the desire for Keagan to have the longest life possible, and we request that as options are presented to us, that the staff will keep this in mind. Attached is our Perinatal Palliative Care Plan that we established with the care team, but we have additional requests that are not outlined in the plan.

We request that Roy be permitted to stay with Jenny at all times. He will remain at the hospital for the duration of our stay. He, Jenny’s mother, and our photographer through “Now I Lay Me Down to Sleep” will be present during Keagan’s delivery.

If labor is not progressing, we ask that Jenny’s water not be broken until absolutely necessary. We request that medication during labor should be in doses to provide maximum comfort for Jenny but in doses that will allow for her to remain alert. She does not desire narcotics or sedatives prior to birth.

During labor, we would like continuous fetal monitoring. We have not decided if we would like to hear Keagan’s heartbeat during labor or not, but please accept our decision. When Keagan is born, we want to be told right away if he is breathing or if he has a pulse. We would like for staff to keep our family updated during this time so they will know if Keagan was born alive. Depending on Keagan’s status, we may ask that the umbilical cord not be cut right away. We will like to be advised as to what is best in this situation and when it would be medically necessary to cut the cord. At that time, Roy would like to cut the cord. We do want suctioning, drying off, etc. but would like these procedures as well as any interventions to be done on my chest or in Roy’s arms when possible. We want the nursing staff to weigh and measure Keagan when we request it; should we forget to do so, please do it prior to us leaving the hospital.We anticipate that Keagan may be born with a large opening on the top of his head. We would like to see our baby then for his head to be dressed using first a covering of Vaseline gauze and then an outer layer of gauze and a hat that we will provide. This dressing is to be changed daily or based on saturation to prevent infection.

If Keagan is still alive, we ask that when it is time for visitors, they not be limited if possible. We want everyone to have the chance to be present when Keagan is alive if the situation allows. If he is stable, we will allow visitors to hold him. Jenny would like to attempt to breastfeed Keagan. If he is unable to suck or swallow, we would like comfort drops of breast milk to be provided. If he lives long enough to require nutrition but is unable to suck or swallow (breastmilk or formula), we would like a feeding tube inserted. If Keagan is still alive at the time of Jenny’s discharge, we would like to take him home with us and request the services of hospice through Children’s Hospital.

If Keagan is not doing well, we ask that a nurse keep us informed on his status and let us know if his time is near. We would feel best if someone compassionately walked us through those last moments of his life as we are not sure what to expect. If Keagan passes away at some point during our hospital stay, we will inform staff when we would like the funeral home contacted as we desire to keep him with us for hours after his passing.

We have brought several things with us – clothing, blankets, toys, keepsake items. We would like to dress Keagan in a few different outfits and will desire our photographer to take several pictures. We are prepared to do this as well as bathe Keagan and create our keepsake items after his passing so that we may fully enjoy the time that he is alive. Please be patient and understanding with the number of things we desire to do and make – this is our baby boy and could be the only chance we have to do these things.

We welcome the open expression of emotion from staff and family. We are grateful for the support and understanding we have received from your staff so far and would like to thank you in advance for your love and care during this difficult time for our family. We have greatly enjoyed Keagan’s life thus far and have created several memories with him. He is our first son and we love him more than we even knew possible. We have faith that our situation is in God’s hands and whatever happens is exactly what was supposed to happen. Keagan is a very special boy and we hope to make this experience as memorable and peaceful as possible and appreciate your part in this.