Putting together your birth plan is an essential part of preparing for the birth of your baby. In high-risk pregnancies, such as pregnancies affected by hemolytic disease of the fetus and newborn (HDFN), a birth plan also need to account for the unexpected.
Taking the time to develop your birth plan during your pregnancy will give you the opportunity to mentally prepare for the birth of your baby and anticipate the next chapter.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (Rh) factor (Rh-positive or Rh-negative) during pregnancy.
Benefits of a birth plan
A birth plan is an empowering step in approaching your delivery day. You may have spent time in and out of hospital throughout your HDFN-affected pregnancy, with associated feelings of powerlessness as your growing baby experienced symptoms. It is likely to have been a pregnancy touched by stress, anxiety and potential risks to your baby.
Part of the process of welcoming your baby will therefore be to participate in planning the delivery, while remaining fully aware that it might result in a premature delivery or a possible cesarean delivery.
Tips for an HDFN-affected birth plan
You might need to write several drafts of your birth plan before you settle on the definitive version. There are templates available online, if you prefer a predefined structure. Be sure you prepare a written copy that you can share with your healthcare team and your support person. Clearly communicate your wishes, but remember that a good plan is a flexible one.
Choose your support person and a back up support person.
This may be the easiest choice for you–your partner. But if your partner is not in the picture or has a tendency to be squeamish, plan to have a friend or family member ready to jump in. You may also like to consider the option of a doula or a midwife.
Plan your immediate environment.
Personalize your environment and make it comfortable. Put together a collection of favorite items such as pillows, a cushion, a throw blanket, music or photos. Create a space you feel relaxed in.
Decide on pain relief options.
Your doctor will give you a clear description of each of the pain management options available: epidural, nitrous oxide (gas) or pain medication delivered intravenously.
Prepare for unexpected events.
Delivery of babies at risk of or affected by HDFN can require additional medical intervention. This may mean a planned or emergency cesarean, which limits how much of your birth plan you can follow. Your baby may be delivered prematurely, which makes acute medical care necessary and potentially time in the NICU. If any of these occur, do your best to focus on the health and well-being of you and your baby if you’re feeling frustrated that you didn’t get to stick to your birth plan.
