ITP Autoimmune Birth Plan; Labour with Low Platelets

Itp and pregnancy, pregnancy complications, pregnancy information, pregnancy facts, itp pregnancy complications, ITP Birth Plans

In the lead up to delivery, I thought a lot about Birth Plans with ITP.  Makes sense right?  We were about to have a little ITP Baby and I wanted to know what that meant, how my ITP was going to change things and what potential risks we should be aware of.

By simply writing an ITP Birth Plan, I was forced to research my options and educate myself about what may happen during our birth.  Even if no one ever reads our birth plan (which I doubt will happen) I know I will have gone through to process of preparing myself for all the possible options during birth.

I thought it was important to share my thoughts and planning, especially to help others get around this very huge time and to make a plan for themselves.

I felt wonderful after I finished writing my own ITP Birth plan.  Unfortunately, he came before I got a chance to read through the draft and get it printed.

So what is a Birth Plan?

A birth plan is a way of clearly communicating to those around you what you would like, need and expect during the birth.  Birth Plans usually include both your medical and emotional needs during labour.  They are a clear way to communicate your wishes and needs to your medical professionals, your labour support people and your friends and family.

This is by no means a comprehensive list of everything you need to consider – Think of these more as ideas and thoughts that will send you on your way to getting a great birth plan.  The following ITP Birth Plan is intended for those having a hospital birth.  If you are well enough to have a home birth then not everything below will apply to you.

Many might laugh at the mention of a birth plan.  “Planning your birth,” they quaff, “You can’t plan a birth, it will be however it will be.” – Not true.

Times have changed.  These days, women and families have options, choices and are taking more and more control over their birthing experience.  But there is some truth in the statement, “You can’t possibly plan how a birth is going to go.” So instead of thinking of it as a ‘Birth Plan’, perhaps think of is as your birthing intentions or strategy.

 

What Does an ITP Birth Plan Look like?

This was something that confused me for a long time, what does a birth plan actually look like?  Where do I write it and in what format?  This is the best answer I received…

A birth plan looks like a single typed piece of paper that can be read at a glance by a lot of people.  You print it out, bring it to the hospital, and hand it to your midwife or doctor or nurse when you arrive.

Birth plans are normally photocopied on arrival and inserted into your file so it can be read at a glance by each of your caring practitioners.

Keep it Short, Simple & Easy to Read

A birth plan will preferably be written in clear simple sentences.  Our midwife suggested dot points under simple headings. Labor | After the Birth | Breastfeeding | Hospital Stay?  You can choose the headings.

What to Consider when Writing your ITP Birth Plan?

Below are a few things to consider when making your birth plan.  It includes all the research I considered when writing mine.

  • Antenatal Classes – Parent Education classes.  Birthing Classes.  Breastfeeding classes.  Research which you would like to attend and book it in as early as possible.  They are all different.  Depending on where you do your Parent Education classes, will influence the advice you are given for writing your birth plan.
  • A Birthing Companion – Who would you like to have with you during the birth? What roles would you like them to play?  Is your partner primarily there to care for you?  Is your birthing companion familiar with your bleeding disorder?  Do they know your medical history?  Will they be an effective advocate for you if you are unable to speak for yourself?  Who is looking after your partner?  Who do you NOT want to be with you during the labour?
  • When to arrive at hospital? Many healthy pregnant women stay home as long as possible in the early stages of labour, before arriving at the hospital.  This is not always the case with ITP.  Be sure to ask staff when you should present to hospital. You might need a platelet count straight away.
  • Inductions – Because of my personal bleeding risk, as well as the combination of medication I was taking, I was counselled towards having a planned induction at 38 weeks.  Having an induction will allow the medical staff to create a more controlled environment for me to labour within, ultimately giving me the best chance of a natural labour overall.
  • Pain Relief –  Pain relief was hard to make a plan for – especially with my first birth as I had no idea what was coming.  I had no idea if I would be able to handle it? I didn’t know what my mental state would be on the day of the birth, so I researched everything and decided to include on my birth plan, ‘Do not offer pain relief until requested’.
  • Epidural – If your platelet count is too low you may not be able to or wish to have an epidural.  This is due to the risk of bleeding around the epidural site, which can cause paralysis.  If a caesarian is performed and you do not have an epidural you’ll be totally knocked out instead or awake.  Frown.  My medication was altered in the lead up to birth to give me the best possible chance of a higher count and to be awake.
  • IV Line – Would you like an IV Line inserted during active pregnancy so blood can be given quickly?  I have read online that many people are against having an IV line inserted as it is seen as a means of hospital staff being lazy.  But what about your comfort?  I personally would prefer being pricked with a needle once over being pricked 10 times!  If you or your medical team are anticipating blood and fluids being regularly received, then why not prepare for it?

ONE FIT MOM blogged about her experience with gestational thrombocytopenia and how she changed her birth plan with her Midwife as information changed.

We reviewed our birth plans with the midwife, and she recommended that A) I have an IV saline lock inserted during active labour to allow for an emergency access point if my blood volume drops precipitously due to hemorrhaging; and B) I allow them to give me a shot of oxytocin immediately after the baby is born, in order to stimulate uterine contractions and expulsion of the placenta, and thus reduce the risk of a post-partum hemorrhage. We agreed to both recommendations, as they sounded like reasonable precautions. ‘

  • The Third Stage of Delivery – Did you know there was a third stage?  The third stage is the delivery of the placenta.  Did you know that there is a drug that can be injected into you to make the placenta come quicker?  Did you know that your body does not need this drug at all to deliver the placenta?  Ask your doctors about this well before birth.
  • Staying in Hospital – Monitoring the baby and you after the delivery.  Make a plan in case this happens, ask what your options are if you badly want to go home.  We were very unprepared for the length of time we had to stay in the hospital.  While we talked about having to stay for about a week, the reality of it was very hard to deal with.  We should have prepared for food, laundry and support well before it was an actuality.
  • Emergency Plans – Unexpected situations.  The definition of an emergency is a serious, unexpected, and often dangerous situation requiring immediate action.  As soon as you make a plan for an emergency then by definition, it is not an emergency anymore as it is not unexpected.  It is simply a different thing.  While many people might consider having an Emergency Plan another way of expecting the worst, I found it incredibly calming and empowering to know I had a plan in place.
  • Things to include not specifically about ITP – Your intentions for breastfeeding, any special needs you have with regard to diets, allergies, religious or cultural preferences, previous medical history, and any kind of disability that requires special assistance.

For me, making a Birth Plan with ITP was about letting go of ‘the Perfect Birth’ and understanding the many possibilities and outcomes of my birth.  Making a birth plan with ITP was about understanding that there is no ‘right’ – or better way to bring this baby into the world; just the safest option at the time for myself and my baby (considering and factoring chaos and confusion into the equation.)

Our son’s birth was such a crazy adventure that I laughed out loud when I read over our ‘birth plan’.  But regardless of the fact we did not use it or need it in the end, the process of preparing, researching and putting together the birth plan gave me confidence and knowledge which lead to an overall calmer, happier and more informed birthing experience.

Recommended Reading – I recommend reading ‘Calling for BIRTH PLAN IDEAS‘ from a woman who wrote a comprehensive birth plan with ITP.

More on writing your own birth plans check out Belly Belly’s article WHY WRITE A BIRTH PLAN and The Bump’s Birth Plan TEMPLATE to get you started.  Remember these are just starting points for you to begin creating your own unique Birth Plan that you feel comfortable with.

 

by Meg

Meghan Brewster is a writer and blogger. She is an ITP patient and launched ITP&Me in 2011. She is a coffee lover and a try hard dancer. @meghan_brewster

Leave a Reply

Your email address will not be published. Required fields are marked *